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February 1995

Solitary Facial Plaque of Long Duration

Author Affiliations

University of California, San Diego

Arch Dermatol. 1995;131(2):216. doi:10.1001/archderm.1995.01690140101019

REPORT OF A CASE  A 52-year-old white man presented with a 2-cm, slightly hypopigmented, firm annular lesion with a slightly elevated border (Figure 1 and Figure 2). The lesion had been present on the right cheek for more than 20 years and had gradually enlarged. In addition, an 8-mm tan-pink nodule that had grown over 6 months was present on the dorsum of the right second toe. Two punch biopsy specimens of the lesion on the cheek were taken to assure a representative sample. A specimen was also taken from the nodule on the toe.A biopsy specimen of the facial lesion is shown (Figure 3 and Figure 4).What is your diagnosis?

DIAGNOSIS:  Desmoplastic trichoepithelioma.

HISTOPATHOLOGIC FINDINGS AND CLINICAL COURSE  The two biopsy specimens of the cheek showed identical features. Cords of basaloid cells and scattered small keratinous cysts were embedded