Abstract: Wei Yun, Feng Yumiao, Sun Lan Department of Dermatology, the East District of Suzhou Municipal Hospital, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou 215001, China Corresponding author: Sun Lan, Email: slszsy@126.com 【Abstract】 Objective To investigate clinical and pathological characteristics of acquired digital fibrokeratoma （ADF）. Methods Clinical data were collected from 12 patients with ADF, and their clinical manifestations, histopathological features, treatment and prognosis were analyzed retrospectively. Results The mean age at onset of ADF was 39.75 ± 17.69 years （range, 17 - 64.5 years）, and the average disease duration was 4.83 ± 5.77 years （range, 0.5 - 20 years）. The ratio of male to female was 1.4∶1. Most skin lesions were polymorphic, and mainly involved fingers, toes and nail grooves. Sometimes non-extremity sites are also involved. Histopathological examination of skin lesions showed epidermal hyperkeratosis, acanthosis and broadened dendroid rete ridges. The dermis consisted of mature collagen bundles, fibroblasts and a large number of dilated capillaries. The characteristic manifestation was that most collagen bundles were vertical to the epidermis. Conclusions ADF, a rare benign fibrous tumor with unknown etiology, usually occurs in adults as a solitary lesion on fingers or toes, sometimes in non-extremity sites. Surgery and laser therapy are common treatments for ADF with low recurrence rate.