What are the other Names for this Condition? (Also known as/Synonyms)

• Trichoblastic Fibroma
• Trichogenic Trichoblastoma
• Trichogerminoma

What is Trichoblastoma? (Definition/Background Information)

• Trichoblastoma is a benign tumor of the hair follicles on skin. The tumor is usually solitary and can be present in individuals of all age groups
• The risk factors for sporadic and solitary Trichoblastomas are unknown, but it may be caused by genetic mutations. Also, multiple tumors are associated with genetic conditions including Brooke-Spiegler and Brooke-Fordyce syndromes
• Trichoblastoma may occur as a small, painless papule on skin, usually in the head and neck region. They may be a few centimeters in size
• In a majority of cases, no treatment is necessary, unless it causes worrisome symptoms or cosmetic concerns in the individual. In case the tumor is associated with a genetic condition, then treatment of the underlying condition may be undertaken
• A simple surgical excision of the tumor is considered curative. The prognosis for Trichoblastoma is excellent with suitable treatment. The prognosis of multiple tumors due to an associated genetic disorder is based on the severity of the underlying disorder

Who gets Trichoblastoma? (Age and Sex Distribution)

• Trichoblastoma is a benign tumor that can occur at any age
• Both males and females may be affected
• Individuals of all racial and ethnic background may be affected

What are the Risk Factors for Trichoblastoma? (Predisposing Factors)

Presently, there are no risk factors identified for solitary Trichoblastoma. In the case of multiple tumors, the following rare genetic conditions may be involved:

• Brooke-Spiegler disease
• Brooke-Fordyce syndrome

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Trichoblastoma? (Etiology)

The exact cause of Trichoblastoma is not well-understood. 

• When numerous tumors are observed, they may be found in association with certain genetic conditions or syndromes (familial Trichoblastomas)
• When the Trichoblastomas occur in isolation, they are usually sporadic and no associated conditions are observed
• However, sporadic and solitary tumors are associated with certain genetic alterations, notably at 9q22.3 (on the long arm q of chromosome 9)
• Research is currently being undertaken to identify the relevant causal factors

The skin condition is not infectious and does not spread from one individual to another through contact.

What are the Signs and Symptoms of Trichoblastoma?

The signs and symptoms of Trichoblastoma include:

• It usually occurs as a single tumor of hair-follicle origin on skin
• The tumor appears like a small papule on hair-bearing skin
• In most cases, the head and neck region (mostly the scalp) is involved. But, Trichoblastomas may form anywhere in the body
• Multiple tumors are associated with certain genetic disorders, and in such cases, the signs and symptoms of the underlying disorder may be seen
• The skin lesions are usually painless and non-itchy
• Trichoblastomas are typically less than 1 cm in size, but may range from a few mm to several cm in size
• They are rarely known to ulcerate

How is Trichoblastoma Diagnosed?

A diagnosis of Trichoblastoma may involve the following:

• A thorough medical history and physical examination
• Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis
• Differential diagnosis of other tumors, such as the following should be ruled out; hence, biopsy is an important diagnostic tool
  • Desmoplastic trichoepithelioma
  • Morpheaform basal cell carcinoma
  • Microcystic adnexal carcinoma
  • Metastatic breast cancer

When a pathologist examines the tumor tissue under the microscope, the following different patterns of Trichoblastoma may be observed:

• Large and small nodular Trichoblastoma
• Retiform Trichoblastoma
• Cribriform Trichoblastoma
• Racemiform Trichoblastoma
• Columnar Trichoblastoma

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Trichoblastoma?

Trichoblastoma does not generally cause any significant complications.

• However, some individuals may have concerns regarding their cosmetic appearance, particularly when the tumors are present on the face and neck area
• Complications may arise from the underlying genetic condition/syndrome, if any, the tumor is associated with

How is Trichoblastoma Treated?

The treatment of Trichoblastoma may involve the following:

• In a majority of cases, removal of the nodule is not necessary, unless it causes bothersome signs and symptoms such as cosmetic issues
• The treatment for solitary tumor is a complete surgical excision, which can result in a cure
• Treatment of the underlying associated genetic disorder, if present, may be undertaken
• Follow-up care with regular screening and check-ups are encouraged

How can Trichoblastoma be Prevented?

Currently, there are no known methods to prevent sporadically-occurring Trichoblastomas. In case of multiple tumors that are associated with genetic disorders, such as Brooke-Spiegler and Brooke-Fordyce disorders, the following may be noted:

• Genetic testing of the expecting parents (and related family members) and prenatal diagnosis (molecular testing of the fetus during pregnancy) may help in understanding the risks better during pregnancy
• If there is a family history of the condition, then genetic counseling will help assess risks, before planning for a child
• Active research is currently being performed to explore the possibilities for treatment and prevention of inherited and acquired genetic disorders

What is the Prognosis of Trichoblastoma? (Outcomes/Resolutions)

• The prognosis for Trichoblastoma is excellent with appropriate treatment, since it is a benign tumor in most cases
• If these skin lesions are associated with any genetic disorders, then the overall prognosis may depend upon the severity of the signs and symptoms of the underlying disorder

Additional and Relevant Useful Information for Trichoblastoma:

• There is no evidence to prove that oily foods and chocolate-based products have an influence on Trichoblastoma formation
• Cleaning the skin too hard with strong chemicals or soaps may aggravate the skin condition. Care must be taken avoid strong soaps and chemicals that could potentially worsen the condition
• The presence of dirt on the body is not a causative factor for the condition. However, it helps to be clean and hygienic, which may help the condition from getting worse