Procedures

A skin biopsy can confirm the diagnosis of infantile digital fibromatosis.

Histologic Findings

Unique histologic features are diagnostic of infantile digital fibromatosis. Interlacing fascicles of uniform spindle-shaped myofibroblast cells and collagen bundles are seen in the dermis or subcutis. A characteristic feature is the presence of distinctive, perinuclear, eosinophilic cytoplasmic inclusion bodies. Masson trichrome stains these characteristic perinuclear inclusion bodies red. Immunohistochemical stains are positive for vimentin, cytokeratin, desmin, calponin, and alpha-smooth muscle actin.^[6]

See the images below.

Dermal tumor with interlacing spindle-shaped cells and collagen bundles. Perinuclear eosinophilic inclusion bodies are not visible at this magnification.

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A dermal nodule extending into the subcutaneous fat.

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Treatment & Management

Eypper EH, Lee JC, Tarasen AJ, Weinberg MH, Adetayo OA. An Algorithmic Approach to the Management of Infantile Digital Fibromatosis: Review of Literature and a Case Report. Eplasty. 2018. 18:e19. [QxMD MEDLINE Link].
Reye RD. Recrring Digital Fibrous tumors of childhood. Arch Pathol. 1965 Sep. 80:228-31. [QxMD MEDLINE Link].
Laskin WB, Miettinen M, Fetsch JF. Infantile digital fibroma/fibromatosis: a clinicopathologic and immunohistochemical study of 69 tumors from 57 patients with long-term follow-up. Am J Surg Pathol. 2009 Jan. 33(1):1-13. [QxMD MEDLINE Link].
Taylor HO, Gellis SE, Schmidt BA, Upton J, Rogers GF. Infantile digital fibromatosis. Ann Plast Surg. 2008 Oct. 61(4):472-6. [QxMD MEDLINE Link].
Kaya A, Yuca SA, Karaman K, Erten R, Dogan M, Bektas MS, et al. Infantile digital fibromatosis (inclusion body fibromatosis) observed in a baby without finger involvement. Indian J Dermatol. 2013 Mar. 58(2):160. [QxMD MEDLINE Link]. [Full Text].
Choi KC, Hashimoto K, Setoyama M, Kagetsu N, Tronnier M, Sturman S. Infantile digital fibromatosis. Immunohistochemical and immunoelectron microscopic studies. J Cutan Pathol. 1990 Aug. 17(4):225-32. [QxMD MEDLINE Link].
Ishii N, Matsui K, Ichiyama S, et al. A case of infantile digital fibromatosis showing spontaneous regression. Br J Dermatol. 1989 Jul. 121(1):129-33. [QxMD MEDLINE Link].
Kawaguchi M, Mitsuhashi Y, Hozumi Y, Kondo S. A case of infantile digital fibromatosis with spontaneous regression. J Dermatol. 1998 Aug. 25(8):523-6. [QxMD MEDLINE Link].
Niamba P, Leaute-Labreze C, Boralevi F, et al. Further documentation of spontaneous regression of infantile digital fibromatosis. Pediatr Dermatol. 2007 May-Jun. 24(3):280-4. [QxMD MEDLINE Link].
Azam SH, Nicholas JL. Recurring infantile digital fibromatosis: report of two cases. J Pediatr Surg. 1995 Jan. 30(1):89-90. [QxMD MEDLINE Link].
Spingardi O, Zoccolan A, Venturino E. Infantile digital fibromatosis: our experience and long-term results. Chir Main. 2011 Feb. 30(1):62-5. [QxMD MEDLINE Link].
Albertini JG, Welsch MJ, Conger LA, Libow LF, Elston DM. Infantile digital fibroma treated with mohs micrographic surgery. Dermatol Surg. 2002 Oct. 28(10):959-61. [QxMD MEDLINE Link].
Kramer A, Har-Shai Y, Metanes I, Harel H, Wollstein R. The Use of Cryotherapy to Treat Infantile Digital Fibromatosis with a Functional Deficit: A Case Report. J Hand Surg Asian Pac Vol. 2018 Jun. 23 (2):278-281. [QxMD MEDLINE Link].
Oh CK, Son HS, Kwon YW, Jang HS, Kwon KS. Intralesional fluorouracil injection in infantile digital fibromatosis. Arch Dermatol. 2005 May. 141(5):549-50. [QxMD MEDLINE Link].
Holmes WJ, Mishra A, McArthur P. Intra-lesional steroid for the management of symptomatic Infantile Digital Fibromatosis. J Plast Reconstr Aesthet Surg. 2011 May. 64(5):632-7. [QxMD MEDLINE Link].

Media Gallery

Dermal tumor with interlacing spindle-shaped cells and collagen bundles. Perinuclear eosinophilic inclusion bodies are not visible at this magnification.
Firm, nontender, erythematous nodule on the fifth finger of a 17-month-old boy.
A dermal nodule extending into the subcutaneous fat.

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Author

Monique Gupta Kumar, MD, MPhil Assistant Professor of Dermatology, Emory University School of Medicine

Monique Gupta Kumar, MD, MPhil is a member of the following medical societies: American Academy of Dermatology, International Society of Dermatology, Pediatric Dermatology Research Alliance, Society for Pediatric Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Susan Joy Bayliss, MD Director of Pediatric Dermatology, Departments of Internal Medicine and Pediatrics, St Louis Children's Hospital; Professor, Washington University in St Louis School of Medicine

Susan Joy Bayliss, MD is a member of the following medical societies: American Academy of Dermatology, American Academy of Pediatrics, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Van Perry, MD Assistant Professor, Department of Medicine, Division of Dermatology, University of Texas School of Medicine at San Antonio

Van Perry, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

Jean Paul Ortonne, MD Chair, Department of Dermatology, Professor, Hospital L'Archet, Nice University, France

Jean Paul Ortonne, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Acknowledgements

Theresa Schroeder Devere, MD Assistant Professor of Dermatology, Residency Director, Oregon Health Sciences University

Theresa Schroeder Devere, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Infantile Digital Fibromatosis Workup

Procedures

Histologic Findings

References

Tables

Contributor Information and Disclosures

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