REVIEW

Skin adnexal neoplasms—part 1: An approach to tumours of the pilosebaceous unit

K O Alsaad, N A Obaidat, D Ghazarian

Department of Laboratory Medicine and Pathobiology, University of Toronto and University Health Network, Toronto, Ontario, Canada

Correspondence to:
Dr D Ghazarian
Department of Laboratory Medicine and Pathobiology, University of Toronto and University Health Network, Toronto General Hospital, 200 Elizabeth Street, Toronto, Ontario, Canada M5G 2M9; danny.ghazarian{at}uhn.on.ca

Skin adnexal neoplasms comprise a wide spectrum of benign and malignant tumours that exhibit morphological differentiation towards one or more types of adnexal structures found in normal skin. Most adnexal neoplasms are relatively uncommonly encountered in routine practice, and pathologists can recognise a limited number of frequently encountered tumours. In this review, the first of two, the normal histology of the skin adnexal structures is reviewed, and the histological features of selected but important benign and malignant tumours and tumour-like lesions of pilosebaceous origin discussed, with emphasis on the diagnostic approach and pitfalls in histological diagnosis.

Abbreviations: BCC, basal cell carcinoma; BEPs, basaloid epidermal proliferations; BFH, basaloid follicular hamartoma; CEA, carcinoembryonic antigen; DTE, desmoplastic trichoepithelioma; EMA, epithelial membrane antigen; GCDEP-15, gross cystic disease fluid protein 15; HAS, hidroacanthoma simplex; H&E, haematoxylin and eosin; HMWK, high molecular weight keratin; IHC, immunohistochemical; LMWK, low-molecular weight cytokeratin; MFT, multiple familial trichoepithelioma; NSJ, nevus sebaceous of Jadassohn; PAS, periodic acid Schiff; PTC, proliferating trichilemmal cyst; SAT, Skin adnexal tumours; SCAP, syringocystadenoma papilliferum; SMA, smooth muscle actin

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