Desmoplastic Trichoepithelioma

Diagnosis: Desmoplastic Trichoepithelioma

DTE: Asymptomatic, slowly growing lesion, depressed with annular border on cheek..

Clinical Presentation

DTE: Asymptomatic, slowly growing lesion, depressed with annular border on cheek..

Clinical History

Submitted by Deepak Ghimire. Originally posted April 15, 2012.

Treatment

See case discussion.

Differential Diagnosis

• Basal cell carcinoma (morpheaform) • Microcystic adnexal carcinoma • Morphea • Dermatofibroma • Syringoma

Key Learnings

• Benign follicular tumor — solitary, firm, skin-colored papule, usually on face • "Annular" or depressed center with raised border is characteristic • Commonly on central face (nasolabial fold, chin) in young women • Must be distinguished from morpheaform BCC — can look identical clinically • Histology: narrow strands of basaloid cells in desmoplastic stroma, horn cysts, no clefting • CK20 (Merkel cell marker positive in trichoepithelioma, negative in BCC) helps differentiate

Tags: desmoplastic, trichoepithelioma, deepak ghimire