Case Number : Case 2236 - 8 January 2019 Posted By: Uma Sundram

Granuloma annularre vs mucinous eccrine nevus.

Acquired digital fibrokeratoma. Clinico pathological correlation is important here. Even a Koenen's tumour may look like this. 

Not typical, but favor Superficial Acral FibroMyxoma.

Superficial acral fibromyxoma, likely

Superficial Acral Fibromyxoma vs Acquired Digital Fibrokeratoma.

I favor the first.

Great suggestions. I would also add digital dermatofibroma and supernumerary digit. S100 and CD34 are both negative. I favored acquired digital fibrokeratoma but superficial acral fibromyxoma is also a possibility; CD34 negative cases have been reported. The patient does not have a history of TS. 

These are difficult cases and there can be overlap among all these entities.

Please Dr Uma, what's the 2232-case's diagnosis?

I was leaning towards a tiny dermatofibroma (which I don't think I've ever seen on a finger) but have to agree it's not easy to classify!