History:

Trichilemmoma Clinical  Multiple or single warty like papules on the face or keratoses on the hands and feet . On the face they are congregated around the mouth, nose or ears and can be associated with Cowden's disease ( multiple hamartomas and marked risk of breast and thyroid carcinomas.). Intraoral papules on the tongue (cobblestoning) are also a feature.

 

Trichilemmoma - This shows a warty surface with lobular proliferation of polygonal cells with clear cell change and peripheral palisading, apoptotic bodies and lobules bounded by an eosinophilic basement membrane . Note association with Cowden syndrome. Virtual Slide

View this video from Joel Gardner   Another video from Ian mcColl