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Fibromas are one of the most common dermatological problems. Although they are cancerous in nature, fibromas are benign and usually do not pose a threat to our health. How is fibroma formed? How are skin fibromas treated and when should you consider removing them?
Fibromas are benign lesions of a cancerous nature. Resembling small pimples or nodules, fibromas arise as a result of excessive multiplication of connective tissue cells – fibroblasts – in a certain part of the skin. However, the growing fibroma does not become malignant, so it usually does not pose a threat to our health.
There are two basic types of fibromas in dermatology: soft fibromas (so-called dermal fibromas) and hard fibromas (otherwise: subcutaneous fibromas). It is recommended that their presence – regardless of the type – is always consulted with a dermatologist. This is the only way to make sure that we are actually dealing with a fibroma, or maybe it is a different, potentially more dangerous type of skin lesion – e.g. lipoma or papilloma.
Also read: HPV (human papillomavirus) – symptoms, stages of infection. HPV and cervical cancer
It is difficult to clearly define the causes of the formation of fibromas. It is known, however, that the development of this type of changes is fostered by various factors, including hormonal disorders, mechanical injuries and metabolic disorders. The genetic predisposition to the formation of fibromas is also probable.
The appearance of fibromas is most often associated with metabolic problems. Metabolic disorders are accompanied by hormonal abnormalities that may favor the development of these neoplastic changes. Fibromas are mentioned especially in the case of insulin resistance, obesity and the atherogenic lipid profile. These could indicate a higher likelihood of diabetes.
Fibromas often occur in people with elevated total cholesterol and LDL cholesterol, as well as a low HDL cholesterol fraction. Moreover, fibroids may be a signal of an increased risk of developing atherosclerosis.
The presence of fibroids can also be influenced by disorders related to sex hormones. The occurrence of fibromas in the following cases is probably favored by disturbed estrogen metabolism:
- pregnancy;
- Polycystic ovary syndrome;
- acromegaly;
- organ transplants;
- intestinal polyps (Gardner’s syndrome);
- the Birt-Hogg-Dubé syndrome;
- Cowden’s syndrome.
One of the theories of the occurrence of fibroids points to the role of HPV infection, i.e. the human papillomavirus, especially if the infection is caused by a mechanical injury such as friction.
Cutaneous (soft) fibromas – characteristics
Soft fibroma – Latin fibroma molle, in the English-language specialist literature referred to as acrochordon – is a small skin lesion usually reaching 2,5 mm. It has the character of a small lump suspended on a narrow peduncle: it is actually an overgrown dermis covered with a layer of epithelium. The structure of the soft fibroma is loose, flaccid and baggy, and its surface – irregular and folded. For this reason, it is sometimes also referred to as hanging fibroma.
Fibromas of this type are brown or flesh-colored. The former, which accumulate a greater amount of melanin (a pigment contained in the skin), usually appear in flexion areas, e.g. under the armpit, knee, groin or elbow. They also appear quite often where the skin is exposed to irritating contact with clothing or jewelry – e.g. on the neck. Lighter fibromas can also form on the face, especially on the eyelids of the eyes, which can sometimes be a complication in everyday life.
In most cases, soft fibromas can be easily inserted into the skin under the influence of pressure. Interestingly, such fibroids usually do not occur individually, but in groups from a dozen to several dozen.
Patients with numerous dermal fibromas should undergo a check-up regarding the functioning of the circulatory system. A large number of fibromas may indicate that the so-called metabolic syndrome – is a set of symptoms including dyslipidemia, insulin resistance, arterial hypertension and obesity.
Cutaneous fibromas are changes that occur quite frequently in the population. According to estimates, they appear in 25-45% of all adults, especially women. Such skin changes may appear at any stage of life, although their intensity usually increases with age. Due to changes in the hormonal balance, large numbers of fibromas also appear during pregnancy.
Zobacz: Neuroma – types, treatment
Soft fibromas – treatment
Although soft fibromas do not pose a health risk, they can be removed for aesthetic reasons. They should not be expected to resolve on their own – they persist throughout life. How are cutaneous fibromas removed? There are several possibilities:
- surgical intervention – excision of the lesion using scissors, a scalpel or a single-use punch (the procedure is performed under local anesthesia);
- cryosurgical intervention – a treatment using a stream of liquid nitrogen at a very low temperature, under the influence of which the lesion is frozen and falls off spontaneously (note – cryosurgery causes local skin discoloration, therefore it is not recommended for people with darker complexion);
- electrocoagulation of fibroma – fibroma excision performed with the use of high-frequency current, which leaves no discoloration on the skin;
- CO2 fractional laser – a procedure that turns the intracellular water into water vapor, thanks to which the fibroma can “evaporate”; the most effective, but also the most expensive way to remove fibromas, which does not have any side effects in the form of scars or discoloration.
Also read: Laser therapy – indications, contraindications, price
Subcutaneous (hard) fibromas – characteristics
Another type of fibroma is hard fibroma, also called subcutaneous – from Latin fibroma durum or fibroma nodularis subepidermalis, and in English-language materials it is referred to as dermatofibroma. This is a slightly larger lesion, usually between 3 and 10 mm in size and appears as a slightly raised subcutaneous nodule. Hard fibromas range in color from light brown to reddish brown and are usually darker in the center.
A characteristic feature of this type of fibroids is the so-called symptom of Fitzpatrick: when applying pressure to the surrounding skin, hard fibromas shrink or only slightly shift. It also happens that such skin lesions react to touch with a slight soreness, they may also itch. Subcutaneous fibromas usually occur on the legs and arms, although they can also form on the abdomen or buttocks. It is much more common in women than in men, appearing between the ages of 20 and 50.
Hard fibromas often appear where the skin has been somehow damaged or severely irritated, for example after an insect bite or sting, or minor injuries even during shaving (including folliculitis). Such a fibroma may take several months or even years to take shape. Unlike in the case of soft fibromas, the subcutaneous type often occurs alone or in a group of a few lesions at most.
Hard fibromas – treatment
Similar to the previously described soft fibromas, the hard type of fibroma does not pose a health hazard. Such changes relatively often go unnoticed, “hiding” under the skin and showing no symptoms. Sometimes, however, they are actually associated with everyday discomfort – they itch, hurt or look ugly. Sometimes there may also be a concern that we are dealing with a different type of skin lesion. Hard fibromas can then be removed in two ways:
- surgical intervention – surgery using a scalpel under local anesthesia; it is usually used when the change is uncertain and suspicious to take a specimen for histopathological examination;
- treatment with steroid injections – dermatologists use this method of removing fibromas after carefully assessing whether this type of treatment will be effective; used for large fibromas that interfere with everyday functioning or look unsightly.
It is not recommended to use other methods of hard fibroma removal. They turn out to be ineffective, and what’s more – they can cause the regrowth of even larger and more painful fibroids.
You can also find home remedies for the removal of fibromas on the Internet. The most popular seems to be applying a cotton swab soaked in apple cider vinegar to the fibroma, repeated until the lesion dries out and falls off spontaneously. However, there is no evidence that such a method is effective, and what’s more – vinegar can dry out the skin and cause other dermatological ailments. So it’s best to just consult a dermatologist about this.
Also read: The most common skin problems – how to relieve their symptoms?
Fibromas in the breast – fibroadenomas
A specific type of fibroma is fibroadenoma (Latin and English fibroadenoma), which is a neoplastic lesion in the breast. In most cases, like other fibroids, it does not become malignant and turns out to be a benign, benign breast cancer. It appears as a lump or thickening under the skin. It usually appears in women under the age of 30 under the influence of large amounts of estrogens.
Fibroids are painless, moveable in relation to the surface and the skin round or oval bumpswhich are usually a few centimeters in diameter (although they can also be larger). Their surface is usually smooth and their consistency is cohesive and elastic. In most cases, fibroadenoma grows slowly – pregnancy, hormone replacement therapy or hormonal contraception can stimulate its growth.
The most popular treatment for fibroadenomas is surgical intervention. It is usually done when the lump is more than 4 cm in diameter, when it grows rapidly, or when the patient has a history of breast cancer in the patient’s family.
Find out more: What should you know about breast screening?
Fibromas can also form in the mouth. They are most often located on the mucosa of the hard and soft palate and the cheeks, much less often – on the tongue or lips. Such fibromas are usually traumatic in nature – they occur, for example, quite often in people wearing orthodontic appliances or dentures. They can also form in people with malocclusion. In the area that is subject to irritation, a small pink lump of oval or round shape is formed.
Oral fibromas do not always require removal. However, such a procedure should be considered if they are in an area that is still prone to irritation or if inflammation develops around it. With such a problem, it is best to go to the dentist first, who will assess the change and determine whether a consultation and intervention of a surgeon is necessary.
Also check: Skin problems and e-visit to a dermatologist. When is it worth opting for on-line consultations?