Typically does not show prominent storiforming of collagen, although it may be focally present in rare cases
• Pleomorphic fibroma
Pleomorphic cells are more prominent, and storiforming pattern of collagen should be absent
• Collagenous fibroma
Densely collagenous or fibromyxoid stroma; lacks prominent storiforming of collagen
• Acral fibrokeratoma (subungual and periungual fibroma)
Usually shows overlying hyperkeratosis and acanthosis
Sclerotic Fibroma at Scanning Magnification Scanning magnification view shows a dermal-based nodular fibroblastic proliferation with storiforming of collagen.
Sclerotic Fibroma With Storiforming Collagen Higher magnification of the lesion shows prominent areas of storiforming collagen bundles separated by small clefts , imparting a typical plywood-like pattern.
Inflamed and Traumatized Sclerotic Fibroma This lesion showed overlying evidence of trauma and mixed, predominantly lymphocytic inflammation in the dermis. However, there are sclerotic collagen bundles with clefts and a vaguely storiforming appearance.
FXIIIA Immunohistochemistry in Sclerotic Fibroma FXIIIA immunohistochemistry shows staining of scattered spindle cells .
TERMINOLOGY
Synonyms
• Storiform collagenoma
• Pleomorphic sclerotic fibroma
Definitions
• Benign, dermal-based fibroblastic proliferation with storiforming bundles of collagen
ETIOLOGY/PATHOGENESIS
Unknown
• May be related to trauma
• Some cases may represent regressed dermatofibromas
Genetic Syndrome
• Multiple lesions are associated with Cowden syndrome, consistent with genetic influence
CLINICAL ISSUES
Epidemiology
• Age
May occur at any age, including in infants and elderly
• Sex
Roughly equal incidence in male and female patients
Site
• Presents most commonly on face, extremities, and trunk
Presentation
• Slow-growing, flesh-colored papule or nodule
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, imparting a typical plywood-like pattern.
with clefts and a vaguely storiforming appearance.
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