Solitary trichoepithelioma: clinical, dermatoscopic and histopathological findings

Trichoepithelioma is part of the adnexal carcinomas. It is a benign, small tumor, usually under a centimeter in diameter, which develops in the basal cells of the hair follicle.

We present the case of a 30-year-old female patient, from rural area, which was hospitalized in the Clinic of Dermatology, Emergency County Hospital, Craiova, Romania, in March 2015, for the presence of a skin tumor, with round-oval shape, 0.5 cm in diameter, brownish colored, located on the left cervical region. The patient had no past medical history. The skin tumor appeared two years ago, and it was slowly increasing in size. Physical examination was in normal ranges. The dermatoscopic examination reveal a pearly white background covered with tumor islands that were oval shaped, with hyperpigmentation, centered by keratin cysts and surrounded by collagen. During hospitalization, we performed tumor biopsy. The histopathological examination showed microscopic structure of trichoepithelioma. After history taking, physical examination, dermatoscopic examination and histopathological result, our diagnosis was left cervical trichoepithelioma.

Trichoepithelioma is a rare trichogenic tumor, which appears at any age, including newborns, with potential for local recurrence. Our case report represents a classic dermatoscopic aspect of trichoepithelioma, that can have close resemblance to basal cell carcinoma and other skin adnexal tumors, clinically, dermatoscopic and histopathological.