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Pathology of Pilar Sheath

Acanthoma 

Dr Sampurna Roy MD

 
Dermatopathology Case 86

Diagnosis: Pilar Sheath Acanthoma

Dermpath-India

Site created by

Dr Sampurna Roy MD

       

http://www. histopathology-india.net/dermpath.htm

March 2014
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Poroma

Hidradenoma

Apocrine adenoma

Papillary eccrine adenoma

Syringofibroadenoma

Malignant sweat  gland tumour 

Microcystic adnexal carcinoma

Eccrine epithelioma

Eccrine ductal carcinoma

Sebaceous tumours

Fordyce's Spots

Steatocystoma

Pilar sheath acanthoma is a rare, benign follicular hamartoma  described first in 1978 by Mehregan and Brownstein.

Clinical presentation: Clinically resembles a comedo and is characterized by a central pore- like opening plugged with keratin.

Lesion is 5-10mm in diameter.

Site:  Solitary lesion occuring almost always on the upper lip.

Cases have been reported on other areas of the head and face.

Microscopic features: 

     

- Central cystically dilated follicle containing keratinous material;

- Follicle opening to surface; 

- Buds of squamous epithelium radiate from the central pore;

- Tumour lobules are composed of outer root sheath epithelium;

- Abundant glycogen in some of the tumour cells ;

- Epidermoid keratinisation ;

- Lesion extends into the dermis or occasionally into the subcutaneous fat.
 


Differential diagnosis: 

1. Dilated pore (small finger-like projections extending into the dermis) ;

2. Trichofolliculoma (secondary hair follicles radiate from the wall of the primary follicle, an outer root sheath, inner root sheath and trichohyaline granules are noted in the secondary follicles) ; 

3. Poroma .
                       

                            

Further reading:

Postauricular pilar sheath acanthoma.

Pilar sheath acanthoma.Hautarzt. 1987;38(1):40-2.

Pilar sheath acanthoma--report of a case with review of the literature.Yonsei Med J. 1989 Dec;30(4):392-5.

Pilar sheath acanthoma - a benign follicular hamartoma. Dermatologica. 1983;167(6):335-8.

Pilar sheath acanthoma. A new benign follicular tumor.J Cutan Pathol. 1979 Oct;6(5):438-40.

Pilar Sheath Acanthoma. Arch Dermatol 1978 :114(10):1495-1497.

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Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)

 

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Tumours of the Hair Follicle

Trichoepithelioma

Desmoplastic trichoepithelioma

Trichofolliculoma

Trichoblastoma

Cutaneous lymphadenoma

Trichoadenoma

Pilar Sheath Acanthoma

Tumour of the Follicular Infundibulum

Trichilemmoma

Trichilemmal Carcinoma 

Proliferating Trichilemmal Tumour

Pilomatrixoma

Nevus Sebaceous

Folliculosebaceous Cystic Hamartoma

Sebaceous Hyperplasia

Sebaceoma              



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