Case and Research Letters
A Tumor in Images: Anetodermic Pilomatrixoma
Un tumor en imágenes: pilomatrixoma anetodérmico
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The plaque is highly indurated and well-demarcated. The skin surface is shiny, some areas are hyperpigmented while others are pearly, and adnexal structures are absent. Note the erythematous border surrounding the entire plaque.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. García-Arpa, E. Lozano-Martín, C. Ramos-Rodríguez, M. Rodríguez-Vázquez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "García-Arpa" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Lozano-Martín" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Ramos-Rodríguez" ] 3 => array:2 [ "nombre" => "M." 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"apellidos" => "Daudén" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731014004062" "doi" => "10.1016/j.ad.2014.08.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731014004062?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157821901500027X?idApp=UINPBA000044" "url" => "/15782190/0000010600000003/v3_202209240641/S157821901500027X/v3_202209240641/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "A Tumor in Images: Anetodermic Pilomatrixoma" "tieneTextoCompleto" => true "saludo" => "To the Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "241" "paginaFinal" => "243" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "C. Martínez-Morán, B. Echeverría-García, L. Nájera, J. Borbujo" "autores" => array:4 [ 0 => array:4 [ "nombre" => "C." "apellidos" => "Martínez-Morán" "email" => array:2 [ 0 => "crismmoran@hotmail.com" 1 => "cmmoran@salud.madrid.org" ] "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" => "B." "apellidos" => "Echeverría-García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "L." "apellidos" => "Nájera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "J." "apellidos" => "Borbujo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Universitario de Fuenlabrada, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Un tumor en imágenes: pilomatrixoma anetodérmico" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1584 "Ancho" => 1584 "Tamanyo" => 177985 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Dermatoscopic image showing a lesion with homogeneous red areas, irregular while-yellow structures, areas covered with a blue-white veil, irregular linear vessels on the periphery, and some chrysalides.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Pilomatrixoma or pilomatricoma is a relatively common benign cutaneous tumor that is derived from immature cells in the matrix of the hair follicle. It presents clinically as a slow-growing solid nodular lesion. There are 2 peaks in its incidence, the first during the first 20 years of life and the second smaller peak in individuals aged 50 to 60 years. In biopsy, the anetodermic or lymphangiectatic variant shows a decrease in collagen and elastic fibers as well as dilated lymphatic vessels in the superficial dermis. Clinically, these findings are manifest as hard palpable nodules within elastic sacs or as pseudobullous lesions.</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 61-year-old woman, whose only relevant condition in her medical history was an operation for breast fibroadenoma, attended the clinic for a mildly painful, rapidly growing lesion in the right frontoparietal region, next to the hairline. The lesion had appeared 1 month earlier, a few days after trauma to the region. Physical exploration showed an exophytic lesion measuring 15<span class="elsevierStyleHsp" style=""></span>mm across. This lesion was well defined and soft to the touch, of reddish and violaceous color with white-yellow patches (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>). The dermatoscopic image showed a lesion with homogeneous red areas, irregular white-yellow structures, areas covered with a blue-white veil, irregular linear vessels, and some chrysalides (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>). Skin ultrasound showed a hypoechoic, lobulated lesion in the superficial dermis, with discrete posterior reinforcement and increased perilesional vascularization (<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>). The lesion was completely excised under local anesthetic and sent for histopathological analysis, which confirmed the suspected diagnosis of anetodermic pilomatrixoma (<a class="elsevierStyleCrossRef" href="#fig0020">Figure 4</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Anetodermic pilomatrixoma is an uncommon variant of a relatively common and well-known tumor. Its etiology is not clear, but recent studies postulate that mechanical trauma could play an essential role in its development by compromising the dermal integrity and altering the vascular microenvironment.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a> Some authors have suggested that the trigger could be an increase in the number or activity of mast cells, which would favor elastolysis and increase epidermal proliferation of the lesion through the activation of certain cytokines.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">2</span></a> This would also explain why some of these tumors exhibit hyperpigmentation in the basal layer due to the capacity of mast cells to activate melanocyte proliferation through certain mediators.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Clinically, anetodermic pilomatrixoma presents as an excrescent tumor with a predilection for the skin of the arms and shoulders, with normal skin coloration, a hyperpigmented appearance, or a vascular appearance.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">3</span></a> The lesions are soft on palpation and can be depressed at the center when vertical pressure is applied.</p><p id="par0025" class="elsevierStylePara elsevierViewall">If we compare the dermatoscopic characteristics of our lesion with those reported for nonanetodermic pilomatrixomas in the study by Zaballos et al.,<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">4</span></a> we find that irregular white structures, homogeneous red areas, and irregular linear vessels are common features. The dilated vessels and hemorrhages observed in pathology may correspond to the linear vessels and homogeneous reddish areas present in the dermatoscopic image.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The ultrasound image of conventional pilomatrixoma shows a lesion with a hypoechoic halo and a central hyperechoic region (corresponding to calcification) that generates the posterior shadow.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">5</span></a> In 1999, Hughes et al.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">6</span></a> published a retrospective preoperative ultrasound study of 28 suspected conventional pilomatrixomas. In 20 of these, the ultrasound findings supported the suspected clinical diagnosis and in 16 of these 20 lesions, histological study confirmed diagnosis of pilomatrixoma. In the literature that we reviewed, we could not find a description of skin ultrasound of anetodermic pilomatrixoma.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Differential diagnosis should include basal cell carcinoma (BCC) and melanoma,<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">4</span></a> and in both cases, the dermatoscopic and ultrasound studies can help in the preoperative diagnosis. From the ultrasound point of view, BCC and melanoma are also considered hypoechoic lesions. The characteristics that can help differentiate these lesions from pilomatroxima are the presence of small hyperechoic nodules in the lesion characteristic of BCC and an irregular border with abundant vascularization within the tumor in characteristic melanoma lesions.<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">7,8</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">In conclusion, we present the clinical description and the first dermatoscopic and ultrasound findings for anetodermic pilomatrixoma.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Martínez-Morán C, Echeverría-García B, Nájera L, Borbujo J. Un tumor en imágenes: pilomatrixoma anetodérmico. Actas Dermosifiliogr. 2015;106:241–243.</p>" ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1113 "Ancho" => 1668 "Tamanyo" => 305584 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinical image showing a multicolor excrescent tumor measuring 15<span class="elsevierStyleHsp" style=""></span>mm across, with a well-defined border in the right frontoparietal region.</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" => 1584 "Ancho" => 1584 "Tamanyo" => 177985 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Dermatoscopic image showing a lesion with homogeneous red areas, irregular while-yellow structures, areas covered with a blue-white veil, irregular linear vessels on the periphery, and some chrysalides.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 777 "Ancho" => 1668 "Tamanyo" => 97262 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Skin ultrasound with a hypoechoic, lobulated lesion in the superficial dermis, with discrete posterior reinforcement.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 946 "Ancho" => 2333 "Tamanyo" => 283501 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Histological image. Hematoxylin-eosin<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>20. A well-delimited pilomatrixoma can be seen beneath an edematous dermis with substantial blood extravasation (A) and complete absence of elastic fibers in staining with orcein (x<span class="elsevierStyleHsp" style=""></span>100, B).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0045" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anetodermic pilomatricoma: Molecular characteristics and trauma in the development of its bullous appearance" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Li" 1 => "Y. Zeng" 2 => "K. Fang" 3 => "Y. Xiao" 4 => "H. Jin" 5 => "H. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 13 | 9 | 22 |
| 2024 Octubre | 130 | 39 | 169 |
| 2024 Septiembre | 171 | 28 | 199 |
| 2024 Agosto | 177 | 73 | 250 |
| 2024 Julio | 175 | 52 | 227 |
| 2024 Junio | 146 | 51 | 197 |
| 2024 Mayo | 166 | 36 | 202 |
| 2024 Abril | 170 | 49 | 219 |
| 2024 Marzo | 174 | 45 | 219 |
| 2024 Febrero | 152 | 39 | 191 |
| 2024 Enero | 168 | 36 | 204 |
| 2023 Diciembre | 157 | 25 | 182 |
| 2023 Noviembre | 176 | 33 | 209 |
| 2023 Octubre | 160 | 37 | 197 |
| 2023 Septiembre | 132 | 38 | 170 |
| 2023 Agosto | 132 | 22 | 154 |
| 2023 Julio | 121 | 34 | 155 |
| 2023 Junio | 99 | 28 | 127 |
| 2023 Mayo | 110 | 19 | 129 |
| 2023 Abril | 84 | 21 | 105 |
| 2023 Marzo | 69 | 23 | 92 |
| 2023 Febrero | 61 | 31 | 92 |
| 2023 Enero | 45 | 28 | 73 |
| 2022 Diciembre | 43 | 36 | 79 |
| 2022 Noviembre | 20 | 25 | 45 |
| 2022 Octubre | 25 | 22 | 47 |
| 2022 Septiembre | 25 | 39 | 64 |
| 2022 Agosto | 28 | 36 | 64 |
| 2022 Julio | 29 | 34 | 63 |
| 2022 Junio | 34 | 23 | 57 |
| 2022 Mayo | 43 | 38 | 81 |
| 2022 Abril | 58 | 34 | 92 |
| 2022 Marzo | 69 | 42 | 111 |
| 2022 Febrero | 67 | 17 | 84 |
| 2022 Enero | 92 | 37 | 129 |
| 2021 Diciembre | 50 | 25 | 75 |
| 2021 Noviembre | 63 | 50 | 113 |
| 2021 Octubre | 57 | 46 | 103 |
| 2021 Septiembre | 54 | 44 | 98 |
| 2021 Agosto | 61 | 26 | 87 |
| 2021 Julio | 62 | 25 | 87 |
| 2021 Junio | 49 | 25 | 74 |
| 2021 Mayo | 42 | 20 | 62 |
| 2021 Abril | 156 | 26 | 182 |
| 2021 Marzo | 81 | 41 | 122 |
| 2021 Febrero | 54 | 33 | 87 |
| 2021 Enero | 68 | 22 | 90 |
| 2020 Diciembre | 56 | 10 | 66 |
| 2020 Noviembre | 38 | 18 | 56 |
| 2020 Octubre | 46 | 8 | 54 |
| 2020 Septiembre | 28 | 15 | 43 |
| 2020 Agosto | 28 | 40 | 68 |
| 2020 Julio | 28 | 16 | 44 |
| 2020 Junio | 28 | 24 | 52 |
| 2020 Mayo | 43 | 21 | 64 |
| 2020 Abril | 24 | 19 | 43 |
| 2020 Marzo | 32 | 22 | 54 |
| 2020 Febrero | 7 | 8 | 15 |
| 2020 Enero | 4 | 7 | 11 |
| 2019 Diciembre | 8 | 7 | 15 |
| 2019 Noviembre | 4 | 2 | 6 |
| 2019 Octubre | 0 | 8 | 8 |
| 2019 Septiembre | 5 | 6 | 11 |
| 2019 Agosto | 6 | 5 | 11 |
| 2019 Julio | 4 | 17 | 21 |
| 2019 Junio | 13 | 19 | 32 |
| 2019 Mayo | 4 | 40 | 44 |
| 2019 Abril | 13 | 29 | 42 |
| 2019 Marzo | 4 | 13 | 17 |
| 2019 Febrero | 2 | 4 | 6 |
| 2019 Enero | 2 | 4 | 6 |
| 2018 Diciembre | 5 | 2 | 7 |
| 2018 Noviembre | 1 | 5 | 6 |
| 2018 Octubre | 5 | 0 | 5 |
| 2018 Septiembre | 4 | 2 | 6 |
| 2018 Agosto | 0 | 8 | 8 |
| 2018 Julio | 0 | 7 | 7 |
| 2018 Junio | 0 | 10 | 10 |
| 2018 Mayo | 1 | 11 | 12 |
| 2018 Abril | 0 | 6 | 6 |
| 2018 Marzo | 3 | 10 | 13 |
| 2018 Febrero | 27 | 3 | 30 |
| 2018 Enero | 24 | 8 | 32 |
| 2017 Diciembre | 26 | 8 | 34 |
| 2017 Noviembre | 27 | 7 | 34 |
| 2017 Octubre | 23 | 9 | 32 |
| 2017 Septiembre | 14 | 8 | 22 |
| 2017 Agosto | 21 | 14 | 35 |
| 2017 Julio | 15 | 3 | 18 |
| 2017 Junio | 35 | 21 | 56 |
| 2017 Mayo | 22 | 16 | 38 |
| 2017 Abril | 19 | 18 | 37 |
| 2017 Marzo | 24 | 19 | 43 |
| 2017 Febrero | 23 | 12 | 35 |
| 2017 Enero | 16 | 7 | 23 |
| 2016 Diciembre | 38 | 12 | 50 |
| 2016 Noviembre | 33 | 10 | 43 |
| 2016 Octubre | 28 | 18 | 46 |
| 2016 Septiembre | 0 | 4 | 4 |
| 2016 Agosto | 0 | 4 | 4 |
| 2016 Julio | 9 | 1 | 10 |
| 2016 Junio | 7 | 1 | 8 |
| 2016 Mayo | 7 | 17 | 24 |
| 2016 Abril | 4 | 21 | 25 |
| 2016 Marzo | 4 | 22 | 26 |
| 2016 Febrero | 3 | 1 | 4 |
| 2016 Enero | 4 | 1 | 5 |
| 2015 Diciembre | 9 | 1 | 10 |
| 2015 Noviembre | 4 | 10 | 14 |
| 2015 Octubre | 2 | 1 | 3 |
| 2015 Septiembre | 0 | 2 | 2 |
| 2015 Agosto | 0 | 4 | 4 |
| 2015 Julio | 4 | 2 | 6 |
| 2015 Junio | 2 | 2 | 4 |
| 2015 Mayo | 3 | 4 | 7 |
| 2015 Abril | 3 | 10 | 13 |
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