Fibrous papule of nose
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Synopsis
Fibrous papules of the face (also known as fibrous papules of the nose) are common, small, benign, skin-colored papules located on the nose or central face. Their onset is typically in middle age, and they are usually solitary or few in number. They are typically asymptomatic, although they may bleed with trauma. Their exact etiology is unknown, but some have suggested that fibrous papules represent nevi that no longer synthesize S-100 protein. Other studies involving electron microscopy suggest that they are derived from fibroblasts because premelanosomes and basal lamina are not seen.
There is no known predilection for a particular sex, ethnicity, or socioeconomic status.
Codes
ICD10CM:D22.39 – Melanocytic nevi of other parts of face
SNOMEDCT:
254745007 – Fibrous papule of nose
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Basal cell carcinoma – Look for a pearly papule with telangiectasias, erosion, or ulceration. Ask about increases in size, bleeding, or ulceration. Shave biopsy if this is suspected.
- Compound nevus – Presents as a round, skin-colored papule; usually present for many years without associated changes.
- Sebaceous hyperplasia – Presents as a skin-colored to yellow papule with a central pore; frequently located on the forehead.
- Common wart
- Cherry hemangioma – Presents as a cherry red, round papule, usually on the trunk but may occur on the head, neck, and extremities.
- Lobular capillary hemangioma (pyogenic granuloma) – Presents as a fungating mass that bleeds excessively when traumatized; more common in children.
- Angiofibromas – Histologically indistinguishable. Tuberous sclerosis should be considered in children, adolescents, or adults with multiple fibrous papules. Also consider the diagnosis of multiple endocrine neoplasia type 1 in patients with numerous angiofibromas.
- Trichoepithelioma – May present as a skin-colored papule.
- Birt-Hogg-Dubé syndrome – Cutaneous findings include fibrofolliculomas, trichodiscomas, and skin tags. Fibrofolliculomas and trichodiscomas may present as skin-colored or whitish papules on the face, neck, trunk, and extremities.
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Management Pearls
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Therapy
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References
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Last Reviewed:10/15/2020
Last Updated:10/25/2020
Last Updated:10/25/2020
Patient Information for Fibrous papule of nose
Overview
A fibrous papule of the nose is a harmless, small, raised pimple-like growth (papule) on the nose or central face that feels firm to the touch and is skin-colored or pink. There is usually a single papule, but you may have multiple papules.Who’s At Risk
Fibrous papules of the nose are seen in equal numbers of middle-aged men and women, regardless of race or ethnicity.Signs & Symptoms
The fibrous papule will not cause any symptoms like pain or itching. However, papules may become inflamed or bleed when irritated or scratched.Self-Care Guidelines
Follow a normal skin-cleaning routine.When to Seek Medical Care
If the papule changes in appearance, or if other symptoms develop, you should contact your doctor to rule out other possible causes.Children with fibrous papules of the nose should be seen by a pediatrician.
Treatments
For cosmetic purposes, you may choose to have the papule removed by shave excision. This may leave a scar.Fibrous papule of nose