Pilar sheath acanthoma

Medical condition

Pilar sheath acanthoma

Pilar sheath acanthoma
Specialty	Oncology

A pilar sheath acanthoma is a cutaneous condition most often found on the face, particularly above the upper lip in adults.^[1]^: 675 Pilar sheath acanthoma is a skin-colored, 5-10 mm diameter papule or nodule with a keratin-filled pore in the center. Pilar sheath acanthoma diagnosis confirmed by shave or excisional biopsy. Successful treatment requires surgical excision.

Signs and symptoms

Pilar sheath acanthoma manifests as a single, skin-colored papule or nodule that is 5–10 mm in diameter and has a keratin-filled pore in the center. These lesions can occur anywhere on the head and neck, however they are typically nearly exclusively located on the upper lip.^[2]

Diagnosis

Confirmation of the diagnosis is aided by a shave or excisional biopsy of the lesion.^[2] It is possible to confuse pilar sheath acanthoma with large comedones, trichoepithelioma, solar comedones (Favre-Racouchot syndrome), dilated pores (Winer), or scars.^[3]

Histopathologically, pilar sheath acanthoma is characterized by a centrally located, cystically dilated follicle that opens to the surface and contains keratinous material. Squamous epithelium buds extend outward from the central hole. The outer rooth sheath epithelium that makes up tumor lobules extends into the nearby dermis and may even reach the subcutis. Possible observations include infundibular keratinization of the epithelium and individual tumor cells with high glycogen content.^[2]

Treatment

The only successful treatment is surgical excision.^[3]

References

^ James, William D.; Berger, Timothy G.; et al. (2006). Andrews' Diseases of the Skin: Clinical Dermatology. Saunders Elsevier. ISBN 0-7216-2921-0.
^ ^a ^b ^c Kushner, JeffreyAlbert; Thomas, RichardScott; Young, RussellJohn (2014). "An unusual location of a pilar sheath acanthoma". International Journal of Trichology. 6 (4). Medknow: 185–186. doi:10.4103/0974-7753.142886. ISSN 0974-7753. PMC 4212299. PMID 25368479.
^ ^a ^b Plewig, Gerd; Kligman, Albert M. (2000). "Pilar Sheath Acanthoma". ACNE and ROSACEA. Berlin, Heidelberg: Springer Berlin Heidelberg. pp. 549–551. doi:10.1007/978-3-642-59715-2_71. ISBN 978-3-540-66751-3.

External links

DermNet
VisualDx

Classification	D ICD-11: XH3EY8 ICD-10: L73.9 MeSH: D049309 SNOMED CT: 254693008
External resources	Scholia: Q7193794

Skin cancer of the epidermis

Tumor

Carcinoma

BCC	Forms Aberrant Cicatricial Cystic Fibroepithelioma of Pinkus Infiltrative Micronodular Nodular Pigmented Polypoid Pore-like Rodent ulcer Superficial Nevoid basal-cell carcinoma syndrome
SCC	Forms Adenoid Basaloid Clear-cell Signet-ring-cell Spindle-cell Marjolin's ulcer Bowen's disease Bowenoid papulosis Erythroplasia of Queyrat Actinic keratosis
Adenocarcinoma	Aggressive digital papillary adenocarcinoma Extramammary Paget's disease
Ungrouped	Merkel-cell carcinoma Microcystic adnexal carcinoma Mucinous carcinoma Primary cutaneous adenoid cystic carcinoma Verrucous carcinoma Malignant mixed tumor

Benign
tumors

Acanthoma	Forms Large-cell Fissuring Clear-cell Epidermolytic Melanoacanthoma Pilar sheath acanthoma Seboacanthoma Seborrheic keratosis Warty dyskeratoma
Keratoacanthoma	Generalized eruptive Keratoacanthoma centrifugum marginatum Multiple Solitary
Wart	Verruca vulgaris Verruca plana Plantar wart Periungual wart

Other

Epidermal nevus	Syndromes Epidermal nevus syndrome Schimmelpenning syndrome Nevus comedonicus syndrome Nevus comedonicus Inflammatory linear verrucous epidermal nevus Linear verrucous epidermal nevus Pigmented hairy epidermal nevus syndrome Systematized epidermal nevus Phakomatosis pigmentokeratotica
Other nevus	Nevus unius lateris Patch blue nevus Unilateral palmoplantar verrucous nevus Zosteriform speckled lentiginous nevus
Ungrouped	Cutaneous horn