Trichoepithelioma Multiplex: A Study of the Relationship between the Anatomical Location and the Histopathological Features.
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Date
2013-10
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Abstract
Trichoepithelioma multiplex is a rare, benign cutaneous genodermatosis of disputed
histogenesis, consisting of tumors of trichogenic origin.
Aim: To explore the relationship between the anatomical location and the
histopathological features of the trichoepitheliomas in a patient cohort with
Trichoepitheliomamultiplex.
Methods: The study was conducted over the period 1995-2008 at the tertiary
Dermatology and Anatomical Pathology referral centers of the University of Pretoria. The
clinical and pathological features of confirmed cases were assessed. Sixty four H&E
stained sections from skin lesions distributed over different body areas were examined
with regard to 16 histopathological parameters for the evidence of follicular differentiation
and features useful in distinguishing trichoepithelioma from basal cell carcinoma. Special
stains were employed for the demonstration of mucin (PAS, Alcian blue) amyloid (Congo
red) calcium (Von Kossa) and epithelial structures (AE1/AE3-CK antibodies).
Results:Trichoepithelioma multiplex was an uncommon diagnosis (20 patients). African
patients were preponderant (16 vs.4 Caucasians) with slight male predominance (11 vs. 9 females). Sporadic cases prevailed (15 vs. 5 familial cases).A wide variation in the
severity of the clinical presentation was observed, young black males and familial cases
being more severely affected. The face was involved in all cases (30 biopsies), followed
by the scalp and back (13 biopsies each) and the neck (8 biopsies). There were variations
in histopathological patterns with considerable overlap between them. Special stains
differentiated between the tumours from different body areas with the exception of
AE1/AE3-CK antibodies. Foreign body reactions were common in lesions showing many
keratinous cysts and follicular damage. Trichoepithelioma was seen in relation to a benign
pigmented intradermal nevus in one biopsy and adjacent to a basal cell carcinoma in two
cases
Conclusion: A positive correlation could be established between the histopathological
pattern of trichoepitheliomas and the body area from which the lesions were removed.
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Keywords
Trichoepithelioma multiplex, familial multiple trichoepitheliomas, trichoblastoma, papillary mesenchymal bodies
Citation
Tenea Daniela, Louw Melanie. Trichoepithelioma Multiplex: A Study of the Relationship between the Anatomical Location and the Histopathological Features. British Journal of Medicine and Medical Research. 2013 Oct-Dec; 3(4): 1015-1029.