Practice Essentials
Fibrous papule of the face is a benign, clinically indistinct papule, also known as sporadic angiofibroma. The papules may be associated with telangiectasia. [11]
Epidemiology
The condition is relatively common, and no racial predilection is known. Both sexes are equally affected. Most patients are in their third to fifth decade of life.
Prognosis
Fibrous papule of the face is a benign lesion. Most of the lesions are asymptomatic, although one third of patients have reported bleeding following minor trauma.
Patient Education
The patient should be reassured that the lesion is harmless. Patients should also be made aware that a surgical procedure results in a scar.
Pathophysiology
In the past, fibrous papule has been suggested to have been derived from preexisting or involuting melanocytic nevi; however, subsequent investigations appear to have refuted this and have confirmed a relationship to factor XIIIa – positive dermal dendrocytes. Fibrous papule is best considered a variant of angiofibroma. [1]
A study from 2014 showed expression of antibodies against p-mTOR in dermal stromal cells and epidermal keratinocytes in fibrous papules, similar to tuberous-sclerosis complex–associated facial angiofibromas, suggesting topical rapamycin may be a treatment option. [2]
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Fibrous papule of the nose. Courtesy of San Antonio Uniformed Services Health Education Consortium Dermatology slide files.
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Histopathology of a fibrous papule shows focal fibrosis and vascular proliferation in the upper dermis. Courtesy of Dirk Elston, MD.
