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February 2003

Multiple Facial Papules in an Adult—Diagnosis

Arch Dermatol. 2003;139(2):215-220. doi:10.1001/archderm.139.2.215-f

The hematoxylin-eosin–stained sections revealed a normal epidermis and perifollicular epithelial proliferation arranged in anastomosing strands within well-circumscribed fibrous stroma in the dermis. These histopathologic findings were consistent with fibrofolliculoma.

Multiple fibrofolliculomas usually occur as part of an uncommon autosomal dominant disorder in which patients develop multiple asymptomatic papules on the face, neck, and axillae during adulthood.1 The papules are considered to be benign hamartomas that are characterized histopathologically by a central dilated hair follicle with numerous thin, anastomosing bands of follicular epithelium that extend into a thick mantle of stroma. This pilar tumor has both ectodermal and mesodermal components. Fibrofolliculoma may also present as a solitary papule on the face.1