PMC3358935_01
(a) Multiple skin-colored papulonodular lesions affecting forehead, upper lip, nasolabial folds (arrow). (b) Single, smooth surfaced, skin colored dome shaped nodule over scalp (arrow). (c) Similar lesions in elder sister (arrow). (d) Similar lesions in her son (arrow)
IJT-4-29-g001.jpg
PMC3358935_01_IJT-4-29-g001.jpg
F1
A 35-year-old female presented with multiple asymptomatic nodules which started over face and gradually increased in size and number since age of 5 years [Figure 1a]. Few nodules appeared over scalp 5 years back and gradually increased in size [Figure 1b]. Her son, younger and elder sister, father, father's sister, and grandmother had history of similar lesions [Figure 1c & d and 2]. On examination, multiple, asymptomatic, skin-colored, firm, papulonodular lesions measuring from 2 to 8 mm with smooth surface were present on central part of face [Figure 1a]. Scalp showed pinkish, firm, dome-shaped nodules with smooth surface measuring about 1 to 3 cm [Figure 1b].
(a) Basaloid inclusions with immature hair follicles and abundant stroma which is consistent with trichoepithelioma (hematoxylin and eosin, original magnification x100). (b) Wellcircumscribed epithelial neoplasm in mid to deep dermis with basaloid inclusions, giving a jigsaw puzzle appearance which is diagnostic of cylindromas (hematoxylin and eosin, original magnification x100)
IJT-4-29-g003.jpg
PMC3358935_01_IJT-4-29-g003.jpg
F3
Histopathological examination of punch biopsy sample from lesion over face showed basaloid inclusions with multiple immature hair follicles and abundant stroma, thus confirming the diagnosis of trichoepithelioma [Figure 3a]. These findings were consistent with the diagnosis of cylindroma [Figure 3b].