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September 1984

Transepithelial Elimination of Suture Material

Author Affiliations

USA Box 172 Letterman Army Medical Center Presidio of San Francisco, CA 94129

Arch Dermatol. 1984;120(9):1137-1138. doi:10.1001/archderm.1984.01650450019003

To the Editor.—  Mehregan's histiopathologic concept of "transepithelial elimination"1 (TE) has been sporadically or consistently observed in an increasing number of dermatoses. I recently observed TE of retained suture material via a hair follicle.

Report of a Case.—  A 68-year-old woman had a basal cell carcinoma excised from the tip of her nose. The elliptical wound was primarily closed with an absorbable, braided polyglycolic acid suture for subcuticular approximation and a monofilament nylon thread for surface suture. The superficial sutures were completely removed four days later. Histologic examination showed the tumor extending to the margin of the excised specimen. Twenty-four days after the original procedure, reexcision of the area was undertaken.Histologic examination of the second specimen disclosed no residual tumor. In the dermis, a granulomatous foreign-body reaction was seen enveloping a dilated hair follicle (Fig 1). The follicular infundibulum was filled with bluish-staining amorphous material, cell debris, brown

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