Medscape is available in 5 Language Editions – Choose your Edition here.


Folliculoma Clinical Presentation

  • Author: Craig G Burkhart, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
Updated: Feb 09, 2016


Patients with this disorder note a small nodule on their face, or possibly scalp, ears, or neck. Although there is one report of multiple lesions, folliculomas normally present as solitary nodules. Lesions are asymptomatic and slow growing, with a diameter of 0.2-1 cm. Lesions have a central punctum through which the patient would note the presence of cottony hair extruding from the bump.



Folliculomas are solitary tumors, most commonly found on the face or occasionally the scalp. The lesion is a firm, slightly elevated, pearly tumor with a central crater or punctum containing keratinous material or a wisp of wool-like or cottony hairs, usually white, protruding from it. If hairs protrude from the crater, the diagnosis is strongly suspected, as clinically, this is a highly diagnostic feature.

Folliculomas have been identified in the vulva, albeit rarely.[5]

Also rarely, this condition has been associated with focal acantholytic dyskeratosis.[6]



Folliculomas are caused by a maldevelopment of the hair follicle unit.

Lesions are organoid, or hamartomatous, adnexal tumors of hair follicle origin.

They undergo anatomical changes corresponding to the regressing normal hair follicle in its various cycles.

Contributor Information and Disclosures

Craig G Burkhart, MD, MPH Clinical Professor, Department of Medicine, Medical College of Ohio; Clinical Assistant Professor, Department of Medicine, Ohio University College of Osteopathic Medicine

Craig G Burkhart, MD, MPH is a member of the following medical societies: Association of Military Dermatologists, American College of Aesthetic and Cosmetic Physicians; American Society of Aesthetic/Cosmetic Physicians, Michigan Dermatological Society, Academy of Medicine of Toledo and Lucas County, Ohio Dermatological Association, American Academy of Dermatology, Ohio State Medical Association, Phi Beta Kappa

Disclosure: Nothing to disclose.


Craig N Burkhart, MD MSBS, Assistant Professor, Department of Dermatology, University of North Carolina at Chapel Hill School of Medicine

Craig N Burkhart, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Jeffrey P Callen, MD Professor of Medicine (Dermatology), Chief, Division of Dermatology, University of Louisville School of Medicine

Jeffrey P Callen, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, American College of Rheumatology

Disclosure: Received income in an amount equal to or greater than $250 from: XOMA; Biogen/IDEC; Novartis; Janssen Biotech, Abbvie, CSL pharma<br/>Received honoraria from UpToDate for author/editor; Received honoraria from JAMA Dermatology for associate editor and intermittent author; Received royalty from Elsevier for book author/editor; Received dividends from trust accounts, but I do not control these accounts, and have directed our managers to divest pharmaceutical stocks as is fiscally prudent from Stock holdings in various trust accounts include some pharmaceutical companies and device makers for i inherited these trust accounts; for: Celgene; Pfizer; 3M; Johnson and Johnson; Merck; Abbott Laboratories; AbbVie; Procter and Gamble; Amgen.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

  1. Cole P, Kaufman Y, Dishop M, Hatef DA, Hollier L. Giant, congenital folliculosebaceous cystic hamartoma: a case against a pathogenetic relationship with trichofolliculoma. Am J Dermatopathol. 2008 Oct. 30(5):500-3. [Medline].

  2. Schulz T, Hartschuh W. Folliculo-sebaceous cystic hamartoma is a trichofolliculoma at its very late stage. J Cutan Pathol. 1998 Aug. 25(7):354-64. [Medline].

  3. Kurokawa I, Kusumoto K, Sensaki H, Shikata N, Tsubura A, Nishijima S. Trichofolliculoma: case report with immunohistochemical study of cytokeratins. Br J Dermatol. 2003 Mar. 148(3):597-8. [Medline].

  4. Ishii N, Kawaguchi H, Takahashi K, Nakajima H. A case of congenital trichofolliculoma. J Dermatol. 1992 Mar. 19(3):195-6. [Medline].

  5. Peterdy GA, Huettner PC, Rajaram V, Lind AC. Trichofolliculoma of the vulva associated with vulvar intraepithelial neoplasia: report of three cases and review of the literature. Int J Gynecol Pathol. 2002 Jul. 21(3):224-30. [Medline].

  6. Bogle MA, Cohen PR, Tschen JA. Trichofolliculoma with incidental focal acantholytic dyskeratosis. South Med J. 2004 Aug. 97(8):773-5. [Medline].

  7. Mizutani H, Senga K, Ueda M. Trichofolliculoma of the upper lip: report of a case. Int J Oral Maxillofac Surg. 1999 Apr. 28(2):135-6. [Medline].

  8. Hartschuh W, Schulz T. Immunohistochemical investigation of the different developmental stages of trichofolliculoma with special reference to the Merkel cell. Am J Dermatopathol. 1999 Feb. 21(1):8-15. [Medline].

  9. Manabe M, Yaguchi H, Iqbal Butt K, O'Guin WM, Loomis CA, Sung TT, et al. Trichohyalin expression in skin tumors: retrieval of trichohyalin antigenicity in tissues by microwave irradiation. Int J Dermatol. 1996 May. 35(5):325-9. [Medline].

  10. Zimmermann T, Hartschuh W, Raulin C. [Facial folliculo-sebaceous cystic hamartoma. Treatment with CO2 and Er:YAG lasers]. Hautarzt. 2004 Mar. 55(3):289-91. [Medline].

  11. Morton AD, Nelson CC, Headington JT, Elner VM. Recurrent trichofolliculoma of the upper eyelid margin. Ophthal Plast Reconstr Surg. 1997 Dec. 13(4):287-8. [Medline].

  12. Gray HR, Helwig EB. Trichofolliculoma. Arch Dermatol. 1962. 86:619-25.

  13. Miescher G. Trichofolliculoma. Dermatologica. 1944. 89:193-194.

All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.