title: Follicular malignant melanoma: primary follicular or folliculotropic?
abstract: Follicular malignant melanoma (FMM) is a rare variant of melanoma arising on sun-damaged skin of elderly patients. It is characterized histopathologically by a prominent involvement of 1 or 2 adjacent hair follicles. The authors report 3 new cases of FMM (M:F = 2:1; age range, 23-67 years; median age, 50 years) located on the scalp, cheek, and upper back. Complete effacement of the hair follicle, replaced by neoplastic melanocytes, was observed in 1 case. The interfollicular epidermis and adventitial dermis were involved in all 3 cases. Our series shows that FMM is not restricted to elderly patients but may arise also in young individuals without association with chronic sun damage. FMM should be distinguished from folliculotropic metastases of melanoma and from atypical melanocytic nevi. Although the histopathological features and the term FMM may suggest a derivation from melanocytes of the hair follicle, the exact origin of neoplastic cells is yet unclear, and at least some of these cases may represent folliculotropic examples of primary epidermal malignant melanoma.
authors.affiliation: *Research Unit of Dermatopathology, Department of Dermatology, Medical University of Graz, Graz, Austria; †Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain; and ‡Institute of Pathology, General Hospital of Leoben, Austria.
authors.forename: Salma
authors.initials: S
authors.lastname: Machan
authors.forename: Laila
authors.initials: L
authors.lastname: El Shabrawi-Caelen
authors.forename: Eva
authors.initials: E
authors.lastname: Nikolay
authors.forename: Helmut
authors.initials: H
authors.lastname: Kerl
authors.forename: Luis
authors.initials: L
authors.lastname: Requena
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Cerroni
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D018859:Hair Follicle / Q000737:chemistry / Q000473:pathology*; D006258:Head and Neck Neoplasms / Q000737:chemistry / Q000145:classification / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008544:Melanocytes / Q000737:chemistry / Q000473:pathology*; D008545:Melanoma / Q000737:chemistry / Q000145:classification / Q000473:pathology*; D008875:Middle Aged; D011237:Predictive Value of Tests; D012535:Scalp / Q000737:chemistry / Q000473:pathology*; D012878:Skin Neoplasms / Q000737:chemistry / Q000145:classification / Q000473:pathology*; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor