Mohs' micrographic surgery of a proliferating trichilemmal tumor in a young black man

BACKGROUND. Proliferating trichilemmal tumor is an uncommon tumor of the follicular isthmus of the hair follicle. It usually presents as a solitary nodule on the scalp of older white women. Although these lesions typically behave in a benign fashion, recurrences and metastasis after local excision have been reported. Mohs' micrographic surgery has been effectively used to treat adnexal neoplasms. OBJECTIVE. To report a case of a proliferating trichilemmal tumor in a young black man, which was excised using Mohs' micrographic surgery. METHODS. Case report and review of the literature. RESULTS. Moh's I micrographic surgery demonstrated an irregular extension of the tumor beyond a 1 cm surgical margin. CONCLUSIONS. Proliferating trichilemmal tumors should be considered in the differential diagnosis of cutaneous neoplasms on the scalp in persons of any age (with the possible exception of infants and children), sex, or race. Mobs' micrographic surgery may be considered an optimal treatment option for proliferating trichilemmal tumors because these lesions may have an infiltrative component that may not be clinically apparent.