the nose that has been present for about six months.
O/E: The examination shows a healthy, outgoing woman with type I skin. There is a solitary 3 mm in diameter dome-shaped papule with a central keratin on the bulb of the nose. The remainder of the cutaneous examination is unremarkable.
Clinical and Dermatoscopic Images:
Preoperative diagnosis: This has the appearance of keratoacanthoma, squamous cell carcinoma, or hypertrophic actinic keratosis.
PLAN: The lesion was shave excised. The base was lightly electrodesiccated and curetted and a
specimen was submitted for pathology.
Pathology: Assistant Professor Hye Jin Chung, MD from Boston University Skin Pathology kindly provided the photomicrographs.
At x4: parakeratosis, papillomatosis and a lobular proliferation of pale cells
At x10: peripheral palisading with focal eosinophilic hyaline basement membrane
Diagnosis: Solitary Tricholemmoma
Daignosis: Solitary tricholemmoma. Tricholemmomas can be a marker for Cowden's disease. However, I don't feel that a solitary tricholemmoma is a red flag in a 39 yo woman. I asked the patient about a personal or family history of cancer and there was no history of thyroid, lung or colon.
This case is presented because there are few to no accessible cases of solitary tricholemmoma online and no dermatoscopic images that I could fine..