Clinical history and examination are important. In a significant number of patients there is a familial trait. Examination will white, translucent, slightly raised papules which have a pearly white appearance.
Treatment
Any suspicicion of malignant change calls for adequate excision and histological examination.
The only other reason for treatment is cosmetic . Partial destruction is usually followed by regrowth. Many treatment modalities may be used including surgical excision, curettage, cryotherapy and dermabrasion. High-energy pulsed carbon dioxide laser has also been advocated as a useful treatment.
Trichoepitheliomas consists of nests of basaloid cells, with palisading. They lack the myxoid stroma and artefactual clefting seen in basal cell carcinoma. Mitoses are uncommon when compared to basal cell carcinoma.
