Sclerotic fibromas of the skin

Eleven cases of a peculiar, hyalinized, hypocellular dermal fibroma are reported. The lesions are characterized by epidermal atrophy, a whorled appearance of sclerotic collagen bundles separated by clefts containing mucin, and sharp demarcation of the lesions from the surrounding normal skin. They are small white or flesh-colored waxy papules. Multiple lesions of this type have been reported in the multiple hamartoma syndrome (Cowden's disease). We believe that the solitary lesions of these eleven patients who did not have Cowden's disease represent an unrecognized form of the same fibrous hamartoma that occurs in Cowden's disease.