Acquired Digital Fibrokeratoma Clinical Presentation

Updated: Jan 23, 2017
  • Author: Elizabeth K Satter, MD, MPH; Chief Editor: William D James, MD  more...
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Most acquired digital fibrokeratoma patients present with an asymptomatic protuberance.


Physical Examination

Clinically, acquired digital fibrokeratomas manifest as solitary, skin-colored, dome-shaped papules or tall fingerlike protrusions with a hyperkeratotic surface. Most acquired digital fibrokeratoma lesions are small and do not exceed 1.5 cm in height or diameter, but giant lesions measuring in excess of 3 cm have been documented. [12, 13]

An important clinical finding reported to help differentiate acquired digital fibrokeratomas from other similar lesions is a collarette of slightly raised skin that encircles the base of the lesion, thereby creating a moatlike configuration. [14]

Clinical picture of a pedunculated acquire digital Clinical picture of a pedunculated acquire digital fibrokeratoma.
Flat-topped, skin-colored acquired digital fibroke Flat-topped, skin-colored acquired digital fibrokeratoma in an acral location.
Slightly raised skin encircling the base of an acq Slightly raised skin encircling the base of an acquired digital fibrokeratoma, creating a moat.


The etiology of acquired digital fibrokeratomas is unknown. Although trauma has been implicated, no studies can substantiate this hypothesis.

One report describes familial occurrence of an acral fibrokeratoma variant that had mucinous deposition; however, the case reported by Moulin et al [15] histologically more closely resembles a superficial acral fibromyxoma.