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Skin - Nonmelanocytic tumors

Adnexal tumors-hair follicles

Trichoepithelioma

Reviewer: Christopher Hale, M.D. (see Reviewers page)
Revised: 5 July 2012, last major update June 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

General
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● Hair follicle tumor
● Often in children, may be familial
● Autosomal dominant related tumors are multiple, semitransparent, dome-shaped papules on face, scalp, neck, upper trunk

Case reports
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● 29 year old Puerto Rican man (Dermatol Online J 2008;14:5)

Clinical images
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Multiple confluent pink and gray 1-4 cm nodules and tumors

Gross description
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● Often multiple, may be huge, no ulceration

Micro description
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● Basaloid cells (like cylindroma) that form primitive hair follicle-germ structures with fibromyxoid stroma
● Cells are often in fronds, may have 2 or more layers of basaloid cells, may have papillary mesenchymal bodies

Micro images
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Contributed by Angel Fernandez-Flores, MD, PhD, Hospital El Bierzo and Clinica Ponferrada, Spain


Various images

Differential diagnosis
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● Basal cell carcinoma

Desmoplastic trichoepithelioma

General
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● Benign, resembles basal cell carcinoma-morphea type
● Usually solitary tumor

Micro description
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● Extensive fibrous stroma surrounds epithelial islands

Micro images
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Desmoplastic trichoepithelioma

Negative stains
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● Stromalysin-3 (positive in most basal cell carcinomas)

Differential diagnosis
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● Syringoma
● Basal cell carcinoma (morphea type)

End of Skin - Nonmelanocytic tumors > Adnexal tumors-hair follicles > Trichoepithelioma

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