Abstract
Solitary trichoepithelioma (TE) is a rare, benign tumor of follicular origin that in certain cases is difficult to differentiate from basal cell carcinoma (BCC). We report the case of an 8-year-old girl with a pale pink, soft lesion on the neck. The clinical image of the lesion was equivocal, while some dermoscopic findings—blue-gray globules and arborizing vessels—could not exclude the presence of BCC from the differential diagnosis, although that would have been a very unlikely case considering the age of the patient. The histopathologic examination established the diagnosis of TE. Given the occasion of this challenging case we try to list the key clinical, dermoscopic and histopathological characteristics of TE and BCC in order to elucidate the differential diagnosis of these two entities.
Highlights
Solitary trichoepithelioma (TE) is a rare, benign tumor of follicular origin that in certain cases is difficult to differentiate from basal cell carcinoma (BCC)
We report the case of an 8-year-old girl with a pale pink, soft lesion on the neck
We report the case of an 8-year-old girl who was referred to our pigmented lesions clinic exhibiting a pale pink lesion with a soft, lobulated surface (Figure 1)
Summary
We report the case of an 8-year-old girl who was referred to our pigmented lesions clinic exhibiting a pale pink lesion (almost 1 cm in diameter) with a soft, lobulated surface (Figure 1). The dermoscopic examination, performed at that time with a handheld dermatoscope (Dermlite II HR PRO by 3GEN), revealed a translucent white background with blue-gray globules at the periphery and very subtle arborizing vessels (Figure 2). These features could not exclude the possibility of basal cell carcinoma (BCC) that would have been a very unlikely diagnosis in an 8-year-old child. At the periphery of the lobules, the neoplastic cells displayed characteristic palisad-
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