False positive margins during Mohs micrographic surgery of a nodular basal cell carcinoma in a patient with multiple trichoepitheliomas

Authors

  • Ana Reggiardo Academic Unit of Medical-Surgical Dermatology, Montevideo, Uruguay
  • Daniela Bermúdez Academic Unit of Medical-Surgical Dermatology, Montevideo, Uruguay
  • Julio Magliano Academic Unit of Medical-Surgical Dermatology, Montevideo, Uruguay

DOI:

https://doi.org/10.47196/dxr68665

Keywords:

basal cell carcinoma, multiple trichoepitheliomas, Mohs micrographic surgery

Abstract

The clinical and histopathological overlap between trichoepitheliomas and basal cell carcinoma can pose a significant diagnostic challenge, potentially resulting in incorrect treatment strategies. This report details the case of a patient with multiple trichoepitheliomas who also presented with a basal cell carcinoma on the face, which was managed using Mohs micrographic surgery. The intraoperative dermatopathological assessment encountered difficulties, requiring subsequent delayed processing of the excised tissue with conventional methods to achieve diagnostic confirmation.

Author Biographies

  • Ana Reggiardo, Academic Unit of Medical-Surgical Dermatology, Montevideo, Uruguay

    Postgraduate studies in Dermatology

  • Daniela Bermúdez, Academic Unit of Medical-Surgical Dermatology, Montevideo, Uruguay

    Medical-Surgical Dermatologist, Assistant

  • Julio Magliano, Academic Unit of Medical-Surgical Dermatology, Montevideo, Uruguay

    Medical-surgical Dermatologist, Adjunct Professor

References

I. McCalmont TH, Pincus LB. Trichoepithelioma. En: Bolognia JL, Schaffer JV, Cerroni L, editors. Dermatología. 5th Ed. Philadelphia: Elsevier; 2024:1954-1956.

II. Trejo AJR, Ramos GA, Gómez BNE, Hernández ER. Tricoepitelioma solitario: consideraciones clínico-histopatológicas de su diagnóstico diferencial con carcinoma basocelular. Rev Cent Dermatol Pascua. 2019;28:82-85.

III. Lobo Y, Blake T, Wheller L. Management of multiple trichoepithelioma: a review of pharmacological therapies. Australas J Dermatol. 2021;62:e192-e200.

IV. França K, Alqubaisy Y, Hassanein A, Nouri K, et al. Histopathologic pitfalls of Mohs micrographic surgery and a review of tumor histology. Wien Med Wochenschr. 2018;168:218-227.

V. Weisberg NK, Becker DS. Potential utility of adjunctive histopathologic evaluation of some tumors treated by Mohs micrographic surgery. Dermatol Surg. 2000;26:1052-1056.

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Published

2026-04-28

Issue

Vol. 32 No. 1 (2026): January-april

Section

Clinical Cases

License

Copyright (c) 2026 on behalf of the authors. Reproduction rights: Argentine Dermatology

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