Sebaceous trichofolliculoma of the cheek in a 65-year-old man

Introduction

Sebaceous trichofolliculoma is a variant of trichofolliculoma (TF), which is considered as a hamartomatous lesion with follicular differentiation. In this report we describe a classic case of TF present as a cheek mass in a 65-year-old man.

Discussion

Trichofolloculoma usually arises in skin of the face, neck and scalp [1] but it can arise in other sites, such as the vulva [2] and penis [3]. Affection of cheek similar to that seen in our case was also reported [4]. The age of TF greatly varied from young age (7 years) [5] to very old one (86 years) [6].
The present case represents the classic histopathologic picture of TF that also showed dense inflammation. Inflammation may be absent in TF or present in variable degrees [7]. TF usually presents with a single nodule with or without pore formation, its size varies greatly from 0.3 cm up to 1.8 cm according to Wu, 2008 [7]. The case under discussion concern large nodule that reached 4 cm in maximal diameter. Folliculosebaceous cystic hamartoma is an intimately related lesion to TF that may reach giant forms up to 15 cm [8]. The two entities shared each other in histopathological changes of hair follicles but mesenchymal changes are more apparent in folliculosebaceous cystic hamartoma [9]. Schulz and Hartschuh [9] proposed that folliculosebaceous cystic hamartoma is a late-stage of TF and represents an abnormal variant along the normal hair follicle cycle of regression.

The authors declare no conflict of interest.

References

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6. Ryu HJ, Song HJ, Oh C. A case of sebaceous trichofolliculoma. Korean J Dermatol 2003; 41: 1662-1663.
7. Wu YH. Folliculosebaceous cystic hamartoma or trichofolliculoma? A spectrum of hamartomatous changes inducted by perifollicular stroma in the follicular epithelium. J Cutan Pathol 2008; 35: 843-848.
8. Cole P, Kaufman Y, Dishop M, Hatef DA, Hollier L. Giant, congenital folliculosebaceous cystic hamartoma: a case against a pathogenetic relationship with trichofolliculoma. Am J Dermatopathol 2008; 30: 500-503.
9. Schulz T, Hartschuh W. The trichofolliculoma undergoes changes corresponding to the regressing normal hair follicle in its cycle. J Cutan Pathol 1998; 25: 341-353.

Address for correspondence
Asmaa Gaber Abdou
Faculty of Medicine
Pathology Department
Maxeem street
002 Shebein Elkom, Egypt
e-mail: asmaa_elsaidy@yahoo.com