Journal Information
Vol. 109. Issue 3.
Pages 265-266 (April 2018)
Visits
...
Vol. 109. Issue 3.
Pages 265-266 (April 2018)
Case for Diagnosis
Full text access
Fast-growing Tumor of the Eyelid
Tumor de rápido crecimiento en el párpado
Visits
...
C.A. Morales-Cardonaa,
Corresponding author
camiderm@yahoo.com

Corresponding author.
, C. Rodríguez-Zakzukb, A. Téllez-Lozadab
a Hospital Universitario Centro Dermatológico Federico Lleras Acosta E.S.E., Bogotá, D.C., Colombia
b Fundación Universitaria Sanitas, Bogotá, D.C., Colombia
Article information
Full Text
Bibliography
Download PDF
Statistics
Figures (3)
Show moreShow less
Full Text
Medical History

A 24-year-old woman with no relevant past history presented with a fast-growing, asymptomatic nodular lesion on the left lower eyelid that had first appeared 5 months earlier. The patient reported no history of manipulation or trauma in the affected area. However, she did report an episode of pain, redness, and edema on the left cheek a month earlier, which was resolved with an oral antibiotic.

Physical Examination

Physical examination revealed a 2.5×1.5cm multilobulated, erythematous nodule with yellowish-white areas that was firm on palpation and had a smooth, friable surface, a few telangiectasias, hematic crusts, and an ulcerated central depression (Fig. 1).

Figure 1
(0.25MB).
Histopathology

Histologic examination revealed a dermal lesion composed of basaloid cells and ghost cells, with foci of calcification surrounded by fibrous stroma without atypia (Fig. 2).

Figure 2.

Hematoxylin-eosin, original magnification×40.

(0.5MB).

What Is Your Diagnosis?

Diagnosis

Perforating pilomatrixoma.

Clinical Course

Complete excision of the lesion was carried out under local anesthesia. No recurrence of the lesion was observed during a 6-month follow-up period (Fig. 3).

Figure 3
(0.23MB).
Comment

Pilomatrixoma, a benign tumor of the hair follicle matrix, is among the most common skin neoplasms in children and young adults.1 It is more common in women and usually appears on the head and neck, where it manifests as a single subcutaneous nodule measuring 0.5-2cm in diameter that is firm on palpation, with blood vessels and discoloration of the overlying skin.2 The perforating presentation is extremely rare and fast-growing; it is characterized by the elimination of the content of the tumor, with or without ulceration, depending on the depth of the lesion.3 Diagnosis is confirmed by histologic examination, which shows basophilic cells, and, in the perforating variant, ossification and transepidermal elimination.4 Pilomatrixoma is usually confused with other lesions such as epidermoid cyst, keratoacanthoma, molluscum contagiosum, foreign body granuloma, juvenile xanthogranuloma, sebaceous carcinoma, matrical carcinoma, dermatofibrosarcoma protuberans, and amelanotic melanoma, and preoperative diagnosis is correct in only 21%5 to 54%2 of cases. Spontaneous remission has not been reported. The lesion is treated by surgical excision, with an estimated recurrence risk of 3%-4%.2

Conflicts of Interest

The authors declare that they have no conflicts of interest.

References
[1]
P. Stefano, S. Apa, B. Balancini.
Ulcerated giant pilomatrixoma in a child.
Actas Dermosifiliogr, 104 (2013), pp. 924-925
[2]
A. Hernandez-Nuñez, L. Nájera, A. Romero, C. Martínez-Sanchez, M. Utrera, A. Calderón, et al.
Retrospective study of pilomatricoma: 261 tumors in 239 patients.
Actas Dermosifiliogr, 105 (2013), pp. 699-705
[3]
J.S. Lo, J. Guitart, W.F. Bergfeld, E.A. Benedetto, A.L. Mehle.
Perforating pilomatricoma: A case report.
Cutis, 44 (1989), pp. 130-132
[4]
O. Takamitsu, Y. Nakamura, S. Watanabe.
Perforating pilomatricoma in a process of total elimination.
J Am Acad Dermatol, 49 (2003), pp. 146-147
[5]
C.G. Julian, P.W. Bowers.
A clinical review of 209 pilomatricomas.
J Am Acad Dermatol, 39 (1998), pp. 191-195

Please cite this article as: Morales-Cardona CA, Rodríguez-Zakzuk C, Téllez-Lozada A. Tumor de rápido crecimiento en el párpado. Actas Dermosifiliogr. 2018;109:265–266.

Copyright © 2017. Elsevier España, S.L.U. and AEDV
Idiomas
Actas Dermo-Sifiliográficas (English Edition)

Subscribe to our newsletter

Article options
Tools
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?