Pathology of Fibrous Papule of the Nose

Dr Sampurna Roy MD                2022 

Fibrous papule is a benign condition that commonly appears on the nose.

The size of the firm papule is between 1-5 mm, and its anatomic distribution predominates at the ala, alar groove and tip of the nose.

It has been considered a variant of angiofibroma with a relationship to plasma pro-enzyme factor XIIIa-positive dermal dendrocytes, a population of mononuclear dendritic cells normally present in the papillary and upper reticular dermis .

Histologically, fibrous papules are characterized by fibrous stroma with fibroblasts and dilated blood vessels.

Histopathologically, a clear cell fibrous, hypercellular fibrous, inflammatory fibrous, pigmented fibrous, pleomorphic fibrous papule and epithelioid variant can be distinguished.A granular cell variant has also been described.

Recognition of such fibrous papule variants is important to avoid misdiagnosis as potentially more worrisome and/or aggressive melanocytic, soft tissue, or neural lesions that may require more aggressive treatment.

A biopsy can be necessary to differentiate fibrous papules from benign adnexal tumors or basal cell carcinomas that sometimes closely resemble its "pearly" appearance.