Folliculosebaceous Cystic Hamartoma Arising in Miescher-Type Melanocytic Nevi

Folliculosebaceous cystic hamartoma (FSCH) is a rare cutaneous hamartoma consisting of dilated folliculosebaceous units associated with mesenchymal elements. Ansai et al reported that distinctive features of Miescher-type melanocytic nevi (MMCNs) accompanied 4.6% of FSCH; however, there have been no data about how often FSCH features accompany MMCNs. In this study, we used 7829 cases that had been histopathologically diagnosed as MMCNs of the face, neck, and scalp at the Department of Dermatopathology, Nippon Medical School Musashi Kosugi Hospital and observed whether features of FSCH accompanied them. Of the resected MMCNs, 274 of 7829 (3%) were accompanied by features of FSCH. The nose was the most common resection site, followed by the eyebrow area, ear, and cheek. The coexistence rate for the nevi on the nose and features of FSCH was as high as 10%-20%, and its rate increased with age. We found that FSCH appears mostly in seborrheic areas, such as the nose and cheek, which are rich in normal sebaceous glands. This suggests that nevi, especially on and around the nose, may induce FSCH or similar lesions.