The natural history of trichilemmal cysts

Abstract

The histological features of 149 trichilemmal cysts removed from sixty-five patients are reviewed and related to the clinical findings. These cysts, which may be solitary or multiple, gradually increase in size and number, and may produce daughter cysts by budding. When a breach occurs in the wall, inflammatory cells pour in but do not replace the cyst wall. This event may be followed by healing from the margins of the breach, by marsupialization to the overlying epidermis and thus natural resolution, or by proliferation to produce a pseudo-epitheliomatous change which can be confused with a well differentiated squamous cell carcinoma.

Development of a Malignant Proliferating Trichilemmal Cyst in a Patient with Multiple Trichilemmal Cysts

“…Brownstein and Arluk [1] de scribed that trauma and inflammation may induce TC to develop into PTC. 2 of 3 pa tients with PTC reported by Leppard and Sanderson [4] had multiple TC. In the case of multiple TC reported by Segami et al [8], TC had a tendency to develop into PTC.…”

Three Cases of Type 2 Segmental Manifestation of Multiple Glomus Tumors: Association with Linear Multiple Trichilemmal Cysts in a Patient

“…The cyst wall is derived from an outer root sheath surrounding the lower portion of the hair follicle [8]. …”

Invasive Tricholemmal Carcinoma of the Nose

“…They are mainly distributed over the head, particularly on the scalp, but they are also found occasionally on the trunk, face and extremities [20]. They are multiple in 70% of the cases [21].…”

“…Although tricholemmal and other epithelial cysts are very common, the benign proliferating variants and their malignant degeneration are rare [7,14,15,19,21]. A case associating tricholemmal cysts, proliferating tricholemmal cysts and malignant tricholemmal cysts was reported suggesting a continuum between these three types of lesions [14].…”