Hair Follicle Matrix Cells Research Articles

Clinical and Histopathological Perspectives of Pilomatrixoma: A Case Report.

Pilomatrixoma is a rare, benign tumor arising from hair follicle matrix cells, commonly seen in children and young adults. This case report discusses an 8-year-old male with a progressively enlarging posterior neck swelling over three months. Clinical examination revealed a mobile, subcutaneous mass. Fine-needle aspiration cytology (FNAC) suggested an adnexal tumor, characterized by cohesive clusters of basaloid cells, nucleated and anucleated squamous cells, and ghost cells. The patient underwent surgical excision of the mass, and histopathological examination confirmed a diagnosis of pilomatrixoma. Postoperative recovery was uneventful, with no signs of recurrence at the three-month follow-up. This case highlights the importance of combining clinical, cytological, and histopathological findings to accurately diagnose and manage pilomatrixoma, emphasizing the role of complete surgical excision in achieving favourable outcomes. The report adds valuable insights to the literature, aiding clinicians in recognizing and differentiating this rare tumour in paediatric patients.

Childhood pilomatrixoma: Case series with a comprehensive literature review

Pilomatrixoma is a benign skin tumor that develops from the hair follicle matrix cells. It represents around 0.1% of all skin tumors. Although pilomatrixomas are well-recognized lesions, clinically they are frequently misdiagnosed primarily due to a lack of awareness by clinicians. We have retrospectively reviewed medical records of six children with a histologically diagnosed pilomatrixoma between January 2018 and April 2023. There were four boys and two girls with median age at presentation of 8 (range 4 to 12) years. The common complaint was of a painless swelling that was immobile and fixed to the overlying skin. All but one patient had solitary lesions and most of them were in the head and neck region. The size of the lesions ranged from 0.8 to 1.5 cm. All the patients had their lesions excised completely and sent for histopathological examination which confirmed the diagnosis of a pilomatrixoma. After a median follow-up of 16 (range 12 to 47) months, none of our patients developed any recurrence or malignancy. Pilomatrixoma is an uncommon benign skin tumor, sometimes with atypical forms, with no tumor-specific diagnostic feature except for a careful histopathological examination. It is easily excisable and recurrence is rare.

A systematic review of Pilomatrix carcinoma arising from the previous scar site of Pilomatrixoma.

Pilomatrix carcinoma is a rare tumor arising from the hair follicle matrix cells most commonly seen in the head and neck region. Also known as "calcified epithelial carcinoma of Melherbe," it was first reported in 1980 by Lopansri and Mihm. Since then till date to the best of our knowledge only around 125 cases were reported in literature, of which only 11 cases were reported to arise from histologically proven areas of previous pilomatrixoma which is the benign variant. One such case is being reported here along with the review of literature. A 50-year-old man presented with a swelling in the nape of his neck since 6 months, which was gradually increasing in size. He had a history of similar swelling at the same site 18 months back for which he underwent a surgery at a center outside. Final histopathology report was suggestive of pilomatrixoma with negative margin. Wide local excision of the tumor with 3 cm margin, placement of surgical clips followed by a primary closure was done. The final histopathology report is suggestive of pilomatrix carcinoma. The patient has no recurrence in 6 months follow-up. The differential diagnosis of pilomatrix carcinoma should be considered in cases of recurrent skin tumors. Wide local excision is the preferred treatment. Re-excision should be done in margin positive cases and cases where simple excision was done due to improper preoperative diagnosis. Due to the rarity of the disease, adjuvant treatment is not properly defined.

Investigate the role of Zinc and Ferritin in Iraqi patients with alopecia areata

Alopecia areata (AA) is an auto-immune disease in which there is an inflammation around the anagen phase of hair follicles. Many nutritional elements were found to modulate this immune response. Zinc and ferritin have many vital roles inside the body and are considered among the most important nutritional factors in immune modulation and division of hair follicle matrix cells. This study aimed to investigate the role of zinc and ferritin in patients with alopecia areata. A case control study including a total of 40 patients with AA who were attending the outpatient clinic at Al-Kindy Teaching Hospital, Baghdad during the period from 2nd June 2019 to 31st March 2020. Other 65 age- and gender- matched apparently healthy subjects. Demographic of the patients and controls and clinical data of the patients were recorded through direct interview. Blood samples were collected from all participants, and serum level of zinc and ferritin were measured using enzyme linked immunosorbent assay(Elisa). Results revealed that in three-fourth of the patients, only scalp was involved in the lesion, while mixed lesion was reported in the 25% of the patients. Single and multiple lesions were reported in 42.5% and 57.5% of the patients respectively. Median serum level of ferritin in patients was 23.0 μg/L (range=3-98 μg/L) which was lower than that of controls (median = 27.0 μg/L, range= 10-166 μg/L) with a significant difference. Likewise, median serum level of zinc was 59.5 μg/dl (range= 15-175 μg/dl) in patients compared with 71.5 μg/dl (range= 21-201 μg/dl) in controls with a significant difference. Zinc level showed a significant positive correlation with age (r= 0.334, p= 0.041) and negative correlation with lesion size (r= -0.327, p= 0.045). In conclusion, multiple lesions in the scalp are the most common presentation of patients with AA. Low levels of ferritin and/or zinc could be involved in the pathogenesis of AA and increase the risk of disease severity.

LB1019 The early region of trichodysplasia spinulosa polyomavirus drives proliferation, altered differentiation, and ectopic expression of hair follicle differentiation markers in interfollicular tail epidermis

Trichodysplasia spinulosa (TS) is a rare hair follicle disorder that develops in immunosuppressed patients and is associated with productive infection by the TSPyV polyomavirus. Affected follicles contain an attenuated hair matrix, expanded compartment of aberrantly proliferating inner root sheath (IRS)-like cells containing viral particles, and a disorganized mass of hair shaft-like cells. The expression of viral early region (ER) genes encoding T antigens (TAgs) that drive cellular proliferation and viral genome replication is tightly restricted to hair follicle matrix cells and IRS-like cells.

Dermoscopy of pilomatricoma: A case report with a review of the literature

Pilomatricoma is a benign tumor originating from hair follicle matrix cells and characterized by the presence of cutaneous and subcutaneous nodules up to 3.0 cm in diameter, usually on the head, neck, and upper extremities, rarely on the trunk and lower extremities. An eleven-year-old female with a painless, erythematous-purplish tumor of the back. A dermoscopic examination revealed irregular linear vessels, white structures, and structureless grayish-blue areas. Histological examination after excision confirmed the diagnosis of pilomatricoma. Dermoscopy may be a useful tool for improving the clinical recognition of pilomatricoma.

Pilomatrixoma and its Imitators.

Introduction: Pilomatrixomas are benign neoplasms derived from hair follicle matrix cells. They are among the most common soft tissue head and neck tumors of childhood. Pilomatrixomas are typically isolated, slow-growing, firm, nontender masses that are adherent to the epidermis but mobile in the subcutaneous plane. This clinical presentation is so characteristic that many experienced surgeons will excise suspected pilomatrixomas without prior imaging. We reviewed the results of this approach to determine whether physical examination alone differentiates pilomatrixomas from other similar soft tissue lesions of the pediatric head and neck. Methods: Computerized review of all pilomatrixomas over a 20-year period in a single academic pediatric otolaryngology practice. Results: 18 patients presented to our pediatric otolaryngology practice between 2001 and 2021 with historical and physical findings consistent with pilomatrixoma. Of the 18 patients, 7 were male and 11 were female. Ages ranged from 1.5 to 14years, with a mean of 7.5years. Most of the lesions (12) were located in the head and face, while the rest (6) were found in the neck. All patients were treated with complete surgical excision. Pathology confirmed pilomatrixoma in 15 patients. The remaining 3 children were found to have an epidermal inclusion cyst, a ruptured trichilemmal cyst, and a giant molluscum contagiosum lesion, respectively. One additional patient presented with a small lesion of the auricular helix that was thought to be a dermoid cyst, but proved to be a pilomatrixoma on histologic examination. Discussion: As pilomatrixomas are common and have a very characteristic presentation, surgical excision without prior diagnostic imaging will lead to correct treatment in the majority of cases. High resolution ultrasonography can help to confirm the diagnosis preoperatively, but is not definitive in large case series. Most of the cystic lesions that imitate pilomatrixoma will ultimately require surgical excision.

Reticulocyte hemoglobin content as a best indicator of iron deficiency in female patients with diffuse non-scarring hair loss

Iron deficiency is a well-known cause of diffuse nonscarring hair loss in women. One of the rapidly diving cells in the body is the hair follicle matrix cells and iron is a cofactor for the ribonucleotide reductase which is the ratelimiting enzyme for DNA synthesis and, also is a regulator for multiple genes in the hair follicles. Iron deficiency without anemia is far more prevalent and about two-folds higher than iron deficiency anemia and iron deficiency is more prevalent in women than men. Iron deficiency with or without anemia is more common in menstruating women, black race, athletes, vegetarians and obese or overweight

Pilomatrix carcinoma - pilomatrixoma: Two ends of the disease spectrum

Pilomatrixoma, pilomatrix carcinoma, are neoplasms of skin appendage with differentiation towards hair follicle matrix cells. They represent two ends of the spectrum with varying clinical and pathological characteristics. Pilomatrix carcinoma is a rare malignant neoplasm, having a tendency to recur locally, with a rare propensity for distant metastasis. There is a need to differentiate the two entity, for appropriate selection of treatment. We describe a case of a pilomatrixoma in a 62 year old gentleman over the right chest along with a review of pathology and treatment options. Keywords: Pilomatrix Carcinoma, Pilomatrixoma, Cutaneous neoplasms.

A skin tumor from an orthopedic oncology perspective: Pilomatrixoma in extremities (11 years experience with 108 cases).

Pilomatrixoma, also known as calcifying epithelioma of Malherbe, is a benign skin neoplasm originating from hair follicle matrix cells. Pilomatrixoma is a common skin neoplasm that is often misdiagnosed as another type of skin condition. The aim of our study is to review 11 years' worth of experience in examining clinical and histopathological presentations, imaging findings, management approaches, and treatment outcomes of pilomatrixoma at a tertiary hospital. A review of the pathology database revealed that 108 extremity pilomatrixomas were excised between 2007 and 2018. Hospital charts, and pathology and orthopedic clinic records, were reviewed for patient data such as age, gender, clinical and histopathological presentations, preoperative diagnosis and imaging results, management approach, recurrence, and treatment outcomes. The main presenting symptom was a hard, subcutaneous, slowly growing mass. The preoperative diagnosis was accurate and consistent with the pathological diagnosis of pilomatrixoma in only 35 cases (32%). The optimal diagnostic tool for pilomatrixoma seems to be ultrasound imaging of superficial tissue, and the optimal first-line treatment might be surgical excision with clear margins. However, pilomatrixoma is a benign tumor, with atypical forms, and there no tumor-specific diagnostic tool is available other than careful histopathological examination.

The Girl With the Bleeding Earlobe Mass.

Pilomatrixomas, also known as epithelioma calcificans, are benign tumors of hair follicle matrix cells that are often mistaken for other lesions, especially cutaneous abscesses. We report an illustrative case in which a teenage girl developed a red, swollen earlobe that required multiple care visits and interventions until definitive diagnosis and treatment were provided. Although the lesion was initially treated as an abscess, it continued to progress in size and discomfort. The correct diagnosis was established after imaging and complete excision with pathologic examination. Ultimately, our patient was subjected to avoidable procedures that carried the risk of potentially negative cosmetic sequelae before the proper intervention. Although abscesses are common, it is important for clinicians to avoid incision and drainage of lesions, unless the diagnosis is certain.

Pilomatricoma in the pinna: a case report

<p class="abstract">Benign calcifying epithelioma of Malherbe or pilomatricoma is rare benign skin tumours, typically seen in head and neck region. This is supposed to arise from hair follicle matrix cells. Though head and neck is the commonest area involved by this tumour, only 4.5% cases have been reported in the pinna. Neck is most commonly involved followed by cheek, scalp, pre auricular and peri orbital areas. Here we report a case of pilomatricoma over medial surface of pinna in a 20 years old female. She had the swelling which was gradually increasing for the past 5 years. Histopathological examination following excision biopsy confirmed the diagnosis.</p><p class="abstract"> </p>

Pilomatrixoma: A Comprehensive Review of the Literature.

Pilomatrixoma, also known as calcifying epithelioma of Malherbe, is a superficial benign skin tumor that arises from hair follicle matrix cells. Although pilomatrixomas are well-recognized lesions, clinically they are frequently misdiagnosed as other skin conditions. By reviewing all the literature over the past 10 years, the aims of this article are to analyze the cause, clinical presentation, management, and outcome of pilomatrixoma among children and adults to gain a more complete understanding of this lesion in today's clinical context. A MEDLINE and EMBASE search was conducted from January 2005 to February 2015 using a combination of the terms: "child," "childhood," "adult," and keywords: "pilomatrixoma," "pilomatricoma," and "calcifying epithelioma of Malherbe." A total of 150 articles were reviewed. The lesions occurred most commonly in the first and second decades (mean age 16 years and 7 months). The commonest presentation was of an asymptomatic, firm, slowly growing, mobile nodule. Only 16% were accurately diagnosed on clinical examination. Imaging in the form of ultrasound, computed tomography, and magnetic resonance imaging has been reported. Pathological diagnosis was achieved through incision, punch, and shave biopsies. Pathological findings are discussed and summarized in this review. Pilomatrixomas are thought to arise from mutation in the Wnt pathway and has been linked to several genetic conditions. It is commonly misdiagnosed preoperatively; however, with better awareness of the lesion, it can be appropriately treated while avoiding unnecessary diagnostic tests. Complete surgical excision with clear margins is almost always curative.

Pilomatrixoma of the Thigh - A Case Report

Pilomatrixoma is a benign skin tumor derived from hair follicle matrix cells. They typically present as a superficial, firm, solitary, slow-growing, painless mass in the dermis. Pilomatricomas are frequently misdiagnosed and are not usually considered in differential diagnoses, either in clinical set-up or during cytological reporting. These lesions are typically found in the head and neck region. Involvement of the lower extremities is relatively uncommon and can be mistaken for malignancy. We present the case of a 55-year-old male with a pilomatrixoma of thigh which is a rare site of occurrence of the lesion and we review the literature regarding pilomatrixomas.

Pilometrixoma of the Thigh - A Case Report

Pilomatrixoma is a benign skin tumor derived from hair follicle matrix cells. They typically present as a superficial, firm, solitary, slow-growing, painless mass in the dermis. Pilomatricomas are frequently misdiagnosed and are not usually considered in differential diagnoses, either in clinical set-up or during cytological reporting. These lesions are typically found in the head and neck region. Involvement of the lower extremities is relatively uncommon and can be mistaken for malignancy. We present the case of a 55-year-old male with a pilomatrixoma of thigh which is a rare site of occurrence of the lesion and we review the literature regarding pilomatrixomas.

Pilomatrixoma case report: A very rare localization

Pilomatrixoma (pilomatricoma) is a benign neoplasm of hair follicle matrix cells of the head and neck. Pilomatrixoma, firm mass found most commonly on the face, neck, back and upper extremity, however is rarely found in the lower extremity. We report a case of a 12-year-old female patient with a rare localisation of pilomatrixoma on the lower extremities. Key words: Pilomatrixoma, neoplasms, lower Extremity

Pilomatricoma arising at an influenza vaccination site.

Pilomatricoma is a benign skin neoplasm that arises from hair follicle matrix cells. It occurs on the head, neck, and upper extremities, and less frequently on the trunk and lower extremities. The etiology of pilomatricoma is subject to controversy. Trauma, insect bites, or surgery are thought to be antecedent events to the onset of the tumors. Influenza vaccination is a common annual event among individuals. Complications are usually mild and self-limiting. Prophylactic influenza vaccinations rarely cause cutaneous complications. Few cases of foreign body granuloma, infectious reaction, and other cutaneous complications have been reported. In this article, we describe a case of pilomatricoma arising at an influenza vaccination site. Although there has been a report of an association between pilomatricoma and bacille Calmette-Guerin (BCG) vaccination [1], an association with influenza vaccination has not been reported previously. The clinical manifestations and progress of the case are presented in this report. A 7-year-old girl received her routine influenza vaccination in the left upper arm. One month later, a sensation of warmth and redness developed on the vaccination site. Serous discharge was drained with a small amount of blood. Three months later, the patient was referred to the plastic surgery outpatient department, where she presented with a pinkish ulcerative nodule on her left upper arm at the site of administration of the influenza vaccine. At that time, the nodule was covered with a dressing, but it gradually became harder to the touch and larger in size.

Pilomatricoma-Study of 3 cases and review of literature

Pilomatricoma is a benign neoplasm arising from hair follicle matrix cells. It is the most common lesion in pediatric age group. The most frequent sites are head and neck region followed by upper extremities. It is usually asymptomatic and pres­ent as a hard, subcutaneous slow-growing mass. Most of the cases present as a single nodule with a size smaller than 3 cm in diameter. We report three cases of pilomatricoma in arm and pre-auricular regions in a child and two young adults. We discuss the clinical presentation and histopathological findings of this uncommon skin tumor, and compare our findings with the previous literature. DOI: http://dx.doi.org/10.3126/jcmc.v4i1.10849 Journal of Chitwan Medical College 2014; 4(1): 45-46

Clinicopathological features of pilomatricoma cases: Analysis of 21 cases

Background: Pilomatricoma is a slow-growing, asymptomatic tumour originating from outer sheath cells of hair follicle. In this study, we describe the clinical presentation and histopathological features of pilomatricoma. Materials and Methods: This was a hospital based retrospective study carried out in all patients who were diagnosed as pilomatricoma over a period of January 2001 to December 2013. The study was done in department of pathology, Manipal Teaching Hospital, Nepal. Results: A total of 21 cases of pilomatricoma were reported with age range of 9-53 years (mean age 23.7) and male female ratio of 1:1.1. The most common site of occurrence was neck and preauricular region. The size of the tumour ranged from 0.3 to 4.7cm with a mean of 1.2cm. Multiple occurrences were seen in 3 patients and ossifying pilomarticoma was seen in 4 cases. Conclusion: Pilomatricoma is a benign skin neoplasm of hair follicle matrix cells. Calcification is a common finding while dystrophic ossification also can occur in the tumour. Histopathology gives the definite diagnosis as fine needle aspiration cytology and clinical impression may be misleading. DOI: http://dx.doi.org/10.3126/jpn.v4i7.10293 Journal of Pathology of Nepal (2014) Vol. 4, 530-533

English

Pilomatrixoma is a benign neoplasm derived from hair follicle matrix cells. They usually present in 1st decade of life and most commonly occur in head and neck region. Here we present an interesting case of a 6 year old girl with pilomatrixoma bilaterally over the arms.