Soft Fibromas: Common Questions and Concerns

Consultation for Soft Fibromas

Dear Dr.
Wu,
I have a soft, protruding skin tag about 0.2 cm in size under my right armpit.
It feels very soft and is a light black color, with hair growing on it.
Over the years, its size and color have not changed.
A dermatologist previously diagnosed it as a soft fibroma after a visual examination.
I still have some questions, and I would like to ask Dr.
Wu:
Q1.
Is it possible for a skin tag (soft fibroma) to be "light black" in color? I searched online and found that most images of soft fibromas are flesh-colored, similar to the skin.
Since mine is light black, I initially thought it might be a protruding mole (nevus).
Q2.
Is it normal for hair to grow on my skin tag (soft fibroma)? Does a soft fibroma also contain normal hair follicle tissue?
Q3.
My skin tag (soft fibroma) is located in the middle of my right armpit, where it experiences frequent friction.
In your experience or opinion, does a skin tag (soft fibroma) in the armpit that is frequently rubbed have a risk of undergoing malignant transformation? Have there been similar cases in clinical practice?
Q4.
Regarding my skin tag (soft fibroma), what would you recommend as the best course of action? Should I continue to observe and coexist with it, or should I consider surgical removal?
Thank you, Dr.
Wu.

Axiang, 40~49 year old female. Ask Date: 2022/11/18

Dr. Wu Yuxin reply Dermatology

1.
The color is not always consistent; darker shades are also quite commonly observed.
2.
It is relatively rare.
3.
Friction is more likely to cause inflammation, but the probability of developing lesions is not high.
4.
If it affects daily life, it is advisable to consider removal.

Reply Date: 2022/11/18

More Info

Understanding soft fibromas, also known as soft fibromas or dermatofibromas, can be a source of concern for many individuals. Based on your questions, let’s address each one while providing a comprehensive overview of soft fibromas, their characteristics, and management options.

Q1: Color Variations in Soft Fibromas
Soft fibromas can indeed vary in color. While many appear flesh-colored or similar to the surrounding skin, they can also present in shades of brown or black, especially if they have been subjected to friction or irritation. The color can be influenced by factors such as the presence of melanin, which is the pigment responsible for skin color. Therefore, a soft fibroma that appears dark may not be unusual, and it is essential to have it evaluated by a healthcare professional to rule out other skin conditions.

Q2: Hair Growth on Soft Fibromas
It is normal for soft fibromas to have hair growth on them, particularly in areas like the armpits where hair follicles are present. These growths can contain normal hair follicles, and the presence of hair does not indicate any pathology. The soft fibroma is benign and typically does not affect the hair follicles surrounding it.

Q3: Friction and Potential Malignancy
The location of your soft fibroma in the armpit, where it may experience frequent friction, raises valid concerns. While soft fibromas are generally benign and do not typically undergo malignant transformation, chronic irritation can lead to changes in the fibroma's appearance or texture. In rare cases, persistent trauma to any skin lesion can lead to atypical changes, but this is not common with soft fibromas. It is advisable to monitor the lesion for any changes in size, color, or texture, and consult a dermatologist if you notice any concerning changes.

Q4: Management Options
Regarding management, the approach depends on several factors, including the size, location, and symptoms associated with the soft fibroma. If the fibroma is asymptomatic and not causing any discomfort, a watchful waiting approach may be appropriate. However, if it becomes bothersome due to friction or aesthetic concerns, surgical removal is a viable option. The procedure is typically straightforward and can be performed in an outpatient setting.
In conclusion, soft fibromas are generally harmless growths that can vary in appearance and may have hair follicles. While they are usually benign, monitoring for any changes is crucial, especially in areas subject to friction. If you have ongoing concerns or if the fibroma changes in any way, it is best to consult with a dermatologist for a thorough evaluation and potential treatment options. Regular check-ups can help ensure that any skin changes are appropriately managed, providing peace of mind and maintaining skin health.

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