Systematic analysis and case series of the diagnosis and management of trichilemmal carcinoma

Abstract

BackgroundTrichilemmal carcinoma (TLC) is a rare malignant cutaneous adnexal neoplasm, with no relatively comprehensive research.ObjectiveThe aim of this study is to perform an updated statistical analysis so as to better understand TLC’s epidemiology, clinical features, diagnosis, and treatment.MethodsThe diagnosis and treatment of three TLC cases in our department were summarized. Then, all TLC cases published in the literature were retrieved for a comprehensive analysis, followed by the analysis of global trends and regional distribution, demographic characteristics, clinical features, pathogenesis, histopathological features, and treatment and prognosis of TLC.ResultsOf the 231 cases, the incidence of TLC has shown an upward trend recently, especially in China, in Asia. The susceptible population is men aged 60–80 and women over 80, and the most prone location is head and neck. The phenotype of TLC is not always typical and may be misdiagnosed because of the coexistence of other diseases. There is a linear relationship between the diameter and its duration or thickness. UV, locally present skin lesions, trauma, scarring, organ transplantation, and genetic disorders may trigger the occurrence of TLC. Periodic acid–Schiff staining and CD34, but not Epithelial Membrane Antigen (EMA), were helpful in the diagnosis of TLC. Although effective, surgical excision and Mohs micrographic surgery need further improvement to reduce recurrence of TLC. Carcinoma history is an independent risk factor for TLC recurrence.LimitationsThe limitation of this study is the lack of randomized controlled trial on TLC treatment and recurrence.ConclusionTLC has the possibility of invasive growth and recurrence, especially in patients with longer duration and carcinoma history.

Excision of a large trichilemmal carcinoma of the back with staged reconstruction using biodegradable temporizing matrix (BTM): A case report

“… 1 The above case is atypical as, in addition to the sheer size of the lesion, it was not consistent with the most common locations for occurrence, and our patient was young in comparison to the average age for females (71 years). 1 …”

“…Trichilemmal carcinoma (TC) is a rare cutaneous tumour that originates from the external root sheath of a hair follicle. 1 They commonly occur on sun exposed skin, areas of thick hair growth and incidence increases with advanced age. 1 The above case is atypical as, in addition to the sheer size of the lesion, it was not consistent with the most common locations for occurrence, and our patient was young in comparison to the average age for females (71 years).…”

“…Trichilemmal carcinoma (TC) is a rare cutaneous neoplasm that originates from the external root sheath of a hair follicle. 1 TCs share characteristics of some more common cutaneous lesions such as squamous cell (SCC) and basal cell carcinoma (BCC). Whilst they are often asymptomatic and rarely metastasise, TC's can be locally invasive.…”

“…Split-skin grafting (SSG) and full-thickness grafting (FTG) have been documented as methods for wound closure as well as local and free-flap reconstruction of larger defects. 1 BTM is a synthetic material that promotes growth of a neodermis, priming the wound bed in advance of SSG. 2 It has been used in reconstruction post excision of large skin lesions, however, there are no documented cases of BTM use for reconstruction post excision of a TC.…”

Analysis of the Effects of Surfactants on Extracellular Polymeric Substances

“…The raw fluorescence spectra in the interval of 460~620 nm were subjected to Gaussian curve fitting [24], and the number of constituent peaks and their center positions are shown in Figure 6. The fluorescence intensity of EPS without additives was much higher than the fluorescence intensity of EPS containing 1 × 10 3 mg/L SDS.…”