Pathology
- Benign overgrowth of hair follicle cells
- produces a central plug of keratin
- Rapidly growing, forming within 6 weeks and regressing after 6 weeks leaving a depressed scar
- Clinically and cytologically look like well-differentiated squamous cell carcinoma
- Found on sun-exposed parts of the body
- Commoner in males
- Inspect
- Dome-shaped with central crater (containing keratin)
- Normal skin colour (except for central core which is brown or black due to normal keratin)
- Palpate
- Firm consistency (except for central core which is hard)
- Fully mobile over deep tissues (as they occur in the skin)
Completion
- Ask how the lump affects the patients life
Treament options
- Non-surgical
- Leave alone if asymptomatic
- Surgical
- Complete excision of lesion with histology (particularly elderly patients where there is a high index of suspicion for SCC)