Benign adnexalFollicularICD-10 D23
Trichofolliculoma
Hair-follicle hamartoma; sebaceous trichofolliculoma (variant with sebaceous differentiation)
Trichofolliculoma is a benign hamartomatous proliferation of the hair-follicle apparatus, presenting as a solitary, firm, skin-coloured papule on the face — most often the nose, cheek, scalp or ear — with a characteristic central depression or pore from which a tuft of fine vellus hairs emerges. The central hair tuft is pathognomonic when present. Complete surgical excision is curative.
CurrentLast reviewed 15 May 2026
Clinical features
- Solitary firm, dome-shaped, skin-coloured papule, 2–8 mm.
- Central depression or pore containing a tuft of fine vellus hairs — the diagnostic clue.
- Distribution — central face (nose, cheek), scalp, ear; occasionally trunk.
- Adult patients; median age 40–60; both sexes.
- Slow growth, asymptomatic.
Histology
- A central dilated primary follicle with numerous secondary follicles radiating from its walls into the surrounding dermis.
- Secondary follicles show variable degrees of differentiation (immature to mature hair shafts).
- Sebaceous variant — secondary follicles with prominent sebaceous differentiation.
- Differential — dilated pore of Winer (single dilated follicle, no radiating secondary follicles), trichoadenoma, trichoepithelioma, follicular naevus.
Management
- Reassurance for typical lesions with a clinical hair-tuft sign.
- Surgical excision for cosmetic concern or diagnostic uncertainty.
- Recurrence after complete excision is rare.
References
- Pinkus H, Sutton RL Jr. Trichofolliculoma — a hamartoma of the pilosebaceous unit. Arch Dermatol; 1965.
- Misago N, Narisawa Y. Trichofolliculoma — clinicopathological review. J Cutan Pathol; 1997.
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