DESMOPLASTIC TRICHOEPITHELIOMA ASSOCIATED WITH OSTEOMA CUTIS
Osteoma cutis occurs in a variety of clinical settings duly noted in most dermatopathology textbooks. Ossification of products of follicular rupture presumably is the etiology when seen in the background of cicatricial acne vulgaris. Evidence of rupture of follicular microcysts is seen occasionally in desmoplastic trichoepitheliomas, so this case should not come as a surprise.

From the nasolabial fold of a 48 year old female:
Scan power view showing bone and microcysts. Small strands of epithelial cells are barely visible at this magnification.
Medium power view showing microcysts.
High power view showing calcification of keratin within a microcyst.
Medium power view showing small strands of epithelium in the upper half of the picture and bone in the lower part of the picture.
A high power view of one of the small strands of epithelium that is wrapped by a collagenous sheath.

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