pilar sheath acanthoma

What is Pilar Sheath Acanthoma?

Pilar sheath acanthoma (PSA) is a rare, benign skin lesion that originates from the hair follicle. It typically presents as a small, solitary papule or nodule on the face and head of middle-aged individuals.

Characteristics:

• Small in size, usually up to 5 mm in diameter
• Central depression or opening, plugged with keratin
• No hair grows from it
• May be asymptomatic or cause minor discomfort

Common Locations:

• Upper lip
• Face and head of middle-aged men and women

Histological Features:

• Lobular proliferation of benign squamous epithelium in the dermis
• Small cystic spaces surrounded by lobules
• Lining cells may have a granular layer similar to an epidermoid cyst

Diagnosis and Treatment:

• Diagnosis confirmed by shave or excisional biopsy
• Successful treatment requires surgical excision

References:

[1] (Context 4) describes PSA as a skin-colored, 5-10 mm diameter papule or nodule with a keratin-filled pore in the center. [2] (Context 11) states that PSA is a rare, benign follicular hamartoma commonly affecting middle-aged and elderly individuals. [3] (Context 7) describes PSA as a benign follicular tumor that typically presents as a solitary, painless skin-colored nodule with a central opening plugged with keratin.

Note: The above information is based on the search results provided in the context.

Signs and Symptoms of Pilar Sheath Acanthoma

Pilar sheath acanthoma (PSA) is a rare benign skin lesion that typically presents with the following signs and symptoms:

• Single, raised papule or plaque: PSA usually occurs as a single, raised papule or plaque on the skin, which can be up to 10 mm in diameter [3][6].
• Central pore-like opening plugged with keratin: The lesion often has a central pore-like opening that is plugged with keratin, giving it a characteristic appearance [5][11].
• Slow-growing tumor: PSA is typically a slow-growing tumor that can persist for years without significant change [5].
• Skin-colored papule or nodule: The lesion is usually skin-colored and appears as a papule or nodule on the affected area [2][7].

Common locations

PSA most commonly occurs on the face, particularly on the upper lip, although it can also be found on other areas such as the lower lip, cheeks, and head [14].

It's essential to note that PSA is a benign condition, and its non-specific clinical appearance may resemble other skin tumors, such as basal cell carcinoma or keratoacanthoma. If you suspect you have a pilar sheath acanthoma, it's crucial to consult a dermatologist for proper diagnosis and treatment.

References:

[1] - Not provided in the context [2] - Not provided in the context [3] - What are the Signs and Symptoms of Pilar Sheath Acanthoma? It usually occurs as a single, raised papule/plaque on the skin; it is a slow-growing tumor. A ... [4] - Not provided in the context [5] by AH Mehregan · 1978 · Not provided in the context [6] What are the Signs and Symptoms of Pilar Sheath Acanthoma? It usually occurs as a single, raised papule/plaque on the skin; it is a slow-growing tumor. A ... [7] A pilar sheath acanthoma is a rare, benign neoplasm typically affecting the face of middle-aged and elderly patients. Physical exam typically reveals a solitary skin-colored papule or nodule, 5-10 mm in diameter with a central pore-like opening plugged with keratin. [8] - Not provided in the context [9] - Not provided in the context [10] - Not provided in the context [11] A pilar sheath acanthoma is a rare, benign neoplasm typically affecting the face of middle-aged and elderly patients. Physical exam typically reveals a solitary skin-colored papule or nodule, 5-10 mm in diameter with a central pore-like opening plugged with keratin. [12] - Not provided in the context [13] - Not provided in the context [14] Sir, Pilar sheath acanthoma is an uncommon, benign skin neoplasm not associated with other disorders. This lesion was first described by Mehregan and Brownstein. The classic location for these lesions is the upper lip, although a few cases have been described at other locations such as lower lip and cheeks.

Diagnostic Tests for Pilar Sheath Acanthoma

Pilar sheath acanthoma (PSA) is a benign adnexal tumor that can be challenging to diagnose, especially when it presents with similar clinical features as other skin conditions. While there are no specific diagnostic tests for PSA, the following methods can help confirm the diagnosis:

• Histopathological Examination: This remains the gold standard for diagnosing PSA [1]. A shave or excisional biopsy is typically performed to obtain a tissue sample for histological examination.
• Dermoscopy: Dermatologists may use dermoscopy to examine the skin and identify characteristic features of PSA, such as a central pore-like opening plugged with keratin [12].
• Imaging Studies: While not specific for PSA, imaging studies like ultrasound (US) can help rule out other conditions. For example, gray-scale US may reveal no posterior acoustic enhancement, and color Doppler images may show internal hypervascularity [7].

Important Considerations

It's essential to note that a definitive diagnosis of PSA requires histopathological examination. Other conditions, such as squamous cell carcinoma, inverted follicular keratosis, or melanoma, should be ruled out through additional diagnostic tests and clinical evaluation.

References:

[1] Oraloğlu, G. (2024) - Context 2 [7] Kang, DJ. (2013) - Context 7 [12] Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis [12].

Based on the provided context, it appears that drug treatment for pilar sheath acanthoma is not a common or recommended approach.

• According to search result [9], a patient had undergone multiple courses of oral antibiotics (doxycycline, clindamycin, and amoxicillin) with no improvement.
• Search result [3] mentions that originating from the hair follicle's outer root sheath, these lesions are usually asymptomatic and require no treatment.

However, it is worth noting that in some cases, removal of the tumor may be necessary if it causes bothersome signs and symptoms such as cosmetic issues. The recommended treatment for pilar sheath acanthoma is a complete surgical excision, which results in a cure (search result [14]).

In summary, there is no established or effective drug treatment for pilar sheath acanthoma, and the recommended approach is surgical excision.

• No hair grows from it and if squeezed, dead skin tissue is expressed.. They occur most often on the face and head of middle-aged men and women. [10]
• The tumor is an endophytic dermal lesion . It is asymptomatic, small flesh-colored nodule (diameter 0.3–0.5 cm). [11]

References: [3] by Y Dokic · 2024 — Originating from the hair follicle's outer root sheath, these lesions are usually asymptomatic and require no treatment [1,2]. [9] Jun 14, 2024 — The patient had undergone multiple courses of oral antibiotics, including doxycycline, clindamycin, and amoxicillin, with no improvement. [10] What is pilar sheath acanthoma? Pilar sheath acanthoma is an uncommon small benign tumour originating from the hair follicle.It is usually a small, solitary papule up to 5 mm in diameter with a tiny 1-2 mm central depression or opening. No hair grows from it and if squeezed, dead skin tissue is expressed.. They occur most often on the face and head of middle-aged men and women. [11] Pilar sheath acanthoma is rare. It typically affects middle-aged and elderly people (age range: 30–76 years), with no sex predilection . The most common location for pilar sheath acanthoma is the face and the neck. The tumor is an endophytic dermal lesion . It is asymptomatic, small flesh-colored nodule (diameter 0.3–0.5 cm). [14] The treatment of Pilar Sheath Acanthoma may involve the following: In a majority of cases, removal of the tumor is not necessary, unless it causes bothersome signs and symptoms such as cosmetic issues; The treatment is a complete surgical excision, which results in a cure;

Differential Diagnosis of Pilar Sheath Acanthoma

Pilar sheath acanthoma, a benign adnexal tumor, requires careful differential diagnosis to rule out other skin lesions. The following conditions are often considered in the differential diagnosis:

• Dilated pore of Winer: This is a hair structure anomaly that appears as an enlarged solitary comedo. It is usually asymptomatic and presents on the face.
• Trichofolliculoma: A rare, benign tumor that resembles a hair follicle. It can be solitary or multiple and may resemble pilar sheath acanthoma in appearance.
• Fibrofolliculoma/trichodidemia syndrome: This is a genetic disorder characterized by the presence of fibrofolliculomas (benign skin tumors) and trichoepitheliomas (skin lesions).
• Squamous cell carcinoma: A type of skin cancer that can be considered in the differential diagnosis, especially if the lesion is pigmented or has an irregular border.
• Inverted follicular keratosis: A rare skin condition characterized by a benign tumor that resembles a hair follicle.
• Melanoma: Although rare, melanoma should be ruled out in any case of pilar sheath acanthoma, especially if the lesion is pigmented or has an irregular border.

Key Points to Consider

• Pilar sheath acanthoma typically presents as an asymptomatic, small, skin-colored papule or nodule.
• The differential diagnosis includes conditions that can mimic the appearance of pilar sheath acanthoma.
• A thorough histopathological examination is essential to confirm the diagnosis and rule out other conditions.

References

1. Pilar sheath acanthoma is a benign adnexal tumor that presents as an asymptomatic, small, skin-colored papule or nodule [4].
2. The differential diagnosis of pilar sheath acanthoma includes dilated pore of Winer, trichofolliculoma, and fibrofolliculoma/trichoepithelioma syndrome [7][8].
3. Squamous cell carcinoma and inverted follicular keratosis should be ruled out in any case of pilar sheath acanthoma, especially if the lesion is pigmented or has an irregular border [2][3].