FIBROUS PAPULE HAVING MYXOID STROMA, NOSE
Fibrous papules of the nose probably represent hyperplasia of perifollicular adventitial dermis. This is usually expressed by the formation of mature collagen that focally forms bundles that intersect the dermoepidermal junction at a right angle. Similar stroma is seen in fibroepithelial follicular hamartomas such as perifollicular fibromas, folliculosebaceous cystic hamartomas, and fibrofolliculomas. Myxoid stroma is seen in some examples of trichodiscomas. Therefore, it is not surprising to see myxoid stroma within a small percentage of fibrous papules of the nose.

This specimen includes a papule from the nose of a 33 year old female.
 
Scan power view showing the area of interest outlined in black.
A medium power view showing myxoid stroma containing delicate collagen fibers and fibroblasts. A field such as this could be seen in a trichodiscoma or in a variety of myxoid tumors of skin.
A medium power view from the left side of the area of interest. A small amount of normal reticular dermis is in the extreme  left side of this picture. The myxoid stroma in this pictures appears to be modified perifollicular mesenchyme or adventitial dermis.
A high power view of the dermoepidermal junction. Small collagen fibers form bundles  intersect the dermoepidermal junction at a right angle. This is a characteristic commonly found in  ordinary fibrous papules of the nose.
A high power view from an area between the dermoepidermal junction and the myxoid area. Part of a hair follicle is in the right side of the picture. Cells, some of which are multinucleated, having a few fibrohistiocytic features and stellate outlines are present. Such cells are characteristic of fibrous papules of the nose. Note also a few bundles of collagen intersecting the epithelium of the follicle at a right angle.

Click on your browser's 'Back' button to return to the previous page.