Multiple Sclerotic Fibromas in an HIV‐Positive Patient Without Evidence of Cowden’s Disease

Abstract

Sclerotic fibroma is an uncommon benign neoplasm of the skin which may occur sporadically in a solitary form or as multiple lesions as a component of Cowden’s disease. Sclerotic fibromas have a distinctive histologic appearance characterized by well‐circumscribed, hypocellular dermal nodules of thick, hyalinized collagen bundles arranged in a whorled or storiform pattern with prominent clefts. We present the case of a 52‐year‐old HIV‐positive, African‐American female who presented with multiple firm flesh‐colored nodules of several year duration on bilateral lower extremities. Biopsies of the lesions demonstrated characteristic features of sclerotic fibroma. Detailed physical examination and extensive systemic work‐up failed to reveal evidence of Cowden’s disease. To our knowledge, multiple sclerotic fibromas have not been reported in the absence of Cowden’s disease, and this is the first reported case of multiple sclerotic fibromas occurring in an HIV‐positive patient without evidence of Cowden’s disease.