Brownstein M H
Am J Dermatopathol. 1980 Fall;2(3):229-31. doi: 10.1097/00000372-198000230-00006.
Trichilemmoma is a follicular tumor because of its resemblance to follicular outer root sheath, overlapping features with other tumors in the spectrum of benign follicular neoplasms, occurrence as multiple dominantly inherited and solitary noninheritable tumors, and occasional complication of organoid nevus. The dangerous misinterpretation that trichilemmomas are viral warts, unsupported by scientific evidence, has harmed patients. All electron-microscopic, immunologic, and clinical transmission attempts to demonstrate viral etiology of trichilemmoma have failed. If trichilemmomas were simply old warts, we might expect to see them frequently in children, extrafacially, of long duration, associated with multiple authentic ("young") warts, as multiple lesions, and associated with authentic warts in patients with Cowden's syndrome (multiple trichilemmomas). Actually, trichilemmomas are rarely seen in children, extrafacially, of long duration, associated with multiple authentic warts, as multiple lesions in patients without Cowden's syndrome, and associated with authentic warts in Cowden's syndrome. Unfortunately, patients with multiple trichilemmomas, Cowden's syndrome, and associated internal disease have been passed off as "simply old viral warts." The missed opportunity to identify women with a 50% risk of breast cancer is a disservice to the patient, to say nothing about malpractice implications for the physician when generally accepted medical standards are not applied.
毛发上皮瘤是一种毛囊肿瘤，因其与毛囊外根鞘相似，在良性毛囊肿瘤谱系中与其他肿瘤有重叠特征，可表现为多发性显性遗传性肿瘤和散发性非遗传性肿瘤，且偶尔会并发类器官痣。将毛发上皮瘤误认为是病毒疣这种没有科学依据的危险误解已经对患者造成了伤害。所有通过电子显微镜、免疫学和临床传播途径来证明毛发上皮瘤病毒病因的尝试均告失败。如果毛发上皮瘤仅仅是陈旧性疣，那么我们可能会经常在儿童身上、面部以外部位、病程较长、伴有多个真正的（“新发”）疣、表现为多发性损害，以及在患有考登综合征（多发性毛发上皮瘤）的患者中见到伴有真正的疣。实际上，在没有考登综合征的患者中，毛发上皮瘤很少见于儿童、面部以外部位、病程较长、伴有多个真正的疣且表现为多发性损害，而在考登综合征患者中也很少与真正的疣相关联。不幸的是，患有多发性毛发上皮瘤、考登综合征及相关内科疾病的患者一直被误诊为“仅仅是陈旧性病毒疣”。错失识别有50%乳腺癌风险的女性的机会对患者是一种伤害，更不用说当未应用普遍接受的医学标准时，对医生而言还存在医疗过失的问题。
