bcl-2 expression reliably distinguishes trichoepitheliomas
from basal cell carcinomas.
Histopathology confirmed the diagnosis of trichoepitheliomas
are characterised by cords and islands of basaloid tumour cells within dermis, peripheral palisading of tumour cells, horn cysts and papillary mesenchymal bodies (Fig.
Larger syringomas, trichoepitheliomas
, and hyperplastic sebaceous glands should be "drilled out" with erbium ablation.
This condition typically presents as deforming epidermoid cysts, though it may also include fibromas, lipomas, leiomyomas, trichoepitheliomas
, and neurofibromas.
Calcified cysts and occasionally trichoepitheliomas
have also been described.
Various immunohistochemical markers have been studied to help distinguish desmoplastic trichoepitheliomas
(DTE), infiltrating or morpheaform BCCs, and microcystic adnexal carcinomas, including CD23, CD5, CD10, CD34, CK20, CK15, stromelysin-3, BCL2, AR, pleckstrin homology-like domain, family A, member 1 protein (PHLDA1), p75 neurotrophin receptor (p75NTR), fibroblast activation protein (FAP), Ber-EP4, p63, and others (34-48) (Table 2).
Multiple cylindromas can be associated with Brooke-Spiegler syndrome which also includes trichoepitheliomas
Reports in the medical literature since 1990 indicate that these lesions can vary in their clinical presentation The diagnosis has been applied to flesh-colored and translucent dome-shaped papules on the face solitary flesh colored to dark-red papules in the head and neck area and trichoepitheliomas
on the face and trunk.
Cutaneous nodules are found in many other disorders, including Gardner syndrome, Cowden syndrome, multiple trichoepitheliomas
, (32) basal cell nevus syndrome, (33) multiple keratoacanthomas, (34) and tuberous sclerosis (35) (Table).
Coexistence of acral syringomas and multiple trichoepitheliomas
on the face.
Other adnexal lesions, such as basaloid follicular hamartomas and trichoepitheliomas
, are also common.