Case for Diagnosis
Fast-growing Tumor of the Eyelid
Tumor de rápido crecimiento en el párpado
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Morales-Cardona, C. Rodríguez-Zakzuk, A. Téllez-Lozada" "autores" => array:3 [ 0 => array:4 [ "nombre" => "C.A." "apellidos" => "Morales-Cardona" "email" => array:1 [ 0 => "camiderm@yahoo.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" => "C." "apellidos" => "Rodríguez-Zakzuk" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "A." "apellidos" => "Téllez-Lozada" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Hospital Universitario Centro Dermatológico Federico Lleras Acosta E.S.E., Bogotá, D.C., Colombia" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Fundación Universitaria Sanitas, Bogotá, D.C., Colombia" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tumor de rápido crecimiento en el párpado" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1283 "Ancho" => 1167 "Tamanyo" => 264708 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Medical History</span><p id="par0005" class="elsevierStylePara elsevierViewall">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.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Physical Examination</span><p id="par0010" class="elsevierStylePara elsevierViewall">Physical examination revealed a 2.5<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>1.5<span class="elsevierStyleHsp" style=""></span>cm 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 (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Histopathology</span><p id="par0015" class="elsevierStylePara elsevierViewall">Histologic examination revealed a dermal lesion composed of basaloid cells and ghost cells, with foci of calcification surrounded by fibrous stroma without atypia (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">What Is Your Diagnosis?</span></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Diagnosis</span><p id="par0020" class="elsevierStylePara elsevierViewall">Perforating pilomatrixoma.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Clinical Course</span><p id="par0025" class="elsevierStylePara elsevierViewall">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 (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Comment</span><p id="par0030" class="elsevierStylePara elsevierViewall">Pilomatrixoma, a benign tumor of the hair follicle matrix, is among the most common skin neoplasms in children and young adults.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> It is more common in women and usually appears on the head and neck, where it manifests as a single subcutaneous nodule measuring 0.5-2<span class="elsevierStyleHsp" style=""></span>cm in diameter that is firm on palpation, with blood vessels and discoloration of the overlying skin.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> 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.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> Diagnosis is confirmed by histologic examination, which shows basophilic cells, and, in the perforating variant, ossification and transepidermal elimination.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> 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%<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> to 54%<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> of cases. Spontaneous remission has not been reported. The lesion is treated by surgical excision, with an estimated recurrence risk of 3%-4%.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conflicts of Interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:8 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Medical History" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Physical Examination" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Histopathology" ] 3 => array:2 [ "identificador" => "sec0025" "titulo" => "Diagnosis" ] 4 => array:2 [ "identificador" => "sec0030" "titulo" => "Clinical Course" ] 5 => array:2 [ "identificador" => "sec0035" "titulo" => "Comment" ] 6 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflicts of Interest" ] 7 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">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.</p>" ] ] "multimedia" => array:3 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1283 "Ancho" => 1167 "Tamanyo" => 264708 ] ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1230 "Ancho" => 1167 "Tamanyo" => 528291 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Hematoxylin-eosin, original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>40.</p>" ] ] 2 => array:6 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1579 "Ancho" => 1167 "Tamanyo" => 236885 ] ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ulcerated giant pilomatrixoma in a child" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P. 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Watanabe" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2003" "volumen" => "49" "paginaInicial" => "146" "paginaFinal" => "147" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A clinical review of 209 pilomatricomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.G. Julian" 1 => "P.W. 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| 2023 Mayo | 78 | 23 | 101 |
| 2023 Abril | 43 | 21 | 64 |
| 2023 Marzo | 134 | 39 | 173 |
| 2023 Febrero | 69 | 22 | 91 |
| 2023 Enero | 55 | 34 | 89 |
| 2022 Diciembre | 82 | 40 | 122 |
| 2022 Noviembre | 30 | 25 | 55 |
| 2022 Octubre | 25 | 20 | 45 |
| 2022 Septiembre | 21 | 42 | 63 |
| 2022 Agosto | 26 | 37 | 63 |
| 2022 Julio | 22 | 40 | 62 |
| 2022 Junio | 28 | 15 | 43 |
| 2022 Mayo | 48 | 36 | 84 |
| 2022 Abril | 57 | 39 | 96 |
| 2022 Marzo | 54 | 56 | 110 |
| 2022 Febrero | 40 | 39 | 79 |
| 2022 Enero | 40 | 34 | 74 |
| 2021 Diciembre | 32 | 42 | 74 |
| 2021 Noviembre | 47 | 66 | 113 |
| 2021 Octubre | 58 | 64 | 122 |
| 2021 Septiembre | 30 | 44 | 74 |
| 2021 Agosto | 47 | 51 | 98 |
| 2021 Julio | 31 | 42 | 73 |
| 2021 Junio | 31 | 39 | 70 |
| 2021 Mayo | 41 | 58 | 99 |
| 2021 Abril | 71 | 88 | 159 |
| 2021 Marzo | 61 | 47 | 108 |
| 2021 Febrero | 82 | 39 | 121 |
| 2021 Enero | 45 | 40 | 85 |
| 2020 Diciembre | 46 | 55 | 101 |
| 2020 Noviembre | 32 | 49 | 81 |
| 2020 Octubre | 28 | 17 | 45 |
| 2020 Septiembre | 32 | 22 | 54 |
| 2020 Agosto | 32 | 28 | 60 |
| 2020 Julio | 31 | 26 | 57 |
| 2020 Junio | 28 | 28 | 56 |
| 2020 Mayo | 19 | 13 | 32 |
| 2020 Abril | 25 | 15 | 40 |
| 2020 Marzo | 16 | 9 | 25 |
| 2020 Febrero | 6 | 0 | 6 |
| 2020 Enero | 2 | 0 | 2 |
| 2019 Diciembre | 8 | 0 | 8 |
| 2019 Noviembre | 3 | 0 | 3 |
| 2019 Septiembre | 10 | 0 | 10 |
| 2019 Agosto | 4 | 0 | 4 |
| 2019 Julio | 4 | 0 | 4 |
| 2019 Junio | 4 | 0 | 4 |
| 2019 Mayo | 6 | 0 | 6 |
| 2019 Abril | 2 | 0 | 2 |
| 2019 Marzo | 2 | 0 | 2 |
| 2019 Febrero | 2 | 0 | 2 |
| 2018 Diciembre | 2 | 0 | 2 |
| 2018 Noviembre | 3 | 0 | 3 |
| 2018 Octubre | 1 | 0 | 1 |
| 2018 Septiembre | 2 | 0 | 2 |
| 2018 Mayo | 1 | 0 | 1 |
| 2018 Abril | 2 | 0 | 2 |
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