What is Trichoepithelioma?
In the medical literature, trichoepithelioma is presented as a benign form of cancer and it is often considered to be the superficial form of trichoblastoma, a benign skin condition in which the follicular germinative cells are involved. Trichoepithelioma is a skin condition in which the benign tumors appear at the site of the hair follicle. These lesions can be individual or multiple, appearing on the face, after puberty. This condition can be inherited and it is more common in women.
The lesions might be confused with the lesions caused by carcinoma and this is why dermoscopy is often used for the confirmation of the diagnosis. Often times, however, the confirmation of the diagnosis comes after an excision biopsy has been performed and the tissue has been sent to the pathology lab. Skin biopsy is helpful not only when it comes to confirming the diagnosis of trichoepithelioma but also to determine which type of this condition the patient actually has.
Types of Trichoepithelioma
There are three main types of trichoepithelioma:
- Multiple familial trichoepithelioma (Brooke Spiegler syndrome) – this type is inherited and it is characterized by the appearance of nodules on the face. These nodules are numerous and they have a cyst-like aspect.
- Solitary trichoepithelioma – this type is characterized by the presence of papules or nodules on the face. The lesions have a firm texture.
- Desmoplastic trichoepithelioma – this type is characterized by the presence of a single lesion on the face. The lesion is unique and it also has a firm texture. Keep in mind that this is a benign tumor as well.
These are the most common symptoms of trichoepithelioma:
- The tumor cells form hair follicles without any hair shafts.
- The lesions can be single or multiple, always affecting the skin on the face.
- Lesions grow slowly and they can take different forms, including papules and cystic nodules.
- In case of desmoplastic trichoepithelioma, the lesion is solitary as it was already mentioned and it has the shape of a ring.
- The lesions appear after puberty and their number increases with the passing of time.
- Their size is small, under one centimeter.
- They can have a firm texture, a round shape and a shiny aspect.
- The most encountered colors for these lesions are yellow, pink, brown and blue.
- The areas on the face in which these lesions appear are the cheeks but they can also appear around the nose and on the eyelids.
- Although these tumors are often presented as benign, there were cases when the lesions transformed into malignant forms of cancer.
These are the most common courses of treatment undertaken for trichoepithelioma:
- Surgical removal – in some cases, a biopsy can also be performed, in case there is a suspicion of malignancy.
- Electrodesiccation – the tumor cells are scraped down to the dermis using an electrosurgical device.
- Curettage – the doctor will use a special instrument, known as a curette in order to remove the lesion.
- A good but partial response has been identified in patients who were treated with imiquimod cream (this is an immunosuppressant treatment).
- Carbon dioxide laser – follows the principles of mechanical abrasion as well.
- Dermabrasion – when performed, this procedure will deliver cosmetic advantages but, in time, the lesions will re-appear in the same areas.
- Micrographic surgery – this type of treatment is especially recommended in the case of desmoplastic trichoepithelioma, as it ensures clear margins and successful treatment results.
- In rare cases, cryotherapy and radiotherapy are used for the treatment of this skin condition.
Collection of pictures of Trichoepithelioma….