patients with clinically confirmed CS. We did not explore such possible genetic alterations in our study because a different technical approach would be needed.In summary, our study showed that loss of PTEN protein expression is frequently detected in CS-associated trichilemmomas, suggesting that IHC on these benign cutaneous neoplasms may be a useful screening test. These preliminary data also indicate that there is no significant correlation between the loss of PTEN expression as detected by IHC and gene deletion by FISH. Thus, another mechanism must account for PTEN gene inactivation. Further studies of larger sample sizes are needed to define more clearly the prevalence and significance of PTEN status in trichilemmomas.