Clinical cases

Trichoblastoma is a benign, rare, small-sized tumor, more commonly having 1-2 cm diameter, developed from germ cells of the hair follicle. A 55-year-old male addressed to the Dermatology Clinic for a nodular tumor on the face, with slow evolution of about 1 year. Clinical examination and dermoscopy, imposed the following differential diagnosis: basal cell carcinoma, trichoepithelioma or trichoblastoma. It was performed excisional biopsy and the diagnosis was trichoblastoma with reactive hyperplasia of eccrine ducts. Since there are not enough studies in the literature about dermoscopy of these tumors to make a clear differential diagnose, the gold standard remains histopathological examination. Although surgical excision is the first line treatment for trichoblastoma, other options have been reported in the literature without being supported by safety and efficacy studies such as electrodessication, photodynamic therapy, CO2 laser. Trichoblastoma, although has a reduced incidence, should be take into consideration when we make a differential diagnosis of basal cell carcinoma because the therapeutic decision and prognosis are different for the two types of tumors.