Fibrous papules, or angiofibromas, are small benign bumps on the skin that do not change in appearance throughout a person’s lifetime. These small spots are usually flesh-colored and may resemble a mole. The most common location for a fibrous papule to develop is on the face, especially on and around the nose. Most papules appear late in adolescence or during early adulthood, and bumps that suddenly appear later in life should be promptly evaluated by a medical professional. Treatment is not necessary unless removal is desired for cosmetic reasons.
The majority of fibrous papules develop as a singular lesion. When multiple papules form at the same time, it is often part of systemic condition such as tuberous sclerosis or multiple endocrine neoplasia type 1. Diagnosis usually occurs after a visual inspection and biopsy of the bump. Biopsy results will indicate an increase in blood vessels in the dermis of the skin and underlying fibrous stromal tissue.
Fibrous papules often resemble other, more serious lesions that require medical treatment. Reddish bumps may indicate the spots are caused by adenoma sebaceum, and their presence should lead to a screening test for tuberous sclerosis. Another form of lesions that are similar in appearance are called Koenen tumors, and any bumps of this type require medical treatment. Basal cell carcinomas may look similar as well, but grow much faster than the benign spot. A healthcare professional should assess any quickly growing or changing bump on the skin.
When these bumps are removed, it's usually an outpatient procedure. One hour before the appointment to remove the bump, an analgesic cream will be applied to the skin around the papule to numb it. After injecting a local anesthetic, a medical professional will quickly scrape away the small lesion with short horizontal strokes in a process called shave excision. He will then cauterize the site to prevent infection and promote a faster healing time.
Other methods of fibrous papule removal are curettage, elliptical excision, or laser removal. Laser treatment options include the pulsed dye laser, the CO2 laser, the KTP laser, or the argon laser. Each laser variation results in different after-care guidelines and healing times.
The fibrous papule will sometimes grow back in the same location after a few months. If the lesion returns, a follow-up appointment to remove the new growth will be scheduled. This procedure may need to be repeated several times if the fibrous papule may come back more than once.