Abstract
First described more than 30 years ago, desmoplastic trichoepithelioma is a rare but benign adnexal neoplasm. Most often identified in middle-aged individuals and females, desmoplastic trichoepithelioma usually is a solitary annular plaque. Though the tumors are benign, the possibility of malignant neoplasm may spark both clinical and histologic concern. A full-thickness skin biopsy is advisable when desmoplastic trichoepithelioma is suspected. A patient's clinical history may provide some clues to help guide diagnosis, as the tumors may be present for years and slow growth is commonly reported. We present a patient with desmoplastic trichoepithelioma that uniquely documents and supports the typical natural history of this tumor, as demonstrated by annual school photographs.