Practical Dermoscopy
A Shiny Purple Nodule on the Forehead
Nódulo de color púrpura brillante en la frente
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"apellidos" => "Gusmão Palmeiro" "email" => array:1 [ 0 => "apgalmeiro@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "R." "apellidos" => "Sampaio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "A." 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Physical examination disclosed a 0.9<span class="elsevierStyleHsp" style=""></span>cm<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>1<span class="elsevierStyleHsp" style=""></span>cm nodular, well-defined, purple tumor (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Dermoscopy of the lesion (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>)</span><p id="par0010" class="elsevierStylePara elsevierViewall"></p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">What is your diagnosis?</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Comment</span><p id="par0020" class="elsevierStylePara elsevierViewall">Dermoscopic evaluation revealed white/yellow homogenous areas on a blue-violaceous background, as well as linear irregular vessels. Histopathological exam disclosed the presence of solid nests of basaloid cells with abrupt trichilemmal-type keratinization and ghost cells, confirming the diagnosis of pilomatrixoma.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Pilomatrixoma is a benign soft tissue tumor that originates from the follicular matrix of hair and is also known as Malherbe's calcified epithelioma, due to its tendency toward calcification.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> It usually presents as a single, solid, deep subcutaneous or dermal mass, often on the head or neck.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> There are two incidence peaks, the first in children and adolescents, and a second smaller peak, in older individuals, usually 50–60 years-old.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">3</span></a> Skin lesions are often blue or red in color.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">1,3</span></a> Due to the wide variety of possible clinical findings, clinical misdiagnosis is frequent.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> Common histological features include basaloid cell, calcifications, and ghost cells. Histological subtypes include giant (>5<span class="elsevierStyleHsp" style=""></span>cm in diameter), anetodermic, proliferating and perforating pilomatrixomas.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">4</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The most frequent dermoscopic findings are the white-yellow homogenous areas, irregularly shaped and distributed, that on histology correspond to calcification; white streaks; reddish homogenous areas and vessels, most often hairpin or linear and irregular.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> Additional findings include ulceration, dotted vessels, and structureless blue-gray areas. Specific dermoscopic criteria for melanocytic or nonmelanocytic tumors are absent.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> Although the presence of the criteria mentioned above may suggest the diagnosis of pilomatrixoma, histopathological exam remains essential for confirmation.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conflict of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Case presentation" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Dermoscopy of the lesion (Fig. 2)" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Comment" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflict of interest" ] 4 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 570 "Ancho" => 1007 "Tamanyo" => 108600 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Solitary left supracilliary purple nodule.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 570 "Ancho" => 1007 "Tamanyo" => 111122 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Dermoscopy of the lesion.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0025" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Three different dermoscopic view of three new cases with pilomatrixoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E. Ayhan" 1 => "O. Ertugay" 2 => "R. Gundogdu" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Int J Trichol" "fecha" => "2014" "volumen" => "6" "paginaInicial" => "21" "paginaFinal" => "22" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0030" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dermoscopy of adnexal tumors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P. Zaballos" 1 => "I. Gómez-Martín" 2 => "J.M. Martin" 3 => "J. Bañuls" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.det.2018.05.007" "Revista" => array:6 [ "tituloSerie" => "Dermatol Clin" "fecha" => "2018" "volumen" => "36" "paginaInicial" => "397" "paginaFinal" => "412" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30201149" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0035" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A tumor in images: anetodermic pilomatrixoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C. Martínez-Morán" 1 => "B. Echeverría-García" 2 => "L. Nájera" 3 => "J. Borbujo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ad.2014.07.003" "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2015" "volumen" => "106" "paginaInicial" => "241" "paginaFinal" => "243" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25439144" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0040" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pilomatrixoma: a comprehensive review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C.D. Jones" 1 => "W. Ho" 2 => "B.F. Robertson" 3 => "E. Gunn" 4 => "S. Morley" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/DAD.0000000000001118" "Revista" => array:6 [ "tituloSerie" => "Am J Dermatopathol" "fecha" => "2018" "volumen" => "40" "paginaInicial" => "631" "paginaFinal" => "641" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30119102" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00017310/0000011400000009/v1_202310020456/S0001731023004246/v1_202310020456/en/main.assets" "Apartado" => array:4 [ "identificador" => "19290" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Dermatoscopia práctica" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00017310/0000011400000009/v1_202310020456/S0001731023004246/v1_202310020456/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731023004246?idApp=UINPBA000044" ]
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