Pilomatrixoma: a common, benign childhood skin tumour.

OBJECTIVE

To review recent experience with pilomatrixoma, particularly 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 presentation was typically that of an asymptomatic superficial mass that increased slowly in size and was located in the head and neck (78%) or chest and upper limbs. In one case the mass increased rapidly over 2 weeks and changed in colour from red to purple with areas of pink and tan. The referring diagnosis was incorrect in 94% of cases, and the preoperative diagnosis was incorrect in 57%. Pathologically the tumours were situated in the dermis or subcutaneous tissue. None were cystic, but several had areas of calcification. None of the tumours recurred after excision, but two patients had multiple lesions at different locations and times.

CONCLUSIONS

Pilomatrixomas in children are simple to treat successfully but have variable clinical presentation. Early diagnosis is important so that unnecessary, aggressive surgery can be avoided.