Angiofibroma

Angiofibroma, also known as fibrous papule, is a relatively common lesion seen in males and females after puberty. Angiofibromas represent focal growth of vascular and collagen structures normally found in the skin. They most often present as 1-5 mm, solitary, flesh-colored to slightly red bumps on the nose, and have no hereditary predisposition. These lesions may sometimes be confused with basal cell carcinoma.

Therefore, biopsy is needed to make the distinction. Uncommonly, individuals may present with multiple angiofibromas distributed on their face and less often, other parts of the body. Multiple angiofibromas have been associated with several genetic conditions, including tuberous sclerosis, Birt-Hogg-Dubé syndrome, and multiple endocrine neoplasia type 1 (MEN1). Unlike the solitary variant, these hereditary conditions have additional cutaneous and systemic findings.

Treatment:
Before treatment is considered, biopsy is often needed to confirm the diagnosis and to rule out other possibilities, including basal cell carcinoma. If multiple lesions exist or there is a family history of similar lesions, your physician may order laboratory and radiographic studies to exclude the syndromes listed above. Due to angiofibromas’ benign nature and small size, you and your physician will need to discuss the benefits and risks of pursuing treatment.

The majority of treatments available for angiofibromas are destructive. Depending on the location or number of lesions, your physician may elect to choose shave excision, dermabrasion, electrodessication and curettage, or laser therapy to treat these growths. Once these growths are treated, they seldom come back, although new lesions may form.

The majority of treatments available for angiofibromas are destructive. Depending on the location or number of lesions, your physician may elect to choose shave excision, dermabrasion, electrodessication and curettage, or laser therapy to treat these growths. Once these growths are treated, they seldom come back, although new lesions may form.

References:
Schaffer JV, Gohora MA, McNiff JM et al. Multiple facial angiofibromas: a cutaneous manifestation of Birt-Hogg Dubé syndrome. J Am Acad Dermatol 2005;53:S108-111.

Brian Walther, D.O.
Department of Dermatology
Philadelphia College of Osteopathic Medicine/Frankford Hospital
Philadelphia, Pennsylvannia