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Trichofolliculoma Clinical Presentation

  • Author: Michael S Howard, MD; Chief Editor: Dirk M Elston, MD  more...
 
Updated: Nov 13, 2015
 

History

Patients typically present with a single, flesh-colored or whitish nodule or papule of varying duration, typically on the face (most frequently around the nose).

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Physical

Classic trichofolliculomas have a central pore or black dot, possibly draining a sebaceouslike material. A tuft of white hair may be present emerging from the central pore.

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Causes

Usually, these tumors develop spontaneously. Rarely, a prior history of trauma at the tumor site is obtained.

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Contributor Information and Disclosures
Author

Michael S Howard, MD Dermatopathologist and Laboratory Director, Georgia Dermatopathology Associates

Disclosure: Nothing to disclose.

Coauthor(s)

Bruce R Smoller, MD Executive Vice President, United States and Canadian Academy of Pathology

Bruce R Smoller, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, Arkansas Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD Herman Beerman Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System

Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, Pennsylvania Academy of Dermatology

Disclosure: Received royalty from Lippincott Williams Wilkins for textbook editor.

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.

Additional Contributors

James W Patterson, MD Professor of Pathology and Dermatology, Director of Dermatopathology, University of Virginia Medical Center

James W Patterson, MD is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, American Society of Dermatopathology, Royal Society of Medicine, Society for Investigative Dermatology, United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.

References
  1. Gokalp H, Gurer MA, Alan S. Trichofolliculoma: a rare variant of hair follicle hamartoma. Dermatol Online J. 2013 Aug 15. 19 (8):19264. [Medline].

  2. Abdou AG, Asaad NY. Sebaceous trichofolliculoma of the cheek in a 65-year-old man. Pol J Pathol. 2014 Oct. 65 (3):253-4. [Medline].

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

  4. 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].

  5. Wu YH. Folliculosebaceous cystic hamartoma or trichofolliculoma? A spectrum of hamartomatous changes inducted by perifollicular stroma in the follicular epithelium. J Cutan Pathol. 2008 Sep. 35(9):843-8. [Medline].

  6. Misago N, Kimura T, Toda S, Mori T, Narisawa Y. A revaluation of trichofolliculoma: the histopathological and immunohistochemical features. Am J Dermatopathol. 2010 Feb. 32(1):35-43. [Medline].

  7. 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].

  8. Plewig G. Sebaceous trichofolliculoma. J Cutan Pathol. 1980 Dec. 7(6):394-403. [Medline].

  9. Tanimura S, Arita K, Iwao F, et al. Two cases of folliculosebaceous cystic hamartoma. Clin Exp Dermatol. 2006 Jan. 31(1):68-70. [Medline].

  10. Stern JB, Stout DA. Trichofolliculoma showing perineural invasion. Trichofolliculocarcinoma?. Arch Dermatol. 1979 Aug. 115(8):1003-4. [Medline].

  11. Gray HR, Helwig EB. Trichofolliculoma. Arch Dermatol. 1962. 86:99-105.

  12. Kligman AM, Pinkus H. The histogenesis of nevoid tumors of the skin. The folliculoma--a hair-follicle tumor. Arch Dermatol. 1960 Jun. 81:922-30. [Medline].

  13. Pinkus H, Sutton RL Jr. Trichofolliculoma. Arch Dermatol. 1965 Jan. 91:46-9. [Medline].

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Low-power view of trichofolliculoma with a primary follicle opening onto the skin surface.
Edge of the primary follicle with associated secondary and tertiary budding follicular structures.
Higher magnification of budding follicular structures.
Low-power view of a section of trichofolliculoma demonstrating budding follicular structures and associated stroma.
Higher magnification of budding follicular structures and associated stroma.
Low-power view of sebaceous trichofolliculoma demonstrating dilated, primary follicle; budding follicular structures; and numerous associated sebaceous lobules.
Higher magnification of central primary follicle and associated sebaceous lobules.
Clinical appearance of trichofolliculoma.
 
 
 
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