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February 1978


Author Affiliations

New York City

Arch Dermatol. 1978;114(2):286. doi:10.1001/archderm.1978.01640140094028

To the Editor.—  Trichilemmoma as a term and concept has had considerable attention in the recent medical literature.1-4 A diagnosis by that term is now frequently made by many histopathologists, but rarely, if ever, by clinicians. In 1973, Brownstein and Shapiro5 wrote that "the correct clinical diagnosis was not mentioned in any case in this series (or 40 cases), and we could find no record of trichilemmoma ever having been recognized before biopsy." Goldman and Richfield2 recently pondered the course of so-called trichilemmoma, asking: "Why does it spread so rapidly sometimes, suggesting a viral infectious agent."I have an explanation of the phenomenon that I would like to propose to dermatopathologists and clinical dermatologists, namely, that what is now called trichilemmoma by some or most dermatopathologists is nothing more than an old verruca vulgaris, generally on the face, in which the virus has affected the epithelial cells