European Journal of Biomedical and Pharmaceutical Sciences

A RARE PRESENTATION OF MIDDLE FINGERTIP TRICHILEMMAL CYST: A CASE REPORT

Ahmad Smadi MD*, Mutaz Aljader MD, Ahmad Omari MD, Mohammad Shorman MD, Mahmoud Jaradat MD, Haneen Noures MD and Mohammad Bdour MD

ABSTRACT

Trichilemmal or pilar cysts (TCs) are common benign cutaneous lesions that arise from the outer root sheath of hair follicles and represent 5–10% of skin-related conditions in the general population. Characterized by a squamous epithelial lining and containing keratin, these cysts primarily appear in areas abundant in hair follicles, notably the scalp, which hosts about 90% of such cases. However, they have also been seen on the face, neck, arms, and legs. The rarity of TC occurrences in non-hair-bearing regions, such as the fingertips, presents an intriguing divergence from the norm, suggesting a wider spectrum of manifestation sites than previously acknowledged. We herein report a case of a 52-year-old male who sought medical attention for a lump on his middle finger that had been growing painlessly over two years but had recently become painful, ulcerated, and started discharging pus. Initially treated as a finger abscess, further investigation through biopsy revealed the true nature of the condition as a trichilemmal cyst. This case adds to the sparse literature on TCs manifesting in unusual, non-hair-bearing sites and underscores the necessity for healthcare professionals to consider a broader differential diagnosis for cystic lesions, even in unexpected locations

Keywords: Abscess; benign; trichilemmal cyst; pilar cyst; keratin.