A 32-year-old man presented with an asymptomatic, solitary, keratotic papule surrounded by an elevated skin collar on the dorsal surface of the proximal interphalangeal joint of the middle finger of more than one year. duration. AcraI fibrokeratoma, often called acquired digital fibrokeratoma, is characterized by a pinkish, hyperkeratotic, horn-like projection occurring on a finger, toe, or palm. The projection usually emerges from a collarette of elevated skin. The average age of the patient is 40. The lesion resembles a rudimentary supernumerary digit, cutaneous horn, or a neuroma. Simple surgical excision or laser ablation at the level of the skin surface is effective.