PILOMATRIXOMA - A COMMON, BENIGN CHILDHOOD SKIN TUMOR

Objective: To review recent experience with pilomatrixoma, particularl y with respect to diagnosis. Design: Chart review for an 8-year period . Setting A university-affiliated children's hospital. Patients: Fifty children with 51 histologically proven pilomatrixomas. Intervention: Excision of the lesion. Main Outcome Measures: Clinical presentation, diagnosis and pathological findings. Results: The clinical presentatio n was typically that of an asymptomatic superficial mass that increase d slowly in size and was located in the head and neck (78%) or chest a nd upper limbs. In one case the mass increased rapidly over 2 weeks an d changed in colour from red to purple with areas of pink and tan. The referring diagnosis was incorrect in 94% of cases, and the preoperati ve diagnosis was incorrect in 57%. Pathologically the tumours were sit uated in the dermis or subcutaneous tissue. None were cystic, but seve ral had areas of calcification. None of the tumours recurred after exc ision, but two patients had multiple lesions at different locations an d times. Conclusions: Pilomatrixomas in children are simple to treat s uccessfully but have variable clinical presentation. Early diagnosis i s important so that unnecessary, aggressive surgery can be avoided.