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We report a case of a slowly growing papule on the nasal bridge of an elderly woman. Histopathological findings revealed a very unusual type of folliculosebaceous cystic hamartoma with a retiform and primitive epithelial proliferation associated with the stromal component. Folliculosebaceous cystic hamartoma is an uncommon lesion that involves a cystically dilated follicle embedded in a stroma of distinct mesenchymal tissue. Because folliculosebaceous cystic hamartoma is a rare and clinically indistinct lesion, clinical photographs of the lesion are not widely available. A recent search on PubMed revealed less than 50 published articles on folliculosebaceous cystic hamartoma; among these manuscripts there was a scarcity of clinical images of the lesion. This disparity is to be expected as the lesion typically has a very indistinct presentation. We thus describe an inconspicuously appearing case of folliculosebaceous cystic hamartoma to bring attention to the indistinct clinical morphology of the lesion and to report a histopathologically uncommon variant.

Folliculosebaceous cystic hamartoma (FSCH) is a rare cutaneous hamartoma characterized by follicular, sebaceous, and mesenchymal elements. Folliculosebaceous cystic hamartoma is probably not as rare as previously thought and its inclusion in the differential diagnosis of asymptomatic skin colored papules or nodules is warranted, especially if it is present in the head and neck region.