Fibrous Papule of the Nose

section name header

Basics ⬇

A fibrous papule of the nose is a relatively common benign lesion that may be difficult to distinguish from a compound or dermal nevus; furthermore, it may resemble a basal cell carcinoma.

Clinical Manifestations ⬆ ⬇

Asymptomatic.
Generally they are dome-shaped, pale or pink firm papules with a shiny appearance. They usually range from 1 to 5 mm in diameter (Fig. 30.40).
Lesions appear in late adolescence or adulthood most often as a single lesion, but, occasionally, several lesions may be present.
Most are noted on the nose; less commonly, they are found on the cheeks and chin.

Diagnosis ⬆

Histopathology reveals a combined vascular and fibrous proliferation.

Differential Diagnosis

Melanocytic Nevus (see earlier in this chapter)

Compound or dermal nevi are typically “old” lesions that have been present since adolescence.

Basal Cell Carcinoma (see Chapter 31: Premalignant and Malignant Cutaneous Neoplasms)

Typically have “pearly”, shiny, semi-translucent, color; a rolled (raised) border, telangiectasias, a possible history of bleeding, and ulceration.

Management

No treatment is necessary.
A shave biopsy if the diagnosis is in doubt or to rule out a basal cell carcinoma.
They may also be removed for cosmetic reasons.