Trichofolliculoma 

  • Author: Michael S Howard, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Jan 13, 2012
 

Background

Trichofolliculoma represents an uncommon hamartoma of hair follicle tissue, typically occurring on the face of adults.

Clinical appearance of trichofolliculoma. Clinical appearance of trichofolliculoma.

The prognosis is excellent, and therapy is usually directed toward cosmetic improvement.

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Pathophysiology

Although the precise etiology of trichofolliculoma is uncertain, these tumors are not associated with systemic disease or other skin disorders. Trichofolliculomas are believed to represent abortive differentiation of pluripotent skin cells toward hair follicles.

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Epidemiology

Frequency

International

Trichofolliculoma represents an uncommon clinical entity.

Mortality/Morbidity

Trichofolliculomas are associated with minimal clinical morbidity; no confirmed cases of malignant transformation or clinical mortality are reported in the literature.

Race

In reported cases, trichofolliculomas demonstrate no definitive racial predilection.

Sex

No definitive sexual predilection is observed in reported cases, although sporadic reports indicate a probable male preponderance.

Age

From published reports, trichofolliculoma appears to primarily be a tumor of adults; however, at least 1 case of congenital trichofolliculoma has been reported.[1]

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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, and Arkansas Medical Society

Disclosure: Nothing to disclose.

Specialty Editor Board

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, and United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.

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, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD  Herman Beerman Associate 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 and American Society of Dermatopathology

Disclosure: Lippincott Williams Wilkins Royalty Textbook editor; DLA Piper Consulting fee Consulting

Joel M Gelfand, MD, MSCE  Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania

Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology

Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds Investigator; Genentech Grant/research funds investigator; Centocor Consulting fee Consulting; Abbott Grant/research funds investigator; Abbott Consulting fee Consulting; Novartis investigator; Pfizer Grant/research funds investigator; Celgene Consulting fee DMC Chair; NIAMS and NHLBI Grant/research funds investigator

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

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

Disclosure: Nothing to disclose.

References

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

  2. 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. Oct 2008;30(5):500-3. [Medline].

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

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

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

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

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

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

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

  10. Headington JT. Tumors of hair follicle differentiation. In: Farmer E, Hood A, eds. Pathology of the Skin. New York, NY: McGraw-Hill; 1990:596-614.

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

  12. McKee P. Farmer E, Hood A, eds. Pathology of the Skin. 2nd ed. New York, NY: McGraw-Hill; 1996:15.25-15.28.

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

  14. Wick MR, Swanson PE, Barnhill RL. Sebaceous and pilar tumors. In: Barnhill R, ed. Textbook of Dermatopathology. New York, NY: McGraw-Hill; 1998:593-621.

 
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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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