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Images in Clinical Practice
89 (
5
); 765-765
doi:
10.25259/IJDVL_753_2021
pmid:
35841357

Multiple proliferating trichilemmal cysts with cutaneous horn on scalp

Department of Dermatologic Surgery, Shanghai Skin Disease Hospital, Tongji University School of Medicine, Shanghai, China

Corresponding Author: Dr. Yichen Tang, Shanghai Skin Disease Hospital, 1278 Baode Road, Shanghai, China. tangyichen@medmail.com.cn

Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Wu L, Jiang L, Tang Y. Multiple proliferating trichilemmal cysts with cutaneous horn on scalp. Indian J Dermatol Venereol Leprol 2023;89:765

A 45-year-old man was referred to our outpatient clinic with multiple soft skin tumours on the scalp, which had slowly grown for last 20 years. One year ago, a firm, nail-like keratin mass was found at the edge of the middle tumour [Figure 1]. The tumours were removed by radical excision surgery and histopathologically diagnosed as proliferating trichilemmal cyst [Figure 2].

Multiple skin tumours on the scalp with the middle tumour showing firm, nail-like keratin mass
Figure 1:
Multiple skin tumours on the scalp with the middle tumour showing firm, nail-like keratin mass
Hematoxylin and eosin stained section showing a cyst in the dermis with the cyst wall composed of squamous epithelium without granular layer. The cells near the cyst cavity are large with the cytoplasm lightly stained (yellow arrow). Red-stained and densely arranged keratin is seen in the cyst. (H&E, ×200)
Figure 2:
Hematoxylin and eosin stained section showing a cyst in the dermis with the cyst wall composed of squamous epithelium without granular layer. The cells near the cyst cavity are large with the cytoplasm lightly stained (yellow arrow). Red-stained and densely arranged keratin is seen in the cyst. (H&E, ×200)

Association with human papillomavirus infection has been suspected in the pathogenesis of proliferating trichilemmal cysts. The histopathology of the tumour showed suspicious hollow cells in the local hyperplastic cyst wall, supporting a viral etiology. After the radical resection, there has been no recurrence or metastasis in this patient thus far.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.


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