Diagnosis: Desmoplastic Trichoepithelioma
Submitted by Deepak Ghimire to dermRounds Dermatology Network
Submitted by Deepak Ghimire to dermRounds Dermatology Network
Firm, skin-colored papule on central face in young woman. Annular configuration.
Excision for definitive diagnosis (to exclude BCC). Observation if biopsy-confirmed.
• Basal cell carcinoma (morpheaform) • Microcystic adnexal carcinoma • Morphea • Dermatofibroma • Syringoma
• 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: case, dermatologist, dermatology, image, kodachrome