A Case of Desmoplastic Trichilemmoma of the Lip Treated with Mohs Surgery

Desmoplastic tricholemmoma of the eyelid misdiagnosed as sebaceous carcinoma: a potential diagnostic pitfall

“…Although both entities have been shown to be amenable to Mohs micrographic surgery, 17,18 mistaking DTL for SC is an important diagnostic pitfall because it may result in unnecessary and disfiguring surgical treatment and consequent medical‐legal liability. Therefore, the findings in this case report underscore the importance of considering DTL in the differential diagnosis of clear‐cell neoplasms of the eyelid.…”

Desmoplastic Trichilemmoma—A Report of Successful Treatment with Mohs Micrographic Surgery and a Review and Update of the Literature

“…Age at presentation has ranged from 8 to 89 years old (average 59.5, median 63.5). DT have been reported in many races, including Caucasian, black, Hispanic, Japanese, and Korean…”

“…A comprehensive literature review was conducted by searching the PubMed database using the keyword “desmoplastic trichilemmoma.” References to additional publications not indexed in PubMed were also followed to obtain a complete record of published data. We identified 19 publications worldwide reporting a total of 81 distinct individual cases of DT …”

“…Mohs micrographic surgery (MMS) has been shown to be the most effective therapy for a number of rare cutaneous tumors. In 2004, Schweiger and colleagues first reported on the successful management of DT using MMS, without evidence of recurrence at 5‐month follow‐up . Given that more than 7% of reported DT are associated with atypical basaloid proliferations, including BCC, MMS may represent an ideal treatment modality for this rare condition, given its superior margin control.…”

Three patients with desmoplastic tricholemmoma with an incidental histological surprise impacting on management: Figure 1

“…Therefore, the traditional management of DT had been non-specific, ranging from curettage, shave excision, topical 5-fluorouracil to complete surgical excision 8 9. In the recent literature, a histological diagnosis of DT had been emphasised to prevent patients from undergoing aggressive surgical treatment 6…”