Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China.
Department of Ultrasound, Peking Union Medical College Hospital, Beijing, China.
J Cosmet Dermatol. 2022 Oct;21(10):4245-4248. doi: 10.1111/jocd.14934. Epub 2022 Apr 24.
Pilomatrixoma is a benign, asymptomatic skin tumor that forms from hair follicle matrix cells. Most are under 3 cm in diameter and occur on the head, face, or neck. Bullous appearance is very rare in pilomatrixoma. In this case report, we present a case of bullous pilomatrixoma of unusual size, region, symptoms, and patient age. It had been misdiagnosed as a keloid and as dermatofibrosarcoma protuberans. Early treatments were ineffective. The patient approached our outpatient facility and underwent excision. He was then diagnosed with pilomatrixoma by pathological examination. The clinical appearance of this case was quite difficult to diagnose, even MRI and B-ultrasonic examinations provided limited diagnostic evidence. Given the revelations from this case, we reemphasize the importance of performing a biopsy (if patients refused operation or preferred conservative treatment) before any invasive treatment to minimize economic or time loss of patients who have difficulties in diagnosis.
毛发基质瘤是一种良性、无症状的皮肤肿瘤，起源于毛囊基质细胞。大多数直径小于 3 厘米，发生于头、面或颈部。毛发基质瘤中水疱样外观非常罕见。在本病例报告中，我们介绍了一例罕见大小、部位、症状和患者年龄的水疱样毛发基质瘤。该病例曾被误诊为瘢痕疙瘩和隆突性皮肤纤维肉瘤。早期治疗无效。患者来到我们的门诊就诊并接受了切除手术。随后通过病理检查诊断为毛发基质瘤。该病例的临床表现极难诊断，甚至 MRI 和 B 超检查也提供了有限的诊断依据。鉴于该病例的启示，我们再次强调在进行任何有创治疗之前进行活检的重要性（如果患者拒绝手术或更倾向于保守治疗），以最大限度地减少诊断困难的患者在经济或时间上的损失。
