A 6-month-old female patient presented with swelling in a finger of the left hand. Physical examination revealed a 1x1 cm firm, painless, nodular mass on the medial aspect of the distal phalanx of the fourth finger. On pathological examination of the excised mass, the patient was diagnosed as infantile digital fibromatosis (IDF). Nine months later, soft tissue masses of 1x1 cm formed at the operation site and also on the posterolateral surface of the distal phalanx of the third finger (Fig. 1). No treatment was administered since the tumor had a benign character, recurred after surgical treatment, and did not cause pain or loss of function.

Fig. 1 Skin-colored firm nodules on the distal phalanx of the third and fourth fingers.

Skin and subcutaneous nodules that occur among infants are typically benign, but malignant lesions like rhabdomyosarcoma, fibrosarcoma, neuroblastoma and congenital leukemia, may occur as well. IDF is a rare benign childhood tumor that presents almost exclusively in the fingers or toes. The lesion is typically firm and painless and presents on the dorsal, lateral, or ventral aspect of a finger as an erythematous or skin-colored, solitary papule less than 2 cm in diameter. Medical or surgical treatment may be required for lesions causing functional impairment. In medical treatment, topical steroids, intralesional steroids and topical tacrolimus treatment are applied. Recurrence occurs in 60-75% following surgical excision. As the lesions regress spontaneously over several months to years, observation is recommended in cases without pain or dysfunction.