SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyReferences

View all Images (8)

Cutaneous neuroma in Adult
Other Resources UpToDate PubMed

Cutaneous neuroma in Adult

Contributors: Vivian Wong MD, PhD, Lowell A. Goldsmith MD, MPH
Other Resources UpToDate PubMed


Neuromas are single or multiple benign cutaneous tumors of neural tissue (Schwann cells and axons). There are two major types of cutaneous neuromas: 1) traumatic and 2) palisaded, encapsulated.

Traumatic neuroma (amputation neuroma, pseudoneuroma, scar neuroma) – Traumatic neuroma is a solitary papulonodular tumor at a previous site of trauma, surgery / amputation, or scar. It is thought to form as aberrant nerve regeneration following injury, with subsequent inflammation, fibrosis, scarred tissue formation, and disorganized proliferation of nerve fascicles. This entity has no specific predilection for sex, anatomic site, or age. Some rudimentary supernumerary digits are considered a congenital variant of traumatic neuroma due to in utero amputation of a supernumerary digit.

Palisaded encapsulated neuroma (PEN, solitary circumscribed neuroma) – Palisaded encapsulated neuroma is a solitary, spontaneous papulonodular growth secondary to the proliferation of nerve fibers encapsulated within the perineum (hence its encapsulation). There is no clear etiology. Often PEN favors the face, but it can also appear on the neck, genitalia, trunk, extremities, hands, and feet. It is most common in middle-aged adults. As opposed to traumatic neuroma, there is typically no inciting trauma.

Multiple nonencapsulated PENs are plexiform and intraneural variants of PENs. Multiple mucosal nonencapsulated PENs are pathognomonic findings in multiple endocrine neoplasia type 2B (MEN2B). Multiple nonencapsulated PENs are found on both the mucosal and cutaneous surfaces of the face and distal extremities in PTEN hamartoma tumor syndrome (including Cowden syndrome, Bannayan-Riley-Ruvalcaba syndrome, PTEN-related Proteus syndrome, and Proteus-like syndrome). Lesions typically appear at birth or during early childhood.


D21.9 – Benign neoplasm of connective and other soft tissue, unspecified

404018006 – Cutaneous neuroma

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

  • Neurilemmoma
  • Neurothekeoma
  • Fibrous histiocytoma
  • Scar
  • Dermatofibroma
  • Foreign body granuloma
  • Granular cell tumor
  • Cutaneous leiomyosarcoma
  • Cutaneous leiomyoma
  • Solitary neurofibroma
  • Nodular basal cell carcinoma
  • Microcystic adnexal carcinoma
  • Common acquired nevus
  • Acrochordon
  • Tuberous sclerosis (adenoma sebaceum)
  • Collagenoma
  • Connective tissue nevi
  • Polydactyly with genetic basis
  • Desmoplastic trichoepithelioma
  • Keratinocytic epidermal nevus
  • Kimura disease
  • Metastatic cutaneous carcinoma
  • Trichoepithelioma
  • Genital wart (if anogenital area)

Best Tests

Subscription Required

Management Pearls

Subscription Required


Subscription Required


Subscription Required

Last Updated:06/30/2020
Copyright © 2024 VisualDx®. All rights reserved.
Cutaneous neuroma in Adult
A medical illustration showing key findings of Cutaneous neuroma (Traumatic) : Erythema, Smooth nodule, Smooth papule, Surgical incision, Hyperesthesia, Neuralgia
Clinical image of Cutaneous neuroma - imageId=323600. Click to open in gallery.  caption: 'A close-up of a smooth skincolored papule with fine telangiectasias and a hyperpigmented portion.'
A close-up of a smooth skincolored papule with fine telangiectasias and a hyperpigmented portion.
Copyright © 2024 VisualDx®. All rights reserved.