Generalized trichoepithelioma

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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W8MD medical weight loss NYC and sleep center NYC

Generalized trichoepithelioma
Synonyms	Multiple familial trichoepithelioma
Pronounce	N/A
Specialty	Dermatology
Symptoms	Multiple small skin-colored papules
Complications	Basal cell carcinoma
Onset	Childhood or adolescence
Duration	Lifelong
Types	N/A
Causes	Genetic mutation
Risks	Family history
Diagnosis	Skin biopsy, Genetic testing
Differential diagnosis	Basal cell carcinoma, Syringoma, Milia
Prevention	N/A
Treatment	Surgical excision, Laser therapy, Electrodesiccation
Medication	Topical retinoids, Oral retinoids
Prognosis	Generally benign
Frequency	Rare
Deaths	N/A

Generalized trichoepithelioma is a rare genetic disorder characterized by the presence of multiple benign skin tumors known as trichoepitheliomas. These tumors originate from the hair follicles and are typically found on the face, scalp, and neck.

Clinical Features

Generalized trichoepithelioma presents with numerous small, firm, skin-colored papules. These papules are usually symmetrically distributed and can coalesce into larger plaques. The condition is often first noticed in childhood or adolescence and tends to progress with age.

Symptoms

- Multiple papules on the face, particularly around the nose, cheeks, and forehead. - Papules may also appear on the scalp, neck, and upper trunk. - Lesions are typically asymptomatic but can occasionally cause itching or irritation.

Pathophysiology

Generalized trichoepithelioma is caused by mutations in the CYLD gene, which is responsible for encoding a protein that regulates cell growth and division. The mutation leads to uncontrolled proliferation of cells in the hair follicle, resulting in tumor formation.

Diagnosis

Diagnosis is primarily clinical, based on the characteristic appearance of the lesions. A skin biopsy can be performed to confirm the diagnosis, revealing nests of basaloid cells with peripheral palisading and keratin cysts.

Treatment

There is no definitive cure for generalized trichoepithelioma, but several treatment options can help manage the condition: - Surgical excision: Individual lesions can be removed surgically, although new lesions may develop. - Laser therapy: Carbon dioxide laser or pulsed dye laser can be used to reduce the appearance of lesions. - Topical treatments: Topical retinoids or imiquimod cream may be used to reduce lesion size.

Prognosis

The prognosis for individuals with generalized trichoepithelioma is generally good, as the condition is benign and does not affect overall health. However, the cosmetic appearance of the lesions can be distressing for patients.

See Also

- Trichoepithelioma - Basal cell carcinoma - Skin tumor - Genetic disorder