Folliculoma

Updated: Mar 09, 2017
  • Author: Kristen D Fajgenbaum; Chief Editor: Dirk M Elston, MD  more...
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Overview

Background

Folliculoma, also known as trichofolliculoma, is a type of benign cutaneous adnexal tumor. Cutaneous adnexal tumors are neoplasms that are classified based on their morphologic differentiation towards at least one type of normal skin structure: hair follicles, apocrine glands, eccrine glands, or sebaceous glands. [1, 2]

A folliculoma is a rare, asymptomatic tumor of the hair follicle. This is a hamartoma of the hair follicle, a malformation of cells and tissues that resembles a normal hair follicle. Clinically, it appears as a small, solitary, skin-colored papule or nodule on the face or scalp. A tuft of vellus hair often protrudes from a central punctum. Folliculomas usually present in middle-aged adults, but they have been found at birth and can develop throughout life.

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Pathophysiology

Trichofolliculomas represent a hamartomatous, adnexal tumor originating from the hair follicle. The tumor is a benign malformation of hair follicle cells and structures. All stages of follicular development can be observed in the lesion.

A variant of the trichofolliculoma is the sebaceous trichofolliculoma. Schulz and Hartschuh suggest folliculosebaceous cystic hamartoma is a folliculoma at its very late stage. [3] Cole et al suggest no pathogenetic relationship exists with giant, congenital folliculosebaceous cystic hamartomas. [4]

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Epidemiology

Frequency

United States

Folliculomas are uncommon. Given their benign nature, no large screening has been performed in the general population. As a result, an exact incidence has not been determined.

International

The condition has been reported worldwide. It is a rare entity among all nationalities.

Race

A study performed with military personnel demonstrated that folliculomas are more common in whites than in any other race.

Sex

Folliculomas occur predominantly in males.

Age

The mean age of manifestation is 45 years, but lesions can be congenital or occur much later in life. [5]

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Prognosis

The prognosis is excellent. Folliculomas are benign, asymptomatic lesions with no malignant potential. 

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Patient Education

Patients should be informed of the benign nature of these lesions and that they require no follow-up care.

Clinically, trichofolliculomas may be confused with a more serious entity, such as basal cell carcinoma. Thus, the lesion may need to be excised to confirm the diagnosis. If excision is performed for diagnostic or cosmetic purposes, recurrence can occur if the lesion is not completely removed. [6]

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