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Kemaloğlu CA, Öztürk M, Aydın B, Canöz Ö, Eğilmez O. Malignant proliferating trichilemmal tumor of the scalp: report of 4 cases and a short review of the literature. Case Reports Plast Surg Hand Surg 2022; 9:158-164. [PMID: 35634539 PMCID: PMC9132464 DOI: 10.1080/23320885.2022.2077208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Malignant proliferating pilar tumors are very rare adnexial lesions that can be confused with other skin neoplasms. The authors present four patients with malignant proliferating trichilemmal tumors located on the scalp. A review of the literature search for malignant proliferating pilar tumors and treatments was performed.
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Affiliation(s)
- Cemal Alper Kemaloğlu
- Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Melikgazi Öztürk
- Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Beyza Aydın
- Department of Plastic, Reconstructive and Aesthetic Surgery, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Özlem Canöz
- Department of Pathology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Orhun Eğilmez
- Department of Pathology, Faculty of Medicine, Erciyes University, Kayseri, Turkey
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2
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Treatment of Malignant Adnexal Tumors of the Skin: A 12-Year Perspective. Cancers (Basel) 2022; 14:cancers14040998. [PMID: 35205753 PMCID: PMC8870474 DOI: 10.3390/cancers14040998] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 01/25/2023] Open
Abstract
Malignant adnexal cancers of the skin—extremely rare neoplasms—are mostly reported as non-symptomatic, slow-growing nodules. These carcinomas occur mainly in the middle-aged (50–60 years of age); they are mostly localized on the upper part of the body and are locally aggressive, infiltrate surrounding tissue, and metastasize to regional lymph nodes. The patients’ outcomes depend on multiple prognostic factors, including the size of the primary tumor and its mitotic count. Surgical resection of the primary tumor with or without regional lymph nodes is the treatment method of choice; however, due to aggressive tumor behavior, perioperative treatment may be considered. The role and efficacy of radiotherapy in the treatment of skin adnexal malignancies are not yet fully defined. Some authors suggest that adjuvant radiotherapy may be considered in locally advanced and regional disease. The aim of this study was to evaluate treatment outcomes and assess the efficacy of combined therapy in patients with adnexal malignancies. Our analysis covered all cases of cutaneous adnexal tumor patients diagnosed and provided with multidisciplinary treatment with surgery and radiotherapy since the beginning of 2009.
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Azizi M, Ramezani M. Malignant proliferating trichilemmal tumor in abdominal wall: Report of a rare case at an uncommon site with literature review. Clin Case Rep 2022; 10:e05259. [PMID: 35028148 PMCID: PMC8742517 DOI: 10.1002/ccr3.5259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 11/30/2021] [Indexed: 11/15/2022] Open
Abstract
The proliferating trichilemmal tumor (PTT) is a very rare cutaneous neoplasm that rarely is malignant. PTTs mainly occur in the scalp of elderly women. Only 10% occur in places other than scalp. We present a 62-year-old male patient with malignant PTT in his abdominal wall.
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Affiliation(s)
- Mahdokht Azizi
- Department of PathologyShahid Beheshti HospitalYasuj University of Medical ScienceYasujIran
| | - Mazaher Ramezani
- Molecular Pathology Research CenterImam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
- Clinical Research Development CenterImam Reza HospitalKermanshah University of Medical SciencesKermanshahIran
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4
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Fukunaga Y, Kawamoto M, Nishimura K, Hakuba N. Proliferating trichilemmal tumor-like neoplasm in the external auditory canal: A case report. OTOLARYNGOLOGY CASE REPORTS 2021. [DOI: 10.1016/j.xocr.2021.100354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Lakhani R, Khullar G, Sharma S. An unusual case of co-localization of proliferating trichilemmal tumor and seborrheic keratosis. Indian J Dermatol Venereol Leprol 2021; 87:551-554. [PMID: 33969650 DOI: 10.25259/ijdvl_817_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 12/01/2020] [Indexed: 11/04/2022]
Affiliation(s)
- Ridhima Lakhani
- Department of Dermatology and Sexually Transmitted Diseases, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Geeti Khullar
- Department of Dermatology and Sexually Transmitted Diseases, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Shruti Sharma
- Department of Pathology, National Institute of Pathology (Indian Council of Medical Research), Safdarjung Hospital Campus, New Delhi, India
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Dboush HG, Al-Doud MA, Shannaq RY, Abudarweesh IS, Jabali EH, Alabbadi AS. Trichilemmal carcinoma of the axilla with regional lymph nodes metastasis: A case report. Int J Surg Case Rep 2021; 81:105760. [PMID: 33752035 PMCID: PMC8010626 DOI: 10.1016/j.ijscr.2021.105760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/06/2021] [Accepted: 03/07/2021] [Indexed: 12/04/2022] Open
Abstract
Cutaneous adnexal neoplasms are calcified according to the skin appendage origin. Clinical diagnosis is impossible. Thus, surgical excision is always required. Pathological examination is generally adequate for their correct classification. Trichilemmal carcinoma is a malignant cutaneous adnexal neoplasm of hair follicles. Trichilemmal carcinoma is a rare tumour, mainly when located in the axilla.
Introduction and importance Trichilemmal carcinoma is a rare malignant cutaneous adnexal neoplasm of hair follicles originating from the external root sheath epithelium. The diagnosis is rarely made clinically and is still challenging for an experienced pathologist. Aim To report a rare case of trichilemmal carcinoma presenting as a right axillary mass with regional lymph nodes metastasis and was treated with wide local excision in the General Surgery Department Jordanian Royal Medical Services (JRMS), Jordan. Case presentation A 45-year-old presented with a right axillary mass of six-month duration. Physical examination revealed a hyperemic, thickened skin of both armpits with a palpable 5-cm mass in the right axilla. He underwent an excisional biopsy of the right mass. Histopathologic examination revealed a malignant adnexal skin tumour with foci of trichilemmal-type keratinisation. It was excised with adequate margins. Clinical discussion Trichilemmal carcinoma usually occurs on the forehead, scalp, neck, back of hands and trunk. These neoplasms are rare lesions presenting as locally aggressive, low-grade carcinomas and have the potential for nodal involvement and distant metastasis. Therefore, the establishment of a correct diagnosis is vital to guide the treatment plan. Wide excision with adequate tumour-free margins is considered a curative treatment and offers a successful outcome. Conclusion Malignant cutaneous adnexal tumours are one of the most challenging subjects of dermatopathology. Surgical excision is always required to establish a definitive diagnosis and differentiation subtypes. Trichilemmal carcinoma is a relatively rare tumour, mainly when located in the axilla.
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Affiliation(s)
- Heba G Dboush
- Department of General Surgery, Jordanian Royal Medical Services (JRMS), Amman, Jordan.
| | - Mohammad A Al-Doud
- Department of General Surgery, Jordanian Royal Medical Services (JRMS), Amman, Jordan.
| | - Ruba Y Shannaq
- Department of Laboratory Medicine and Pathology, Jordanian Royal Medical Services (JRMS), Amman, Jordan.
| | - Ishraq S Abudarweesh
- Department of Radiology, Jordanian Royal Medical Services (JRMS), Amman, Jordan.
| | - Eslam H Jabali
- Department of Nuclear Medicine, Jordanian Royal Medical Services (JRMS), Amman, Jordan.
| | - Ahmad S Alabbadi
- Department of General Surgery, Jordanian Royal Medical Services (JRMS), Amman, Jordan.
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Rajbhar R, Anvikar A, Sulhyan K. Clinicopathological correlation of malignant skin tumors: A retrospective study of 5 years. Int J Health Sci (Qassim) 2020; 14:18-25. [PMID: 32536845 PMCID: PMC7269623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Skin cancers are relatively uncommon malignancies worldwide, but there is a progressive increase in the incidence over the last few decades. METHODS We have studied the clinical and histopathological features of malignant skin tumors received in the department of pathology of our tertiary care institute over a period of 3 years and 8 months. A detailed analysis of clinical, gross, and microscopic findings was performed, followed by clinicopathological correlation. RESULTS One hundred and one specimens of skin tumors were received during this period, of which 37 (36.27%) were malignant tumors. Keratinocytic tumors were most common (81.08%) followed by appendageal tumors (10.81%). Squamous cell carcinoma (SCC) was the most frequent malignancy followed by basal cell carcinoma (BCC). Malignant melanoma, hidradenocarcinoma, malignant proliferating trichilemmal tumor (MPTT), sebaceous carcinoma, and fibrosarcomatous dermatofibrosarcoma were also observed. Variants such as hybrid verrucous SCC, basosquamous carcinoma, infiltrating BCC, and MPTT with spindle SCC were also found. Malignant skin tumors were most frequent in the seventh decade (40.54%). Males and females were almost equally affected. Overall, head and neck region was the most common site for malignant skin tumors. CONCLUSION The vast diversity of skin tumors produces difficulty in diagnosis. Any lesion, for which the diagnosis is uncertain, based on the history and clinical examination, should be biopsied for histopathological examination to rule out malignancy.
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Affiliation(s)
- Rahul Rajbhar
- Department of Pathology, Seth G.S. Medical College and K.E.M. Hospital, Mumbai Maharashtra, India,Address for correspondence: Dr. Rahul Rajbhar, Seth G.S. Medical College and K.E.M. Hospital, Mumbai, Maharashtra, India. E-mail:
| | - Arti Anvikar
- Department of Pathology, Government Medical College, Miraj, Maharashtra, India
| | - Kalpana Sulhyan
- Department of Pathology, Government Medical College, Miraj, Maharashtra, India
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Mohan B, Letha V, Anilkumar V. Malignant Proliferating Trichilemmal Tumor: A Rare Adnexal Neoplasm. INDIAN JOURNAL OF DERMATOPATHOLOGY AND DIAGNOSTIC DERMATOLOGY 2020. [DOI: 10.4103/ijdpdd.ijdpdd_54_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Singh P, Usman A, Motta L, Khan I. Malignant proliferating trichilemmal tumour. BMJ Case Rep 2018; 2018:bcr-2018-224460. [PMID: 30121565 DOI: 10.1136/bcr-2018-224460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Proliferating trichilemmal tumours are benign but locally aggressive skin neoplasms arising from hair follicles. Rarely, they can become malignant and must be appropriately managed to prevent recurrence and metastasis. One must have a low threshold for diagnosing this rare neoplasm.
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Affiliation(s)
- Prateush Singh
- Department of Plastic Surgery, Royal Free Hospital, London, UK
| | - Ayesha Usman
- Department of Plastic Surgery, St Helens and Knowsley NHS Trust, Prescot, UK
| | - Luisa Motta
- Department of Pathology, St Helens and Knowsley NHS Trust, Prescot, UK
| | - Irfan Khan
- St Helens and Knowsley NHS Trust, Prescot, UK
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Jaehn T, Kaiser J, Billner M, Kaiser A, Reichert B. [Gigantic exophytically growing tumor of the occipital scalp : A complex diagnostic and reconstructive challenge]. Chirurg 2017; 88:879-883. [PMID: 28421260 DOI: 10.1007/s00104-017-0425-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- T Jaehn
- Universitätsklinik für Plastische, Wiederherstellende und Handchirurgie, Zentrum für Schwerbrandverletzte, Paracelsus Medizinische Privatuniversität, Klinikum Nürnberg, Breslauer Straße 201, 90471, Nürnberg, Deutschland.
| | - J Kaiser
- Universitätsinstitut für Pathologie, Paracelsus Medizinische Privatuniversität, Klinikum Nürnberg, Nürnberg, Deutschland
| | - M Billner
- Universitätsklinik für Plastische, Wiederherstellende und Handchirurgie, Zentrum für Schwerbrandverletzte, Paracelsus Medizinische Privatuniversität, Klinikum Nürnberg, Breslauer Straße 201, 90471, Nürnberg, Deutschland
| | - A Kaiser
- Universitätsinstitut für Pathologie, Paracelsus Medizinische Privatuniversität, Klinikum Nürnberg, Nürnberg, Deutschland
| | - B Reichert
- Universitätsklinik für Plastische, Wiederherstellende und Handchirurgie, Zentrum für Schwerbrandverletzte, Paracelsus Medizinische Privatuniversität, Klinikum Nürnberg, Breslauer Straße 201, 90471, Nürnberg, Deutschland
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11
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Atypical Proliferating Trichilemmal Cyst with Malignant Breast Skin Transformation: A Case Report and Review of the Literature. Case Rep Oncol Med 2016; 2016:7481569. [PMID: 27403361 PMCID: PMC4923530 DOI: 10.1155/2016/7481569] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 01/18/2016] [Indexed: 11/17/2022] Open
Abstract
Proliferating trichilemmal tumors (PTTs) are benign adnexal skin neoplasms that arise from the outer root sheath of the hair follicle. These tumors are most commonly observed on the scalp and occur, most of the time, in elderly women. Malignant transformation of these neoplasms is a rare event; less than 50 cases have been reported in the English medical literature. We present the case of a 39-year-old Hispanic woman with a tumor located on the skin of one of her breasts that in her third surgical procedure the histologic examination revealed the presence of a malignant proliferating trichilemmal tumor (MPTT). Furthermore, a review of the medical literature and a discussion of the clinical and pathologic features of this rare entity are provided.
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12
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Sia PI, Figueira E, Allende A, Selva D. Malignant hair follicle tumors of the periorbital region: A review of literature and suggestion of a management guideline. Orbit 2016; 35:144-56. [PMID: 27171562 DOI: 10.1080/01676830.2016.1176048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Malignant hair follicle tumors are rare skin adnexal malignancies that have a predilection for the head and neck region. They can be categorized into a number of different subtypes. Histologically, they are distinct from their benign counterpart. To the best of our knowledge, there is no extensive review of these malignancies, especially in the periorbital region. We aim to provide a literature review and a guideline for management of these malignant tumors in the periorbital region. Database from Medline, PubMed, Embase, and Google Scholar were consulted. A total of 16 cases from the literature on hair follicle malignancies in the periorbital region were included in this review. The clinical presentations, diagnostic patterns, investigations used, and best management approach of these tumors are discussed. The American Joint Committee on Cancer (AJCC) 7(th) edition carcinoma of the eyelid staging system was used to describe their behaviors. We recommend wide excision surgery and a close follow-up for these tumors. Tumors presenting with a late stage require work-up for distant metastasis and consideration for exenteration procedures. The role of radiotherapy and chemotherapy in this context is still uncertain.
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Affiliation(s)
- Paul Ikgan Sia
- a South Australian Institute of Ophthalmology and Discipline of Ophthalmology & Visual Sciences , University of Adelaide , Adelaide , Australia
| | - Edwin Figueira
- a South Australian Institute of Ophthalmology and Discipline of Ophthalmology & Visual Sciences , University of Adelaide , Adelaide , Australia
| | - Alexandra Allende
- b Douglass Hanly Moir Pathology , Sydney , New South Wales , Australia
| | - Dinesh Selva
- a South Australian Institute of Ophthalmology and Discipline of Ophthalmology & Visual Sciences , University of Adelaide , Adelaide , Australia
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Rizvi MM, Singh RB, Sarkar A, Choubey S. Anaesthesia for a "Scalped" Patient. J Clin Diagn Res 2015; 9:UD03-4. [PMID: 26266193 DOI: 10.7860/jcdr/2015/12863.6038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 04/21/2015] [Indexed: 11/24/2022]
Abstract
Trichilemmal carcinoma of scalp is a rare malignant tumour of scalp. A 52-year-old female presented with an extensive ulcerative lesion of the scalp. As the location of the tumour was in the occipital region and there was loss of bony skull in the region, this case became challenging. This patient was managed in the left lateral which was a difficult situation for even the experienced Anaesthesiologist. Intravenous access was acquired, central venous catheter (CVC) was placed in the right internal jugular vein under ultrasonography (USG) guidance and intubation was carried out in the lateral position. After the procedure, patient was again returned to the left lateral position. The trachea was extubated in the lateral position once the patient was awake, after thorough reversal of neuromuscular blockade. Patient had an uneventful postoperative period. This case report highlights the management of an unusual case of Trichilemmal carcinoma of the scalp.
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Affiliation(s)
- M M Rizvi
- Assistant Professor, Department of Anaesthesiology and Critical Care, Era's Lucknow Medical College and Hospital , Lucknow, India
| | - Raj Bahadur Singh
- Assistant Professor, Department of Anaesthesiology and Critical Care, Era's Lucknow Medical College and Hospital , Lucknow, India
| | - Arindam Sarkar
- Assistant Professor, Department of Anaesthesiology and Critical Care, Era's Lucknow Medical College and Hospital , Lucknow, India
| | - Sanjay Choubey
- Professor, Department of Anaesthesiology and Critical Care, Era's Lucknow Medical College and Hospital , Lucknow, India
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Alam K, Gupta K, Maheshwari V, Varshney M, Jain A, Khan AH. A large proliferating trichilemmal cyst masquerading as squamous cell carcinoma. Indian J Dermatol 2015; 60:104. [PMID: 25657426 PMCID: PMC4318032 DOI: 10.4103/0019-5154.147854] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Proliferating trichilemmal cyst (PTC), a rare benign tumor, is a fascinating follicular neoplasm. It occurs on head and neck region of elderly women and its histologic hallmark is trichilemmal keratinization. A 70-year-old female presented to skin outpatient department with complaints of a slowly growing mass on scalp for the past 2 years. On examination, the lesion was firm, mobile, painless, and measured 6 × 5 × 3 cm and was not fixed to the underlying bone. Laboratory investigations were unremarkable. Excisional biopsy was done. Histopathology revealed well-demarcated tumor with variably sized lobules of squamous epithelium undergoing an abrupt change into eosinophilic amorphous keratin without granular cell layer (trichilemmal keratinization). PTC should be differentiated from trichilemmal cyst as it has potential for malignant transformation. Thus, complete excision is recommended for all benign proliferating variants owing to their potential for locally aggressive behavior and malignant transformation.
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Affiliation(s)
- Kiran Alam
- Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Kanupriya Gupta
- Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Veena Maheshwari
- Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Manoranjan Varshney
- Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Anshu Jain
- Department of Pathology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Arshad Hafeez Khan
- Department of Plastic Surgery, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
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Sharma R, Verma P, Yadav P, Sharma S. Proliferating trichilemmal tumor of scalp: benign or malignant, a dilemma. J Cutan Aesthet Surg 2012; 5:213-5. [PMID: 23112524 PMCID: PMC3483585 DOI: 10.4103/0974-2077.101394] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Reena Sharma
- Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital, University of Delhi, Delhi, India E-mail:
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