Indian Journal of Dermatology
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E-IJD®-DERMATOPATHOLOGY ROUND
Year : 2022  |  Volume : 67  |  Issue : 5  |  Page : 625
Sebaceous trichofolliculoma of the scrotum: A rare occurrence


Department of Dermatology, Third People's Hospital of Hangzhou, Hangzhou, Zhejiang, China

Date of Web Publication29-Dec-2022

Correspondence Address:
Hong Shen
No. 38 West Lake Road, Shangcheng Zone, Hangzhou City, Zhejiang Province
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijd.ijd_1056_20

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   Abstract 


Sebaceous trichofolliculoma is a very uncommon skin tumour, the tumour occurred on the nose and consisted of a solitary lesion. Sebaceous trichofolliculoma occurring in patients of the scrotum is very rare; only one case has been reported to date. The patient has many small soft nodules on the scrotum for several years, then the number and the size of the nodules increased. Histological examination showed many large cystic cavities open to the skin surface and numerous sebaceous glands connected to the cavity. Plastic surgery excision or necessary skin grafting is planned for the patient until maturity is attained.


Keywords: Folliculosebaceous cystic hamartoma, scrotum, sebaceous trichofolliculoma


How to cite this article:
Lei JH, Shen H. Sebaceous trichofolliculoma of the scrotum: A rare occurrence. Indian J Dermatol 2022;67:625

How to cite this URL:
Lei JH, Shen H. Sebaceous trichofolliculoma of the scrotum: A rare occurrence. Indian J Dermatol [serial online] 2022 [cited 2023 Jan 30];67:625. Available from: https://www.e-ijd.org/text.asp?2022/67/5/625/366094





   Introduction Top


Sebaceous trichofolliculoma is a variant of trichofolliculoma which was first described by Plewig in 1980, mostly involving the nose and presenting as a solitary lesion.[1] Herein, we report an interesting case of sebaceous trichofolliculoma on an unusual site. Histopathological findings confirm an appropriate diagnosis.


   Case Report Top


A 16-year-old male presented with multiple, skin-coloured soft nodules with a yellowish pore in the centre with some hair emerging from it on his scrotum lesion of approximately 3 years duration [Figure 1]. In the beginning, there were several nodules on his scrotum, then the number and the size of the nodules increased. To confirm the diagnosis, an excisional biopsy of the mass was performed with the informed consent of the patients. Histology of the biopsy specimen showed many large cystic cavities, some of them were open to the skin surface. The walls of these cavities were lined by keratinized stratified squamous epithelium and were filled with horny material and hair shafts. There were numerous sebaceous glands connected to the cavity and collagenous fibre proliferation was found around the folliculo-cystic structures [Figure 2]. The histopathological findings of the excised lesion were consistent with sebaceous trichofolliculoma. Therefore, a diagnosis of a sebaceous trichofolliculoma was made.
Figure 1: Skin-coloured soft nodules with a yellowish pore in the centre were scattered on the scrotum

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Figure 2: The cavity opening to the surface of the skin was lined with stratified squamous epithelium, filled with the debris of corneocytes and hairs of different thicknesses and surrounded by radially arranged sebaceous glands (H and E × 40 for a, ×100 for b)

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   Discussion Top


Sebaceous trichofolliculoma is a rare variant of trichofolliculoma, which is considered as a hamartomatous lesion with follicular differentiation. Sebaceous trichofolliculoma is susceptible in adolescence and young adults, and it is typically a solitary lesion occurring mainly on the face, the scalp or the neck.[2] The clinical features of the case included multiple, skin-coloured soft nodules with a yellowish pore, with some hair emerging from it in the centre of the pore, which differed from the typical symptoms of sebaceous trichofolliculoma. Only one case of sebaceous trichofolliculoma in the scrotum has been reported by Masao, the clinical manifestations were consistent with this patient and the final diagnosis was made based on histological findings.[3] The characteristic pathological features in sebaceous trichofolliculoma included the cystic cavity lined by keratinized epithelium and which was open to the skin surface, and there were numerous pilosebaceous structures in the adjacent dermis.[1]

The lesion may be differentiated from folliculosebaceous cystic hamartoma. The latter has been described more frequently in the literature in the present, and it may be a part of the spectrum of cystic follicular tumours. And histopathologic findings are the main criterion for the differential diagnosis of those diseases. The most important finding that differentiates folliculoebaceous cystic hamartoma from sebaceous trichofolliculoma is that folliculoebaceous cystic hamartoma shows mesenchymal changes, with double clefts that exist between the fibroepithelial units and the surrounding altered stroma, and at the periphery between the altered stroma and the adjacent compressed fibrous tissue.[4] Moreover, folliculoebaceous cystic hamartoma can present only as focal follicular differentiation and lacks the rudimentary hair follicles and hair shafts in the cyst lumen.[5]

Nomura et al. reported a sebaceous trichofolliculoma on the scrotum and penis, which part of the lesion was successfully managed by surgical excision and no recurrence has been seen.[3] Sebaceous trichofolliculoma of the scrotum can be disfiguring, leading to sexual and psychological issues that will affect the quality of life. Plastic surgery excision or necessary skin grafting is the best method of therapy for this case.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patients have given their consent for their images and other clinical information to be reported in the journal. The patient understands that name and initials will not be published and due efforts will be made to conceal identity but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
Plewig G. Sebaceous trichofolliculoma. J Cutan Pathol 1980;7:394-403.  Back to cited text no. 1
    
2.
Al-Ghadeer H, Edward DP. Congenital sebaceous trichofolliculoma of the upper eyelid. Opthalmic Plast Reconstr Surg 2017;33:S60-1.  Back to cited text no. 2
    
3.
Nomura M, Hata S. Sebaceous trichofolliculoma on scrotum and penis. Dermatologica 1990;181:68-70.  Back to cited text no. 3
    
4.
Ansai S, Kimura T, Kawana S. A clinicopathologic study of folliculosebaceous cystic hamartoma. Am J Dermatopathol 2010;32:815-20.  Back to cited text no. 4
    
5.
Kim E, Lee D, Lee E, Kim Y. Folliculosebaceous cystic hamartoma on the nipple. J Dermatol 2011;38:197-9.  Back to cited text no. 5
    


    Figures

  [Figure 1], [Figure 2]



 

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