Trichofolliculoma ( Hair Follicle Tumors) : Clinical features, Pathogenesis, Treatment

November 24, 2012 | By | Reply More

Trichofolliculoma ( Hair Follicle Tumors)


The trichofolliculoma is a hamartomatous process representing an aborted and disrupted attempt at hair follicle formation. This tumor is analogous to the odontoma or ameloblastic fibro-odontoma of the jaws, which represents an aborted and disrupted attempt at tooth formation. The trichofolliculoma arises from the midshaft area of the hair follicle and seems to mark a disturbance between the normal epidermal and the dermal cell components of the hair follicle cycle.


Clinical features

  • Clinically, trichofolliculomas are usually irregular papules ranging from 1 to 4 cm that may have tufts of white hair emerging from their surface.
  • Larger ones have a surface that is dome shaped with a reddened base and yellow surface crusting.
  • Smaller ones have a normal surface color, a regular shape, and a central pore with a white or gray hair emerging from it.


Differential diagnosis

Depending on their size and shape, trichofolliculomas may resemble most of the common sun damage-related tumors:

  • keratoacanthoma,
  • basal cell carcinoma, and
  • skin squamous cell carcinoma.

Those with a reddened base and yellow crusting may mimic skin infections, particularly

  • folliculitis and
  • infected epidermoid cysts.


The architecture is of major significance and shows a dilated follicular structure with secondary follicles developing from it. The degree of differentiation of the secondary follicles is variable. There is a well-organized fibrous stroma.



Trichofolliculomas are treated with a local excision with 2-mm margins and should include the subcutaneous layer deep to the tumor. Such an excision should be curative without recurrence. Recurrences should raise suspicion of an unrecognized malignancy.

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Category: Medical, Pathology, Uncategorized

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