Numerous recurrent trichilemmal cysts of the scalp: differential diagnosis and surgical management.

Trichilemmal cysts are common benign soft tissue tumors that occur in hairy areas, especially the scalp, where they present themselves as solitary masses that could be easily treated by surgical excision followed by pathologic identification. It is unusual to find these benign masses in very large numbers in 1 scalp. In the current article, we describe a 43-year-old woman who presented with 51 scalp masses, some of which recurred after repetitive excisions somewhere else by different surgeons under local anesthesia. These masses involved only the scalp and spared all the face. The patient presented to our clinic for a radical solution to clear her scalp from the unaesthetic look and appearance that forbid her from exposing her head and for hygienic reasons relating to the foul smell of repeated previous recurrences and infections. Her clinical presentation is described, and the suggested differential diagnosis and management for such a patient is discussed.