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Tasar R, Peckruhn M, Tittelbach J. Giant Folliculosebaceous Cystic Hamartoma of the Face. Dermatopathology (Basel) 2023; 11:19-25. [PMID: 38247726 PMCID: PMC10801620 DOI: 10.3390/dermatopathology11010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/22/2023] [Accepted: 12/27/2023] [Indexed: 01/23/2024] Open
Abstract
Folliculosebaceous cystic hamartoma (FSCH) is a rare and benign form of cutaneous hamartomas. These skin lesions often lead to clinical and histopathological misdiagnosis due to their similarities to cutaneous lesions with overproduction of clustered sebaceous glands. Clinically, the lesions often present as solitary, skin-colored, pedunculated warts to cauliflower-like, exophytic papules and nodules, usually with a diameter ranging 0.5-1.5 cm that rarely exceed 2 cm in size. Only a small number of giant variants are reported in the literature with a diameter in the range of 5-23 cm. The vast majority of the lesions appear in the central face and show a striking predilection for the nose, ears, and scalp, but also emerge on the nipples, extremities, and genitals. Histologically, the epithelial components of folliculosebaceous cystic hamartoma comprise dilated infundibular cystic proliferation with surrounding mesenchymal components, which commonly include fibroplasia and vascular and adipose tissue proliferation. These histological characteristics were coined by Kimura and colleagues (1991). To the best of our knowledge, our case represents the biggest variant of giant folliculosebaceous cystic hamartoma.
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Affiliation(s)
- Ramona Tasar
- Department of Dermatology, Jena University Hospital, Friedrich Schiller University Jena, 07747 Jena, Germany
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Urso C, Yarygina M. Folliculosebaceous Cystic Hamartoma with Spindle Cell Lipomatous and Neural Components. Dermatopathology (Basel) 2023; 10:193-200. [PMID: 37489451 PMCID: PMC10366756 DOI: 10.3390/dermatopathology10030027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/06/2023] [Accepted: 06/21/2023] [Indexed: 07/26/2023] Open
Abstract
Folliculosebaceous cystic hamartoma is a cutaneous malformation composed of a cystic folliculosebaceous structure associated with mesenchymal elements, generally consisting of fibrous stroma, adipocytes and small vascular channels. We report the case of a 55-year-old female patient with a cutaneous nodule of the right nasal wing. Microscopically, the lesion showed a dilated hair follicle with multiple sebaceous glands, surrounded by a mesenchymal component composed of fibromyxoid stroma, spindle cells, mature-appearing adipocytes and collagen bundles, resembling spindle cell lipoma, associated with an additional neural component, consisting of small nerve bundles. In folliculosebaceous cystic hamartoma, the association of spindle cell lipomatous and neural components has not previously reported.
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Affiliation(s)
- Carmelo Urso
- Dermatopathology Study Center of Florence, I-50129 Florence, Italy
- Synlab Med, I-50041 Calenzano, Italy
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Alegría-Landa V, Jo-Velasco M, Prieto-Torres L, Requena L. Genital folliculo-sebaceous cystic hamartoma: A claim of the stroma as a clue in the diagnosis of proliferations with follicular differentiation. J Cutan Pathol 2017; 44:504-508. [PMID: 28211590 DOI: 10.1111/cup.12920] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 02/02/2017] [Accepted: 02/10/2017] [Indexed: 11/27/2022]
Abstract
Folliculo-sebaceous hamartomas comprise a series of entities whose boundaries are imprecise. We present the clinical case of a folliculo-sebaceous cystic hamartoma of genital localization where the diagnosis was established based on the epithelial proliferation, but mostly, on the characteristic stroma. Because this lesion lacked of the cystic component, we mention the most frequent differential diagnoses and review the literature of the few cases published on this infrequent localization.
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Affiliation(s)
| | - Margarita Jo-Velasco
- Department of Pathology, Fundación Jiménez Diaz, Universidad Autónoma, Madrid, Spain
| | | | - Luis Requena
- Department of Dermatology, Fundación Jiménez Diaz, Universidad Autónoma, Madrid, Spain
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Abstract
Folliculosebaceous cystic hamartoma is a distinctive cutaneous hamartoma composed of follicular, sebaceous, and mesenchymal components. The lesions are most commonly found on the face and scalp of young adults, with approximately 30% occurring in the nasal or paranasal regions of the face. The clinical differential diagnoses are extensive and include epidermoid cyst, dermal nevus, soft fibroma, and adnexal tumors including sebaceous neoplasms. Here, the authors present a case of a 24-year-old man who presented for evaluation of an asymptomatic growth on the nose, which had slowly enlarged over 9 years. On examination, there was a 0.6 cm dome-shaped flesh-colored papule on the nasal bridge. The clinical differential included dermatofibroma versus intradermal nevus. A shave biopsy was performed, and histological examination of the sections showed a proliferation of multiple enlarged and irregular-appearing sebaceous glands attached to a cystic follicular structure. The associated dermal mesenchymal component consisted of numerous mature-appearing adipocytes associated with a fibromyxoid stroma, prominent collections of mucin, and bundles of ropey collagen resembling a spindle cell lipoma. This combination of a folliculosebaceous cystic hamartoma with a spindle cell lipoma-like mesenchymal proliferation is unusual and has not been previously reported.
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Yeom MI, Kim SS. Folliculosebaceous Cystic Hamartoma of the Eyelid. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2016. [DOI: 10.3341/jkos.2016.57.9.1460] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Myeong In Yeom
- Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea
| | - Sang Soo Kim
- Department of Ophthalmology, Maryknoll Medical Center, Busan, Korea
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Distinctive genital folliculosebaceous cystic hamartomas in a patient with fibrous dysplasia. J Craniofac Surg 2012; 23:e132-4. [PMID: 22446447 DOI: 10.1097/scs.0b013e31824cdafc] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Folliculosebaceous cystic hamartoma is a benign tumor composed of follicular, sebaceous, and mesenchymal components. Usually, it appears in adulthood as a dome or a pedunculated nodule on the face, especially the nose. Extracephalic lesions are sporadically reported, such as on the upper back, forearm, ear, labia majora, and the nipple. Herein, we report a patient with left maxillary fibrous dysplasia who experienced bilateral labia majora disfigurement after her puberty. She experienced physical distress because of tenderness due to the tangled, stretched hamartomas and psychological distress because of failure to have sexual contacts. The exophytic dark skin-colored fusing polypoid labia majora deformities were excised, and the folliculosebaceous cystic hamartoma was impressed by the pathology. We used an advancing flap for labiaplasty, and the outcome was aesthetically satisfactory. There is no recurrence in the 6-month follow-up period. To our knowledge, this is the first report of a folliculosebaceous cystic hamartoma on the bilateral labia majora in a patient with fibrous dysplasia. This extraordinary presentation is much different from others owing to its unusual appearance and a larger size.
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Carneiro FP, Vianna LMDS, dos Santos AM, Raymundo IT, de Azevedo AEB. Folliculosebaceous cystic hamartoma of the external auditory canal in an adult. EAR, NOSE & THROAT JOURNAL 2012; 91:E12-4. [PMID: 22359138 DOI: 10.1177/014556131209100216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Folliculosebaceous cystic hamartoma (FSCH) is a cutaneous hamartoma of pilosebaceous origin that usually occurs on the face. We present what we believe is only the second reported case of FSCH of the external auditory canal, and the first in an adult. The patient was a 59-year-old woman who presented with a 4-year history of a firm nodule on the left external auditory canal that had caused hearing loss, pruritus, and pain. The lesion was excised, and histopathologic examination identified infundibular cysts, hyperplasia of the sebaceous lobules, and a large amount of mucin, features that are consistent with FSCH. One year postoperatively, the patient was asymptomatic, and no evidence of recurrence was noted.
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Merklen-Djafri C, Batard ML, Guillaume JC, Kleinclauss I, Cribier B. [Folliculosebaceous cystic hamartoma: anatomo-clinical study]. Ann Dermatol Venereol 2011; 139:23-30. [PMID: 22225739 DOI: 10.1016/j.annder.2011.10.402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2011] [Revised: 08/07/2011] [Accepted: 10/17/2011] [Indexed: 11/24/2022]
Abstract
BACKGROUND Folliculosebaceous cystic hamartoma (FSCH) is a relatively recently described malformation with follicular and sebaceous components and a particular type of stroma with adipocytes. We conducted an anatomo-clinical study in order to clarify the clinical and histological characteristics of FSCH. MATERIALS AND METHODS We included all cases of FSCH diagnosed between 1985 and February 2011 at our dermatopathology laboratory. Clinical information was obtained from medical records and requests for histological examination. RESULTS We studied 25 cases of FSCH in 25 patients of mean age 51 years. The sex ratio was 1.3. The mean disease duration was 9 years. Lesions were described mainly as flesh-colored, occasionally pedunculated nodules and were found primarily on the face (60%). The diagnosis of FSCH had never been mentioned by the clinician. Histological examination revealed in all cases one or more follicular cystic structures surrounded by sebaceous glands in a stroma containing adipocytes. A number of variants were identified, such as the presence of a mucinous stroma, a neuroid component with protein S 100 expression, and rudimentary hair follicles in adjacent dermis. One case involved a proliferating cyst while another was on the scalp in the area of pre-existing radiodermatitis. Only one relapse was noted, 5 years after the initial excision. DISCUSSION FSCH is a benign, underdiagnosed lesion, localized on the face, particularly on the nose. It is dome-shaped or pedunculated and grows slowly. Differential diagnoses include nevus lipomatosus superficialis and "sebaceous" trichofolliculoma. FSCH can be readily identified by the presence of adipocytes and a fibrous stroma. One case was unique in its appearance of a large pedunculated nodule with a proliferating cyst. Prior to the invidualization of this entity, such cases were interpreted as nevus lipomatosus superficialis or "sebaceous" trichofolliculoma, although their histological appearance was inconsistent with such a diagnosis.
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Affiliation(s)
- C Merklen-Djafri
- Clinique dermatologique, université de Strasbourg, hôpitaux universitaires de Strasbourg, France.
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Emsen IM, Livaoglu A. An uncommon folliculosebaceous cystic hamartoma on the lower extremity. THE CANADIAN JOURNAL OF PLASTIC SURGERY = JOURNAL CANADIEN DE CHIRURGIE PLASTIQUE 2011; 15:231-3. [PMID: 19554184 DOI: 10.1177/229255030701500402] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Folliculosebaceous cystic hamartomas (FSCH) are a recently recognized cutaneous hamartoma comprised of follicular, sebaceous and mesenchymal elements. Only nine cases have been previously reported. The authors present a case of FSCH on the lower extremity in addition to a literature review. OBJECTIVE To further characterize the clinical, histological and immunohistological features of FSCH. METHODS The clinical, histological and immunohistological features of FSCH were evaluated and the literature reviewed. RESULTS This lesion uncommonly presents as exophytic papules or nodules on the leg, and most commonly presents on the central part of the face. Clinical differential diagnoses included nevus, neurofibroma and adnexal tumour. The diagnostic microscopic features of infundibular cystic structures with attached sebaceous glands and characteristic stroma were present in all lesions. Many of the stromal spindle cells were CD34-positive. CONCLUSION The FSCH is a recently recognized hamartoma comprised of follicular, sebaceous and mesenchymal elements. Although reported only rarely, its incidence is likely much higher. In the present patient, the FSCH was located in femoral region, which is very rare.
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Affiliation(s)
- Ilteris Murat Emsen
- Department of Plastic and Reconstructive Surgery, Numune State Hospital, Erzurum, Turkey
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Abstract
Folliculosebaceous cystic hamartoma (FCH) is a relatively rare and recently described lesion of the skin. Mostly, it involves the skin of the head and neck area. It is considered by most authors as a form of non-neoplastic cutaneous hamartoma comprising follicular, sebaceous and stromal elements. However, few regard it as a sebaceous trichofolliculoma, i.e. a variant of trichofolliculoma. FCH of the nipple of female breast is a very rare lesion with only one previous case reported so far in the literature. We report a similar case with a brief review of the literature.
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Affiliation(s)
- AbdullGaffar Badr
- Department of Histopathology, Dubai Hospital, Dubai, United Arab Emirates.
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Haw S, Lee MH. A case of giant folliculosebaceous cystic hamartoma. Ann Dermatol 2009; 21:63-5. [PMID: 20548860 DOI: 10.5021/ad.2009.21.1.63] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2008] [Accepted: 08/18/2008] [Indexed: 11/08/2022] Open
Abstract
Clinically, folliculosebaceous cystic hamartoma (FSCH) lacks distinct features, but it has been reported as an asymptomatic, 1- to 3-cm, dome-shaped nodule on the face. Histopathologically, FSCH is characterized by adnexal and folliculosebaceous cystic proliferation with various mesenchymal changes. This case presented an unusually large, small-fist-sized mass in the right mandibular area that was accompanied by intermittent itching. Histopathologic findings demonstrated appropriate features of FSCH. We present an interesting case of giant FSCH in a 48-year-old female.
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Affiliation(s)
- Sik Haw
- Department of Dermatology, College of Medicine, Kyung Hee University, Seoul, Korea
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Giant, Congenital Folliculosebaceous Cystic Hamartoma: A Case Against a Pathogenetic Relationship With Trichofolliculoma. Am J Dermatopathol 2008; 30:500-3. [DOI: 10.1097/dad.0b013e318183eb07] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wu YH. Folliculosebaceous cystic hamartoma or trichofolliculoma? A spectrum of hamartomatous changes inducted by perifollicular stroma in the follicular epithelium. J Cutan Pathol 2008; 35:843-8. [DOI: 10.1111/j.1600-0560.2007.00914.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Suarez-Peñaranda JM, Vieites B, Ramírez-Santos A, Fernández-Redondo V, Toribio J, Del Rio E, Forteza-Vila J. Clinicopathological and immnuohistochemical findings in a series of folliculosebaceous cystic hamartoma. J Cutan Pathol 2008; 36:251-6. [PMID: 18715254 DOI: 10.1111/j.1600-0560.2008.01011.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Folliculo-sebaceous cystic hamartoma (FSCH) is an uncommon skin condition presenting as a slow-growing papulo-nodular lesion, in or around the nose. Most cases are not clinically suspected and only histopathological examination allows the diagnosis. Pathological features include a dermal-located infundibulo-cystic structure with sebaceous glands radiating around, a stromal component encircling the epithelial structures, with clefts between the lesional epithelial and stromal parts, as well as between this and the adjacent dermis. RESULTS We report eight patients with the diagnosis of FSCH (5 females and 3 males), with ages ranging from 35 to 77 years. Most cases (5 out of 8) were located in or around the nose and sizes were comprised between 0.6 and 1.2 cm. Lesions had grown for long periods of time, up to ten years in one case. Immunohistochemistry showed staining for p63 in the epithelial component of all lesions, while CD10 was only present in some sebocytes. CD34 and Factor XIIIa positive cells were present in the lesional stroma. Staining for androgen and alpha-estrogen receptors was also usually noticed. CONCLUSIONS FCSH is a hamartomatous skin lesion, clinically indistinct but with well-defined histopathological features. Immunohistochemistry shows a profile very close to normal sebaceous glands.
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Affiliation(s)
- Jose M Suarez-Peñaranda
- Department of Pathology, University Hospital and School of Medicine, Santiago de Compostela, Spain.
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Saadat P, Doostan A, Vadmal MS. Folliculosebaceous smooth muscle hamartoma. J Am Acad Dermatol 2007; 56:1021-5. [PMID: 17504719 DOI: 10.1016/j.jaad.2006.08.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2006] [Revised: 07/19/2006] [Accepted: 08/01/2006] [Indexed: 11/21/2022]
Abstract
Cutaneous hamartomas are a group of heterogenous benign skin conditions demonstrating epithelial and mesenchymal components in varying proportions. Folliculosebaceous (cystic) hamartomas comprise a distinct group of uncommon cutaneous tumor-like malformations. Histologically, these lesions demonstrate varying proportions of adnexal and stromal tissues. We review the literature on folliculosebaceous hamartoma and report a case with smooth muscle as its only stromal component.
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Affiliation(s)
- Payam Saadat
- Department of Dermatology, University of Southern California-Keck School of Medicine, Los Angeles, California, USA
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Tanimura S, Arita K, Iwao F, Kasai M, Fujita Y, Kawasaki H, Abe R, Sawamura D, Kimura T, Shimizu H. Two cases of folliculosebaceous cystic hamartoma. Clin Exp Dermatol 2006; 31:68-70. [PMID: 16309487 DOI: 10.1111/j.1365-2230.2005.01974.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Folliculosebaceous cystic hamartoma (FSCH) is a rare cutaneous hamartoma composed of dilated folliculosebaceous units associated with mesenchymal elements. Two cases of FSCH with typical histopathological features are reported. Patient 1 was a 60-year-old man presented with a normal skin-coloured asymptomatic nodule on his scalp. Patient 2 was a 70-year-old man with an asymptomatic nodule on his right auricle that had persisted for the previous 15 years. In all, 34 cases of FSCH have been reported in the English literature. Clinically, the lesions are asymptomatic, usually rubbery to firm in consistency, and usually occur on or above the neck (> 90%). Most lesions do not exceed 25 mm in diameter (> 90%). Histopathologically, FSCH shares several similar features to sebaceous trichofolliculoma, but it is usually possible to differentiate these two tumours.
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Affiliation(s)
- S Tanimura
- Department of Dermatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
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Hamada M, Kiryu H, Satoh E, Moroi Y, Urabe K, Furue M. A case of genital folliculosebaceous cystic hamartoma with an unique aggregated manifestation. J Dermatol 2006; 33:191-5. [PMID: 16620225 DOI: 10.1111/j.1346-8138.2006.00044.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Folliculosebaceous cystic hamartoma (FCH) is a recently recognized cutaneous hamartoma composed of follicular, sebaceous and mesenchymal components, and usually occurring on the head and neck. We describe herein a case of FCH with an unique aggregated manifestation in a genital lesion. The patient was a 40-year-old woman with a genital lesion composed of a pedunculated nodule, a dome-shaped nodule and a subcutaneous nodule, measuring 5 cm in the greatest dimension. The largest, pedunculated nodule was histologically composed of an infundibulo-cystic structure with follicular, sebaceous and mesenchymal elements accompanied by cystic structures of various sizes lined by stratified squamous epithelium and follicular germinative cells suggesting follicular cysts. The dome-shaped nodule consisted of anastomosing strands of epithelial cells with follicular components. The subcutaneous nodule had two components, an infundibulo-cystic structure and a cyst lined by squamous epithelium. In our case, the unusual clinical feature of large and multiple nodules was due to the presence of several prominent hamartomatous cystic structures with FCH. This is the third case of giant FCH. The clinical presentation and location of giant FCH is unusual.
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Affiliation(s)
- Manabu Hamada
- Department of Dermatology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
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Sturtz DE, Smith DJ, Calderon MS, Fullen DR. Giant folliculosebaceous cystic hamartoma of the upper extremity. J Cutan Pathol 2004; 31:287-90. [PMID: 14984585 DOI: 10.1111/j.0303-6987.2004.00174.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Folliculosebaceous cystic hamartoma (FSCH) is a rare cutaneous hamartoma consisting of dilated folliculosebaceous units invested in mesenchymal elements. These lesions have a striking predilection for the central face and scalp of adults. The vast majority of lesions present as 0.5-1.5-cm papules or exophytic nodules. A single case of giant FSCH has been reported on the upper back. METHODS A 32-year-old woman presented with a (15 cm in greatest dimension) plaque-like, multinodular lesion on her left upper arm for several years. The lesion was clinically suspected to be a nevus sebaceus. RESULTS The skin excision showed numerous dermal and subcutaneous dilated follicular structures with peripherally radiating sebaceous lobules, hair follicles, and surrounding mesenchymal elements consistent with FSCH. CONCLUSION To our knowledge, this is the second case of giant FSCH. Our case is unique for its larger size, more plaque-like growth, and location on an extremity when compared to the seminal case of giant FSCH.
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Affiliation(s)
- David E Sturtz
- Department of Pathology, University of Michigan Hospitals, Ann Arbor, MI 48109, USA
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Affiliation(s)
- M A El-Darouty
- Dermatology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Abstract
BACKGROUND Clinically, folliculosebaceous cystic hamartomas (FSCH) present as skin-colored papulonodules of the face, especially the nose. This is in contrast to sebaceous trichofolliculomas which often present as depressed ostia containing terminal or vellus hairs. OBSERVATION A 34-year-old female had a skin-colored multinodular plaque of the labia majora that demonstrated the histologic findings of an FSCH. These included an irregularly shaped central cystic structure surrounded by multiple sebaceous lobules as well as a fibrous stroma. The epithelial-lined cyst contained no hair shafts. CONCLUSION A single case report of a scrotal lesion with a similar clinical appearance and histologic findings has previously been described as a genital variant of sebaceous trichofolliculoma. However, the report predated the initial description of FSCH. In our opinion, both cases represent examples of the genital variant of FSCH.
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Affiliation(s)
- J L Bolognia
- Department of Dermatology, Yale University, New Haven, Conn., USA.
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Schulz T, Hartschuh W. Folliculo-sebaceous cystic hamartoma is a trichofolliculoma at its very late stage. J Cutan Pathol 1998; 25:354-64. [PMID: 9765020 DOI: 10.1111/j.1600-0560.1998.tb01758.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Folliculo-sebaceous cystic hamartoma (FCH) was described as an entity recently and was defined as an adnexal hamartoma, showing above all an infundibular cystic structure linked to many sebaceous lobules. Differentiation toward the inferior segment of the hair follicle also occurs, although to a markedly lesser degree. Signs of regression and rest corresponding to the normal follicular cycle are often apparent in these follicular proliferations. Therefore so-called FCH has much in common with the newly described late stage of trichofolliculoma, which also exhibits an infundibular cyst and sebaceous and follicular differentiation with various signs of catagen and telogen. Comparing our 8 cases of FCH and 31 cases of trichofolliculoma, we came to the conclusion that FCH is the very late stage of trichofolliculoma. This stage could be characterized by a nearly complete regression of the transient follicular epithelium, whereas concurrent growth and maturation of sebaceous elements appear.
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Affiliation(s)
- T Schulz
- Institute for Pathology, Bayreuth, Germany
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Abstract
Although folliculosebaceous cystic hamartoma (FCH) is an uncommon cutaneous entity with distinct classical and variant histopathologic features, it lacks distinctive typifying clinical features. Since the original description of five cases of FCH by Kimura et al. in 1991, 12 cases have been documented. We report a further case of FCH presenting as facial lesion in a 35 year old African male. FCH comprises prominent epithelial and mesenchymal components. The epithelial component is characterised by folliculosebaceous proliferation with cyst-like infundibular dilatation, and the mesenchymal component exhibits variable fibroplasia, vascular and neural proliferation and adipocyte metaplasia. Awareness of the lesion is important to avoid confusion with other cystic or cyst-like cutaneous lesions that contain prominent epithelial folliculosebaceous and variable mesenchymal components.
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Affiliation(s)
- P K Ramdial
- Department of Anatomical Pathology, Faculty of Medicine, University of Natal, South Africa
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