Acquired fibrokeratomas may occur on digits or on hands or feet. Hyperkeratosis, acanthosis, and vertical streaking of collagen in the papillary dermis probably are manifestations of repeated picking at the lesion. The central core, however, is composed of interlacing collagen bundles of the type normally found in the reticular dermis. In some examples, the central core contains the normal number of fibroblasts expected in the reticular dermis, but fibroblasts are increased in number in other cases. The architecture is acuminate in some examples and dome shaped in others. Collarette formation and mucinous foci are seen in a few examples.
 

	Composite scan power view. The hyperkeratotic lesion has a fibrous core, and it protrudes above the adjacent epidermal surface. The superficial features can be seen in picker's nodules.
	Low power view. The core contains an increased number of fibroblasts in this example. Collagen bundles of the size and orientation expected in the reticular dermis are present.

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