Huet P, Jegou M-H, Bourlond F, Dupin C, Cribier B
Cabinet médical, zone médicale de Fescau, 50, allée des Vignes, 34980 Montferrier-sur-Lez, France.
Cabinet de dermatologie, 8, rue Jules-Ferry, 33290 Blanquefort, France.
Ann Dermatol Venereol. 2020 May;147(5):334-339. doi: 10.1016/j.annder.2020.01.014. Epub 2020 Feb 19.
Trichoadenoma is a very rare follicular tumour with a remarkable histopathological appearance. In this article we present a series of 12 cases of trichoadenoma, as well as the anatomoclinical and dermatoscopic findings in a typical case. We discuss these findings in the light of an extensive literature research.
We collated 12 cases of trichoadenoma of indisputable diagnosis made at the dermatopathology laboratory of the Dermatological Clinic of the University Hospitals of Strasbourg over a 30-year period (1989-2018).
The 12 cases comprised 7 women and 5 men, of average age 58.9 years, the majority having lesions on the cephalic extremity followed by the buttocks and thighs. Histopathological examination, which was similar in all 12 cases, showed multiple epidermal cysts containing an eosinophil lamellar keratin with a stratified wall without any visible hair, located in the superficial and mid dermis and appearing to be stacked on top of one another. In immunohistochemistry, broad spectrum keratin markers were still positive, the follicular marker Ber-EP4 weakly expressed and PHLDA1 was negative. For the case examined using polarized-light dermatoscopy, small rounded white-yellow areas were observed corresponding to cystic structures surrounded by irregular linear vessels.
Trichoadenoma is a rare tumour seen in middle-aged adults of mean age 45 years, and has no sexual predominance. It is asymptomatic, slow-growing, variable in colour, measures less than one centimeter and is most often located on the face or buttocks. In terms of histology, the juxtaposition of multiple small cystic structures suggests a follicular origin. Differential diagnosis is made with trichoblastomas, which always intensely express PHLDA1 and/or Ber-EP4, desmoplastic trichoepithelioma, which consists of multiple much thinner spans in a highly fibrous stroma with clearly visible arborescent vessels over a white-yellow ivory background at dermatoscopy, microcystic carcinoma, which has a deeper extension, and plaque milium, in which the cysts are larger.
毛发腺瘤是一种非常罕见的毛囊肿瘤，具有显著的组织病理学表现。在本文中，我们报告了12例毛发腺瘤病例系列，以及1例典型病例的解剖临床和皮肤镜检查结果。我们结合广泛的文献研究对这些结果进行了讨论。
我们整理了30年间（1989 - 2018年）在斯特拉斯堡大学医院皮肤科诊所皮肤病理学实验室确诊的12例毛发腺瘤病例。
12例患者中，女性7例，男性5例，平均年龄58.9岁，大多数患者的病变位于头部，其次是臀部和大腿。12例患者的组织病理学检查结果相似，显示多个表皮囊肿，内含嗜酸性层状角蛋白，囊壁分层，未见明显毛发，位于真皮浅层和中层，似乎相互堆叠。免疫组化结果显示，广谱角蛋白标志物仍为阳性，毛囊标志物Ber-EP4弱阳性，PHLDA1阴性。在偏振光皮肤镜检查的病例中，观察到小的圆形白黄色区域，对应于被不规则线性血管包围的囊性结构。
毛发腺瘤是一种罕见肿瘤，多见于平均年龄45岁的中年人，无性别优势。它无症状，生长缓慢，颜色各异，大小小于1厘米，最常位于面部或臀部。在组织学方面，多个小囊性结构的并列提示毛囊起源。鉴别诊断包括总是强烈表达PHLDA1和/或Ber-EP4的毛母细胞瘤、在皮肤镜检查中在白黄色象牙色背景上有明显可见的树枝状血管且由高度纤维性基质中多个更细条索组成的促纤维增生性毛发上皮瘤、具有更深浸润的微囊性癌以及囊肿更大的粟丘疹。
