Multiple Proliferating Trichilemmal Cysts with Clinical and Microscopic Correlation

Authors: Jouari OEL , Haddad MJEL and Gallouj S

DOI: 10.23880/cdoaj-16000342

Volume 10, Issue 1

Abstract

Proliferating Trichilemmal Cyst (PTC), also known as pilar cyst, is an uncommon benign intradermal or subcutaneous cystic lesion. It occurs in 5–10% of the population, most commonly on the scalp of elderly women. We present the case of an elderly Moroccan woman with multiple rapidly enlarging proliferating trichilemmal cysts on her scalp, which were surgically excised. Histological analysis revealed localized cystic lesions with trichilemmal keratinization and no signs of malignancy. PTC originates from the isthmic region of hair follicles. It’s typically presents as a slow-growing, subcutaneous cystic nodule that has been present for several years, often following a history of trauma or chronic inflammation. Although several case reports have been published in the literature, those involving multiple PTCs with rapid expansion and progression are rare. Differential diagnoses included epidermoid cysts, pilomatrocomas and squamous cell carcinoma and basal cell carcinoma. PTCs are a rare histopathological entity, as their histological characteristics may not always align with their clinical behavior. A thorough histological examination is crucial to identify any focal areas of malignant transformation. Complete surgical excision with a margin of 1.0 cm to reduce recurrence, is the standard treatment. This case highlights the importance of regular follow-up to monitor for recurrence or rare malignant transformation, as clinical behavior may not align with histological findings.

Keywords: Skin Tumors; Surgery; Histology; Proliferating Trichilemmal Cyst

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