Pilar sheath acanthoma is an uncommon small benigntumour originating from the hairfollicle. It is usually a small, solitary papule up to 5 mm in diameter with a tiny 1-2 mm central depression or opening. No hair grows from it and if squeezed, dead skin tissue is expressed.
They occur most often on the face and head of middle-aged men and women. In many cases lesions appear on the skin of the upper lip. Apart from their physical appearance they show no other signs or symptoms. They have not been associated with any other medical syndromes or skin tumours.
Pilar sheath acanthoma is a benign follicular tumour that requires no treatment. Occasionally they may be excised for cosmetic reasons or if they occur in functionally sensitive areas. Treatment options include curettage and electrodesiccation or surgical excision.