What are the other Names for this Condition? (Also known as/Synonyms)

• Multiple Fibrofolliculoma
• Solitary Fibrofolliculoma

What is Fibrofolliculoma? (Definition/Background Information)

• Fibrofolliculoma is a rare, slow-growing benign tumor of the hair follicles, generally observed in children and young adults
• It is strongly associated with Birt-Hogg-Dubé syndrome, which is a rare, genetic condition that is associated with benign tumors of the skin that form in large numbers
• Fibrofolliculoma typically does not present any major signs and symptoms. Often, multiple tiny papules may be observed on the head and neck region
• In a majority of cases, no treatment in necessary, unless it causes severe signs and symptoms or presents cosmetic concerns (it can be visually unappealing)
• The prognosis of Fibrofolliculoma is generally good with suitable treatment, though it is also based upon the course of the underlying disorder (if any present)

Who gets Fibrofolliculoma? (Age and Sex Distribution)

• Fibrofolliculoma can occur anywhere within the first 30 years of life (i.e., in children, adolescents, and young adults). It can also be present at birth
• Both males and females may be affected
• Individuals of all racial and ethnic background may be affected. Worldwide, no geographical localization of Fibrofolliculoma has been reported

What are the Risk Factors for Fibrofolliculoma? (Predisposing Factors)

The following risk factors have been identified for Fibrofolliculoma:

• Birt-Hogg-Dubé syndrome (BHD syndrome): It is a hereditary disorder that is characterized by numerous tiny follicles on the skin. This rare condition also affects the kidneys and lungs. A majority of Fibrofolliculoma cases are linked to BHD syndrome
• Nevus lipomatosus: A rare, benign tumor of the soft tissue

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Fibrofolliculoma? (Etiology)

• Presently, the cause of development of Fibrofolliculoma is largely unknown
• Many individuals with the genetic disorder Birt-Hogg-Dubé syndrome are known to present Fibrofolliculomas

Research is currently being undertaken to identify the relevant causal factors.

What are the Signs and Symptoms of Fibrofolliculoma?

Fibrofolliculoma is typically asymptomatic, indicating that they do not present any significant signs and symptoms. However, the following features may be observed:

• It occurs as solitary or multiple papules on the skin 
• It is a slow-growing tumor with an average size of 1-3 mm
• The papule is usually painless and non-itchy
• It can occur anywhere in the body, but are commonly observed in the head and neck region (frequently on the face), also on the arms, thighs, and trunk
• Fibrofolliculoma can be sometimes confused with basal cell carcinoma (a malignant skin tumor), because of their occasional pigmented appearance

How is Fibrofolliculoma Diagnosed?

A diagnosis of Fibrofolliculoma may involve the following:

• A thorough medical history and physical examination
• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis
• In consultation with the clinician, a patient with Fibrofolliculoma should be considered at risk for having Birt-Hogg-Dubé syndrome (BHD). This would lead to a more extensive physical examination, possible genetic testing, and imaging of the lungs and kidneys. The greatest health risk for BHD patients is renal carcinomas in a large number of cases

Note: A biopsy may be performed, since sometimes the tumor resembles basal cell carcinoma.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Fibrofolliculoma?

• However, some individuals may have concerns regarding their cosmetic appearance, especially if the tumor occurs on the face.
• Complications, such as increased risk for renal carcinomas, may arise from Birt-Hogg-Dubé Syndrome (if the disorder is present)

How is Fibrofolliculoma Treated?

The treatment of Fibrofolliculoma may involve the following:

• The healthcare provider may recommend a ‘wait and watch’ approach in many cases
• In a majority of cases, removal of the tumor is not necessary, unless it causes bothersome signs and symptoms
• The treatment of choice is a complete surgical excision
• Treatment of the underlying disorder (such as Birt-Hogg-Dubé syndrome) by genetic testing, imaging, and referral to a urologic surgeon for ongoing cancer treatment and surveillance is important and highly-recommended

How can Fibrofolliculoma be Prevented?

Currently, there are no known methods to prevent Fibrofolliculoma occurrence.

What is the Prognosis of Fibrofolliculoma? (Outcomes/Resolutions)

• The prognosis for the cutaneous aspect of Fibrofolliculoma is excellent with appropriate treatment, since it is a benign tumor
• However, the overall and long-term prognosis is dependent upon the presence or absence of Birt-Hogg-Dubé syndrome

Additional and Relevant Useful Information for Fibrofolliculoma:

• There is no evidence to prove that oily foods and chocolate-based products have an influence on Fibrofolliculoma formation
• Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition
• The presence of dirt on the body is not a causative factor for the condition. However, it helps to be clean and hygienic, which may help the condition from getting worse