Case Number : Case 2187 - 26 October 2018 Posted By: Dr. Richard Carr

Nasal fibrous papula. Associated Toker cells hyperplasia and an epidermal cyst...I don't know what does it mean...probably an incidental finding. 

Agree whit Vicenzo. Angiofibroma or nasal fibrous papula.

If multiples It could be related to tuberous sclerosis. I dont know if that could explain the cyst and the other findings.

Fibrous papule of the face associated with pagetoid dyskeratosis (PD). PD is not an uncommon finding in this kind of lesion, as well as in achrocordons and fibroepithelial polyps, but it is usually not reported.

Agree with IgorSC, that the epidermal changes represent pagetoid dyskeratosis, which can be associated with chronic irritations. As far as the overall lesion, I wonder if it is an epidermal inclusion cyst because the area showing vascular proliferations and spindle stromal cells is only focal. Isolated fibrous papule is not common at this age. Angiofibromas in tuberous sclerosis are usually multiple. Correlating with clinical appearance might further help.

I reported it as a fibrous papule (angiofibroma). I interpreted the cyst-like component as cross-cutting. Agree with pagetoid dyskeratosis (I submitted this to contrast with case 2152 pagetoid bowen's) rather striking in this case. Note there is no dyskeratosis in PD.