Difference between revisions of "Pilar sheath acanthoma"

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{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = SkinTumors-P8190634.JPG
| Width      =
| Caption    = Possibly a pilar sheath acanthoma. [[H&E stain]].
| Micro      = cystic cavity with branching - contains keratineous material, usually extends from surface to deep cutis, cyst lining consists of a thickened squamous epithelium
| Subtypes  =
| LMDDx      = [[trichofolliculoma]], [[dilated pore of Winer]], [[epidermal inclusion cyst]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      = raised lesion, central cavitation
| Grossing  =
| Site      = [[skin]] - classically upper lip
| Assdx      =
| Syndromes  =
| Clinicalhx = typically middle aged - 50s
| Signs      =
| Symptoms  =
| Prevalence = rare
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    =
}}
'''Pilar sheath acanthoma''' is a rare benign [[skin]] lesion.
'''Pilar sheath acanthoma''' is a rare benign [[skin]] lesion.


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*Considered a [[hamartoma]].<ref name=pmid3557980/>
*Considered a [[hamartoma]].<ref name=pmid3557980/>
*Does not regress like keratoacanthoma.
*Does not regress like keratoacanthoma.
*Typically middle aged individuals.<ref name=pmid718186>{{Cite journal  | last1 = Mehregan | first1 = AH. | last2 = Brownstein | first2 = MH. | title = Pilar sheath acanthoma. | journal = Arch Dermatol | volume = 114 | issue = 10 | pages = 1495-7 | month = Oct | year = 1978 | doi =  | PMID = 718186 }}</ref>
*Typically middle aged individuals - median age in one series 55 years old, range 46-75 years old.<ref name=pmid718186>{{Cite journal  | last1 = Mehregan | first1 = AH. | last2 = Brownstein | first2 = MH. | title = Pilar sheath acanthoma. | journal = Arch Dermatol | volume = 114 | issue = 10 | pages = 1495-7 | month = Oct | year = 1978 | doi =  | PMID = 718186 }}</ref>


==Gross==
==Gross==
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==Microscopic==
==Microscopic==
Features:<ref name=pmid718186/>
Features:<ref name=pmid718186/>
*Cystic cavity with:
*Cystic cavity with branching:<ref name=pmid2697113>{{Cite journal  | last1 = Choi | first1 = YS. | last2 = Park | first2 = SH. | last3 = Bang | first3 = D. | title = Pilar sheath acanthoma--report of a case with review of the literature. | journal = Yonsei Med J | volume = 30 | issue = 4 | pages = 392-5 | month = Dec | year = 1989 | doi =  | PMID = 2697113 | URL = http://www.eymj.org/Synapse/Data/PDFData/0069YMJ/ymj-30-392.pdf }}</ref>
**Keratineous material.
**Contains keratineous material.
**Usually extends from surface to deep cutis - like a hair shaft.
**Usually extends from surface to deep cutis - like a hair shaft.
**Lining consists of a thickened squamous epithelium.
**Cyst lining consists of a thickened squamous epithelium ([[acanthosis]]).
*+/-Mitoses.


DDx:
DDx:
*[[Trichofolliculoma]].
*[[Trichofolliculoma]] - no branching of cavity, associated with hair & sebaceous glands.<ref name=pmid2697113/>
*[[Dilated pore of Winer]].
*[[Dilated pore of Winer]] - associated with hair & sebaceous glands.<ref name=pmid2697113/>
*[[Epidermal inclusion cyst]].
*[[Epidermal inclusion cyst]] - no branching, no accessory structures.


===Images===
===Images===
<gallery>
Image:SkinTumors-P8190634.JPG | Possibly a pilar sheath acanthoma. (WC)
</gallery>
www:
www:
*[http://www.dermnet.org.nz/pathology/pilar-sheath-path.html Pilar sheath acanthoma (dermnet.org.nz)].
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3129125/figure/F1/ Pilar sheath acanthoma (nih.gov)].<ref name=pmid21769237>{{Cite journal  | last1 = Bavikar | first1 = RR. | last2 = Gaopande | first2 = V. | last3 = Deshmukh | first3 = SD. | title = Postauricular pilar sheath acanthoma. | journal = Int J Trichology | volume = 3 | issue = 1 | pages = 39-40 | month = Jan | year = 2011 | doi = 10.4103/0974-7753.82136 | PMID = 21769237 }}</ref>
*[http://www.dermnet.org.nz/pathology/pilar-sheath-path.html Pilar sheath acanthoma - several images (dermnet.org.nz)].
*[http://www.eymj.org/Synapse/Data/PDFData/0069YMJ/ymj-30-392.pdf Pilar sheath acanthoma (eymj.org)].<ref name=pmid2697113/>
*[http://www.dermatopathonline.com/pilar%20sheath%20acanthoma2.html Pilar sheath acanthoma - several images (dermatopathonline.com)].


==See also==
==See also==
*[[Dermatopathology]].
*[[Dermatopathology]].
*[[Skin cysts]].
*[[Skin cysts]].
*[[Non-malignant skin disease]].


==References==
==References==

Latest revision as of 12:36, 30 October 2013

Pilar sheath acanthoma
Diagnosis in short

Possibly a pilar sheath acanthoma. H&E stain.

LM cystic cavity with branching - contains keratineous material, usually extends from surface to deep cutis, cyst lining consists of a thickened squamous epithelium
LM DDx trichofolliculoma, dilated pore of Winer, epidermal inclusion cyst
Gross raised lesion, central cavitation
Site skin - classically upper lip

Clinical history typically middle aged - 50s
Prevalence rare
Prognosis benign

Pilar sheath acanthoma is a rare benign skin lesion.

General

  • Rare.[1]
  • Considered a hamartoma.[1]
  • Does not regress like keratoacanthoma.
  • Typically middle aged individuals - median age in one series 55 years old, range 46-75 years old.[2]

Gross

  • Raised lesion with a central depression - somewhat similar to keratoacanthoma.
  • Classcially upper lip.[2]

DDx:

Microscopic

Features:[2]

  • Cystic cavity with branching:[3]
    • Contains keratineous material.
    • Usually extends from surface to deep cutis - like a hair shaft.
    • Cyst lining consists of a thickened squamous epithelium (acanthosis).
  • +/-Mitoses.

DDx:

Images

www:

See also

References

  1. 1.0 1.1 Vakilzadeh, F. (Jan 1987). "[Pilar sheath acanthoma].". Hautarzt 38 (1): 40-2. PMID 3557980.
  2. 2.0 2.1 2.2 Mehregan, AH.; Brownstein, MH. (Oct 1978). "Pilar sheath acanthoma.". Arch Dermatol 114 (10): 1495-7. PMID 718186.
  3. 3.0 3.1 3.2 3.3 Choi, YS.; Park, SH.; Bang, D. (Dec 1989). "Pilar sheath acanthoma--report of a case with review of the literature.". Yonsei Med J 30 (4): 392-5. PMID 2697113.
  4. Bavikar, RR.; Gaopande, V.; Deshmukh, SD. (Jan 2011). "Postauricular pilar sheath acanthoma.". Int J Trichology 3 (1): 39-40. doi:10.4103/0974-7753.82136. PMID 21769237.