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A skin exam of a black woman aged 45 years revealed papules on the outside of her pinkies. According to the patient, the papules had been present since birth and did not bother her. She also stated that they had not changed in size since childhood.

An x-ray of the lesion revealed that these nubbins of flesh, containing no bone. The woman stated that to the best of her knowledge, neither her parents nor her brother and two sisters had similar lesions. Her three children had no lesions that resembled hers, either.

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A man aged 40 years presented with a six-month history of a growth on the side of one middle finger. The lesion did not itch, burn, or hurt. OTC wart treatments had no affect. The patient was not taking any medication and had no history of any systemic disease.

The lesion was removed by a shave excision. Histologic examination showed a dermal core composed of thick, closely intertwined collagen bundles with numerous capillaries, varying numbers of fibroblasts, and thin elastic fibers oriented along the vertical axis of the lesion.

What is the diagnosis?

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