In vivo reflectance confocal microscopic findings in a case of trichofolliculoma.

Trichofolliculoma is a rare follicular hamartoma whose dermoscopic features have been scarcely reported. On the other hand, reflectance confocal microscopy features have not been described yet. In the present study, the authors report reflectance confocal microscopy features in a case of trichofolliculoma as squamous hyperplasia forming irregular finger-like protrusions around the hair follicle and papillomatous hyperplasia of the hair follicle epithelium, which correlated with histopathology. This case suggests that reflectance confocal microscopy may help incorrect in vivo diagnosis of trichofolliculoma in cases difficult to diagnose by morphology and dermoscopy.

Colgajo giratorio retroauricular / Retroauricular flip-flop flap

Resumen El colgajo retroauricular en isla (flip-flop flap) fue descrito por Masson en 1972 y consiste en tejido dermoepidérmico irrigado por un pedículo de patrón aleatorio subcutáneo de ramas de la arteria auricular posterior. Proviene de la región mastoidea y retroauricular y aporta buena cobertura para la región anteromedial del pabellón auricular. Se describen dos casos, en que se realizó cobertura inmediata secundario a un defecto de la concha auricular posterior a resección neoplásica, obteniendo resultados satisfactorios y sin complicaciones.

Abstract The retroauricular island flap (flip-flop flap), was described by Masson in 1972 and consists on dermoepidermal tissue irrigated by a random subcutaneous pedicle of branches of the posterior auricular artery. It comes from the mastoid and retroauricular region and provides a good coverage for the anteromedial region of the pinna. Two cases are described, in which immediate coverage was performed secondary to a defect in the auricular concha after a neoplastic resection, obtaining satisfactory results without complications.

Adenocarcinoma de células basales / Basal cell adenocarcinoma

El adenocarcinoma de células basales, también conocido como carcinoma salival basaloide, adenoma maligno de células basales, es una neoplasia epitelial de bajo grado, infiltrante, localmente destructivo y con tendencia a ser recidivante. Su aparición es entre la 5ª y 6ª década de vida, sin predilección por sexo. Clínicamente se manifiesta con un edema o un aumento repentino de tamaño en la zona, de consistencia firme, crecimiento lento e indoloro. El diagnóstico de certeza es a través de la histopatología; su tratamiento quirúrgico, y tiene buen pronóstico en sus estadios iniciales (AU)

Basal cells adenocarcinoma also known as salivary basaloide carcinoma basal cells malignant adenoma is a low degree, infiltrating, locally destructive and prone to be relapsing, epithelial neoplasia. It occurs between the 5th and 6th decade of life, with no predilection for sex. Clinically it manifests with an edema or sudden increased size in the area, of firm consistency, slow growth and pain-less. Its treatment is surgical and the diagnosis of certainty is histopathological with a good prognosis. The purpose of this presentation is to show the case of a 57- years-old male patient with clinical and anatomopathological diagnosis of adenocarcinoma of basal cells located in the yugal mucosa (AU)

Management of 3 Proliferating Pilar Tumors: Definition, Differential Diagnosis, and Treatment Options. / Experiencia en el manejo de 3 tumores pilares proliferantes: definición, diagnósticos diferenciales y alternativas terapéuticas.

A proliferating pilar tumor is a rare skin neoplasm that arises from the outer root sheath of a hair follicle. Presentation varies widely, as the tumor can be benign or malignant and has a high probability of recurring after excision. We report our experience managing 3 proliferating pilar tumors with different clinical presentations and pathology findings at Hospital de San José, Bogota, Colombia.

Respuesta al tratamiento con HeberFERON desde el diagnóstico de enfermería en pacientes con neoplasia basocelular / Response to Treatment with HeberFERON since the Nursing Diagnosis in Patients with Basal Cell Neoplasia

RESUMEN Introducción: En Cuba, la introducción del HeberFERON para el tratamiento de neoplasias de piel no melanomas perioculares ha permitido respuestas clínicas y estéticas muy favorables, evitando cirugías y reconstrucciones complejas, obteniéndose resultados muy promisorios. Objetivo: Describir la respuesta al tratamiento con HeberFERON en pacientes con neoplasia basocelular desde el diagnóstico de enfermería. Métodos: Estudio descriptivo longitudinal prospectivo en el Servicio de Oftalmología del Hospital General Docente Abel Santamaría Cuadrado de Pinar del Río en el periodo julio-diciembre 2017. El universo estuvo constituido por 12 pacientes con neoplasia basocelular, tratados con HeberFERON. Las variables analizadas fueron: edad, sexo, fototipo de piel, localización y tamaño de la lesión, respuesta al tratamiento, diagnóstico de enfermería. Resultados: El 50,00 por ciento de los pacientes estudiados pertenecieron al grupo de edades de 71 y más, de sexo masculino, y la lesión tenía un tamaño de menos de 20 mm, el 66,66 por ciento fototipo de piel II , la lesión se localizaba en el parpado inferior y tuvieron una respuesta completa al tratamiento con el HeberFERON, el diagnóstico de enfermería de desconfianza e insuficiente conocimiento de su enfermedad estuvo en el 100,00 por ciento de los casos , temor a la muerte en el 91,66 por ciento, y el deterioro de la piel y los tejidos adyacentes en un 83,33 por ciento de los casos estudiados. Conclusiones: La mayoría de los pacientes tratados con HeberFERON presentaron una respuesta completa a la terapéutica utilizada, traducido en una desaparición completa de la neoplasia(AU)

ABSTRACT Introduction: In Cuba, HeberFERON introduction in the treatment of non-melanomas periocular skin neoplasms has allowed very favorable clinical and aesthetic outcomes, avoiding complex surgeries and reconstructions and obtaining very promising results. Objective: To describe the response to HeberFERON treatment in patients with basal cell neoplasia since the nursing diagnosis. Methods: Prospective, longitudinal and descriptive study carried out in the ophthalmology service of Abel Santamaría Cuadrado General Teaching Hospital of Pinar del Río, in the period from July to December 2017. The study population consisted of 12 patients with basal cell neoplasia and treated with HeberFERON. The variables analyzed were age, sex, skin phototype, location and size of the lesion, response to treatment, and nursing diagnosis. Results: 50.00 percent of the patients studied belonged to the age group of 71 years or older, of male sex, and whose lesion was less than 20 mm in size. 66.66 percent had a skin phototype II. The lesion was located in the lower eyelid and had a complete response to treatment with HeberFERON. Based on the nursing diagnosis, lack of confidence and knowledge about the disease was in 100 percent of the cases; fear of death, in 91.66 percent; deterioration of skin and tissues around, in 83.33 percent. Conclusions: The majority of the patients treated with HeberFERON presented a complete response to the therapy, resulting in a total disappearance of the neoplasm(AU)

High CD90 (THY-1) expression positively correlates with cell transformation and worse prognosis in basal-like breast cancer tumors.

Breast cancer is the most prevalent cancer among women, with the basal-like triple negative (TNBC) being the most agressive one, displaying the poorest prognosis within the ductal carcinoma subtype. Due to the lack of adequate molecular targets, the diagnosis and treatment of patients with the TNBC phenotype has been a great challenge. In a previous work, we identified CD90/Thy-1 as being highly expressed in the aggressive high malignancy grade Hs578T basal-like breast tumor cell line, pointing to this molecule as a promising breast tumor marker, which should be further investigated. Here, CD90 expression was analyzed in human breast cancer samples and its functional role was investigated to better assess the oncogenic nature of CD90 in mammary cells. Quantification of CD90 expression in human breast cancer samples, by tissue microarray, showed that high CD90 positivity correlates with metastasis and poor patient survival in the basal-like subtype. The functional genetic approach, by overexpression in the CD90 cDNA in a basal-like normal mammary cell line (MCF10A) and knockdown in a highly malignant cell line (Hs578T), allowed us to demonstrate that CD90 is involved with several cellular processes that lead to malignant transformation, such as: morphological change, increased cell proliferation, invasiveness, metastasis and activation of the EGFR pathway. Therefore, our results reveal that CD90 is involved with malignant transformation in breast cancer cell lines and is correlated with metastasis and poor patient survival in the basal-like subtype, being considered as a promising new breast cancer target.

Dermatoscopia para establecer márgenes quirúrgicos mínimos en la resección de carcinomas basocelulares / Dermoscopy for establishing the minimal surgical margins in basal cells carcinoma resection

Introducción: el carcinoma basocelular es la forma más común de cáncer de piel y elproceder quirúrgico es la elección para su tratamiento. Aparece más frecuente enáreas visibles o fotoexpuestas, por lo que en ocasiones, con el fin de preservar tejidossu resección es insuficiente; o por el contrario si se amplían a los márgenesestablecidos, pudieran generar secuelas cicatrizales. La dermatoscopía es una técnicade fácil aplicación que permite previamente la visualización de los límites reales deltumor para así obtener márgenes quirúrgicos no comprometidos de menor tamaño queevitan posteriores deformidades estéticas.Objetivos: determinar la utilidad de la dermatoscopía para obtener márgenesquirúrgicos mínimos, libres de carcinomas basocelulares en cara y cuello, conposterior comprobación histológica.Materiales y Métodos: estudio observacional, descriptivo, en Hospital “ ComandanteFaustino Pérez Hernández” de la ciudad de Matanzas, a 21 pacientes, con diagnósticoclínico y dermatoscópico de carcinoma basocelular. Se les estableció mínimo margenquirúrgico a través de la dermatoscopía y posterior a ello, se comprobóhistológicamente si los bordes de incisión estaban comprometidos o no.Resultados: el 95,5 % de los informes histopatológicos revelaron que las lesionesfueron bien resecadas.Conclusiones: el establecimiento dermatoscópico de un mínimo margen quirúrgicoantes de la excéresis, constituye un método confiable para la obtención de lesiones bien resecadas, y disminuyen así las secuelas deformantes que provocan las cicatricesde las grandes incisiones en lesiones de cara y cuello (AU).

Introduction: the basal cell carcinoma is the most common form of skin cancer andthe surgical procedure is the election for its treatment. It appears more frequently invisible or photo exposed areas, therefore, occasionally its resection is insufficient withthe aim of preserving tissues, or because if it reaches the established margins it couldgenerate scar sequels. Dermoscopy is an easily applicable technique allowing theprevious visualization of the real limits of the tumor for obtaining surgical, noncompromised margins of less size that avoid subsequent esthetic deformities.Objectives: to determine the usefulness of dermoscopy for obtaining minimal surgicalmargins, free of basal cell carcinomas in the face and neck, with following histologicverification.Materials and Methods: observational, descriptive study carried out in the Hospital“Comandante Faustino Pérez Hernandez” of Matanzas, in 21 patients with clinical anddermoscopic of basal cell carcinoma. Through dermoscopy the minimal surgical marginwas established and after that, it was checked histologically if the incision borders werecompromised or not.Results: 95.5 % of the histopathological reports showed that the lesions werecorrectly resected.Conclusions: the dermoscopical establishment of a minimal surgical margin beforethe excision, is a reliable method for getting good resected lesions; that way, thedeforming sequels caused by the scars of large incisions in lesions of the face and neckare reduced (AU).

Dermatoscopia para establecer márgenes quirúrgicos mínimos en la resección de carcinomas basocelulares / Dermoscopy for establishing the minimal surgical margins in basal cells carcinoma resection

Introducción: el carcinoma basocelular es la forma más común de cáncer de piel y el proceder quirúrgico es la elección para su tratamiento. Aparece más frecuente en áreas visibles o fotoexpuestas, por lo que en ocasiones, con el fin de preservar tejidos su resección es insuficiente; o por el contrario si se amplían a los márgenes establecidos, pudieran generar secuelas cicatrizales. La dermatoscopía es una técnica de fácil aplicación que permite previamente la visualización de los límites reales del tumor para así obtener márgenes quirúrgicos no comprometidos de menor tamaño que evitan posteriores deformidades estéticas. Objetivos: determinar la utilidad de la dermatoscopía para obtener márgenes quirúrgicos mínimos, libres de carcinomas basocelulares en cara y cuello, con posterior comprobación histológica. Materiales y Métodos: estudio observacional, descriptivo, en Hospital " Comandante Faustino Pérez Hernández" de la ciudad de Matanzas, a 21 pacientes, con diagnóstico clínico y dermatoscópico de carcinoma basocelular. Se les estableció mínimo margen quirúrgico a través de la dermatoscopía y posterior a ello, se comprobó histológicamente si los bordes de incisión estaban comprometidos o no. Resultados: el 95,5 % de los informes histopatológicos revelaron que las lesiones fueron bien resecadas. Conclusiones: el establecimiento dermatoscópico de un mínimo margen quirúrgico antes de la excéresis, constituye un método confiable para la obtención de lesiones bien resecadas, y disminuyen así las secuelas deformantes que provocan las cicatrices de las grandes incisiones en lesiones de cara y cuello (AU).

Introduction: the basal cell carcinoma is the most common form of skin cancer and the surgical procedure is the election for its treatment. It appears more frequently in visible or photo exposed areas, therefore, occasionally its resection is insufficient with the aim of preserving tissues, or because if it reaches the established margins it could generate scar sequels. Dermoscopy is an easily applicable technique allowing the previous visualization of the real limits of the tumor for obtaining surgical, noncompromised margins of less size that avoid subsequent esthetic deformities. Objectives: to determine the usefulness of dermoscopy for obtaining minimal surgical margins, free of basal cell carcinomas in the face and neck, with following histologic verification. Materials and Methods: observational, descriptive study carried out in the Hospital "Comandante Faustino Pérez Hernandez" of Matanzas, in 21 patients with clinical and dermoscopic of basal cell carcinoma. Through dermoscopy the minimal surgical margin was established and after that, it was checked histologically if the incision borders were compromised or not. Results: 95.5 % of the histopathological reports showed that the lesions were correctly resected. Conclusions: the dermoscopical establishment of a minimal surgical margin before the excision, is a reliable method for getting good resected lesions; that way, the deforming sequels caused by the scars of large incisions in lesions of the face and neck are reduced. (AU)

Fatores associados à ressecção incompleta do câncer não melanoma / Factors associated with incomplete resection of non-melanoma cancer

Introdução: Analisar fatores associados e taxa de positividade de margem cirúrgica após ressecção primária de Câncer de Pele Não Melanoma (CNM). Métodos: Estudo transversal, quantitativo, realizado mediante a revisão de prontuários de pacientes submetidos à ressecção cirúrgica de carcinoma basocelular (CBC) e espinocelular (CEC) de pele. Foram estudadas as seguintes variáveis: idade, tipo de câncer, localização, diâmetro, variante histológica, presença de ulceração, presença e ressecção de lesões associadas e presença de comprometimento de margens cirúrgicas. Resultados: Foram inclusos 183 paciente no estudo. Destes, 130 eram CBC (71%) e 53 eram CEC (29%). A taxa global de comprometimento de margem foi de 13,1%, sendo 21 CBC (16%) e 3 CEC (5,66%). Margens cirúrgicas positivas estiveram mais associadas a lesões do tipo CBC (p<0,05) e em lesões localizadas em nariz e pálpebra (p<0,05). Presença de ulceração, diâmetro das lesões e variante histológica não foram associadas a uma maior taxa de ressecções incompletas. Conclusão: Nossa taxa global de ressecção incompleta de Câncer de Pele (CNM) apresenta-se semelhante ao encontrado na literatura. Lesões por CBC ou localizadas em nariz e pálpebra têm maiores taxas de positividade de margem após ressecção primária (AU)

Introduction: To analyze associated factors and surgical margin positivity rate after primary resection of Non-Melanoma Skin Cancer (NMC). Methods: A cross-sectional, quantitative study was carried out by reviewing medical records of patients submitted to surgical resection of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) of the skin. The following variables were studied: age, type of cancer, location, diameter, histological variant, presence of ulceration, presence and resection of associated lesions, and presence of surgical margins involvement. Results: 183 patients were included in the study. Of these, 130 were BCC (71%) and 53 were SCC (29%). The overall rate of margin involvement was 13.1%, of which 21 were CBC (16%) and 3 SCC (5.66%). Positive surgical margins were more associated with BCC lesions (p <0.05) and lesions located in the nose and eyelid (p <0.05). Presence of ulceration, lesion diameter and histological variant were not associated with a higher rate of incomplete resections. Conclusion: Our overall rate of incomplete resection of Skin Cancer is similar to that found in the literature. Lesions by BCC or located in the nose and eyelid have higher rates of margin positivity after primary resection (AU)

Comparison of p63 and p40 (ΔNp63) as Basal, Squamoid, and Myoepithelial Markers in Salivary Gland Tumors.

p40 is selective for ΔNp63 isoforms and appears to be more specific for squamous differentiation than p63. Its performance as a basal/myoepithelial marker in salivary gland tumors has only rarely been addressed in the literature. We thus compared the performance of p63 and p40 (ΔNp63) immunohistochemical stain as markers of basal, squamoid, and myoepithelial differentiation in 105 salivary gland tumors selected from our archives. The neoplasms were categorized according to their presumed phenotype as ductoacinar (n=45), biphasic (dual ductal and myoepithelial/basal differentiation, n=44), purely myoepithelial (n=5), and excretory duct phenotype (n=11). Only nuclear staining for p63 and p40 was considered positive. Distribution of staining was scored as: 0 (no staining), 1+ (1% to 25%), 2+ (26% to 50%), 3+ (51% to 75%), and 4+ (76% to 100%). Intensity was scored as weak, moderate, or strong. p63 and p40 highlighted the basal and myoepithelial cells in normal salivary gland tissue as well as basal/myoepithelial/squamoid elements in biphasic tumors, purely myoepithelial tumors, and excretory duct type tumors (4+ with strong staining for p63, and moderate staining for p40). All ductal tumors were negative for p40. However, 13/13 polymorphous low-grade adenocarcinoma/cribriform adenocarcinomas of salivary gland, 7/9 canalicular adenomas, and 3/5 mammary analog secretory carcinomas showed some degree of p63 staining. Thus, we confirm that p40 is a more specific basal/myoepithelial/squamoid marker than p63 in salivary gland tumors. A subset of ductal tumors show a discordant p63+/p40- immunoprofile that can be a pitfall if not recognized, but may also help distinguish these tumors from truly biphasic tumors and myoepithelial tumors.

Trichoblastoma in young dog (Canis lupus familiaris) - first case report in Mozambique, Africa / Tricoblastoma em cão jovem (Canis lupus familiaris) - primeiro relato de caso na República de Moçambique, África

Trichoblastoma is a cutaneous benign neoplasia which is derivate of primitive hair follicles and have epithelial and mesenchymal elements. The study aimed to describe a case of an unusually aggressive trichoblastoma in a male dog, Maltese breed, 7 months old and 7 kg of body weight, with history of increased and rapid growth volume in frontal head region. The neoformation was ulcerated; hard consistency and not adhered; presence of alopecia and pink color; and no pain during palpation. The blood count, serum biochemical tests, urinalysis and imaging exams revealed no changes. On the cytological examination was observed the presence of basal epithelial cells with monomorphic nuclei and basophilic cytoplasm. The treatment was surgery with total excision of the neoformation. Twenty-one months after the surgical procedure was not observed any signs of recurrence and metastasis. Even rare in dogs and with age under 6 years, it was identified a macroscopically aggressive trichoblastoma in young dog with 7 months old, with histopathological features similar to that of adult dogs, and was the first case reported in Mozambique. The total surgical excision of the trichoblastoma was the treatment for this case report.

O tricoblastoma é uma neoplasia benigna cutânea derivada do folículo piloso primitivo, possuindo elementos epiteliais e mesenquimais. O trabalho teve como objetivo descrever um caso raro de tricoblastoma agressivo, em um cão macho da raça Maltês, sete meses de idade e pesando 7 kg, com histórico de aumento de volume, de crescimento rápido, em região frontal da cabeça. A neoformação apresentava-se ulcerada; de consistência dura e não aderida; presença de alopecia e coloração rósea; e ausência de dor à palpação. O hemograma, os exames bioquímicos séricos, urinálise e exames de imagem não revelaram alterações. No exame citopatológico foi observado presença de células epiteliais basais com núcleo monomórfico e citoplasma basofílico. O tratamento consistiu no procedimento cirúrgico por excisão total da neoformação. Vinte e um meses após o procedimento cirúrgico, não foi observado quaisquer sinais de recidiva e metástases. Visto que o tricoblastoma é raro em cães e com idade inferior a seis anos, o mesmo foi identificado na sua forma macroscopicamente agressiva em cão jovem de sete meses de idade, com características histopatológicas similares à dos cães adultos, sendo o primeiro caso reportado em Moçambique. A exérese total do tricoblastoma foi o tratamento para o presente relato de caso.

Trichoblastoma in young dog (Canis lupus familiaris) - first case report in Mozambique, Africa / Tricoblastoma em cão jovem (Canis lupus familiaris) - primeiro relato de caso na República de Moçambique, África

Trichoblastoma is a cutaneous benign neoplasia which is derivate of primitive hair follicles and have epithelial and mesenchymal elements. The study aimed to describe a case of an unusually aggressive trichoblastoma in a male dog, Maltese breed, 7 months old and 7 kg of body weight, with history of increased and rapid growth volume in frontal head region. The neoformation was ulcerated; hard consistency and not adhered; presence of alopecia and pink color; and no pain during palpation. The blood count, serum biochemical tests, urinalysis and imaging exams revealed no changes. On the cytological examination was observed the presence of basal epithelial cells with monomorphic nuclei and basophilic cytoplasm. The treatment was surgery with total excision of the neoformation. Twenty-one months after the surgical procedure was not observed any signs of recurrence and metastasis. Even rare in dogs and with age under 6 years, it was identified a macroscopically aggressive trichoblastoma in young dog with 7 months old, with histopathological features similar to that of adult dogs, and was the first case reported in Mozambique. The total surgical excision of the trichoblastoma was the treatment for this case report.(AU)

O tricoblastoma é uma neoplasia benigna cutânea derivada do folículo piloso primitivo, possuindo elementos epiteliais e mesenquimais. O trabalho teve como objetivo descrever um caso raro de tricoblastoma agressivo, em um cão macho da raça Maltês, sete meses de idade e pesando 7 kg, com histórico de aumento de volume, de crescimento rápido, em região frontal da cabeça. A neoformação apresentava-se ulcerada; de consistência dura e não aderida; presença de alopecia e coloração rósea; e ausência de dor à palpação. O hemograma, os exames bioquímicos séricos, urinálise e exames de imagem não revelaram alterações. No exame citopatológico foi observado presença de células epiteliais basais com núcleo monomórfico e citoplasma basofílico. O tratamento consistiu no procedimento cirúrgico por excisão total da neoformação. Vinte e um meses após o procedimento cirúrgico, não foi observado quaisquer sinais de recidiva e metástases. Visto que o tricoblastoma é raro em cães e com idade inferior a seis anos, o mesmo foi identificado na sua forma macroscopicamente agressiva em cão jovem de sete meses de idade, com características histopatológicas similares à dos cães adultos, sendo o primeiro caso reportado em Moçambique. A exérese total do tricoblastoma foi o tratamento para o presente relato de caso.(AU)

Benign follicular tumors

Abstract: Benign follicular tumors comprise a large and heterogeneous group of neoplasms that share a common histogenesis and display morphological features resembling one or several portions of the normal hair follicle, or recapitulate part of its embryological development. Most cases present it as clinically nondescript single lesions and essentially of dermatological relevance. Occasionally, however, these lesions be multiple and represent a cutaneous marker of complex syndromes associated with an increased risk of visceral neoplasms. In this article, the authors present the microscopic structure of the normal hair follicle as a basis to understand the type and level of differentiation of the various follicular tumors. The main clinicopathological features and differential diagnosis of benign follicular tumors are then discussed, including dilated pore of Winer, pilar sheath acanthoma, trichoadenoma, trichilemmoma, infundibuloma, proliferating trichilemmal cyst/tumor, trichoblastoma and its variants, pilomatricoma, trichodiscoma/fibrofolliculoma, neurofollicular hamartoma and trichofolliculoma. In addition, the main syndromes presenting with multiple follicular tumors are also discussed, namely Cowden, Birt-Hogg-Dubé, Rombo and Bazex-Dupré-Christol syndromes, as well as multiple tumors of follicular infundibulum (infundibulomatosis) and multiple trichoepitheliomas. Although the diagnosis of follicular tumors relies on histological examination, we highlight the importance of their knowledge for the clinician, especially when in presence of patients with multiple lesions that may be the cutaneous marker of a cancer-prone syndrome. The dermatologist is therefore in a privileged position to recognize these lesions, which is extremely important to provide further propedeutic, appropriate referral and genetic counseling for these patients.

Three different clinical faces of the same histopathological entity: hair follicle nevus, trichofolliculoma and accessory tragus.

BACKGROUND: Hair follicle nevus is a rare, congenital hamartoma with follicular differentiation characterized histologically by numerous, tiny, mature hair follicles. Trichofolliculoma, the histopathological features of which are quite similar to those of hair follicle nevus, is also a hamartoma that differs from hair follicle. Accessory tragus is a relatively common, benign congenital abnormality of the external ear with an incidence rate of 1 to 10 per 1,000 live births. OBJECTIVE: This study seeks to assess the discriminatory value of currently available, histological criteria in the differential diagnosis of hair follicle nevus, accessory tragi and trichofolliculoma. METHODS: Twenty-one patients comprising 9 cases of hair follicle nevus, 8 accessory tragi patients and 4 trichofolliculoma cases, were recruited to perform the study. RESULTS: There were 10 males and 11 females in the study group. No significant difference was observed between the three study groups in terms of age, gender or histopathological parameters such as density of hair follicles, subcutaneous fat score and presence of connective tissue framework. Cartilaginous component was seen in 8 cases that were diagnosed as accessory tragi, while central cyst and radiating hair follicles were seen in 4 cases which were diagnosed as trichofolliculoma. CONCLUSION: The results of our study showed that diagnostic discrimination of these diseases could be made only with the clinicopathologic correlation because of their clinical and histopathological similarities.

Three different clinical faces of the same histopathological entity: hair follicle nevus, trichofolliculoma and accessory tragus

AbstractBACKGROUND:Hair follicle nevus is a rare, congenital hamartoma with follicular differentiation characterized histologically by numerous, tiny, mature hair follicles. Trichofolliculoma, the histopathological features of which are quite similar to those of hair follicle nevus, is also a hamartoma that differs from hair follicle. Accessory tragus is a relatively common, benign congenital abnormality of the external ear with an incidence rate of 1 to 10 per 1,000 live births.OBJECTIVE:This study seeks to assess the discriminatory value of currently available, histological criteria in the differential diagnosis of hair follicle nevus, accessory tragi and trichofolliculoma.METHODS:Twenty-one patients comprising 9 cases of hair follicle nevus, 8 accessory tragi patients and 4 trichofolliculoma cases, were recruited to perform the study.RESULTS:There were 10 males and 11 females in the study group. No significant difference was observed between the three study groups in terms of age, gender or histopathological parameters such as density of hair follicles, subcutaneous fat score and presence of connective tissue framework. Cartilaginous component was seen in 8 cases that were diagnosed as accessory tragi, while central cyst and radiating hair follicles were seen in 4 cases which were diagnosed as trichofolliculoma.CONCLUSION:The results of our study showed that diagnostic discrimination of these diseases could be made only with the clinicopathologic correlation because of their clinical and histopathological similarities.

Correspondencia entre diagnóstico clínico e histopatológico de los tumores de los anexos oculares / Correspondence between clinical and histopathological diagnosis of tumors of the ocular adnexa

Fundamento: los tumores de los anexos oculares constituyen una causa frecuente de visita a la consulta de Oftalmología. Una adecuada relación clínico patológica es importante para su pronóstico. Objetivo: describir la correspondencia entre el diagnóstico clínico e histopatológico de los tumores de los anexos oculares. Métodos: estudio de serie de casos sobre los pacientes atendidos en la consulta de Oculoplastia del Centro Oftalmológico del Hospital General Universitario Dr. Gustavo Aldereguia, de Cienfuegos, desde enero del 2014 hasta igual mes del 2015, a los que por criterio de sospecha de malignidad se les realizó estudio histopatológico. Se analizó: edad, color de piel, tipo de tumor, correspondencia entre diagnóstico clínico e histopatológico y margen de seguridad de la cirugía. Resultados: la correspondencia entre el diagnóstico clínico y el histopatológico fue del 79,1 por ciento. El grupo etario más afectado fue el de 40-59 años, con mayor incidencia en el sexo femenino; la localización más frecuente fue a nivel palpebral en pacientes de color de piel blanca. Primaron las lesiones benignas tanto de párpado como de la conjuntiva; el carcinoma de conjuntiva y el carcinoma basal fueron los tumores malignos más representativos; el margen de seguridad fue de 2, 19 por ciento. Conclusiones: se observó un porciento adecuado de correspondencia entre el diagnóstico presuntivo y el histopatológico, el margen de seguridad logrado fue satisfactorio(AU)

Background: tumors of the ocular adnexa are a common cause of patient visits to the Ophthalmology consultation. An adequate clinical-pathological relationship is important for prognosis. Objective: to describe the correspondence between clinical and histopathological diagnosis of tumors of the ocular adnexa. Methods: a case series study was conducted in patients who underwent a histopathological study due to suspicion of malignancy treated at the Oculoplastic Service of the Ophthalmology Center of the Dr. Gustavo Aldereguía University General Hospital, from January 2014 to the same month of 2015. The variables analyzed were: age, skin color, type of tumor, correspondence between clinical and histopathological diagnosis and safety margin. Results: correspondence between clinical and histopathological diagnosis was 79.1 percent. The 40-59 age group was the most affected, with a higher incidence in females. The most common location was the eyelid region in white patients. Benign lesions of the eyelid and conjunctiva predominated. Conjunctival carcinoma and basal cell carcinoma were the most common malignancies; the safety margin was 2.19 percent. Conclusions: an adequate correspondence between presumptive and histopathological diagnosis was observed. The safety margin achieved was satisfactory(AU)

Benign follicular tumors.

Benign follicular tumors comprise a large and heterogeneous group of neoplasms that share a common histogenesis and display morphological features resembling one or several portions of the normal hair follicle, or recapitulate part of its embryological development. Most cases present it as clinically nondescript single lesions and essentially of dermatological relevance. Occasionally, however, these lesions be multiple and represent a cutaneous marker of complex syndromes associated with an increased risk of visceral neoplasms. In this article, the authors present the microscopic structure of the normal hair follicle as a basis to understand the type and level of differentiation of the various follicular tumors. The main clinicopathological features and differential diagnosis of benign follicular tumors are then discussed, including dilated pore of Winer, pilar sheath acanthoma, trichoadenoma, trichilemmoma, infundibuloma, proliferating trichilemmal cyst/tumor, trichoblastoma and its variants, pilomatricoma, trichodiscoma/fibrofolliculoma, neurofollicular hamartoma and trichofolliculoma. In addition, the main syndromes presenting with multiple follicular tumors are also discussed, namely Cowden, Birt-Hogg-Dubé, Rombo and Bazex-Dupré-Christol syndromes, as well as multiple tumors of follicular infundibulum (infundibulomatosis) and multiple trichoepitheliomas. Although the diagnosis of follicular tumors relies on histological examination, we highlight the importance of their knowledge for the clinician, especially when in presence of patients with multiple lesions that may be the cutaneous marker of a cancer-prone syndrome. The dermatologist is therefore in a privileged position to recognize these lesions, which is extremely important to provide further propedeutic, appropriate referral and genetic counseling for these patients.