Pilar sheath acanthoma

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Pilar sheath acanthoma is a rare benign skin lesion.

Pilar sheath acanthoma
Diagnosis in short

Pilar sheath acanthoma. H&E stain.
LM DDx trichofolliculoma, dilated pore of Winer, epidermal inclusion cyst
Gross raised lesion, central cavitation
Site skin - classically upper lip

Clinical history typically middle aged - 50s
Prevalence rare
Prognosis benign

General

  • Rare.[1]
  • Considered a hamartoma.[1]
  • Does not regress like keratoacanthoma.
  • Typically middle aged individuals - median age in one series 55 years old, range 46-75 years old.[2]

Gross

  • Raised lesion with a central depression - somewhat similar to keratoacanthoma.
  • Classcially upper lip.[2]

DDx:

Microscopic

Features:[2]

  • Cystic cavity with:
    • Keratineous material.
    • Usually extends from surface to deep cutis - like a hair shaft.
    • Lining consists of a thickened squamous epithelium.

DDx:

Images

www:

See also

References

  1. 1.0 1.1 Vakilzadeh, F. (Jan 1987). "[Pilar sheath acanthoma].". Hautarzt 38 (1): 40-2. PMID 3557980.
  2. 2.0 2.1 2.2 Mehregan, AH.; Brownstein, MH. (Oct 1978). "Pilar sheath acanthoma.". Arch Dermatol 114 (10): 1495-7. PMID 718186.
  3. Bavikar, RR.; Gaopande, V.; Deshmukh, SD. (Jan 2011). "Postauricular pilar sheath acanthoma.". Int J Trichology 3 (1): 39-40. doi:10.4103/0974-7753.82136. PMID 21769237.