Trichofolliculoma
Steven D. Billings, MD
Key Facts
Clinical Issues
Usually presents on the face
Benign hamartomatous lesion
Face is most common location
Microscopic Pathology
Cystic tumor that communicates to overlying epidermis
Cystic space filled with keratinous debris and hair shafts
Numerous small, primitive follicles radiate around periphery of the tumor and communicate with central cystic space
May have small attached sebaceous glands
Follicles surrounded by perifollicular stromal sheath
Top Differential Diagnoses
Folliculosebaceous cystic hamartoma
Dilated pore of Winer
Trichoepithelioma
 Trichofolliculoma is an invaginated cystic tumor lined by keratinizing squamous epithelium that communicates with the overlying epidermis. The central cystic space is usually filled with keratinous debris. |
 Radiating around the central cystic space are numerous primitive follicles that connect with the central cystic space. The follicles often have secondary branching  . |
TERMINOLOGY
Definitions
Hamartoma with prominent follicular differentiation
ETIOLOGY/PATHOGENESIS
Unknown
Majority of cases are sporadic
Likely represents a hamartoma rather than a true tumor
CLINICAL ISSUES
Epidemiology
Incidence
Rare
Age
Usually presents in adults
Gender
Males and females equally affected
Presentation
Dome-shaped papule with central dilated pore
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