Fibrous papule of the nose.

Case 1193  19.1.15 (M. Hurt)  F 41 columella – clear cell variant 

Looked like an intravenous pyogenic granuloma to me.  Wasn’t aware of this variant.  There is also a variant with granular cells. 

Ref: Lee AN. Am J Dermatopathol 2005; 27(4): 296-300 

Case 1428   14.12.15  (M. Hurt)  M 77 papule nose 

Cellular variant.  Numerous fibroblasts/histiocytes/dendrocytes with clear vacuolated cytoplasm embedded in dense sclerotic and hyalinized stroma.  

Case 2187  26.10.18 (R. Carr) 

Epidermis shows clear (Toker) cells due to Pagetoid “dyskeratosis” (PD).  This is not uncommon in FPN (and skin tags) ?due to irritation.  Toker cells also seen in some nipple biopsies (see 2170  3.10.18 ).  This biopsy also shows an apparent epidermoid cyst, attributed to cross-cutting. 

Case 2949 26.10.21  (U. Sundram)  F 55 lesion, cheek 

Pleomorphic variant. Stellate fibroblasts in a fibrotic stroma.  Giant cells. 

Case 4154 22.12.22 (S. Taibjee) M 37 shave of lesion near nose 

Granulomatous lesion showing xanthoma, Touton GC’s, haemosiderin pigment.  Some favoured xanthogranuloma.  Perl’s, CD68 and Factor 13a all +ve. Large number of variants of fibrous papule described.  See review: 

Ref: Am J Dermatopath 2018 40(8): 551-560 doi: 10.1097/DAD.0000000000001083. 

Case 4296 10.7.23 (M. Abdel-Halim)  F 16 small papule on nose 

Epithelioid/clear cell variant .