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Virtual case of the month
Persistent cheek lesion with surrounding clusters
  1. Stephanie Liu1,
  2. Ameer Aldarragi2,
  3. Linda Mullen3,
  4. Iskander Chaudhry3,
  5. Bakshi Arti3,
  6. Robert Phelps1
  1. 1 Pathology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA
  2. 2 Medical School, University of Liverpool, Liverpool, UK
  3. 3 Pathology, Royal Liverpool University Hospital, Liverpool, UK
  1. Correspondence to Ameer Aldarragi, Medical School, University of Liverpool, Liverpool L69 3BX, UK; al-ameer{at}live.co.uk

http://dx.doi.org/10.1136/jclinpath-2019-206165

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    Clinical history

    A 50-year-old woman presented with groups of multiple small, round, whitish papules on her cheeks. Biopsy was take from one of the papules. There was no significant prior medical history and this was the first presentation to a dermatologist.

    Review the high-quality, interactive digital Aperio slides at http://virtualacp.com/JCPCases/jclinpath-2019-206165_1/ and http://virtualacp.com/JCPCases/jclinpath-2019-206165_2/ and consider your diagnosis.

    What is your diagnosis?

    1. Fibrous papule

    2. Fibrofolliculoma/trichodiscoma

    3. Basaloid follicular hamartoma

    4. Trichofolliculoma

    5. Pan-folliculoma

    Answer

    B Fibrofolliculoma/trichodiscoma

    Discussion

    The diagnosis is fibrofolliculoma. The histological examination shows a non-encapsulated fibrous lesion with central keratin-filled follicular structures. Thin strands of epithelium extended from the follicles, with some joining sebaceous ducts or anastomosing with other strands. A sclerotic fibrous proliferation of mucinous connective tissue …

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    Footnotes

    • Handling editor Tahir S Pillay.

    • Contributors Case report.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Commissioned; internally peer reviewed.