Superficial Acral Fibromyxoma on the Second Toe

477 nodular lesion with a well-defined margin, but had no erosion, eschar, or bleeding. In addition, it did not invade the periungual or subungual region. Furthermore, it had a soft surface with soft tissue adhesion. There were no notable findings on radiography nor a family history. However, the patient did have a severalyear history of tinea pedis. The patient scratched the itching area, resulting in alternating wound healing and scarring. The patient was tentatively diagnosed with hypertrophic scar or keloid, for which we performed a complete resection of the mass (Fig. 1B). On histopathology, the mass was located underneath the hyperkeratinized epidermis, and it extended into the dermal and subcutaneous layer. Its cross-section showed a yellowish-white, jelly-like substance. Its histopathologic findings included a fascicular or storiform arrangement of spindle-shaped or stellateshaped tumor cells in the myxocollagenous matrix (Fig. 2A). These findings were suggestive of proliferative fibroblasts. Accentuated microvasculature was present in the matrix, accompanied by the overall presence of mast cells throughout the lesion. However, there was no marked presence of other inflammatory cells. Moreover, there was no dysplasia or hyperplasia of the tumor cells. On immunohistochemistry, the tumor cells were positive for CD34 and negative for desmin, S100, and epithelial membrane antigen (EMA) (Fig. 2B). The patient was eventually diagnosed with SAF. At a 12-month follow-up, there were no notable complications or recurrence (Fig. 3). SAF is a solitary, nodular, slowly-growing, asymptomatic soft-tissue tumor with a well-defined margin. It is a rare tumor entity that mainly affects the soft tissue of the extremities and commonly occurs as a Superficial Acral Fibromyxoma on the Second Toe