Pilomatrixoma in the cheek: a clinical case report

ABSTRACT Pilomatrixoma is a follicular benign tumor of unknown etiology that originates in the matrix of a hair follicle. It develops more frequently in children and young adults, with a slight predominance in female patients. It is a slow-growing tumor that presents as a mobile nodule, firm, and with well-defined borders. The present study aimed to report the clinical, histopathologic, and radiographic aspects of pilomatrixoma in the cheek area of a 20-year-old female patient as the established treatment at an oral maxillofacial department. Pilomatrixoma is rarely included in the differential diagnosis of masses and nodules in the skin, and it is often confused with other nodular lesions, such as epidermoid cysts. The diagnostic method to identify this entity is an incisional biopsy. Because of its high incidence in the head and neck region, oral surgeons should be well-acquainted with this type of tumor so that it can be included as a diagnostic hypothesis of masses and nodules of the head and neck.

Analysis of clinical and pathological features of 29 cases of perforating pilomatricoma / 中华皮肤科杂志

Objective:To analyze clinical and pathological features of childhood perforating pilomatricoma, and to explore its pathogenesis.Methods:A retrospective analysis was conducted on clinical and histopathological data from 29 children with perforating pilomatricoma in Department of Dermatology, Beijing Children′s Hospital from 2014 to 2020.Results:Among the 29 patients, 11 were males, and 18 were females, with a male-to-female ratio of 1∶1.64. Their age at onset ranged from 3 months to 14 years and 10 months, and the median age at onset was 4.58 years. The disease duration ranged from 2 months to 2 years, with an average of 8.72 months. The perforation occurred 2 days to 1 year and 6 months after the onset of pilomatricoma, with an average of 1.85 months. Ulceration occurred in 1 patient after the treatment with ichthammol, as well as in 3 patients after local scratching or bumping, and spontaneous ulceration without definite precipitating factors occurred in the remaining 25 patients. The average duration from the onset of disease to tumor perforation was 6.87 months. Skin lesions occurred on the face in 15 cases, on the lateral neck in 8, on the upper limb in 4, as well as on the scalp in 2. Perforating pilomatricoma clinically manifested as indurated subcutaneous nodules with crusts or ulcers, and was classified into 3 subtypes: ulcerative type (19 cases) , horny type (8 cases) , and crusted type (2 cases) . The tumor diameter ranged from 0.3 to 2.5 cm, with an average of 1.2 cm. Histopathological examination showed that the tumor was located in the superficial to middle dermis, and mainly consisted of basophils and ghost cells; in 19 cases, the tumor mass was extruded onto the skin surface through a perforated epidermal channel, and the epidermis around the perforation site was hyperplastic and invaginated into the dermis, forming epithelial tunnels surrounding the tumor; in 4 cases, the skin on the tumor surface was thinned and ruptured; in 6 cases, the perforation site could not be observed due to surgical separation of the epidermis and tumor. All lesions were resected, and no infection or recurrence was observed during the postoperative follow-up.Conclusions:Childhood perforating pilomatricoma mostly occurs on the face and neck, usually with rapid progress, and can be classified into ulcerative type, horny type and crusted type. Histological findings suggest that transepithelial elimination is an important mechanism underlying the occurrence of perforation in pilomatricoma.

Diagnostic Pitfall in Fine Needle Aspiration Cytology of Pilomatrixoma with Unusual Clinical Presentation

@#Pilomatrixoma (PMX) is a benign skin adnexal tumour with matrical differentiation. It frequently presents as a painless and slow growing solitary skin nodule primarily at the head, face and neck regions. Although there is increasing understanding on the clinical presentations and morphological features of PMX, difficulties are still expected in establishing the clinical and cytological diagnosis. We report a young girl who presented with a painless post-auricular swelling for one year with sudden increased in size. Computed Tomography (CT) scan and fine needle aspiration cytology (FNAC) findings were suggestive of a malignancy. Diagnosis of PMX was established and confirmed by tissue histopathological examination. The purpose of this study is to demonstrate the diagnostic pitfall of PMX in FNAC specimens, especially in patients with unusual clinical presentations.

Multiple pilomatricomas in twins with Rubinstein-Taybi syndrome

Abstract Pilomatricomas are benign tumors originating from the capillary matrix, which may present as solitary lesions or, less commonly, multiple. Myotonic dystrophy and familial adenomatous polyposis are the most frequently associated disorders with multiple pilomatricomas. There are few reports relating these tumors to other genetic syndromes. Rubinstein-Taybi syndrome is a rare autosomal dominant disorder characterized by intellectual disability and typical dysmorphic characteristics. There are five case reports relating to multiple pilomatricoma to Rubinstein-Taybi syndrome, an association that needs to be clarified. For this reason, we report the first case of multiple pilomatricoma in monozygotic twins with typical Rubinstein-Taybi syndrome.

Histopathological Profile of Skin Adnexal Tumours - A Three Year Experience at a Tertiary Care Centre in Manipur.

Skin adnexal tumours are a large group of benign and malignant tumours that arise from pluripotent stem cells and differentiate toward one or more adnexal structures. So, quite often they may exhibit more than one line of differentiation (hybrid tumours). Moreover, they are uncommon, clinically nonspecific, and remain a diagnostic challenge to surgeons and pathologists alike. The present study is aimed at analysing the histopathological profile of skin adnexal tumours in a hospital based population in Manipur.METHODSThe present study is a retrospective analysis conducted over a period of 3 years from January 2017 to December 2019 in the Department of Pathology, Jawaharlal Institute of Medical Sciences, Manipur, India. Specimens were fixed in formalin, paraffin embedded and stained with haematoxylin and eosin for histopathologic analysis.RESULTSA total of 34 cases of skin adnexal tumours were reported in the Department of Pathology, JNIMS, Imphal, over a period of 3 years out of which 94% (32/34) of the total cases were benign tumours and 5.88% (2/34) were malignant tumours. Tumours with hair follicle differentiation comprised the largest group (44.1%). Pilomatrixoma was the most common tumour followed by Nevus Sebaceous. Both malignant adnexal tumours were sebaceous carcinomas.CONCLUSIONSSkin adnexal tumours are uncommon tumours with most of them being benign tumours and there is a low incidence of malignant tumours. Malignant tumours although rare, need to be diagnosed accurately since they can be aggressive with distant and nodal metastasis. Histopathologic examination remains the gold standard in diagnosing these rare lesions.

Pilomatrix carcinoma of the lacrimal caruncle: a case report / Carcinoma pilomatricial da carúncula lacrimal: relato de caso

ABSTRACT A 45-year-old man presented with a 3-month history of a mass located in the caruncle of his right eye. An incisional biopsy had been performed one month prior by another specialist, and the histopathology report showed basal cell carcinoma. The mass was completely excised with a 2 mm safety margin, and the large conjunctival defect was reconstructed with one sheet of amniotic membrane allograft. A histological diagnosis of pilomatrix carcinoma was established. To prevent recurrence after surgery, we added bevacizumab (25 mg/mL, 1.25 mg/mL per drop) eye drops four times per day for three months. At the one-year follow-up, the patient showed no evidence of local recurrence or distant metastasis after initial excision and remains under close follow-up. Pilomatrix carcinoma should be considered in the differential diagnosis of a caruncular mass.

RESUMO Um homem de 45 anos apresentou história de massa na carúncula no olho direito durante 3 meses. Uma biópsia incisional foi realizada 1 mês antes por outro especialista e o laudo histopatológico mostrava carcinoma basocelular. A massa foi completamente excisada, com uma margem de segurança de 2 mm, e a grande lesão conjuntival foi reconstruída com uma folha de aloenxerto de membrana amniótica. Foi estabelecido um diagnóstico histológico de carcinoma pilomatricial. Para evitar a recorrência após a cirurgia, adicionamos colírio de bevacizumabe (25 mg/mL, 1,25 mg/mL por gota) quatro vezes ao dia durante três meses. No seguimento de 1 ano, o paciente não apresentou evidência de recidiva local ou metástase distante após a excisão inicial e continua sob acompanhamento próximo. O carcinoma pilomatricial deve ser considerado no diagnóstico diferencial de uma massa caruncular.

Pilomatrixoma (Epitelioma Calcificante de Malherbe) da região temporal - relato de caso / Pilomatricoma (calcifying epithelioma of Malherbe) of the temporal region - a case report

O pilomatrixoma constitui uma neoplasia benigna incomum de folículos pilosos, observado mais frequentemente em crianças. O tumor apresenta-se como um nódulo solitário e firme, recoberto com epiderme normal. É relatado o caso de uma paciente feminina de 26 anos com lesão na região temporal. Nos cortes histológicos, observou-se uma proliferação expansiva de ilhotas de células epiteliais configuradas de forma irregular, mostrando na área central sombra de núcleos perdidos (células- fantasma). O pilomatrixoma deve ser considerado no diagnóstico diferencial de nódulos cutâneos, especialmente aqueles de cabeça, pescoço e membros superiores.

Pilomatricoma is an uncommon benign neoplasm of hair follicles, most commonly seen in children. The tumor appears as a solitary and firm nodule, covered with normal epidermis. We report the case of a 26-year-old woman with a lesion in the temporal region. In histological sections, there was an expansive proliferation of islets of epithelial cells configured irregularly, showing the shadow of lost nuclei (ghost cells) in the central area. Pilomatricoma should be considered in the differential diagnosis of skin nodules, especially those of the head, neck, and upper limbs

Pilomatrixoma buloso: una rara pero característica variante clínica / Bullous pilomatrixoma: a rare but characteristic clinical variant

El pilomatrixoma es un tumor anexial benigno, que muestra diferenciación hacia células matriciales y supramatriciales del folículo piloso. Es el segundo tumor benigno más frecuente en la población infantil luego del quiste epidérmico. Su presentación clínica habitual consiste en una lesión única, de consistencia firme y generalmente indolora.1 La variante anetodérmica o bulosa es poco frecuente, en general de rápido crecimiento y en ocasiones dolorosa.2 Se presenta a continuación un caso clínico de esta rara variante, por la importancia de conocer esta particular forma presentación.

A clinical case of bullous pilomatrixoma is present. Correspond to the second most frequent benign tumor in children, derived from the matrix cells of the hair follicle. It commonly presents as a single lesion, of firm consistency and mostly painless. The bullous variant corresponds to 2% of the presentations, the morphology is explained by the dilation of the lymphatic vessels and the consequent extravasation of lymph, as well as by the absence of elastic and collagen fibers. Treatment is the surgical excision of the lesion, and a biopsy specimen is necessary to establish a definitive diagnosis. Knowing this form of presentation allows us to pose it as a diagnostic option in clinical practice.

Pilomatrixoma of the Cheek – A Case Report

@#Pilomatrixoma is an uncommon benign tumour arising from the matrix and inner sheath of a normal hair follicle as well as hair cortex. It is usually presented as a superficial, solitary, firm mass which is asymptomatic and slowly growing. It accounts for about 0.2% of all routine skin specimens and may poses a diagnostic challenge as it may resemble other common benign lesions found in the head and neck region. We report a case of a 33-year old men presented to us with a pilomatrixoma of the right cheek, surgical management and histological findings.

Pilomatrixomas en niños: a propósito de 149 casos. Estudio retrospectivo en dos centros pediátricos / Pilomatrixomas in children: Report of 149 cases. A retrospective study at two children's hospitals

El pilomatrixoma es un tumor benigno cutáneo, de frecuente aparición en los niños, que se origina en las células de la matriz del folículo piloso. Se presenta como un nódulo o tumor, aproximadamente, de 0,5 a 3 cm de tamaño, de consistencia cálcica, de bordes facetados, con piel suprayacente eritematoazulada. En ocasiones, la piel puede atrofiarse, dar la apariencia de una ampolla e, incluso, extruir material cálcico. El diagnóstico se sospecha por la presentación clínica característica y los estudios de imágenes complementarios. El diagnóstico definitivo es por los hallazgos histológicos. La extirpación quirúrgica es el tratamiento de elección. Se presentan los datos epidemiológicos, clínicos, estudios complementarios y técnicas quirúrgicas empleadas de 149 pilomatrixomas resecados en 137 pacientes tratados en los Servicios de Dermatología de los hospitales de pediatría Dr. Pedro de Elizalde y Prof. Dr. Juan P. Garrahan.

A pilomatrixoma is a benign skin tumor common in children, which develops from the matrix cells of hair follicles. It presents as a nodule or tumor of approximately 0.5-3 cm in size, with calcium-like consistency, faceted edges, and blue erythematous overlying skin. Sometimes, the skin may atrophy and look like a blister or even extrude calcium. Diagnosis is suspected based on the typical clinical presentation and supplementary imaging tests. The definite diagnosis is made according to histological findings. Surgical removal is the treatment of choice. Here we describe the epidemiological and clinical data, supplementary tests, and surgical techniques in relation to 149 pilomatrixomas resected in 137 patients treated at the Departments of Dermatology of two children's hospitals: Dr. Pedro de Elizalde and Prof. Dr. Juan P. Garrahan.

Manifestaciones clínicas de pilomatrixoma en un paciente pediátrico / Clinical manifestations of pilomatrixoma in a pediatric patient

Introducción: El pilomatrixoma es un tumor benigno que afecta fundamentalmente a pacientes femeninas menores de 10 años. Se manifiesta como una masa sólida y encapsulada, situada profundamente en la dermis inferior y recubierto de piel normal; puede medir entre 3 y 30 milímetros. Objetivo: Informar las manifestaciones clínicas de este tumor que permiten llegar al diagnóstico de un pilomatrixoma. Presentación del caso: Se presenta el caso de un adolescente de 12 años de edad, que acude a consulta de dermatología del Hospital Andino de Chimborazo, con manifestaciones clínicas que permiten hacer el diagnóstico de pilomatrixoma. Conclusiones: El pilomaxitroma es un raro tumor que, aunque afecta frecuentemente a niñas menores de 10 años, también puede presentarse en pacientes mayores del sexo masculino. El estudio anatomopatológico resulta vital para realizar el diagnóstico de la enfermedad y una vez realizado dicho diagnóstico la excéresis del tumor es el procedimiento más adecuado(AU)

Introduction: Pilomatrixomais a benign tumor that mainly affects female patients under 10 years old. It manifests as a solid and encapsulated mass, located deep in the lower dermis and covered with normal skin; it can measure between 3 and 30 mm. Objective: To present the clinical manifestations that allow to reach the diagnosis of a pilomatrixoma. Case presentation: It is presented the case of a 12-year-old male adolescent, who attended the dermatology clinic in the Andean Hospital of Chimborazo, with clinical manifestations that allow the diagnosis of pilomatrixoma. Conclusions: Pilomaxitroma is a rare tumor that, although it frequently affects girls under 10 years of age, can also occur in older male patients. The anatomopathological study is vital to make the diagnosis of the disease and once performed the same exceresis of the tumor is the most appropriate procedure(AU)

A Prospective Study of Histomorphological Spectrum of Biopsy Confirmed Skin Adenexal Tumors in a Tertiary Care Centre at Bikaner Region

Introduction: The adenexa are part of skin andcomprised of sebaceous glands, sweat glands and hairfollicles. Skin adenexal tumors are rare in occurrenceand precise classification of these neoplasms is difficult.Benign tumors are more common than malignanttumors. Current study aimed to know the histopathologyof skin adenexal neoplasm and to correlate with age,gender, loacation and type of differentiation.Material and methods: A prospective study of 57histopathologically confirmed cases of skin adenexaltumors was carried out in Department of Pathology. Inthis study biopsies were received in 10% formalin andstained by routine haematoxylin and eosin stain. Nonneoplastic conditions were excluded from the study.Results: Out of the 57 cases of skin adenexal tumorsstudied 55 (96.5% ) were benign and 2 (3.5% ) weremalignant with a male: female ratio of 1:1.3. The mostfrequent group of tumors were of eccrine/apocrineorigin 28/57 (49.1%) followed by follicular origin(38.6%) 22/57 and sebaceous origin 7/57 (12.9%).Pilomatrixoma was the most common benign tumorand sebaceous carcinoma was the only malignant tumorencountered in the study. Most common age groupaffected range from 41-60 years and mean age observedwas 45 years. Head and neck (47.5%, 27/57) was themost common site involved in both males and femaleswith a predominance in the facial region.Conclusion: Skin adenexal tumors (SAT) are very rareand the classification of these tumours is complex. Thesetumors are usually missed clinically and histopathologyproves to be the gold standard for diagnosis of theseneoplasms.

Pilomatrixoma: A Clinico - Pathological Study

Introduction: Pilomatrixoma (calcifying epithelioma ofMalherbe) is a benign skin tumor with differentiation towardshair follicles. Pilomatrixoma may be mistaken for many otherconditions like epidermoid cyst, dermoid cyst, calcified lymphnode or a hemiangioma. The aim of this study was to describethe clinical and histopathological characteristics of patientspresenting with pilomatrixoma.Material and Methods: The present study was conductedin the Post Graduate department of pathology, govt. medicalcollege Srinagar. 51 cases of pilomatrixoma were included inthe study. The final diagnosis was arrived by histopathologicalexamination of the specimens. The clinical features andphysical examination including age, sex, site of lesion andsize were noted and analyzed.Results: 51 cases of pilomatrixoma, comprising about 37%cases of all skin adnexal tumors were considered. The mostcommon age group involved was 11-20 years comprising of33.34% of all cases. 23 (45.10%) were males and 28 (54.90%)were females. There was a slight female predominance. Themost common anatomical location for the tumor was foundto be head and neck followed by trunk, upper limbs and lowerlimbs. The histopathological findings observed were: a benignwell demarcated lesion surrounded by a capsule in almost allof the cases. The lesions were found to be composed of islandsof epithelial cells embedded in a stroma. Two types of cellswere identified in these epithelial islands basaloid cells andshadow cells.Conclusions: Pilomatrixoma should be considered in thedifferential diagnosis of nodules, especially those on the headand neck. Careful clinical examination and familiarity withthe condition may lead to accurate diagnosis and appropriatetreatment.

Pilomatrix carcinoma: Reporte de un caso y revisión de la literatura / Pilomatrix carcinoma: Case report and literature review

Pilomatrix carcinoma es la forma maligna del pilomatrixoma que es una neoplasia benigna que se presenta en niños y adultos. Es infrecuente, se presenta como un nódulo solitario a predominio de cabeza y cuello, de tamaño variable; en varones de mediana edad. Se considera una neoplasia maligna de bajo grado y el manejo de elección es la escisión completa. Se presenta el caso de un varón de 32 años con un nódulo en región temporal occipital derecha, blando e indoloro, de 1,8 cm de longitud. Al corte se observó un tejido sólido amarillento encapsulado, y a la microscopía, bordes bien delimitados por células basaloides con núcleos hipercromáticos, pleomórficos, nucléolo prominente y de 0 a 3 mitosis atípicas por campo de alto poder; centro necrótico y células "fantasma". Dentro del diagnóstico diferencial debe considerarse el pilomatrixoma proliferante, el quiste triquilemal proliferante maligno y el carcinoma de células basales con diferenciación matricial. Los estudios complementarios de inmunohistoquímica no fueron contributorios. (AU)

Pilomatrix carcinoma is the malignant counterpart of pilomatrixoma, which is a benign neoplasm affecting children and adults. It is a rare condition, presenting as a solitary nodule on the head or neck mostly seen in middle age males. It is considered a low grade malignant condition; surgical removal is the treatment of choice. We report the case of a 32-year-old male patient who presented with a nodular lesion of 1.8 cm located on the temporo-occipital region. The section of this nodule showed an encapsulated solid yellow tissue that showed under the microscopy well demarcated borders with basal cells presenting with pleomorphic, hyperchromatic nucleus, prominent nucleolus and 0-3 atypical mitosis per high power field, necrotic center and "ghost cells". The differential diagnosis should include pilomatrixoma proliferans, malignant proliferative trichilemmal cyst and basal-cell carcinoma with matricial differentiation. Complementary immunohistochemistry studies were non-contributory. (AU)

Malignant pilomatricoma of the cheek in an infant

Malignant pilomatricoma (pilomatrical carcinoma) is a rare, locally occurring malignant tumor with a high rate of recurrence in the case of incomplete excision. This tumor has two characteristics. First, recurrences of pilomatrical carcinoma are common; second, distant metastasis is rare, but if it occurs, it is very fatal. It has characteristic features of high mitotic counts, cellular atypia, and local invasion. Although fine needle aspiration and excisional biopsy could help to confirm this tumor diagnosis, pathologic findings are critical. Pilomatricomas have some characteristic features in histological aspect, such as epithelial islands of basaloid cells and shadow cells or ghost cell. Also, various types of immunohistochemical staining are used to confirm the diagnosis. Despite the lack of clear surgical criteria, treatment is a wide local excision with histologically clear resection margins with or without adjuvant radiotherapy.

Pilomatrixoma quístico con verruga vulgar intraquística: reporte de un caso / Cystic pilomatrixoma with intracystic vulgar wart: case report

El pilomatrixoma es una neoplasia anexial benigna, que habitualmente se presenta como pápula o nódulo subcutáneo, de crecimiento lento y asintomático. Es más frecuente en niños. El diagnóstico se basa en hallazgos clínicos, y la ecografía es útil como examen complementario. El tratamiento es su resección quirúrgica. Se presenta un caso infrecuente de pilomatrixoma quístico con verruga vulgar intraquística en un paciente adulto.

Pilomatricoma is a benign adnexal tumor, usually presenting as a slow growing asymptomatic subcutaneous papule or nodule. It is more common in children. The diagnosis is based on clinical findings, and ultrasound is useful as a complementary workup tool. Its treatment is surgical excision. We present a rare case of a cystic pilomatricoma with an intracystic verruca vulgaris in an adult patient.

Pilomatrixoma proliferante una rara variante histopatológica simulando un carcinoma de células escamosas / Pilomatrixoma proliferating a rare variant histopathological simulating a cell carcinoma scaly

El Pilomatrixoma es un tumor anexial benigno. Presenta una variante histopatológica infrecuente denominada pilomatrixoma proliferante reportada en 1997 por Kaddu et al. Corresponde a una lesión compuesta predominantemente por una proliferación lobular de células basaloides, con atipia nuclear variable y figuras mitóticas, áreas focales que contienen material cornificado eosinófilo, junto con células sombra. Se propuso al pilomatrixoma proliferante como un subconjunto histopatológico distintivo del pilomatrixoma y se consideró como una variante proliferativa con un perfil histopatológico benigno. La dermatoscopía en este tumor, sobre todo en pacientes de edad avanzada, puede llegar a constituir una trampa dermatoscópica, que es difícil de diferenciar de otras lesiones, como el melanoma o el carcinoma de células basales. Existen múltiples reportes de casos en la literatura donde se informa de pilomatrixomas clásicos o proliferantes simulando otras neoplasias. Presentamos el caso de una paciente de 88 años con pilomatrixoma proliferante facial que simuló clínicamente un carcinoma de células escamosas y llevó a confusión diagnóstica inicial, se destacan las características histopatológicas y clínicas de los pilomatrixomas proliferantes.

Pilomatrixoma is a benign adnexal tumor. It has an infrequent histopathological variant called proliferating pilomatrixoma reported in 1997 by Kaddu et al. It corresponds to a lesion composed predominantly by a lobular proliferation of basaloid cells, with variable nuclear atypia and mitotic figures, focal areas containing eosinophilic cornified material, together with shadow cells. The proliferating pilomatrixoma was proposed as a distinctive histopathological subset of the pilomatrixoma and was considered as a proliferative variant with a benign histopathological profile. Dermatoscopy in this tumor, especially in elderly patients, can result in a dermatoscopic trap, which makes it difficult to differentiate from other lesions, such as melanoma or basal cell carcinoma. There are multiple reports of cases in the literature where classic or proliferating pilomatrixomas were reported simulating other neoplasms. We present the case of an 88-year-old patient with a proliferating facial pilomatrixoma that clinically simulated a squamous cell carcinoma and led to an initial diagnostic confusion, highlighting the histopathological and clinical characteristics of the proliferating pilomatrixoma.

Clinical and pathological features of 16 cases of childhood bullous pilomatricoma / 中华皮肤科杂志

Objective To analyze the clinical and pathological features of childhood bullous pilomatricoma.Methods The clinical and pathological features were analyzed in 16 patients with bullous pilomatricoma,who visited Department of Dermatology of Beijing Children's Hospital from 2013 to 2017.Results Among the 16 patients,5 were males,and 11 were females.Their age of onset ranged from 4 months to 11 years,and the median age of onset was 8.5 years.Their course of disease ranged from 2 months to 4 years,and the average course of disease was 10 months.The tumors were found predominantly on the upper limbs (10 cases,including 7 on the upper arm,2 on the shoulder and 1 on the forearm),followed by the face (4 cases) and the neck (2 cases).These tumors manifested as limited pushable red lumps with blister-like appearance,and telangiectasia was observed on the surface of some lesions.The diameters of the lumps ranged from 0.5 cm to 3 cm,and hard nodules could be detected in the blisters by palpation.Under dermoscopy,uniform red background was observed in 16 cases,unstructured white area in 13,unstructured blue-grey area in 4,and liner or irregular branched vessels.Two or more dermoscopic features were observed in 15 patients.All the skin lesions were resected by surgery,and no recurrence was observed during the follow-up of 1-5 years.Histopathological examination showed that the tumors were located in the middle to deep dennis,and mainly consisted of basaloid cells and shadow cells,as well as transitional cells between the above two kinds of cells.Varying degrees of infiltration of inflammatory cells and hyperplasia and calcification of the fibrous connective tissue were observed in the tumor interstitium,with multinucleated giant cells in some areas.There were varying degrees of infiltration of inflammatory ceils,lymphangiectasis,reduction or absence of elastic fibers in the dennis between the epidermis and tumors.Conclusions Childhood bullous pilomatricoma mostly occurs on the upper limbs,face and neck.Histopathologically,the tumor consists of basaloid cells and shadow cells with lymphangiectasis and reduction of elastic fibers in the dermis.The main dermoscopic features are red background and unstructured white areas.Its prognosis is good after surgical excision.

Pilomatrixoma ampollar en caso pediátrico / Bullous pilomatrixoma in pediatric case

Se realiza la presentación de un caso clínico en edad pediátrica con diagnóstico de pilomatrixoma, variedad ampollar. Este tumor benigno originado en la vaina del folículo piloso muestra una incidencia elevada en las dos primeras décadas de vida. El objetivo de este artículo es presentar un caso con diagnóstico de un tumor, con características clínicas atípicas e inusuales. En ocasiones este tipo de tumor, conllevan al diagnóstico erróneo de la entidad, realizándose el diagnóstico de certeza mediante el estudio histopatológico una vez que se procede a la exéresis quirúrgica de la lesión (AU).

A clinical case with diagnosis of bullous variety pilomatrixoma in pediatric age is presented. This benign tumor originated in the sheath of the hair follicle shows a high incidence in the first 20 years of life. The aim of this work is presenting a case with tumor diagnosis, the clinical characteristics of which sometimes leads to an erroneous diagnosis of the entity in the atypical and unusual varieties. The accurate diagnosis was made through the pathologic study after the surgical excision of the lesion (AU).