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THROUGH THE LENS
Year : 2014  |  Volume : 5  |  Issue : 5  |  Page : 56-57  

Multiple papulonodular lesions located over the nasolabial sulcus


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 Publication13-Nov-2014

Correspondence Address:
Dr. Ayse Serap Karadag
Department of Dermatology, Istanbul Medeniyet University, Faculty of Medicine, Goztepe Research and Training Hospital, Istanbul
Turkey
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2229-5178.144543

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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 Dec 5];5, Suppl S1:56-7. Available from: https://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 1: (a) and (b) Papulonodular lesions are around the nose

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Figure 2: (a) Histopathologic photograph in low power (H and E, ×20); (b) better visualization in ×40

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   Discussion Top


Trichoepithelioma is a benign trichogenic tumor that may differentiate into follicular pattern. [1],[2] 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. [3]

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. [3] Brook-Spiegler syndrome is an autosomal dominant inherited syndrome including cylindromas, trichoepitheliomas, and occasional eccrine spiradenomas. [3],[4] 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. [3] 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. [3]

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 Top

1.
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.  Back to cited text no. 1
    
2.
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.  Back to cited text no. 2
    
3.
Kaur T, Puril KJ, Chahal KS, Budhwar J. Multiple familial trichoepitheliomas: A case report and review. J Egypt Dermatol 2012;8:11.  Back to cited text no. 3
    
4.
Baykal C, editor. Adnexal neoplasms. Atlas of Dermatology. Turkey: Argos; 2004.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2]



 

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