Fibromas (ICD-10-GM D23.9: Other benign neoplasms: Skin, unspecified) are benign (benign) skin lesions that result from proliferation (proliferation) of fibrocytes (connective tissue cells). They usually develop as exaggerated scarring around puncture wounds.
Soft fibromas (fibroma molle; flesh wart) can be distinguished from hard fibromas (fibroma durum):
- Soft fibroma (pl. fibromata mollia; fibroma pendulans, “skin appendage”) is cell-rich and fiber-poor or consists of loosely meshed fibers. They are so-called hamartomas, i.e. local tissue excesses as a result of embryonic maldevelopment. Appears mostly after puberty; it is solitary or multiple. It is quite common and is found mainly in the neck, eye, armpit, buttock and groin area; in men also on the scrotum (“scrotum”), sulcus coronarius (glans rim) and penile trunk.The soft fibroma usually remains benign (benign).
- The hard fibroma (fibroma durum) is fibrous and cell-poor – on the skin it is also called dermatofibroma or fibrinous histiocytoma. There are smooth transitions to the more cell-rich histiocytoma.
Fibromas can occur singly or in groups. They usually do not regress on their own.
Symptoms – Complaints
Soft fibromas usually occur on the neck, in the eye region, in the armpits, buttock or groin region and have a small stalk (fibroma pendulans or filiform fibroma) with a slightly thicker, round tip. They are painless.
The hard fibroma is between five and seven millimeters in size and appears as a rough lump. It is skin-colored to a deep brownish color. It is more common in women, especially on the legs.
Differential diagnoses
Because of the mostly clear clinical appearance of soft fibroma, diagnosis is usually straightforward. The following differential diagnoses may need to be considered:
- Dermal or papillomatous nevi (pigmentary mole).
- Neurofibromas
- Neurofibromatosis type 1 (von Recklinghausen’s disease; with 90% of cases, the most common form of this autosomal-dominant and monogenic (chromosome 17) inherited multi-organ disease) – patients develop multiple neurofibromas (nerve tumors) during puberty, often occurring in the skin but also appearing in the nervous system, orbita (eye socket), gastrointestinal tract (gastrointestinal tract), and retroperitoneum (space located behind the peritoneum on the back toward the spine); typically, the appearance of three main features: multiple neurofibromas, café-au-lait spots (light brown macules/color changes of the skin), and pigmented hamartomas (tumor-like, benign tissue changes caused by defectively differentiated or scattered germ tissue) in the iris (iris in the eye), so-called Lisch nodules.
- Condylomata acuminata (synonyms: genital warts, wet warts and genital warts).
Pathogenesis (disease development) – etiology (causes)
Soft fibromas are associated with obesity (overweight), arterial hypertension (high blood pressure), dyslipidemias (disorders of lipid metabolism), and insulin resistance.
Hard fibromas are thought to develop as a result of minor injuries or insect bites.
Diagnostics
Fibroma is detected by visual diagnosis.
Therapy
Fibromas are removed by:
- Electrosurgery
- Cryosurgery
- CO2 laser therapy
Laser removal is virtually painless and regrowth is rare.However, fibromas can reappear at any time in other areas of the skin.
Caution. It is strongly discouraged to remove fibromas yourself. They usually contain a larger blood vessel, so there may be prolonged bleeding and infection and inflammation.