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Chessa MA, Baracca MF, Rossi AN, Piraccini BM, De Pietro V, Picciola VM, Gelmetti A, Neri I. Pilomatricoma: Clinical, Dermoscopic Findings and Management in 55 Pediatric Patients and Concise Review of the Literature with Special Emphasis on Dermoscopy. Dermatol Pract Concept 2024; 14:dpc.1402a140. [PMID: 38810027 PMCID: PMC11135972 DOI: 10.5826/dpc.1402a140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2024] [Indexed: 05/31/2024] Open
Abstract
INTRODUCTION Pilomatricoma is a benign adnexal dermal or subcutaneous tumor derived from immature hair matrix cells. OBJECTIVES The aim of our study is to evaluate clinical and dermoscopic features of pilomatricomas, with a specific focus on pediatric lesions, and to provide a concise review of the existing literature. METHODS A single-center retrospective study was undertaken on 55 patients with a histopathological diagnosis of pilomatricoma referred to the Dermatology Unit, University of Bologna, Bologna, Italy, between 2005 and 2023. Pilomatricomas were retrospectively evaluated relying on clinical and dermoscopic images. A PubMed search was conducted. All the relevant research up to July 31, 2023, was reviewed. We classified the cases as "typical" or "atypical" based on whether they were suspected of being pilomatricomas or not. RESULTS A total of 55 children with pilomatricomas were observed and studied. Two patients presented with 2 pilomatricomas, leading to the identification of 58 pilomatricomas. 'Typical' pilomatricomas were observed in 79% of cases as nodular and pigmented lesions with one or more colors, ranging from blue-gray to red to yellow/white, evident on clinical examination and even better on dermoscopy. In 21% of cases, pilomatricomas presented in an 'atypical' form, which did not allow for a well-founded suspicion, placing them in differential diagnosis with other lesions and therefore requiring histological examination. CONCLUSIONS According to our case series and systematic review of the literature, clinical appearance and dermoscopy may be sufficient to diagnose or suspect pilomatricoma in around 80% of cases, while histological examination is necessary to confirm the diagnosis in the remaining 20% of cases.
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Affiliation(s)
- Marco Adriano Chessa
- Dermatology Unit - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Maria Francesca Baracca
- Dermatology Unit - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Alice Nadia Rossi
- Dermatology Unit - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Vittorio De Pietro
- Dermatology Unit – Azienda Ospedaliera-Universitaria di Siena, Siena, Italy
| | | | - Alessandra Gelmetti
- Dermatology Unit - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
- Department of Experimental, Diagnostic and Specialty Medicine, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Iria Neri
- Dermatology Unit - IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
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2
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Vetsiou E, Gass J, Khoo A, McDonald S, Stefanos N, Rytina E, Burrows N. Anetodermic pilomatrixomas: A case series. SKIN HEALTH AND DISEASE 2023; 3:e284. [PMID: 38047261 PMCID: PMC10690670 DOI: 10.1002/ski2.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/13/2023] [Accepted: 08/25/2023] [Indexed: 12/05/2023]
Abstract
Pilomatrixoma is a benign hair follicle tumour. Anetodermic changes overlying pilomatrixoma are rare. The aim of this study is to evaluate a case series of patients with a clinical diagnosis of anetodermic pilomatrixoma presenting to our Dermatology Department over a 5-year period. Eight cases were identified. The median age of onset was 21 years. All cases presented on the upper limbs and trunk with a solitary rapidly evolving tumour, tender on palpation. They had an erythematous protuberant appearance with a wrinkled and atrophic surface. Underlying pilomatrixomas were firm measuring 1-5 cm. Simple excision was carried out in seven cases without postoperative complications. In conclusion, anetodermic pilomatrixoma is a rare variant of this tumour, occurring more frequently on the upper body. It presents with identifiable features and should be differentiated from other skin tumours. Surgical removal is usually the gold standard treatment.
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Affiliation(s)
- Evangelia Vetsiou
- Department of DermatologyAddenbrooke's HospitalCambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Julia Gass
- Department of DermatologyAddenbrooke's HospitalCambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Andre Khoo
- Department of DermatologyAddenbrooke's HospitalCambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Sarah McDonald
- Department of HistopathologyAddenbrooke's HospitalCambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Niki Stefanos
- Department of HistopathologyAddenbrooke's HospitalCambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Ed Rytina
- Department of HistopathologyAddenbrooke's HospitalCambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Nigel Burrows
- Department of DermatologyAddenbrooke's HospitalCambridge University Hospitals NHS Foundation TrustCambridgeUK
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3
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Rabai NA, Alrababah A, Ba-Shammakh SA, Aloqaily A, Saleh SW, Al-Oqaily MM. Pilomatrixoma of the Arm: A Case Report and Review of Literature. Cureus 2023; 15:e45768. [PMID: 37872911 PMCID: PMC10590536 DOI: 10.7759/cureus.45768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2023] [Indexed: 10/25/2023] Open
Abstract
Pilomatrixoma (PMX), also known as calcifying epithelioma of Malherbe, is a rare benign neoplasm that arises from the hair matrix cells, commonly in the head, neck, and upper trunk regions, infrequently affecting upper and lower extremities. It has to two peaks of presentation: under 20 years of age or between 50 and 65 years of age, slightly more common in females. The neoplasm exhibits diverse clinical manifestations and is frequently subject to misdiagnosis with alternative dermatological diseases. We present an atypical case of PMX affecting the upper extremity of a 62-year-old female patient. Surgical removal of the affected tissue under local anesthesia was performed, and subsequent histopathological analysis confirmed the presence of PMX. Based on the literature search we performed, we found out that this pathology is underreported in Jordan, with only one study published describing this tumor in the maxillofacial region. Physicians should be aware of this condition and its different presentations to include it in the differential diagnosis of suspected cases to provide the appropriate management and follow-up.
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Affiliation(s)
- Nimah A Rabai
- Department of General Surgery, Princess Basma Teaching Hospital, Irbid, JOR
| | - Arqam Alrababah
- Department of General Surgery, Princess Basma Teaching Hospital, Irbid, JOR
| | | | - Ayat Aloqaily
- Department of Pathology and Microbiology, Jordan University of Science and Technology, Irbid, JOR
| | - Siwar W Saleh
- Department of Pathology and Microbiology, Jordan University of Science and Technology, Irbid, JOR
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4
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Multiple subcutaneous nodules. J Paediatr Child Health 2023; 59:1099. [PMID: 37728042 DOI: 10.1111/jpc.1_16172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/03/2022] [Indexed: 09/21/2023]
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5
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Chan CWJ, Sarkissian SD, Ming A. Multiple subcutaneous nodules. J Paediatr Child Health 2023; 59:1097. [PMID: 35969042 DOI: 10.1111/jpc.16172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 08/03/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Chon-Wai J Chan
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Samuel Der Sarkissian
- Department of Dermatology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
- Faculty of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Andrew Ming
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- Department of Dermatology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
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6
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Cammarata-Scalisi F, Diociaiuti A, Cárdenas Tadich A, Sandoval X, Oranges T, Filippeschi C, Araya Castillo M, Willoughby CE, Cerri A, Gervasini C, Callea M. Dermatological findings in Rubinstein-Taybi Syndrome. Ital J Dermatol Venerol 2023; 158:316-320. [PMID: 37282850 DOI: 10.23736/s2784-8671.23.07547-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Rubinstein-Taybi Syndrome is a rare congenital multisystem syndrome inherited in an autosomal dominant pattern caused by mutations in CREBBP and EP300 genes in approximately 60% and 10% respectively. These genes encode two highly evolutionarily conserved, ubiquitously expressed, and homologous lysine-acetyltransferases, that are involved in number of basic cellular activities, such as DNA repair, cell proliferation, growth, differentiation, apoptosis of cells, and tumor suppression. It is mainly characterized by global developmental delay, moderate to severe intellectual disability, postnatal retardation, microcephaly, skeletal anomalies including broad/short, angled thumbs and/or large first toes, short stature, and dysmorphic facial features. There is an increased risk to develop tumors mainly meningiomas and pilomatrixomas, without a clear genotype-phenotype correlation. Although not considered as characteristic manifestations, numerous cutaneous anomalies have also been reported in patients with this entity. Both susceptibility to the formation of keloids and pilomatricomas are the most often associated cutaneous features. In this review, we discuss the genetics, diagnosis, and clinical features in Rubinstein-Taybi Syndrome with a review of the major dermatological manifestations.
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Affiliation(s)
| | | | | | - Ximena Sandoval
- Pediatrics Service, Regional of Antofagasta Hospital, Antofagasta, Chile
| | - Teresa Oranges
- Unit of Dermatology, Department of Pediatrics, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Cesare Filippeschi
- Unit of Dermatology, Department of Pediatrics, Meyer Children's Hospital IRCCS, Florence, Italy
| | | | | | - Amilcare Cerri
- Dermatological Clinic, Department of Health Sciences, AO Santi Paolo e Carlo, University of Milan, Milan, Italy
| | - Cristina Gervasini
- Medical Genetics, Department of Health Sciences, University of Milan, Milan, Italy
| | - Michele Callea
- Pediatric Dentistry and Special Dental Care Unit, Meyer Children's Hospital IRCCS, Florence, Italy
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7
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Raison-Peyron N, Secco LP, Delfour C, Captier G, Bessis D. Multiple Postvaccinal Pilomatrixomas in a Child. Clin Pediatr (Phila) 2023; 62:692-694. [PMID: 37293757 DOI: 10.1177/00099228221144941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Affiliation(s)
- Nadia Raison-Peyron
- Department of Dermatology, Montpellier University Hospital, Montpellier University, Montpellier, France
| | - Léo-Paul Secco
- Department of Dermatology, Montpellier University Hospital, Montpellier University, Montpellier, France
- Department of Pathology, Montpellier University Hospital, Montpellier University, Montpellier, France
| | - Christophe Delfour
- Department of Pathology, Montpellier University Hospital, Montpellier University, Montpellier, France
| | - Guillaume Captier
- Department of Pediatric Surgery, Montpellier University Hospital, Montpellier University, Montpellier, France
| | - Didier Bessis
- Department of Dermatology, Montpellier University Hospital, Montpellier University, Montpellier, France
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8
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Mohr C, Tschen J. Atypical Pediatric Presentation of Pilomatricoma. Cureus 2023; 15:e39909. [PMID: 37404426 PMCID: PMC10317080 DOI: 10.7759/cureus.39909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2023] [Indexed: 07/06/2023] Open
Abstract
Pilomatricomas are uncommon, benign tumors of the hair follicle, which are often misdiagnosed upon initial inspection. Here we describe the case of a 4-year-old boy who presented with a persistent draining tumor on the left side of his neck for approximately two years. The tumor was originally misdiagnosed as scrofuloderma but, eventually, our patient's pilomatricoma was identified with biopsy and successfully treated with elliptical excision. We discuss the importance of considering pilomatricoma in the differential diagnosis.
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Affiliation(s)
| | - Jaime Tschen
- Dermatology, St. Joseph Dermatopathology, Houston, USA
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9
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D’Ambrosio ES, Gonzalez-Perez P. Cancer and Myotonic Dystrophy. J Clin Med 2023; 12:1939. [PMID: 36902726 PMCID: PMC10004154 DOI: 10.3390/jcm12051939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/27/2023] [Accepted: 02/28/2023] [Indexed: 03/05/2023] Open
Abstract
Myotonic dystrophy (DM) is the most common muscular dystrophy in adults. Dominantly inherited CTG and CCTG repeat expansions in DMPK and CNBP genes cause DM type 1 (DM1) and 2 (DM2), respectively. These genetic defects lead to the abnormal splicing of different mRNA transcripts, which are thought to be responsible for the multiorgan involvement of these diseases. In ours and others' experience, cancer frequency in patients with DM appears to be higher than in the general population or non-DM muscular dystrophy cohorts. There are no specific guidelines regarding malignancy screening in these patients, and the general consensus is that they should undergo the same cancer screening as the general population. Here, we review the main studies that investigated cancer risk (and cancer type) in DM cohorts and those that researched potential molecular mechanisms accounting for DM carcinogenesis. We propose some evaluations to be considered as malignancy screening in patients with DM, and we discuss DM susceptibility to general anesthesia and sedatives, which are often needed for the management of cancer. This review underscores the importance of monitoring the adherence of patients with DM to malignancy screenings and the need to design studies that determine whether they would benefit from a more intensified cancer screening than the general population.
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10
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Hong KW, Saulino D, Ching J, Tung P. A Frequently Missed Diagnosis of a Firm, Blue-Tinged Mass. Pediatr Rev 2023; 44:e1-e4. [PMID: 36587024 DOI: 10.1542/pir.2021-005149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
| | | | - Jessica Ching
- Department of Plastic Surgery, University of Florida, Gainesville, FL
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11
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Giacalone S, Spigariolo CB, Brena M, Nazzaro G. The role of high-frequency ultrasound in the clinical management of multiple pilomatricomas. Int J Dermatol 2022; 61:e465-e467. [PMID: 35094382 DOI: 10.1111/ijd.16100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 11/24/2021] [Accepted: 01/06/2022] [Indexed: 12/17/2022]
Affiliation(s)
- Serena Giacalone
- Department of Physiopathology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | | | - Michela Brena
- Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Gianluca Nazzaro
- Department of Physiopathology and Transplantation, Università degli Studi di Milano, Milan, Italy.,Dermatology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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12
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Martínez-Gayosso A, Dávalos-Tanaka M, González-González M, Sáez-de-Ocariz M, Orozco-Covarrubias L. Cutaneous horn on the arm of an adolescent male. Pediatr Dermatol 2022; 39:982-984. [PMID: 36440992 DOI: 10.1111/pde.15119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 07/31/2022] [Indexed: 11/29/2022]
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13
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Smith C, Hamilton D, Waterston S. Rare case of multiple and perforating pilomatrixomas in a young girl with lymphovascular malformation reveals a potential new disease association. BMJ Case Rep 2022; 15:e248076. [PMID: 35613831 PMCID: PMC9134206 DOI: 10.1136/bcr-2021-248076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2022] [Indexed: 11/03/2022] Open
Abstract
This report details the case of a girl of primary school age who was referred to our plastic surgery department with an ulcerating lesion on the nape of her neck. A firm mass was palpable in the underlying subcutaneous tissue. This lesion was accompanied by two smaller firm nodules: one in the adjacent tissue and another in the left preauricular region. Ultrasound and MRI demonstrated multiple calcified nodules confined to the subcutaneous tissue. An incisional biopsy of the ulcerating lesion confirmed a diagnosis of perforating pilomatrixoma; the lesion was subsequently excised, with no sign of recurrence at 3-month follow-up. The patient had a history of lymphovascular malformation (LVM) and a paternal history of Gardner's syndrome. Pilomatrixoma and Gardner's syndrome have a well-documented association in existing literature; aberrant Wnt/beta-catenin signalling is common to both. Recent laboratory studies suggest this pathway is also implicated in the pathogenesis of LVM.
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Affiliation(s)
- Clara Smith
- Department of Plastic Surgery, NHS Tayside, Dundee, UK
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14
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Palacios-Diaz RD, Navarro-Mira MÁ, Ballester-Sánchez R, Calle-Andrino A, de Unamuno-Bustos B, Botella-Estrada R. Multiple pilomatricomas in a child with xeroderma pigmentosum: Coincidence or association? Pediatr Dermatol 2022; 39:478-480. [PMID: 35178751 DOI: 10.1111/pde.14924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 01/08/2022] [Indexed: 12/01/2022]
Abstract
The association of multiple pilomatricomas with xeroderma pigmentosum has not been described. We report a case of a child with multiple pilomatricomas and photosensitivity who was found to have a pathogenic variant in exon 4 of XPA and a likely pathogenic variant in COL6A1.
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Affiliation(s)
| | | | | | - Anaid Calle-Andrino
- Department of Dermatology, Hospital de La Plana, Villarreal, Castellón, Spain
| | | | - Rafael Botella-Estrada
- Department of Dermatology, Hospital Universitari i Politècnic La Fe, Valencia, Spain.,Department of Medicine, Universitat de València, València, Spain
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15
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Kong HE, Pollack BP. Cutaneous findings in myotonic dystrophy. JAAD Int 2022; 7:7-12. [PMID: 35243403 PMCID: PMC8867117 DOI: 10.1016/j.jdin.2021.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2021] [Indexed: 11/06/2022] Open
Abstract
Myotonic dystrophy types 1 and 2 are a group of complex genetic disorders resulting from the expansion of (CTG)n nucleotide repeats in the DMPK gene. In addition to the hallmark manifestations of myotonia and skeletal muscle atrophy, myotonic dystrophy also affects a myriad of other organs including the heart, lungs, as well as the skin. The most common cutaneous manifestations of myotonic dystrophy are early male frontal alopecia and adult-onset pilomatricomas. Myotonic dystrophy also increases the risk of developing malignant skin diseases such as basal cell carcinoma and melanoma. To aid in the diagnosis and treatment of myotonic dystrophy related skin conditions, it is important for the dermatologist to become cognizant of the common and rare cutaneous manifestations of this genetic disorder. We performed a PubMed search using the key terms “myotonic dystrophy” AND “cutaneous” OR “skin” OR “dermatologic” AND “manifestation” OR “finding.” The resulting publications were manually reviewed for additional relevant publications, and subsequent additional searches were performed as needed, especially regarding the molecular mechanisms of pathogenesis. In this review, we aim to provide an overview of myotonic dystrophy types 1 and 2 and summarize their cutaneous manifestations as well as potential mechanisms of pathogenesis.
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Affiliation(s)
- Ha Eun Kong
- Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia
| | - Brian P Pollack
- Atlanta VA Health System, Decatur, Georgia.,Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia.,Department of Pathology, Emory University School of Medicine, Atlanta, Georgia.,Winship Cancer Institute of Emory University School of Medicine, Atlanta, Georgia
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16
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Siadati S, Campbell AA, McCulley T, Eberhart CG. Clinicopathological Features of 19 Eyelid Pilomatrixomas. Ocul Oncol Pathol 2022; 8:30-34. [PMID: 35356601 PMCID: PMC8914276 DOI: 10.1159/000520219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 10/13/2021] [Indexed: 02/03/2023] Open
Abstract
Introduction Pilomatrixoma is a relatively rare, benign tumor arising from the hair root matrix. It is found frequently on the head and neck, with most involving the eyebrow in the periocular region. In contrast, eyelid pilomatrixoma is less common, and often clinically misdiagnosed. Here, we present clinical and histological data from 19 pilomatrixomas arising in the eyelid. Methods The study represents a retrospective study of eyelid pilomatrixoma diagnosed at our institution since 1981. All slides were reviewed, and demographic as well as clinical data were obtained. Results Patient ages ranged from 2 to 63 years (mean 24 years), including 12 (63%) females and 7 (37%) males. Eight (42%) and 4 (21%) cases arose in the first and second decades of life, respectively. Upper eyelid involvement was found in 14 (74%) of cases. Microscopically, the tumors were characterized by basaloid and shadow cells accompanied by calcification and foreign body giant cells. Conclusions Eyelid pilomatrixoma is rarely suspected clinically, and can be mistaken for cyst, chalazion, sebaceous carcinoma, and other tumors. Physicians should consider the possibility of pilomatrixoma in the eyelid area, especially in children or young female patients. Complete excision is curative, and diagnosis can generally be established by histopathological examination.
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Affiliation(s)
- Sepideh Siadati
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ashley A. Campbell
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Timothy McCulley
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Charles G. Eberhart
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA,Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA,*Charles G. Eberhart,
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17
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Tiplica GS, Fritz K, Butacu AI, Ungureanu L, Sălăvăstru CM. Gutartige nichtmelanozytäre Hauttumoren bei Syndromen. Hautarzt 2022; 73:114-126. [DOI: 10.1007/s00105-022-04947-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/07/2022] [Indexed: 12/24/2022]
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18
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Pelizzari M, Giovo ME, Innocente N, Pérez R. Ultrasound findings in 156 children with 169 pilomatricomas. Pediatr Radiol 2021; 51:2038-2046. [PMID: 34255110 DOI: 10.1007/s00247-021-05124-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 04/07/2021] [Accepted: 06/09/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cutaneous lesions present a diagnostic challenge to radiologists and clinicians alike. Pilomatricoma is the second most common skin neoplasm in childhood, yet there are limited reports in the literature focusing on imaging in pediatric patients. OBJECTIVE To characterize the typical and atypical US features of pilomatricoma in pediatric patients and to determine the performance of the adult-based Solivetti classification for assessing pilomatricomas in children. MATERIALS AND METHODS We retrospectively reviewed 169 US scans of pathologically proven pilomatricomas in 156 children performed over a period of 66 months. We evaluated images for the size of the lesion, borders, morphology, content, calcification, location on the skin and Doppler characteristics. RESULTS Most of the pilomatricomas presented as single dermohypodermic lesions with peripheral vascularity on color Doppler interrogation. The cheek was the most common location, followed by the arm. Solivetti type 2 US pattern was the most frequent, and peripheral hypoechoic halo was only observed in this type. One child had an anetodermic pilomatricoma, and 11 children had multiple lesions. CONCLUSION We showed that pilomatricomas exhibit variable sonographic patterns. In our cohort, less than 50% of the lesions showed the characteristic hypoechoic rim and less than 30% of the cases presented as diffusely hyperechoic masses with posterior acoustic shadowing. Our results show that the Solvetti classification for the US assessment of pilomatricomas can be of value in children.
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Affiliation(s)
- Mario Pelizzari
- Universidad Católica de Córdoba, Ciudad de Córdoba, República Argentina. .,Servicio de Radiología Pediátrica, Instituto Oulton, Avenida Vélez Sarsfield 562, Ciudad de Córdoba, República Argentina.
| | - María E Giovo
- Universidad Católica de Córdoba, Ciudad de Córdoba, República Argentina.,Servicio de Dermatología, Hospital de Niños de la Santísima Trinidad, Ciudad de Córdoba, República Argentina
| | - Natalia Innocente
- Servicio de Radiología Pediátrica, Instituto Oulton, Avenida Vélez Sarsfield 562, Ciudad de Córdoba, República Argentina.,Universidad Nacional de Córdoba, Ciudad de Córdoba, República Argentina
| | - Ricardo Pérez
- Universidad Católica de Córdoba, Ciudad de Córdoba, República Argentina.,Servicio de Radiología Pediátrica, Instituto Oulton, Avenida Vélez Sarsfield 562, Ciudad de Córdoba, República Argentina
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Minai L, Yagasaki H, Ogawa Y, Deguchi N, Mitsui H, Shimada S, Kawamura T. Multiple bullous pilomatricomas in a patient with Rubinstein-Taybi syndrome. J Dermatol 2021; 48:e482-e483. [PMID: 34118171 DOI: 10.1111/1346-8138.16030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/04/2021] [Accepted: 05/26/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Lisa Minai
- Department of Dermatology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Hideaki Yagasaki
- Department of Pediatrics, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Youichi Ogawa
- Department of Dermatology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Nobuhiro Deguchi
- Department of Dermatology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Hiroshi Mitsui
- Department of Dermatology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Shinji Shimada
- Department of Dermatology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Tatsuyoshi Kawamura
- Department of Dermatology, Faculty of Medicine, University of Yamanashi, Yamanashi, Japan
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Bollu BK, Collin M, Shun A. Minimally invasive surgical treatment of pilomatrixoma. ANZ J Surg 2020; 91:2126-2129. [PMID: 33369831 DOI: 10.1111/ans.16521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pilomatrixoma is a benign skin tumour often presenting as a firm irregular mass in the paediatric population. The most common site is on the head and neck. Traditionally, a wide local excision has been the method of management. We propose an incision and curettage (I&C) technique for an improved cosmetic outcome. METHODS A retrospective review of children who underwent I&C for pilomatrixoma was done between January 2010 and June 2020. The I&C technique involved making a small incision over or near the lesion in a discrete location such as behind the hairline and removing the tumour piecemeal. Four to six weeks of routine post-operative follow-up was conducted. Patients and families were also subsequently contacted via a survey to assess for late recurrence, any other complications and ascertain their level of satisfaction with the outcome. RESULTS Twenty lesions were removed in 11 patients over this time with a female predominance (seven) and most lesions were on the face (11). No patients had a recurrence in a mean follow-up time of 6 years (1-10 years). All parents are very satisfied with the cosmetic result. CONCLUSION I&C may be an effective and cosmetically pleasing method to removing pilomatrixoma.
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Affiliation(s)
- Bapesh Krishna Bollu
- Department of Paediatric Surgery, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.,Children's Hospital Westmead Clinical School, Faculty of of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Michael Collin
- Department of Paediatric Surgery, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Albert Shun
- Department of Paediatric Surgery, The Children's Hospital at Westmead, Sydney, New South Wales, Australia
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21
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Akhtar S, Rajabi-Estarabadi A, Zheng C, Zade J, Nouri K. Cells to Surgery Quiz: December 2020. J Invest Dermatol 2020. [DOI: 10.1016/j.jid.2020.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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McCormack L, Trivedi A, Lal K, Amano S, Elaba ZRP, McIntyre J, Wiss K. Proliferating pilomatricoma in a 9-year-old girl. Pediatr Dermatol 2020; 37:1187-1188. [PMID: 32985708 DOI: 10.1111/pde.14386] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 07/08/2020] [Accepted: 08/31/2020] [Indexed: 11/29/2022]
Abstract
Proliferating pilomatricoma is a rare, benign tumor of hair matrix origin that rarely occurs in children. We report the case of a 9-year-old girl with a rapidly growing, proliferating pilomatricoma located on the glabella. The lesion was embolized and surgically excised, with histopathological examination of the tissue confirming the diagnosis of proliferating pilomatricoma.
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Affiliation(s)
- Lindsay McCormack
- University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Apoorva Trivedi
- University of Massachusetts Medical School, Worcester, Massachusetts, USA.,Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Karan Lal
- University of Massachusetts Medical School, Worcester, Massachusetts, USA.,Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Shinya Amano
- University of Massachusetts Medical School, Worcester, Massachusetts, USA.,Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Zendee Rose P Elaba
- University of Massachusetts Medical School, Worcester, Massachusetts, USA.,Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Joyce McIntyre
- University of Massachusetts Medical School, Worcester, Massachusetts, USA.,Department of Plastic Surgery, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Karen Wiss
- University of Massachusetts Medical School, Worcester, Massachusetts, USA.,Department of Dermatology, University of Massachusetts Medical School, Worcester, Massachusetts, USA.,Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts, USA
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Bueno ALA, de Souza MEV, Graziadio C, Kiszewski AE. Multiple pilomatricomas in twins with Rubinstein-Taybi syndrome. An Bras Dermatol 2020; 95:619-622. [PMID: 32778355 PMCID: PMC7563002 DOI: 10.1016/j.abd.2020.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Accepted: 03/05/2020] [Indexed: 12/03/2022] Open
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.
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Affiliation(s)
- Ana Laura Andrade Bueno
- Dermatology Service, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil; Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
| | - Maria Emilia Vieira de Souza
- Dermatology Service, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil; Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
| | - Carla Graziadio
- Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil; Discipline of Clinical Genetics, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil
| | - Ana Elisa Kiszewski
- Dermatology Service, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil; Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil; Pediatric Dermatology Unit, Dermatology Service, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS, Brazil.
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