LAUSR

© BMJ Publishing Group Limited 2023. No commercial reuse. See rights and permissions. Published by BMJ. DESCRIPTION A man in his 50s presented to the dermatology outpatient department with a painless skincoloured exophytic hornlike growth arising from the dorsal surface of the left index finger. It measured 3.5 cm in length with a broad base of 1.5 cm in diameter (figure 1). The growth had a characteristic hyperkeratotic collarette at its base. There was no history of any local factors like trauma or irritation. A clinical diagnosis of gaint acquired digital fibrokeratoma (GADFK) was made. Surgical excisional biopsy is performed as both a diagnostic and therapeutic procedure. Histopathology examination revealed a digitate lesion, composed of massive hyperkeratosis, acanthosis, a core of thick collagen bundles and vertically oriented small dermal blood vessels suggestive of ADFK (figure 2). Neural structures were absent and lacked adnexal structures, ruling out the possibility of the supernumerary digit. The final diagnosis of giant ADFK was confirmed because of the size of more than 1 cm and histology. ADFKs are benign, solitary, hyperkeratotic welldefined papules in digitate form looking like horns with a collarette of skin at its base. The lesions are usually domeshaped, although they may present as elongated fingerlike projections, as in the index case. 2 Common sites of occurrence are on fingers and toes but can also