Fibrous Papule on The Hard Palate

Acquired Angiofibroma - Fibrous Papule

Painless, pink-colored, smooth-surfaced and painless lesion 4 mm in diameter on the hard palate.

History: There is a lesion for 6 months

In histopathological examination, microscopic examination report:

In the sections, it was observed that the lesion was covered with thick squamous epithelium. Fibrous tissue and numerous ectatic capillaries and mild chronic inflammatory infiltration are seen in the subepithelial space.

Histopathological diagnosis: Fibrous Papule

An excisional biopsy was performed in office conditions, after local anesthetic injection, in a patient with a painless, pinkish color, smooth surface, gradually and slowly growing, painless lesion on the hard palate, just to the right of the midline, with a diameter of 4 mm. After the biopsy, we performed local chemical cauterization with silver nitrate. At first, I thought it was a wart associated with the HPV virus, but interestingly, the histopathology report resulted in a fibrous papule. In the photos above and below, you can take a look at the examination photos of the patient before and after the excisional biopsy of the hard palate.

Fibrous papules are benign lesions usually seen on and around the nose and have 6 sub-variants: hypercellular, inflammatory, pleomorphic, pigmented, clear-cell and granular-cell types. Also known as angiofibroma (source link >> [Fibrous papules of the face: a retrospective anatomoclinical study of 283 cases] - PubMed (nih.gov)).

Fibrous Papule Diagnosis

Excisional biopsy and histopathological evaluation are sufficient for diagnosis. It is not easy to diagnose with physical examination. In the first image, a lesion such as a fibroma or wart may be considered.

Fibrous Papule Differential Diagnosis

Diseases and conditions that can be considered in the differential diagnosis (source >> Angiofibroma | DermNet NZ):

• Intradermal melanocytic naevus
• Acne
• Basal cell carcinoma
• Viral warts
• Molluscum contagiosum 

Fibrous Papule Treatment

In the treatment, follow-up is sufficient for lesions that do not grow and remain stable; In enlarged lesions, electrocautery, laser, excisional biopsy, cryotherapy options are also available.

Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon

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