Clinical history: 54 year old male with skin lesion superior to left nasolabial fold.
What is the most probable diagnosis?
Trichofolliculomas are benign follicular hemartomas which are found in adults and have a slight male predominance. Clinically, they are tan to whitish, small, dome-shaped papules which are common around the nose and on the face and tend to be solitary. A central pore is typically present and a protruding tuft of white hair is characteristic.
Histologically, a central cystic hair follicle opening to the skin surface is surrounded by radiating secondary and tertiary follicular structures. Within the central cyst, hair shaft fragments may be present. The stroma surrounding the lesion is fibrous.
Immunohistochemistry is non contributory and the differential diagnosis includes fibrofolliculoma and folliculocystic sebaceous hamartoma.
The lesion is benign and excision is performed for cosmetic purposes.