Table 1

Differential diagnosis for ADFK

ConditionDifferentiating pointsManagement
Supernumerary digitUsually found at the base of the fifth finger. Histology shows—neural bundles and neuroid elementsSurgical excision
Verrucae vulgarisTiny black dots on the wart surface, especially after paring the surface.Cauterization—chemical, electrical, radiofrequency cauterisation (RFC)
Topical : Five flouro uracil(FFU), Retinoid
Cryosurgery
Cutaneous hornConical projection above the surface of the skin. Typically occurs in sun exposed areas. Actinic keratoses are the most common premalignant primary cause of cutaneous horn.Surgical excision, RFC, treating the underlying cause
Cutaneous neurofibromaSkin coloured soft, polypoid or dome-shaped noduleCounselling about the benign nature of the disease
Pyogenic granulomaSolitary, rapidly growing, friable, dome-shaped or pedunculated, papule or polyp; easily bleed with minor traumaTopical TCA, eCo3 laser, cryosurgery
Koenen’s tumour (periungual fibroma)Digitated or polypoid growths with glove-clove-like, globoid, fusiform, or vermiform shapesCounselling about the benign nature of the disease
Non-pigmented eccrine poromaSkin-coloured or pink papule, plaque or nodule; occurs in the palms or side of feetSurgical excision
Aggressive papillary digital adenocarcinomaSkin-coloured or tan-brown to grey papule or noduleSurgery
  • ADFK, acquired digital fibrokeratoma .