A 16-year-old-female presented to the dermatology outpatient department seeking evaluation for skin lesions over her face and ears that had been present since childhood, causing cosmetic concerns for the patient. On examination, multiple well-defined skin-colored to slightly yellowish, dome-shaped, firm, papulonodular lesions ranging in size from 0.1 cm × 0.1 cm to 0.8 cm × 0.8 cm were evident on the face, tragus, antihelix, and conchae of the external ear, with clustering seen over the nasolabial folds and forehead Figure 1a. Notably, a history of similar lesions was also reported in the patient’s mother and elder sister, which had manifested during adolescence and progressed with age. Dermoscopy revealed the presence of arborizing vessels and milia-like cysts on a whitish background Figure 1b. Considering the family history and dermoscopic findings, the possibility of multiple familial trichoepitheliomas (MFTs) was considered, and a skin biopsy specimen was sent for histopathological examination. Histopathological analysis was consistent with a diagnosis of trichoepithelioma Figure 1c.Figure 1: (a) Multiple well-defined skin-colored to slightly yellowish, dome-shaped papulonodular lesions ranging in size from 0.1 cm × 0.1 cm to 0.8 cm × 0.8 cm were evident on the face with clustering seen over the nasolabial folds and forehead. (b) Arborizing vessels and milia-like cysts on a whitish background (Illuco, polarized mode, ×10). (c) Thinned-out epidermis and dermis showing islands of uniform basaloid cells along with small keratinous cysts lined by stratified squamous epithelium (hematoxylin and eosin, ×100)Trichoepithelioma is a rare benign adnexal tumor from hair follicles, presenting as solitary or multiple familial papules, primarily on the face. MFTs, often linked to CYLD gene mutations, closely resemble basal cell carcinoma.1-3 Histopathology and immunostains like Bcl-2, CD34, and CD10 aid differentiation. Treatment is difficult due to cosmetic concerns and scarring. Declaration of patient consent The authors certify that they have obtained all appropriate consent forms, duly signed by the parent(s)/guardian(s) of the patient. In the form, the parent(s)/guardian(s) has/have given his/her/their consent for the images and other clinical information of their child to be reported in the journal. The parents understand that the names and initials of their child/children will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
Aneja et al. (Thu,) studied this question.