Both biopsy specimens showed similar findings. Intradermal cystic structures were lined by squamous epithelium and were filled with laminated orthokeratotic keratin fragments. Numerous sebaceous lobules were observed radiating from the cystic structures. Surrounding stroma showed mesenchymal changes, including proliferation of fibrous, adipose, and vascular tissues. The follicular opening is evident in Figure 2.

Folliculosebaceous cystic hamartoma is a rare benign skin tumor. It usually presents as an exophytic solitary papule or nodule on the head, most commonly on the central part of the face. The age at onset varies from 4 to 47 years. The size ranges from 0.5 × 0.4 to 1.4 × 1.1 cm.¹ The histologic features of folliculosebaceous cystic hamartomas include (1) an intradermal cystic structure lined by squamous epithelium that is similar to the epidermal and the infundibular epithelium, (2) numerous sebaceous lobules radiating from the cystic structure, (3) occasional presence of mature or rudimentary hair structure or of apocrine glands, and (4) surrounding stroma made up of mesenchymal changes, including variable proportions of fibrous, adipose, vascular, and neural tissue.² Also, vascular and neural stromal variants of folliculosebaceous cystic hamartoma have been reported.^3,4