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Enlarging, Painful Scalp Nodule

Enlarging, Painful Scalp Nodule Abstract REPORT OF A CASE A 43-year-old woman had a slowly enlarging, painful, bleeding scalp nodule for five to ten years. She stated that she had fallen on the area many years before. She was otherwise in good health and was receiving no medication. There was no family history of skin disease.Physical examination revealed a 1.2 × 1.2-cm friable, focally ulcerated, erythematous, crusted scalp nodule (Fig 1). An excisional biopsy was performed, revealing a well-circumscribed, dark-brown, granular nodule extending to adipose tissue (Fig 2).Histologic examination showed a well-circumscribed nodule continuous with the epidermis, consisting of squamous lobules with abrupt keratinization and intense melanin deposition. There were foci of increased mitoses and a mild degree of nuclear atypia (Figs 3 through 5).What is your diagnosis? DIAGNOSIS: Proliferating trichilemmal tumor. DISCUSSION Proliferating trichilemmal tumor is an uncommon neoplasm of outer root sheath cells. It References 1. Headington JT: Tumors of the hair follicle: A review . Am J Pathol 1976;85:480-505. 2. Amaral A, Nascimento A, Goellner J: Proliferating pilar (trichilemmal) cyst: Report of two cases, one with carcinomatous transformation and one with distant metastases . Arch Pathol Lab Med 1984;108:808-810. 3. Chait GE, Shemen LJ, Robbins KT, et al: Pilar tumor of the scalp . Otolaryngol Head Neck Surg 1985;93:116-119. 4. Janitz J, Wiedersberg H: Trichilemmal pilar tumors . Cancer 1980;45:1594-1597.Crossref 5. Lever WF, Schaumburg-Lever G: Histopathology of the Skin , ed 6. Philadelphia, JB Lippincott, 1983. 6. Brownstein MH, Arluk DJ: Proliferating trichilemmal cyst: A simulant of squamous cell carcinoma . Cancer 1981;48:1207-1214.Crossref 7. Baptista AP, Silva LG, Born MC: Proliferating trichilemmal cyst . J Cutan Pathol 1983;10:178-187.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1988 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1988.01670060083023
Publisher site
See Article on Publisher Site

Abstract

Abstract REPORT OF A CASE A 43-year-old woman had a slowly enlarging, painful, bleeding scalp nodule for five to ten years. She stated that she had fallen on the area many years before. She was otherwise in good health and was receiving no medication. There was no family history of skin disease.Physical examination revealed a 1.2 × 1.2-cm friable, focally ulcerated, erythematous, crusted scalp nodule (Fig 1). An excisional biopsy was performed, revealing a well-circumscribed, dark-brown, granular nodule extending to adipose tissue (Fig 2).Histologic examination showed a well-circumscribed nodule continuous with the epidermis, consisting of squamous lobules with abrupt keratinization and intense melanin deposition. There were foci of increased mitoses and a mild degree of nuclear atypia (Figs 3 through 5).What is your diagnosis? DIAGNOSIS: Proliferating trichilemmal tumor. DISCUSSION Proliferating trichilemmal tumor is an uncommon neoplasm of outer root sheath cells. It References 1. Headington JT: Tumors of the hair follicle: A review . Am J Pathol 1976;85:480-505. 2. Amaral A, Nascimento A, Goellner J: Proliferating pilar (trichilemmal) cyst: Report of two cases, one with carcinomatous transformation and one with distant metastases . Arch Pathol Lab Med 1984;108:808-810. 3. Chait GE, Shemen LJ, Robbins KT, et al: Pilar tumor of the scalp . Otolaryngol Head Neck Surg 1985;93:116-119. 4. Janitz J, Wiedersberg H: Trichilemmal pilar tumors . Cancer 1980;45:1594-1597.Crossref 5. Lever WF, Schaumburg-Lever G: Histopathology of the Skin , ed 6. Philadelphia, JB Lippincott, 1983. 6. Brownstein MH, Arluk DJ: Proliferating trichilemmal cyst: A simulant of squamous cell carcinoma . Cancer 1981;48:1207-1214.Crossref 7. Baptista AP, Silva LG, Born MC: Proliferating trichilemmal cyst . J Cutan Pathol 1983;10:178-187.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Jun 1, 1988

References