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2015 ; 90
(6
): 780-96; quiz 797-8
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Benign follicular tumors
#MMPMID26734858
Tellechea O
; Cardoso JC
; Reis JP
; Ramos L
; Gameiro AR
; Coutinho I
; Baptista AP
An Bras Dermatol
2015[Nov]; 90
(6
): 780-96; quiz 797-8
PMID26734858
show ga
Benign follicular tumors comprise a large and heterogeneous group of neoplasms
that share a common histogenesis and display morphological features resembling
one or several portions of the normal hair follicle, or recapitulate part of its
embryological development. Most cases present it as clinically nondescript single
lesions and essentially of dermatological relevance. Occasionally, however, these
lesions be multiple and represent a cutaneous marker of complex syndromes
associated with an increased risk of visceral neoplasms. In this article, the
authors present the microscopic structure of the normal hair follicle as a basis
to understand the type and level of differentiation of the various follicular
tumors. The main clinicopathological features and differential diagnosis of
benign follicular tumors are then discussed, including dilated pore of Winer,
pilar sheath acanthoma, trichoadenoma, trichilemmoma, infundibuloma,
proliferating trichilemmal cyst/tumor, trichoblastoma and its variants,
pilomatricoma, trichodiscoma/fibrofolliculoma, neurofollicular hamartoma and
trichofolliculoma. In addition, the main syndromes presenting with multiple
follicular tumors are also discussed, namely Cowden, Birt-Hogg-Dubé, Rombo and
Bazex-Dupré-Christol syndromes, as well as multiple tumors of follicular
infundibulum (infundibulomatosis) and multiple trichoepitheliomas. Although the
diagnosis of follicular tumors relies on histological examination, we highlight
the importance of their knowledge for the clinician, especially when in presence
of patients with multiple lesions that may be the cutaneous marker of a
cancer-prone syndrome. The dermatologist is therefore in a privileged position to
recognize these lesions, which is extremely important to provide further
propedeutic, appropriate referral and genetic counseling for these patients.
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