Acquired fibrokeratoma of the heel

We describe a patient with a 3-cm sessile tumor of the heel. Despite its large size and unusual location, it had the histologic characteristics of a fibrokeratoma. The essential microscopic feature of fibrokeratoma is its core of collagenous fibers with both interwoven and parallel arrangements. Epidermal hyperplasia and hyperkeratosis are often present, but probably represent secondary changes. Fibrokeratomas, therefore, have some of the clinical and pathologic features of collagenomas.