Nasal papilla fibrosus D23.3

Graham et al. 1965

In larger studies (n=283) the mean age (at the time of diagnosis) was 46 years (18-90 years). No gender preference.

Solitary, rarely multiple, completely painless, up to 0.5 cm in size, usually firm, hemispherical, surface smooth, skin-coloured to light reddish, flat, inconspicuous papules.

Irregularly pigmented epidermal band with numerous bright cells in the stratum basale. Infiltrate consisting of epithelioid cells and single bizarrely configured giant cells in the upper corium. Connective tissue proliferation with perifollicular emphasis.

6 histological variants are distinguished:

1. cell-rich
2. inflammatory
3. pleomorph
4. pigmented
5. clear-cell
6. granular cell

Except for the clear cell type, all forms express Factor XIIIa

• Basal cell carcinoma
• dermal melanocytic nevus
• Angiofibroma (of the nose)
• Rhinophyma

If necessary, tangential ablation of the papules to slightly below the skin level; alternatively or complementary cauterization or abalative laser (this method requires great clinical experience of the surgeon).

1. Altmeyer P (1977) The fibrous nasal papules - a clinical and histological entity? Dermatologist 28: 416-420 de Cambourg G et al (2013) Fibrous papules of the face: a retrospective anatomoclinical study of 283 cases. Ann Dermatol Venereol 140:763-770
2. Graham JH et al (1965) Fibrous papule of the nose: a clinicopathological study. J Invest Dermatol 45: 194-203
3. Roth W et al (1990) Nasal nodular fibrosis, Sutton nevus and dermatofibroma in oil paintings by famous artists. Dermatologist 41: 406-407
4. Shea CR et al (1996) CD34-reactive fibrous papule of the nose. J Am Acad Dermatol 35: 342-345