Jump to content
In this section we have spot diagnoses posted on a daily basis since June 2010, now over 1700! You can review the archived cases and read the suggested diagnoses by users and the final comment by Dr Uma Sundram, the Editor-in-Chief and main spot diagnosis host. Case are uploaded each week day by 10 a.m. UK time with the correct diagnosis will generally be posted at 8 p.m. UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 852 - 23rd September Posted By: Mark A. Hurt MD

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
   (0 reviews)

The patient is a 37-day old boy with an excision of an enlarging lesion present one month on the right preauricular cheek area.


  Report Record

User Feedback


Guest Romualdo

Posted

Hair follicle nevus (congenital vellus hamartoma).

Share this comment


Link to comment
share_externally

Guest Maria George

Posted

I think hair follicle nevus and accessory tragus are the same.If you see cartilage you will call it the latter, if not , like this case , you cal it hair follicle nevus.More important than the exact name , is that, the baby need to be investigated for associated anomalies and syndromes which can be associated with this lesion.

Share this comment


Link to comment
share_externally

Robledo F. Rocha

Posted

[font=arial,helvetica,sans-serif][size=4]Location close to the tragus and presence of [url="http://www.ncbi.nlm.nih.gov/pubmed/9436838"]adipose tissue[/url] make me favor accessory tragus, a lesion which may be associated to developmental anomalies of the pharyngeal arches. [url="http://www.ncbi.nlm.nih.gov/pubmed/?term=Histological+diagnostic+criteria+for+accessory+tragi."]Elastic c[/url][color=#000000][url="http://www.ncbi.nlm.nih.gov/pubmed/?term=Histological+diagnostic+criteria+for+accessory+tragi."]artilage is not an essential criteria to confirm this diagnosis[/url].[/color]
I believe hair follicle nevus is a variant of trichofolliculoma.[/size][/font]

Share this comment


Link to comment
share_externally

Guest Jim Davie MD

Posted

Accessory tragus. [list]
[*]Histology: Sessile papule featuring evenly spaced, normally placed dermal adnexa including folliculosebaceous and eccrine components, with an adipose tissue core. (A 'classic' accessory tragus would have a cartilaginous component; this one has an adipose tissue core.)
The expected tangential sectioning of a papular lesion makes evaluation of adnexa a bit more challenging; I think the vertically sectioned (non-tangential) adnexa seem normally placed within the deep reticular dermis.
[*]Clinical: Supportive: Preauricular location; congenital history.
[/list]
Whether hair follicle nevus or accessory tragus are separate entities is a matter of debate. They have very similar clinical and histologic features. One recent review article on this issue:
[size=3][b] [size=4] Multiple accessory tragi without cartilage: relationship with hair follicle naevi? [/size][/b][/size]
[size=4][color=#000000][font=arial, helvetica, clean, sans-serif][color=#660066] Acta Derm Venereol.[/color][/font][/color][color=#000000][font=arial, helvetica, clean, sans-serif] 2009;89(3):316-7. [ [url="http://www.medicaljournals.se/acta/content/?doi=10.2340/00015555-0617&html=1"]Full Text[/url] ] [ [url="http://www.medicaljournals.se/acta/content/download.php?doi=10.2340/00015555-0617"]PDF version[/url] (has much better histology images than Full Text version) ][/font][/color][/size]

Share this comment


Link to comment
share_externally

Mark A. Hurt MD

Posted

My diagnosis was: Accessory Tragus.

Thanks to everyone for contributing, and especially Dr. Davie for the reference. Under my [url="https://dermpathpro.com/blog/3/entry-101-how-do-you-file-articles-the-ypa-method/"]YPA system[/url], it is coded "20090316asah accessory tragus hair follicle nevus" See my [url="https://dermpathpro.com/blog/3/entry-101-how-do-you-file-articles-the-ypa-method/"]blog[/url] for details.

Share this comment


Link to comment
share_externally



Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Add a comment...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...

×
×
  • Create New...