This is an angiofibroma.
Angiofibromas (fibrous papules) are very common solitary smooth dome-shaped papules that favor the nose. Lesions can mimic basal cell carcinoma due to a shiny or white appearance under dermoscopy. They are typically skin colored or red and patients frequently recall a history of easy bleeding with trauma.
Angiofibromas can present in different ways:
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Fibrous papules of the nose
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Pearly penile papules arranged in a circumferential manner around the corona
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Multiple facial angiofibromas in tuberous sclerosis (TS), MENI, Birt-Hogg- Dubé, and NF2
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Periungual fibromas associated with TS
Pathology shows a dome-shaped lesion with a dermal proliferation of plump or stellate fibroblasts (some may be multinucleated) in a collagenous stroma with an increased number of dilated and thin-walled vessels. Collagen fibers may be arranged concentrically around these vessels and hair follicles. There are fewer elastic fibers.
Rapid Recognition: Angiofibromas are most commonly observed in clinical practice on the nose. They are common clinical mimickers of both benign and malignant neoplasms and so it is not unusual to biopsy these lesions. Pathology shows a dome-shaped lesion with a dermal proliferation of plump or stellate fibroblasts in a collagenous stroma with an increased number of dilated and thin-walled vessels.
References:
(Bolognia et al. Dermatology 2018)
(Elston et al. Requisites in Dermatology 2009)
