A filiform lesion on a finger

A 27-year-old man developed a filiform lesion on the side of his right middle finger (Figure 1). The lesion was flesh-coloured and it had a keratotic cap. It had been present for five years and had remained static in size. A shave biopsy showed an elevated epidermis covered by a thick stratum corneum, and a central core of collagen, small islands of adipose tissue, scattered stellate fibroblasts and vessels (Figure 2).