Dermoscopic pattern in facial trichilemmomas: Red iris-like structure

Horcajada-Reales, Celia; Avilés-Izquierdo, J.A.; Ciudad-Blanco, C.; Conde-Montero, Elena; Parra‐Blanco, Verónica; Lázaro‐Ochaita, Pablo; Suárez‐Fernández, Ricardo

doi:10.1016/j.jaad.2014.04.064

Cited by 14 publications

(9 citation statements)

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“…In a few cases, the dermoscopic features of trichilemmomas have been reported. Based on dermoscopic images, trichilemmomas have been described as keratin masses with perivascular whitish halos, 27 hyperkeratotic central areas with peripheral erythematous radial lines in a red iris-like structure, 28 non-pigmented nodules with peripheral vessels arranged in a radial and centered manner, 29 and linear vessels arranged in a radial manner with surrounding reflective whitish areas, as well as central crusted and hyperkeratotic areas. 30 In contrast, DT has been described as focal crown vessels with unspecific poorly defined white areas and hyperkeratotic central depression.…”

Section: Authorsmentioning

confidence: 99%

Desmoplastic trichilemmoma of the scalp: case report and literature review of immunohistochemical staining features

2019

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Desmoplastic trichilemmoma (DT) of the scalp is a rare disease. In this report, we describe a 67-year-old man who had a small papule lesion around the hairline of the left scalp for more than 40 years. The lesion had rapidly grown to become a solitary, round, 15-mm neoplasm within 6 months. Histopathological examination showed that the mass was composed of a peripheral layer of columnar cells with nuclear palisading resembling the outer root sheath; the mass was surrounded by a thickened glassy basement membrane. The stroma in the center of the mass displayed solid, hyaline degeneration and an eosinophilic pattern, streaked with epithelial cords or islands. Immunohistochemical evaluation showed diastase-resistant, periodic acid–Schiff-positive desmoplastic stroma at the center, and Ber-EP4-negative tumor cells (CD34-positive focally and Bcl-2-positive at the periphery). The tumor was completely resected, and no recurrence occurred during the follow-up period. In this report, we also summarize immunohistochemical features from previous reports of DT, facilitating differential diagnosis of DT from some invasive skin tumors.

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Section: Authorsmentioning

confidence: 99%

Desmoplastic trichilemmoma of the scalp: case report and literature review of immunohistochemical staining features

2019

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“…2c), however, varied from a KA‐like to hyperkeratotic SCC‐like appearance (cutaneous horn). A specific pattern was also described for trichilemmoma, called iris‐like structure, consisting of a peripheral area with erythematous radial lines surrounded by white shiny areas 16 . Porocarcinoma was the only malignant adnexal tumour classified as wdSCC simulator together with its benign counterpart, poroma.…”

Section: Resultsmentioning

confidence: 98%

Dermoscopy of cutaneous adnexal tumours: a systematic review of the literature

Lai

Muscianese²,

Piana

et al. 2022

Acad Dermatol Venereol

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Cutaneous adnexal tumours (ATs) encompass a variegated group of hamartomas and benign or malignant tumours, originating from the hair follicle, sebaceous, eccrine or apocrine glands that may simulate other cutaneous neoplasms. This study aims to provide a comprehensive overview of the spectrum of clinical and dermoscopic features of ATs, to better define these lesions and assist in the differential diagnosis. We performed a two-step systematic search of the literature in PubMed, Embase and Cochrane Library databases from inception until 4 September 2020. In the first step, we aimed to define histological variants of ATs with descriptions of dermoscopic criteria. The second step included a search for the name of each previously identified AT variants in the same databases adding 'AND (epilum* or dermosc* or dermatosc*)'. All study types in English language reporting dermoscopic images of ATs were included. Collisions between ATs and other inflammatory or neoplastic skin lesions were excluded, with the exception of collisions with a sebaceous nevus. The protocol of this study was prospectively registered in PROSPERO (CRD42021244677). In total, 206 articles met our inclusion criteria, encompassing 372 ATs in 365 patients. Most ATs were apocrine-eccrine (n = 217, 58.3%, n = 173 benign) with a prevalence of poromas (n = 82), followed by follicular ATs (n = 88, 23.7%, n = 83 benign) and sebaceous ATs (n = 67, 18.0%, n = 49 benign). Most patients had a single AT lesion (320, 86.0%), while 42 (11.3%) had multiple ATs. A syndrome causing multiple ATs was identified in 15 patients. Histopathological analysis revealed 82% benign (n = 305) and 18.0% malignant (n = 67). ATs were classified according to their ability to mimic four groups of more common skin tumours: basal cell carcinoma, squamous cell carcinoma, melanocytic lesions and benign cutaneous lesions. Moreover, we have highlighted the ability of malignant variants of ATs to simulate benign skin lesions. This systematic review offers a comprehensive overview of the common clinical and dermoscopic features of follicular, sebaceous and apocrineeccrine ATs and details possible differential dermoscopic features.

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“…A few dermatoscopic findings of trichilemmoma and DT are described, including pink structureless areas, radial vessels, crown vessels, shiny white lines, red irislike structures with peripheral radiated red lines, and central hyperkeratotic areas [6][7][8]. Pigmented BCC is the primary differential diagnosis of a pigmented lesion arising in a long-standing NS.…”

Section: Discussionmentioning

confidence: 99%

Pigmented Desmoplastic Trichilemmoma Arising in Nevus Sebaceous: A Potential Mimicker of Pigmented Basal Cell Carcinoma

Alhameedy

Alrobaish

Almarshoud******

et al. 2023

Skin Appendage Disord

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Introduction: Trichilemmomas are a form of benign adnexal neoplasm with differentiation toward the follicular outer sheath. Nevus sebaceous (NS) of Jadassohn is a congenital malformation characterized as a nonhereditary hamartoma of the adnexal structures of the skin, mainly the pilosebaceous unit. NS represents a fertile field for the development of secondary adnexal neoplasms, commonly benign but occasionally malignant. To our knowledge, one case of a pigmented desmoplastic trichilemmoma (DT) has been reported in the English literature. Case Presentation: We report a case of a 36-year-old male with pigmented DT that developed on long-standing congenital NS, mimicking pigmented basal cell carcinoma (BCC), which was successfully excised with 4-mm margins. Conclusion: Pigmented DT may mimic pigmented BCC on clinical and dermatoscopic examination; therefore, histological evaluation is always recommended to confirm the diagnosis.

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Dermoscopic pattern in facial trichilemmomas: Red iris-like structure

Cited by 14 publications

References 1 publication

Desmoplastic trichilemmoma of the scalp: case report and literature review of immunohistochemical staining features

Desmoplastic trichilemmoma of the scalp: case report and literature review of immunohistochemical staining features

Dermoscopy of cutaneous adnexal tumours: a systematic review of the literature

Pigmented Desmoplastic Trichilemmoma Arising in Nevus Sebaceous: A Potential Mimicker of Pigmented Basal Cell Carcinoma

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