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 © 2001-2009, DermAtlas | Image Name: | trichoblastoma_2_090401 | File Type: | jpg | |
| Diagnosis: | TRICHOBLASTOMA / NEVUS SEBACEUS | Category: | neoplasm, adnexal, follicular / neoplasm, benign | ||
| Body Site: | scalp | Age: | 54 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | At higher power, these basaloid collections form primitive structures, with finger- or floret-like projections into the hypercellular stroma. There are scattered suggestions of papillary mesenchymal bodies, where the stroma sweeps into the basaoild structures. There is no signficant peritumoral clefting, atypia or mitotic activity. The cells are monomorphous and bland. | ||||
| Comments: | This 54 year old woman presented with a solitary plaque on her scalp. Clinically, there was a nevus sebaceus (not seen on the biopsy) with a prominent papule, which was biopsied. Trichoblastomas and other basaloid proliferations are commonly observed in association with nevus sebaceus. Some authors consider trichoblastomas to have low-grade malignant potential like a basal cell carcinoma, but the majority, if not all, are benign with a more hamartomatous quality. This is a typical example of a trichoblastoma, mimicking a BCC at low power. Trichoblastomas tend to have organoid or primitive follicular differentiation with a hypercellular and condensed stroma, and lack of peritumor clefting or significant atypia. Pigmentation is common, as in this case. | ||||
| Related Images: | trichoblastoma_1_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | trichilemmoma_1_090401 | File Type: | jpg | |
| Diagnosis: | TRICHILEMMOMA | Category: | neoplasm, adnexal, follicular / neoplasm, benign | ||
| Body Site: | lip | Age: | 79 years | ||
| Contributors: | Greg Hosler, MD, PhD Patrick Keehan, D.O. | ||||
| Description: | There is a single disrete warty papule on the lip. It is flesh colored. | ||||
| Comments: | This 79 year old man developed a single warty papule on his upper cutaneous lip. This is a typical clinical and histologic appearance of a trichilemmoma. One can see how it can be mistaken for a verruca, but to date, no virus has definitively been associated with a trichilemmoma. This is thought to be derived from the outer root sheath of the follicle, highlighted by the clear cell morphology of the lesion. Multiple trichilemmomas have an association with Cowden disease. | ||||
| Related Images: | All related Images trichilemmoma_3_090401 trichilemmoma_2_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | trichilemmoma_2_090401 | File Type: | jpg | |
| Diagnosis: | TRICHILEMMOMA | Category: | neoplasm, adnexal, follicular / neoplasm, benign | ||
| Body Site: | lip | Age: | 79 years | ||
| Contributors: | Greg Hosler, MD, PhD Patrick Keehan, D.O. | ||||
| Description: | The epidermis is acanthotic and papillomatous. There is coarsening of the granular layer, accentuated in the divots of the papillations. There is an epithelial lesion with a smooth base and clear cell morphology. | ||||
| Comments: | This 79 year old man developed a single warty papule on his upper cutaneous lip. This is a typical clinical and histologic appearance of a trichilemmoma. One can see how it can be mistaken for a verruca, but to date, no virus has definitively been associated with a trichilemmoma. This is thought to be derived from the outer root sheath of the follicle, highlighted by the clear cell morphology of the lesion. Multiple trichilemmomas have an association with Cowden disease. | ||||
| Related Images: | All related Images trichilemmoma_3_090401 trichilemmoma_1_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | trichilemmoma_3_090401 | File Type: | jpg | |
| Diagnosis: | TRICHILEMMOMA | Category: | neoplasm, adnexal, follicular / neoplasm, benign | ||
| Body Site: | lip | Age: | 79 years | ||
| Contributors: | Greg Hosler, MD, PhD Patrick Keehan, D.O. | ||||
| Description: | At higher power, there is peripheral palisading of a basaloid layer. The adjacent epithelium has clear cell change. The cells are monomorphic, without atypia or mitotic activity. | ||||
| Comments: | This 79 year old man developed a single warty papule on his upper cutaneous lip. This is a typical clinical and histologic appearance of a trichilemmoma. One can see how it can be mistaken for a verruca, but to date, no virus has definitively been associated with a trichilemmoma. This is thought to be derived from the outer root sheath of the follicle, highlighted by the clear cell morphology of the lesion. Multiple trichilemmomas have an association with Cowden disease. | ||||
| Related Images: | All related Images trichilemmoma_2_090401 trichilemmoma_1_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | trichoblastoma_1_090401 | File Type: | jpg | |
| Diagnosis: | TRICHOBLASTOMA / NEVUS SEBACEUS | Category: | neoplasm, adnexal, follicular / neoplasm, benign | ||
| Body Site: | scalp | Age: | 54 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | There is a well-demarcated but noncircumscribed basophilic nodule in the superficial dermis. The basaloid cells form nests, some with structure, and are embedded within a condensed and hypercellular stroma. Pigment is present within the structures and the stroma. | ||||
| Comments: | This 54 year old woman presented with a solitary plaque on her scalp. Clinically, there was a nevus sebaceus (not seen on the biopsy) with a prominent papule, which was biopsied. Trichoblastomas and other basaloid proliferations are commonly observed in association with nevus sebaceus. Some authors consider trichoblastomas to have low-grade malignant potential like a basal cell carcinoma, but the majority, if not all, are benign with a more hamartomatous quality. This is a typical example of a trichoblastoma, mimicking a BCC at low power. Trichoblastomas tend to have organoid or primitive follicular differentiation with a hypercellular and condensed stroma, and lack of peritumor clefting or significant atypia. Pigmentation is common, as in this case. | ||||
| Related Images: | trichoblastoma_2_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | Milia_1_090304 | File Type: | jpg | |
| Diagnosis: | MILIUM | Category: | neoplasm, adnexal, follicular | ||
| Body Site: | face / cheek | Age: | 35 years | ||
| Contributor: | Ravi Singh | ||||
| Description: | symmetric grouped well-demarcated uniform 2-3 mm white papules | ||||
| Comments: | This young woman complained of an increasing number of asymptomatic white bumps on her face for a year. | ||||
 © 2001-2009, DermAtlas | Image Name: | pilomatricoma_1_071016 | File Type: | jpg | |
| Diagnosis: | PILOMATRICOMA / PILOMATRIXOMA | Category: | adnexal disorder / neoplasm, adnexal, follicular | ||
| Body Site: | calf / leg | Age: | 3 years | ||
| Contributor: | Katherine Puttgen, MD | ||||
| Description: | firm subcutaneous nodule | ||||
| Comments: | This healthy toddler had a several month history of asymptomatic firm subcutaneous nodules on the calf and upper arm. Biopsy revealed pilomatricoma. | ||||
 © 2001-2009, DermAtlas | Image Name: | pilomatricoma_1_070828 | File Type: | jpg | |
| Diagnosis: | PILOMATRICOMA / PILOMATRIXOMA | Category: | neoplasm, adnexal, follicular / lumps & bumps (plaques, nodules, tumors) | ||
| Body Site: | cheek / face | Age: | 9 years | ||
| Contributor: | Katherine Puttgen, MD | ||||
| Description: | 8 mm yellow white firm nodule | ||||
| Comments: | This 9-year-old boy had a 4 month history of a firm asymptomatic nodule on the right cheek which clinically resembled a pimple initially. A biopsy revealed pilomatricoma. | ||||
| Related Images: | pilomatricoma_2_070828 | ||||
 © 2001-2009, DermAtlas | Image Name: | pilomatricoma_2_070828 | File Type: | jpg | |
| Diagnosis: | PILOMATRICOMA / PILOMATRIXOMA | Category: | neoplasm, adnexal, follicular / lumps & bumps (plaques, nodules, tumors) | ||
| Body Site: | cheek / face | Age: | 9 years | ||
| Contributor: | Katherine Puttgen, MD | ||||
| Description: | 8mm yellow white firm nodule | ||||
| Comments: | This 9-year-old boy had a 4 month history of a firm asymptomatic nodule on the right cheek which clinically resembled a pimple initially. A biopsy revealed pilomatricoma. | ||||
| Related Images: | pilomatricoma_1_070828 | ||||
 © 2001-2009, DermAtlas | Image Name: | neurofollicular_hamartoma_1_070501 | File Type: | jpg | |
| Diagnosis: | NEUROFOLLICULAR HAMARTOMA | Category: | neoplasm, adnexal, follicular / neoplasm, benign | ||
| Body Site: | chin | Age: | 78 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | There is a spindle cell lesion within the dermis, encasing follicular structures, including sebaceous lobules. The two appear intimately related. The spindle cell component blends imperceptibly into the surrounding dermis. | ||||
| Comments: | This unusual lesion was submitted from the chin as a possible nevus. Neurofollicular hamartomas and pilar neurocristic hamartomas (pigmented variant) are rare entities, classified as benign follicular lesions with prominent mesenchymal components. The neurofollicular hamaratoma appears as a neuofibroma, but is intimately associated with a pilar unit, as in this case. Whether these are true hamartomas or neoplasms is controversial. | ||||
| Related Images: | neurofollicular_hamartoma_2_070501 | ||||
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