Proliferating trichilemmal cyst
A proliferating trichilemmal cyst describes an advanced complication of a trichilemmal cyst. Possibly as a result of rupture, the cyst enlarges and expands locally. The patient presents with a slowly-enlarging lobulated tumour. It is associated with an elderly age group, possibly as a result of failure to appreciate the indolent and progressive nature of the lesion.
Ulceration may make a proliferating trichilemmal cyst difficult to differentiate clinically from a squamous cell carcinoma. Rarely, malignant transformation can occur but most lesions show a well-demarcated lobular squamous epithelium with minimal cytological atypia.
Treatment is by excision.
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