Sclerotic Fibroma: A Differential Diagnosis of Spontaneous Keloid

CASE DESCRIPTIONSclerotic fibroma (SF) is a rare neoplasm first described in 1972 by Weary et al in association with Cowden syndrome.1 This rare syndrome typically manifests with mucocutaneous findings (trichilemmomas, verrucous papules in the oral mucosa, acral keratosis and sclerotic fibromas) and an increased risk for several neoplasms.1 Later, Rapini e Golitz coined the term solitary SF in the absence of Cowden syndrome.2 It is debatable whether SF is distinct lesion or a sclerotic evolutionary end-point of other conditions.3 SF manifests clinically as an asymptomatic, well-demarcated skin-colored to erythematous papule or nodule with no site or sex predilection.2,3 The authors present a healthy 56-year-old male with a pink, linear plaque located on the left shoulder slowly growing for about 20 years. He was previously treated with intralesional corticosteroids for a suspected spontaneous keloid but the patient abandoned treatment by his own initiative. [...] REFERENCES1. Weary PE, Gorlin RJ, Gentry WC, Jr., Comer JE, Greer KE. Multiple hamartoma syndrome (Cowden’s disease). Arch Dermatol. 1972;106:682-90.2. Rapini RP, Golitz LE. Sclerotic fibromas of the skin. J Am Acad Dermatol. 1989;20:266-71.3. High WA, Stewart D, Essary LR, Kageyama NP, Hoang MP, Cockerell CJ. Sclerotic fibroma-like change in various neoplastic and inflammatory skin lesions: is sclerotic fibroma a distinct entity? J Cutan Pathol. 2004;31:373-8. Received: 22/09/2017 - Accepted: 30/11/2017