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Folliculosebaceous cystic hamartoma differentiates toward the infundibulum, sebaceous duct and sebaceous cells: immunohistochemical study of keratins and filaggrin

SIR, Folliculosebaceous cystic hamartoma (FSCH) is a rare cutaneous hamartoma with varying proportions of epithelial components and mesenchymal overgrowth. The epithelial components consist of an infundibular cystic structure to which mature sebaceous lobules are attached via sebaceous ducts. The histogenesis of FSCH remains unclear. We report a case of FSCH occurring on the nasolabial fold in an elderly Japanese man. To determine the differentiation of FSCH, we performed an immunohistochemical study of keratins and filaggrin (filament aggregating protein). To our knowledge, this is the first report of FSCH with an immunohistochemical study of keratins and filaggrin. Since this tumour was first described by Kimura et al. in 1991, about 30 cases have been reported. A 78-year-old man presented with a 3-year history of a slow-growing, pink-yellow, elastic hard, pedunculated asymptomatic nodule 17 · 13 mm in size on the right side of his nose. Specimens were fixed in neutral formalin, embedded in paraffin and stained with haematoxylin and eosin. Serial sections were used for the immunohistochemical study. We used 10 antikeratin antibodies: 34bB4 [keratin 1 (K1)], LP5K (K7), LP3K (K8), LHP1 (K10), LL022 (K14), LHK15 (K15), LL025