Basaloid Follicular Hamartoma Treatment & Management

Updated: Dec 15, 2017
  • Author: Kara Melissa T Torres, MD, DPDS; Chief Editor: Dirk M Elston, MD  more...
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Treatment

Medical Care

Systemic isotretinoin has been reported to decrease the size of lesions and improve associated alopecia in a patient with multiple basaloid follicular hamartoma (BFH) and systemic lupus erythematosus (SLE). [21] Topical tazarotene 0.1% gel maintained hair regrowth after discontinuation of isotretinoin therapy. However, the potential for adverse effects with long-term usage, lack of information on long-term benefits, and paucity of reported cases treated with isotretinoin warrant caution. If associated with an autoimmune disease, treatment of the primary disease may result in clinical improvement of the cutaneous lesions.

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Surgical Care

Basaloid follicular hamartomas (BFHs) are typically indolent and innocuous lesions. They may be excised for cosmetic reasons. Nonetheless, basaloid follicular hamartoma lesions should be excised if suspicious changes develop. [17, 35, 33]

Effective treatment of widespread, numerous basaloid follicular hamartoma was achieved in a nevoid basal cell carcinoma syndrome (NBCCS) patient using photodynamic therapy with topical 5-aminolevulinic acid, either in a filtered tungsten-halogen lamp (590-700 nm) or argon dye–pumped laser. [52] This form of therapy is considered the treatment of choice in children.

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Consultations

A rheumatologist should be consulted for patients with multiple basaloid follicular hamartomas (BFHs) who manifest features of systemic lupus erythematosus (SLE). Similarly, a neurologist should be consulted for patients with multiple basaloid follicular hamartomas suspected of having myasthenia gravis.

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Long-Term Monitoring

Follow-up visits for monitoring basaloid follicular hamartoma (BFH) lesions may be considered given rare reports of the development of basal cell carcinoma (BCC). [42] Biopsy should be performed on lesions if they change size or appearance.

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