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Tricholemmoma: causes, symptoms, diagnosis, treatment
Last reviewed: 20.11.2021
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Tricholemoma clinically resembles basal cell or seborrheic keratosis and, as a rule, is a histological finding. The tumor is usually solitary, small in size with predominant localization in the face, somewhat more common in men than in women, the average age of the patients is 59 years. Multiple tumors are an integral part of the syndrome of Kauden.
Pathomorphology of tricholemma. The tumor is lobular, located in the dermis. Lobules of the tumor consist of light, polygonal, cells containing glycogen, surrounded on the periphery by darker ones. Located palisadically. Palisade-shaped tumor complexes surrounded by a thick membrane, similar to the eosinophilic basal membrane. There is a tendency to keratinization. Lobules of the tumor are mostly located around the hair follicles and grow in close proximity or in connection with the epidermis.
A flat variant of this tumor is characterized by less pronounced lobules, which are located parallel to the epidermis.
Histogenesis of tricholemma. The peculiarity of the development of the tricholemma is associated with the cellular elements of the differentiating tricholemma - the outer epithelial layer of the follicle. It forms a specific type of keratin, bypassing the granular appearance, in the upper part of the pilosebaceous complex of the hair follicle - epithelium of the epidermoid type, i.e. The keratinization occurs through the keratogialin stage. A completely different position with respect to tricholemma as an independent nosological form is taken by A.V. Ackerman (1993). From his point of view, tricholemoma is a viral wart in the reduction stage. In the author's opinion, the human papilloma virus can induce the proliferation of the epithelium of any part of the pilosebate complex and sweat glands. In the proliferation of the epithelium of the follicle funnel, the process takes the form of a follicular keratoma, and the proliferation of the outer lining in the area of the bulb leads to the formation of complexes of light cells around the periphery of the bulb.
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