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The inverting White's disease

The inverting White's disease — a benign tumor, gistogenetichesk connected from a ploskoepitelialny vystilky funnel of a hair follicle.

Epidemiology

Arises at any age, in 80% at persons 50 years are more senior. Slightly more often the tumor arises at men.

Etiology and pathogeny

Concerning competency of allocation of this new growth in an independent nosological form there is no consensus.

Clinical signs and symptoms

The prevailing localization — face skin and pilar part of the head.
The tumor represents small painless small knots with a diameter up to 1 cm, grayish color, usually with a hyperkeratosis.
Clinically are not identified and most often go for pathomorphologic research with the diagnosis of a vulgar or seborrheal wart, a keratopapilloma, is more rare — bazalioma, in case of an ulceration.

The diagnosis and the recommended clinical trials

The diagnosis is made on the basis of a clinical picture and data of a biopsy. At ulcerated forms — an ekstsizionny biopsy.
The tumor is provided wide, the wrong outlines by akantotichesky growths of ploskoepitelialny cells of various degree of a differentiation. Among them large cells of acanthceous type with a light kernel, an accurate kernel, a wide rim of the brightened-up cytoplasm and the expressed intercellular bridges meet small extended, bazalioidny type of a cell hyperchromic kernels, and also. Between these 2 types various transitional forms are had.

Bazalioidny elements are grouped mainly in the periphery of complexes. In a follicular keratoma the diffusion and focal keratinization characteristic of a funnel of a hair follicle and interfollicular epidermis takes place.
Not less characteristic sign is melkoochagovy keratinization in the form of "turbulences". These are usually small oval or roundish accumulations concentrically of the grouped epithelial cells which are flattened towards the center and contain a keratin. Enough large sizes, time of the wrong configuration, and also the dyskeratosis centers are characteristic also existence of horn cysts.
Bunches of tonofilaments are shortened, and in cells of the central departments of education bunches of tonofilaments  without  a certain orientation are noted.
In a stroma around tumoral growths find inflammatory infiltrates of limfogistiotsitarny character.

Differential diagnosis

Vulgar and seborrheal wart, keratopapilloma, planocellular cancer, keratoacanthoma, ekkrinny ferry.

General principles of treatment

At the inverting White's disease electroexcision, surgical excision are shown.

Forecast

Favorable.
 
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