de Cambourg G, Cribier B
Service de dermatologie, hôpital civil, 1, place de l'Hôpital, BP 426, 67091 Strasbourg cedex, France.
Ann Dermatol Venereol. 2013 Dec;140(12):763-70. doi: 10.1016/j.annder.2013.09.163. Epub 2013 Oct 17.
Fibrous papules of the face are frequent benign lesions seen in the nasal and perinasal region. Their clinical aspect is indistinct and the histological signs are sometimes mild or possibly misleading in the case of atypical forms. We carried out a retrospective study of 283 fibrous papules diagnosed at our histology laboratory. The goal of this study was to characterize this type of frequent but occasionally unrecognized lesion.
We performed a retrospective study of fibrous papules of the face diagnosed in the dermatopathology laboratory of our dermatology centre between January 2002 and December 2011. The study concerned the clinical information noted in the examination request and the morphological abnormalities seen at optical microscopy. An immunohistological study of factor XIIIa was performed in selected cases.
The fibrous papules of the face came from 129 men and 154 women aged between 18 and 90 years (mean: 46 years). Two hundred and thirty-seven (83.7%) lesions were taken from the nasal region and none were taken from anywhere other than the face. The clinically mentioned diagnoses varied. A diagnosis of fibrous papule of the face was stated in 42% of cases, and the main differential diagnoses were nevus (stated in 34% of cases) and basal cell carcinoma (stated in 14% of cases). The fibrous papules were classic in 85.5% of cases. We observed 6 variants of fibrous papule: hypercellular, inflammatory, pleomorphic, pigmented, clear-cell and granular-cell types. Immunohistochemistry of factor XIIIa was positive in all cases except clear-cell fibrous papules.
This study shows that despite their frequency, these lesions often go unrecognized, since the hypothesis of a fibrous papule of the face was mentioned in fewer than 50% of cases at the time of biopsy. Diagnosis is often made by the histopathologist, who may be misled by some rare types. The principal differential diagnoses are nevus and basal cell carcinoma, thus warranting methodical histological analysis of all pieces.
面部纤维性丘疹是常见的良性病变，多见于鼻部及鼻周区域。其临床表现不明显，组织学特征在非典型病例中有时较为轻微或可能产生误导。我们对在本组织病理学实验室诊断的283例面部纤维性丘疹进行了回顾性研究。本研究的目的是对这种常见但偶尔未被识别的病变类型进行特征描述。
我们对2002年1月至2011年12月期间在我们皮肤科中心皮肤病理学实验室诊断的面部纤维性丘疹进行了回顾性研究。该研究涉及检查申请中记录的临床信息以及光学显微镜下所见的形态学异常。在部分病例中进行了因子ⅩⅢa的免疫组织化学研究。
面部纤维性丘疹患者中男性129例，女性154例，年龄在18至90岁之间（平均46岁）。237例（83.7%）病变取自鼻部区域，且均来自面部以外的其他部位。临床提及的诊断各不相同。42%的病例诊断为面部纤维性丘疹，主要鉴别诊断为痣（34%的病例提及）和基底细胞癌（14%的病例提及）。85.5%的病例为典型的面部纤维性丘疹。我们观察到6种纤维性丘疹变体：细胞增多型、炎症型、多形性、色素沉着型、透明细胞型和颗粒细胞型。除透明细胞型纤维性丘疹外，因子ⅩⅢa免疫组织化学在所有病例中均为阳性。
本研究表明，尽管这些病变常见，但往往未被识别，因为活检时提及面部纤维性丘疹这一假设的病例不到50%。诊断通常由组织病理学家做出，他们可能会被一些罕见类型误导。主要鉴别诊断为痣和基底细胞癌，因此需要对所有切片进行系统的组织学分析。
