Acral Fibrokeratoma of the Foot Treated with Excision and Trap Door Flap Closure: A Case Report

Acral fibrokeratoma is a relatively rare, benign lesion that is typically found on the fingers and toes but can also be found on the palms and soles. Several case reports have been published of this rare lesion, with only a few investigators describing lesions of the feet. The techniques of using skin from a portion of the mass to close the defect left from mass excision have been poorly reported. Our technique, which we have termed the “trap door flap,” has design similarities to the appearance and mechanics of a trap door. We present the case of a patient with a 7-year history of a slow-growing, soft tissue mass on the plantar and medial aspect of his left hallux. The mass was subsequently excised and closed with a local flap. The flap had healed uneventfully by 2 weeks postoperatively, and the patient denied any evidence of recurrence or pain at 12 months of follow-up.