Case Number : Case 852 - 23rd September Posted By: Guest

Hair follicle nevus (congenital vellus hamartoma).

Acessory tragus, though lacking cartilage.

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.

accessory tragus

[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]

Accessory tragus, very beautiful :-)

accessory tragus indeed!

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]