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Fibromatosis over the dorsa of both feet: An unusual presentation.

Kishan Kumar YH, Sujatha C, Jayaprasad S - Indian Dermatol Online J (2015 Mar-Apr)

Bottom Line: The lesion tends to infiltrate and recur when removed, but do not metastasize.A 40-year-old female presented with multiple raised lesions over both feet since 4 years, they were multiple well-defined firm nodules coalescing to form lobulated plaques distributed in a symmetrical pattern over the dorsum of both feet.Histopathology of skin showed epidermis with hyperkeratosis, acanthosis, mild parakeratosis, and prominent granular layer.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Raja Rajeswari Medical College and Hospital, Kambipura, India.

ABSTRACT
Fibromatosis is benign fibrous tissue condition intermediate between benign fibroma and metastasizing fibrosarcoma. The lesion tends to infiltrate and recur when removed, but do not metastasize. The lesion may be single or multiple, and the likelihood of recurrence after surgical removal varies with location of the lesion and age. A 40-year-old female presented with multiple raised lesions over both feet since 4 years, they were multiple well-defined firm nodules coalescing to form lobulated plaques distributed in a symmetrical pattern over the dorsum of both feet. Histopathology of skin showed epidermis with hyperkeratosis, acanthosis, mild parakeratosis, and prominent granular layer. Superficial dermis was unremarkable and deep dermis showed thick bundles of irregular collagen and fibroblastic proliferation, suggestive of fibromatosis. This case is being reported for its unusual presentation of fibromatosis over the dorsum of both feet.

No MeSH data available.


Related in: MedlinePlus

Epidermis showing hyperkeratosis, acanthosis, mild parakeratosis, and a prominent granular layer. Superficial dermis was unremarkable and deep dermis showed fibroblastic proliferation with variable vascularity and lack of an inflammatory infiltrate, with thick bundles of irregular collagen (Hematoxylin and eosin ×40)
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Figure 4: Epidermis showing hyperkeratosis, acanthosis, mild parakeratosis, and a prominent granular layer. Superficial dermis was unremarkable and deep dermis showed fibroblastic proliferation with variable vascularity and lack of an inflammatory infiltrate, with thick bundles of irregular collagen (Hematoxylin and eosin ×40)

Mentions: A 40-year-old female patient presented with multiple raised growths over both feet since four years. The growths started over soles and progressed to involve the dorsum of both feet. It was not associated with pain or itching. There was no history of trauma or application of any irritant prior to onset. There was no history of diabetes, smoking or alcohol addiction. Contractures, bony deformities and keloids were absent. On examination, symmetrical, well-defined, firm nodules coalescing to form lobulated plaques were noted over the dorsum of both feet extending from base of the 2nd, 3rd, 4th, and 5th toes to the mid-foot [Figures 1 and 2]. The skin over swelling was not pinchable. Nails were normal. Clinically, differential diagnoses of callosity, fibromatosis, and keloids were considered. Routine blood and biochemical investigations were within normal limits. HIV and HBsAg were negative. Radiographs of both feet showed no bony deformity and ultrasound of both feet showed no significant soft tissue thickening. An elliptical biopsy of lesion taken for histopathology showed epidermis with hyperkeratosis, acanthosis, mild parakeratosis and prominent granular layer. Superficial dermis was unremarkable and deep dermis showed fibroblastic proliferation with variable vascularity and lack of inflammatory infiltrate, and thick bundles of irregular collagen characteristic of fibromatosis [Figures 3 and 4]. With these clinical and histopathological features, a diagnosis of fibromatosis was made. The patient was advised topical keratolytics along with intralesional steroids for 2 months with minimal response. The patient was counseled about the benign nature of the disease and measures for lifestyle modification and proper footwear.


Fibromatosis over the dorsa of both feet: An unusual presentation.

Kishan Kumar YH, Sujatha C, Jayaprasad S - Indian Dermatol Online J (2015 Mar-Apr)

Epidermis showing hyperkeratosis, acanthosis, mild parakeratosis, and a prominent granular layer. Superficial dermis was unremarkable and deep dermis showed fibroblastic proliferation with variable vascularity and lack of an inflammatory infiltrate, with thick bundles of irregular collagen (Hematoxylin and eosin ×40)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4375774&req=5

Figure 4: Epidermis showing hyperkeratosis, acanthosis, mild parakeratosis, and a prominent granular layer. Superficial dermis was unremarkable and deep dermis showed fibroblastic proliferation with variable vascularity and lack of an inflammatory infiltrate, with thick bundles of irregular collagen (Hematoxylin and eosin ×40)
Mentions: A 40-year-old female patient presented with multiple raised growths over both feet since four years. The growths started over soles and progressed to involve the dorsum of both feet. It was not associated with pain or itching. There was no history of trauma or application of any irritant prior to onset. There was no history of diabetes, smoking or alcohol addiction. Contractures, bony deformities and keloids were absent. On examination, symmetrical, well-defined, firm nodules coalescing to form lobulated plaques were noted over the dorsum of both feet extending from base of the 2nd, 3rd, 4th, and 5th toes to the mid-foot [Figures 1 and 2]. The skin over swelling was not pinchable. Nails were normal. Clinically, differential diagnoses of callosity, fibromatosis, and keloids were considered. Routine blood and biochemical investigations were within normal limits. HIV and HBsAg were negative. Radiographs of both feet showed no bony deformity and ultrasound of both feet showed no significant soft tissue thickening. An elliptical biopsy of lesion taken for histopathology showed epidermis with hyperkeratosis, acanthosis, mild parakeratosis and prominent granular layer. Superficial dermis was unremarkable and deep dermis showed fibroblastic proliferation with variable vascularity and lack of inflammatory infiltrate, and thick bundles of irregular collagen characteristic of fibromatosis [Figures 3 and 4]. With these clinical and histopathological features, a diagnosis of fibromatosis was made. The patient was advised topical keratolytics along with intralesional steroids for 2 months with minimal response. The patient was counseled about the benign nature of the disease and measures for lifestyle modification and proper footwear.

Bottom Line: The lesion tends to infiltrate and recur when removed, but do not metastasize.A 40-year-old female presented with multiple raised lesions over both feet since 4 years, they were multiple well-defined firm nodules coalescing to form lobulated plaques distributed in a symmetrical pattern over the dorsum of both feet.Histopathology of skin showed epidermis with hyperkeratosis, acanthosis, mild parakeratosis, and prominent granular layer.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Raja Rajeswari Medical College and Hospital, Kambipura, India.

ABSTRACT
Fibromatosis is benign fibrous tissue condition intermediate between benign fibroma and metastasizing fibrosarcoma. The lesion tends to infiltrate and recur when removed, but do not metastasize. The lesion may be single or multiple, and the likelihood of recurrence after surgical removal varies with location of the lesion and age. A 40-year-old female presented with multiple raised lesions over both feet since 4 years, they were multiple well-defined firm nodules coalescing to form lobulated plaques distributed in a symmetrical pattern over the dorsum of both feet. Histopathology of skin showed epidermis with hyperkeratosis, acanthosis, mild parakeratosis, and prominent granular layer. Superficial dermis was unremarkable and deep dermis showed thick bundles of irregular collagen and fibroblastic proliferation, suggestive of fibromatosis. This case is being reported for its unusual presentation of fibromatosis over the dorsum of both feet.

No MeSH data available.


Related in: MedlinePlus