Tumor of follicular infundibulum: an unsuspected cause of macular hypopigmentation.

We present three cases of a rare eruptive variant of tumor of follicular infundibulum. Two patients presented with hypopigmented macules. The clinical differential diagnoses considered in these two cases were vitiligo, lichen sclerosus et atrophicus, and idiopathic guttate hypomelanosis. In the third case, the lesions were hypopigmented flat topped maculo-papules diagnosed clinically as verruca plana. In all three cases, the histopathological features of plate like growth of pale keratinocytes connected to the epidermis and peritumoral condensation of elastic fibers were diagnostic. Although no satisfactory treatment is available, the exclusion of other clinical differential diagnosis particularly vitiligo with its psychosocial implications underscores the importance of skin biopsy.

Multiple familial trichoepithelioma: a case report and review of literature.

OBJECTIVE: Multiple familial trichoepitheliomas are rare autosomal dominant skin disease that is rarely reported from this part of the world. The lesions resemble other types of skin diseases that present with papules and nodules. PATIENT AND METHOD: This is case report of a patient who presented with multiple facial papules and nodules. He wanted treatment to improve his facial (cosmetic) appearance. RESULTS: A 36 year old single male with a 25 years history of multiple facial papules and nodules. Similar lesions were present in other members of the family. He had several treatments including that for leprosy. Histologically the lesions showed keratinized stratified squamous epithelium overlying proliferating packets of basoloid cells with hyper chromatic nuclei, along with several keratin horn cysts and moderate stroma infiltrate of chronic inflammatory cells. Based on the history and the histology a diagnosis of multiple familial trichoepithelioma was made. CONCLUSION: For a diagnosis of multiple familial trichoepithelioma to be made in patients presenting with multiple facial papules and nodules a high index of suspicion is needed. This is more so if there is a history of similar lesions in the family.