Crown Vessels of Desmoplastic Trichilemmoma: Use of Dermoscopy with Pathological Correlation

Desmoplastic trichilemmoma is a rare histological variant of a benign tumor of the pilosebaceous hair follicle that often clinically appears as similar in appearance to other cutaneous lesions. Here, an 81-year-old male patient with desmoplastic trichilemmoma found on the left zygoma is presented. During the dermatoscopic evaluation of the neoplasm, crown vessels with radial distribution in the periphery were displayed. Histopathologic evaluation revealed peripheral palisading lobules of tumor cells surrounded by sclerotic hyalinized stroma displacing the vessels of the tumor. This case highlights the value of using dermoscopy for improving the clinical diagnosis of desmoplastic trichilemmoma. These findings highlight a need to further investigate the diagnosis of desmoplastic trichilemmoma when crown vessels are displayed during the clinical evaluation.