Trichoadenoma pathology

Author: Assoc Prof Patrick Emanuel, Dermatopathologist, Auckland, New Zealand, 2014.

Trichoadenomas (of Nikolowski) are benign follicular tumours that usually present as slow growing dermal masses. A rare verrucous variant has been described which resembles a benign keratosis clinically.

Histology of trichoadenoma

In trichoadenoma, there is a well defined dermal mass which contains numerous cysts and epithelial strands/islands(figures 1–3). Some of the cysts may rupture and there may be inflammatory changes and calcification. The cysts are lined by a benign infundibulum-like squamous epithelium as seen in an epidermoid cyst (figure 3).

Special studies for trichoadenoma

None are generally needed.

Differential diagnosis of trichoadenoma

This tumour is highly distinctive. A similar cystic component may be seen within other tumours such as trichoepithelioma and basal cell carcinoma, but the degree of cystification is generally much more extensive in trichoadenoma.

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