DESMOPLASTIC

 

TRICHOEPITHELIOMA

 

Epidemiology.

 

Desmoplastic trichoepithelioma (sclerosing epithelial hamartoma) is a relatively uncommon tumor. The tumor shows a predilection for young and middle-aged adults, more commonly in women.

 

Clinical Findings.

 

Desmoplastic trichoepithelioma presents as a small (up to 1 cm in diameter), asymptomatic, firm, oval, oblong, or annular papule or plaque on the face , particularly around the angle of the lip. Plaques often reveal a raised border and depressed center. Familial cases have been reported.

 

Histopathology.

 

Histopathologic examination reveals a relatively well-circumscribed lesion in the upper two-thirds of the dermis with a focal epidermal connection. It is composed of basaloid aggregations arranged predominantly in columns and cords and admixed with infundibulocystic structures, surrounded by a dense, hypocellular desmoplastic stroma. It may occasionally be difficult to distinguish this entity histologically from malignant desmoplastic lesions such as aggressive growth basal cell carcinoma or MAC.

Treatment.

Local surgical excision is the preferred treatment