Multiple inverted follicular keratoses as a presenting sign of Cowden's syndrome: Case report with human papillomavirus studies

Ruhoy, Steven M.; Thomas, Doug; Nuovo, Gerard J.

doi:10.1016/j.jaad.2003.12.049

Cited by 32 publications

(25 citation statements)

References 22 publications

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“…Recent studies have not detected human papillomavirus in most cases of IFK, questioning the previously reported relationship [1,2], and have provided new evidence supporting its follicular origin and distinguishing it from SK [2,11]. …”

Section: Discussionmentioning

confidence: 98%

“…Inverted follicular keratosis (IFK) is a rare benign tumor originating from the follicular infundibulum characterized by exoendophytic growth [1]. The most typical presentation is as a solitary nonpigmented verrucous papule on the face, often arising in middle-aged or elderly individuals and prevailing in males [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…The most typical presentation is as a solitary nonpigmented verrucous papule on the face, often arising in middle-aged or elderly individuals and prevailing in males [1,2]. Usually the clinical appearance is difficult to differentiate from other keratinizing proliferations such as seborrheic keratosis (SK) or viral wart (VW), and malignant tumors such as squamous cell carcinoma (SCC) and basal cell carcinoma (BCC).…”

Section: Introductionmentioning

confidence: 99%

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Inverted Follicular Keratosis: Dermoscopic and Reflectance Confocal Microscopic Features

Armengot‐Carbó

Abrego²,

González³

et al. 2013

Dermatology

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Inverted follicular keratosis (IFK) is a rare benign tumor which usually appears as a firm papule on the face. The diagnosis is generally made by histopathology because the clinical appearance is difficult to differentiate from other lesions. Dermoscopic features of IFK have not been established to date. Herein we describe the dermoscopic findings of 4 cases of IFK. Radial peripheral hairpin vessels surrounded by a whitish halo arranged around a central white-yellowish amorphous area were observed in 3 cases, and glomerular vessels were present in the central area of one of them. The fourth case also presented a central white amorphous area but showed arborizing vessels. Reflectance confocal microscopy (available in 1 case) revealed a broadened honeycomb pattern, epidermal projections and hairpin and glomerular vessels. To our knowledge this is the first case series describing the dermoscopic features of inverted follicular keratosis and the first confocal microscopy description of this entity.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Inverted Follicular Keratosis: Dermoscopic and Reflectance Confocal Microscopic Features

Armengot‐Carbó

Abrego²,

González³

et al. 2013

Dermatology

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“…Keratinization occurs on the surface of the epidermis and may be sufficient to form a cutaneous horn. Solitary trichilemmomas may be excised for cure using 2-mm peripheral margins and excision deep to the deepest extent of the tumor [14,15].…”

Section: Discussionmentioning

confidence: 99%

Desmoplastic Trichilemmoma of the Facial Region Mimicking Invasive Carcinoma

Sharma¹,

Sirohi²,

Sengupta³

et al. 2010

J. Maxillofac. Oral Surg.

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Trichilemmoma is a hamartomatous proliferation arising from cells of hair follicle. Its desmoplastic variant simulates an invasive carcinoma. In this tumor, the cell of origin seems to be located in the superficial level of the hair follicle just below the basement membrane at the sebaceous gland level. We present a similar case which presented with an asymptomatic nodular lesion in the region above the upper lip on left side. Fine needle aspiration cytology raised the cytological possibility of a malignancy for which the lesion was excised. On histopathology the lesion was diagnosed as desmoplastic trichilemmoma. The case highlights the difficulty encountered in differentiating a benign adnexal tumor from malignant lesion based on cytology alone. Moreover, the extensive desmoplasia on histopathology raises the suspicion of invasive malignancy which requires to be carefully excluded. The superficial features of trichilemmoma and lack of cellular atypia is a useful diagnostic clue in such a situation. Positivity of CD34 can also be used to differentiate from basal cell carcinomas. The case reported here had a solitary lesion, but follow up is required for development of more lesions or multiple hamartomas in other organs as a part of Cowden's disease.

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“…26 Multiple IFKs can be considered to be a cutaneous marker for Cowden's syndrome. 27 IFK may also mimic malignant lesions, particularly squamous cell carcinoma. 25 Large cell acanthoma (LCA) usually presents as a solitary, scaly, tan papule or plaque on sun-damaged skin.…”

Section: Clinical Diagnosesmentioning

confidence: 99%

Are All Seborrheic Keratoses Benign? Review of the Typical Lesion and Its Variants

Noiles

Vender

2008

J Cutan Med Surg

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Multiple inverted follicular keratoses as a presenting sign of Cowden's syndrome: Case report with human papillomavirus studies

Cited by 32 publications

References 22 publications

Inverted Follicular Keratosis: Dermoscopic and Reflectance Confocal Microscopic Features

Inverted Follicular Keratosis: Dermoscopic and Reflectance Confocal Microscopic Features

Desmoplastic Trichilemmoma of the Facial Region Mimicking Invasive Carcinoma

Are All Seborrheic Keratoses Benign? Review of the Typical Lesion and Its Variants

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