|THROUGH THE LENS
|Year : 2014 | Volume
| Issue : 5 | Page : 56-57
Multiple papulonodular lesions located over the nasolabial sulcus
Ayse Serap Karadag1, Emin Ozlu1, Ebru Zemheri2, Seyma Ozkanli2
1 Department of Dermatology, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Research and Training Hospital, Istanbul, Turkey
2 Department of Pathology, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Research and Training Hospital, Istanbul, Turkey
|Date of Web Publication||13-Nov-2014|
Dr. Ayse Serap Karadag
Department of Dermatology, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Research and Training Hospital, Istanbul
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Karadag AS, Ozlu E, Zemheri E, Ozkanli S. Multiple papulonodular lesions located over the nasolabial sulcus. Indian Dermatol Online J 2014;5, Suppl S1:56-7
|How to cite this URL:|
Karadag AS, Ozlu E, Zemheri E, Ozkanli S. Multiple papulonodular lesions located over the nasolabial sulcus. Indian Dermatol Online J [serial online] 2014 [cited 2020 Mar 30];5, Suppl S1:56-7. Available from: http://www.idoj.in/text.asp?2014/5/5/56/144543
A 54-year-old woman presented with multiple, skin colored, papulonodular lesions located on nose and nasolabial sulcus since 30 years. There were no other cutaneous lesions. A systemic examination was normal. There was a history of similar lesions on the face of one sister and two brothers. There was no history of consanguinity.
Dermatologic examination showed multiple, skin colored, solid, 1-10 mm grouped papulonodular lesions, especially on the nose and nasolabial sulcus [Figure 1]a and b. Histopathologic examination showed a tumor consisting of multiple nodules within the dermis [Figure 2]a, basaloid epithelial cells with focal follicular differentiation and small horn cysts [Figure 2]b.
|Figure 2: (a) Histopathologic photograph in low power (H and E, ×20); (b) better visualization in ×40|
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| Discussion|| |
Trichoepithelioma is a benign trichogenic tumor that may differentiate into follicular pattern. , There are two clinical types of trichoepitheliomas: (1) Solitary non-familial type and (2) multiple familial type. The familial type is an autosomal dominant inherited syndrome known as multiple familial trichoepitheliomas or Brook-Fordyce disease. Brook-Fordyce disease is a rare disease and characterized by asymptomatic, multiple, skin colored papulonodular lesions located over the nose, forehead, and nasolabial sulcus. 
Multiple trichoepitheliomas may be associated with genetic diseases such as vermiculate atrophoderma, milia, basal cell carcinoma, peripheral cyanosis in Rombo syndrome, basal cell carcinoma, and follicular atrophy in Bazex syndrome.  Brook-Spiegler syndrome is an autosomal dominant inherited syndrome including cylindromas, trichoepitheliomas, and occasional eccrine spiradenomas. , Inherited multiple trichoepitheliomas can appear in this syndrome.
Multiple familial trichoepithelioma is a benign disease and malignant transformation is very rare. Cosmetic concern forms the main reason for treatment of multiple trichoepitheliomas.  There are various treatment modalities, including surgical excision, chemical cauterization, laser resurfacing, electrosurgery, dermabrasion, and topical 5% imiquimod cream. However, these treatments may not be effective. 
Brook-Fordyce disease is a very rare syndrome. Thus, patients with histologically proven Brook-Fordyce disease should be investigated for family history and systemic involvement. The accompanied syndromes should be investigated, and if detected, malignancy work-up should be performed.
| References|| |
Ying ZX, Ma HQ, Liu Y, Xiao SX, Wang YX, Wang GX. A novel mutation of CYLD in a Chinese family with multiple familial trichoepithelioma. J Eur Acad Dermatol Venereol 2012;26:1420-3.
Genc S, Sirin Ugur S, Arslan IB, Demir A, Tuhanioglu B, Kuskonmaz I, et al
. A giant solitary trichoepithelioma originating from the auricle. Dermatol Surg 2012;38:1527-8.
Kaur T, Puril KJ, Chahal KS, Budhwar J. Multiple familial trichoepitheliomas: A case report and review. J Egypt Dermatol 2012;8:11.
Baykal C, editor. Adnexal neoplasms. Atlas of Dermatology. Turkey: Argos; 2004.
[Figure 1], [Figure 2]