A fibroma is a benign growth of connective tissue. These growths are very common as soft fibroma, hard fibroma and many different subtypes. Most fibroids are found on the skin, but sometimes the mucous membranes are also affected (e.g. in irritable fibroma of the oral mucosa). Read more about causes and therapies for fibroma.
ICD codes for this disease: M72 | D21
• Treatment: Medically not strictly necessary. Removal of cosmetically disturbing fibroma through small surgical intervention.
• Symptoms: Depending on the form of the fibroma, small, flat, raised or pedunculated skin growths on the face, arms, legs, trunk, sometimes also in the genital area and oral mucosa.
• Causes and risk factors: Not known with certainty, errors in tissue differentiation in the embryonic phase, frequency in combination with certain diseases.
• Examinations and diagnosis: Visual diagnosis, if necessary tissue sample (biopsy) to rule out malignant skin tumors.
• Disease course and prognosis: good; no disease value, unless the fibroma is in a disturbing place.
What is a fibroma?
Doctors refer to a new formation of connective tissue as a fibroma. This is a whole group of different growths in which certain connective tissue cells, the so-called fibrocytes, are involved. Fibromas are small benign tumors. Malignant tumors of the connective tissue are called fibrosarcomas.
Doctors distinguish different manifestations of fibroma:
Doctors also refer to the soft fibroma as fibroma molle or fibroma pendulans. The skin-colored, small tumors are common in both men and women. They are especially common in overweight people. Soft fibroma often form for the first time during puberty.
It is usually a few millimeters large skin bulges. Sometimes they sit with a broad base on the skin, more often they are stalked – so they hang like a sack from a narrow base. Colloquially, soft fibroma are therefore also called skin warts.
They often appear on the neck, armpits, and groin. A single soft fibroma is just as possible as multiple fibromas in one part of the body. These then form a skin tumor that reaches a size of a few centimeters.
Most adults have at least one hard fibroma somewhere on their body. Doctors also speak of histiocytoma or dermatofibroma. They are particularly common on the legs, but also on the arms and torso. Hard fibroma are tough nodules that are usually a few millimeters in size, rarely larger.
They sit as slightly darker, often light brown spots in the skin. They are particularly common in young women on the legs.
An irritation fibroma or irritation fibroma is a fibroma of the oral mucosa. The small nodules are smooth and limited. They develop when certain parts of the mouth are repeatedly irritated.
There are some rare tumors that develop from connective tissue cells, especially in the bones. They include:
• Ossifying fibroma: A rare, benign tumor that occurs on the face – usually in the lower jawbone.
• Non-ossifying fibroma: A fibrous abnormality in bone (cortical defect) sometimes seen in children.
• Chondromyxoid fibroma: A tumor found mostly in long bones, primarily affecting adolescents.
• Desmoplastic fibroma: An aggressively growing bone tumor that occurs primarily in young people.
• Angiofibroma: A multivascular tumor of the nasopharynx that occurs almost exclusively in adolescent males.
The following sections deal primarily with fibroma of the skin.
How can a fibroma be treated?
From a medical point of view, a fibroma does not require any therapy. Both soft and hard fibroids are harmless. There is no risk that they will degenerate and develop into skin cancer. They usually stop growing at a certain size and then stay that way.
Having a fibroma removed is usually uncomplicated. The dermatologist does this in a small operation, depending on the size of the fibroma with a local anesthetic. The size and shape of the growth will determine whether the site needs stitches after the fibroma excision.
Caution: It is not advisable to remove a fibroma yourself, for example by tying it off, cutting it off or icing it. This puts you at risk of infection or injury. It is not known that fibroma can be removed with home remedies such as apple cider vinegar. If you want to have a fibroma removed, you are in good hands with a dermatologist.
So-called fibroma patches are commercially available. Before you use them, it is advisable to speak to your dermatologist to see if they are suitable for you.
What symptoms does a fibroma cause?
A fibroma in the skin area is visible from the outside. Soft fibroids are particularly common on the neck, in the armpits, on the groin and in women below the breasts. They are often stalked, with slightly larger growths small wrinkles can be seen on the surface.
Most soft fibroma are skin colored. If you turn them, they may turn red or black due to the injury to the blood vessels.
In contrast, a hard fibroma is usually a little darker, often grey-brownish. It is often slightly raised or sunken from the surface of the skin. The so-called Fitzpatrick sign is characteristic: If you press the area around a hard fibroma together with your thumb and forefinger, it sinks into the skin.
This distinguishes it from a melanocytic nevus (“mole”).
The irritation fibroma sits on the oral mucosa, either in the area of the cheeks, on the side of the tongue or on the gums. It is a small, limited, smooth “bump”. Its color matches the surrounding tissue or is slightly lighter.
Unless they are injured, fibroma do not cause pain.
What are the causes and risk factors?
In most cases, the causes of a fibroma are not precisely known. The soft fibroma is one of the hamartomas. These are tumors that arise from a defect in the embryonic germ tissue. From this tissue precursor, various tissue forms later develop (differentiation).
If an error occurs at individual points during the differentiation, one speaks of a hamarty. This causes excess tissue – in this case connective tissue – to form. In contrast to other tumors, however, hamartomas do not always grow on their own.
Soft fibroma is a common manifestation of hamartoma.
There are individual diseases in which those affected are more likely to develop hamartomas. These include, for example, Cowden’s syndrome and neurofibromatosis type 1 (Recklinghausen’s disease). Hereditary factors play a role in the development of fibroids.
People with systemic lupus erythematosus, the immune deficiency AIDS or a medicinally suppressed immune system (e.g. after transplantations) often develop more dermatofibromas (hard fibromas).
With the hard fibroma, experts suspect that it arises from a small inflammation of the connective tissue. There are various possible reasons for this:
- Insect bites.
- Thorns of plants penetrating the skin.
- Inflammation of a hair follicle (folliculitis).
- Other minor injuries.
A hard fibroma is a small scar under the upper layers of the skin. The trigger often goes undetected.
Irritable fibroma develop in places in the mouth that are frequently irritated, for example by a denture or a sharp edge of a tooth.
How can a fibroma be recognized?
For the diagnosis of a fibroma, the dermatologist is the expert. First he asks when the changed area of skin was noticed for the first time, whether it has changed or has been injured. With a typical fibroma, an expert usually recognizes what it is at first glance.
The doctor examines the fibroma more closely with a special magnifying instrument (dermatoscope). He pays attention to the size, shape, color, structure and edges of the skin change.
If there is a suspicion that it is a malignant growth – for example a malignant melanoma – the doctor takes a tissue sample (biopsy). He usually removes a small fibroma completely (excision). The sample taken can be examined histologically using special methods.
In rare cases, so many fibroma or other skin changes can be found that another underlying disease is suspected. Then further investigations follow.
Is a fibroma curable?
Fibromas are more of an aesthetic problem. The proliferations of the connective tissue are medically harmless and therefore do not necessarily require treatment. Some of those affected find fibroma to be visually disturbing, especially those on the face (e.g. on the eyelid), on the neck or in the intimate area.
With larger fibroma there is a risk of getting caught with clothing or jewelry (e.g. chains) and injuring yourself. A fibroma can usually be removed quickly and easily with a minor surgical procedure.