Our Dermatol Online Our Dermatol Online 2081-9390 Our Dermatology Online Poland OURD-7-477 10.7241/ourd.20164.130 Historical Image Folliculosebaceous cystic hamartoma Bouhaja Leila 1 Jones Meriam 2 Rammeh Soumaya 1 Department of Pathology, Charles Nicolle Hospital, Tunis, Tunisia Department of Dermatology, Charles Nicolle Hospital, Tunis, Tunisia Corresponding author: Dr. Leila Bouhajja, E-mail: bouhaja.leila@gmail.com 2016 7 4 477 478 18032016 13062016 Copyright: © Our Dermatol Online 4 2016

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 <p>Sir,</p> <p>We report a 34 year-old man, with no past medical history, who presented with a 2-year history of a nodule on the nose. At physical examination the lesion was firm, pedunculated, and flesh-colored with a smooth surface. Clinically, the diagnosis of adnexal tumor was suggested and a surgical resection of the lesion was performed. Grossly, the tumor was firm pedunculated measuring 6 mm in size, raising the epidermis (<xref ref-type="fig" rid="F1">Fig. 1</xref>). Histological examination showed a well-circumscribed lesion of the dermis composed of numerous sebaceous follicles structures. Some were dilated forming cysts and connected directly to the epidermis (<xref ref-type="fig" rid="F2">Fig. 2</xref>). These epithelial structures were surrounded by a fibrohyalin stroma combined with a fibrous component containing adipocytes (<xref ref-type="fig" rid="F3">Fig. 3</xref>). These features were reminiscent with the diagnosis of folliculosebaceous cystic hamartoma. At 10 months of follow-up, the patient was asymptomatic and had no recurrence.</p> <fig id="F1"> <label>Figure 1</label> <caption> <p>A slide-mounted pedunculated tumor raising the epidermis.</p> </caption> <graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="OURD-7-477-g001.tif"/> </fig> <fig id="F2"> <label>Figure 2</label> <caption> <p>Dilated follicular cyst structure with infundibular keratinization surrounded by numerous sebaceous lobules in the dermis (HEx100).</p> </caption> <graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="OURD-7-477-g002.tif"/> </fig> <fig id="F3"> <label>Figure 3</label> <caption> <p>Stroma surrounding the folliculosebaceous structures consisting of collagen bundles interspersed with adipocytes (HEx40).</p> </caption> <graphic xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="OURD-7-477-g003.tif"/> </fig> <p>The patient’s informed consent was obtained.</p> <p>Prior to the study, patient gave written consent to the examination and biopsy after having been informed about the procedure.</p> <p>Folliculosebaceous cystic hamartoma (FSCH) is a rare cutaneous hamartoma composed of dilated folliculosebaceous units associated with mesenchymal elements [<xref ref-type="bibr" rid="ref1">1</xref>]. This tumor may occur in all age groups, and females are affected more often than males [<xref ref-type="bibr" rid="ref2">2</xref>]. Clinically, it manifests as a solitary skin-colored sessile or pedunculated nodule that is most commonly located on the face and scalp, with approximately 30% occurring in the nasal or paranasal regions. The lesion is usually less than 3 cm in size [<xref ref-type="bibr" rid="ref3">3</xref>,<xref ref-type="bibr" rid="ref4">4</xref>]. The main differential diagnoses are nevus lipomatosus superficialis or “sebaceous” trichofolliculoma which may include sebaceous glands but no central cyst [<xref ref-type="bibr" rid="ref5">5</xref>]. FSCH can be readily identified by the presence of adipocytes and a fibrous stroma. The treatment consists of total excision of the tumor.</p> <sec id="sec2-1"> <title>Consent

The examination of the patient was conducted according to the Declaration of Helsinki principles. Written informed consent was obtained from the patient for publication of this article.

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