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Clinical, ultrasound and dermoscope features of pilomatricoma
Received:September 22, 2022  Revised:November 03, 2022  Click here to download the full text
Citation of this paper:CHEN Mei-qing,QIU Xiao-yan,QIU Yang-yang,CHEN Yu-ting,HUANG Ling,LIN Le-wu,GAO Lu-juan.Clinical, ultrasound and dermoscope features of pilomatricoma[J].Chinese Journal of Clinical Medicine,2023,30(3):495-501
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Author NameAffiliationE-mail
CHEN Mei-qing Department of Dermatology, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen 361015, Fujian, China
Xiamen Clinical Research Center for Cancer Therapy, Xiamen 361015, Fujian, China 
 
QIU Xiao-yan Department of Dermatology, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen 361015, Fujian, China
Xiamen Clinical Research Center for Cancer Therapy, Xiamen 361015, Fujian, China 
 
QIU Yang-yang Department of Dermatology, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen 361015, Fujian, China
Xiamen Clinical Research Center for Cancer Therapy, Xiamen 361015, Fujian, China 
 
CHEN Yu-ting Department of Dermatology, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen 361015, Fujian, China
Xiamen Clinical Research Center for Cancer Therapy, Xiamen 361015, Fujian, China 
 
HUANG Ling Department of Dermatology, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen 361015, Fujian, China
Xiamen Clinical Research Center for Cancer Therapy, Xiamen 361015, Fujian, China 
 
LIN Le-wu Xiamen Clinical Research Center for Cancer Therapy, Xiamen 361015, Fujian, China
Department of Ultrasound, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen 361015, Fujian, China 
 
GAO Lu-juan Department of Dermatology, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen 361015, Fujian, China
Xiamen Clinical Research Center for Cancer Therapy, Xiamen 361015, Fujian, China 
gao.lujuan@zs-hospital.sh.cn 
Abstract:Objective To explore the clinical manifestation, ultrasonic, dermoscopic and histopathological features of pilomatricoma and to improve the correct rate of preoperative diagnosis. Methods The clinical data of patients who underwent surgery for skin lesions that were pathologically confirmed as pilomatricoma in Zhongshan Hospital, Fudan University (Xiamen Branch) from January 2018 to March 2022 were retrospectively collected. Results A total of 77 tumors in 75 patients (39 female and 36 male) were analyzed. The age of the patients was 4-79 years old, and with a mean age of (32.2±17.2) years old. The tumor mostly presented as firm subcutaneous nodule with predilection site on the head, face and neck (62.3%). Patients mostly presented with single tumor except 2 patients were noted with multiple tumors (2 lesions). Only 14.3% lesions (11/77) were preoperatively diagnosed as pilomatricoma. Soft-tissue ultrasound was performed on 34 lesions, 11(32.4%) of which were compatible with piolmatricoma diagnosis. Ultrasonography revealed that lesions mostly located in the subcutaneous layer (33, 97.1%), oval or oblate, well-defined, heterogeneous hypoechoic masses, with or without punctate, patchy, or band calcification. Most of the lesions did not have hypoechoic halos or posterior acoustic shadows, and there were or no color blood flow signals around or inside. Dermoscopy were performed on 9 lesions, which revealed vascular structure in 7 (77.8%) lesions, included red homogeneous structure (55.6%), irregular linear vascular structure (11.1%), punctate vascular structure (22.2%); white homogeneous structure in 2 (22.2%) lesions and grey blue unstructured area in 3 (33.3%) lesions. The histopathological manifestations were clear-cut dermis or subcutaneous nodules formed by shadow cells and basophils. The microscopic manifestations varied at different stages of the disease. The longer the course of the disease, the more shadow cells observed. Conclusions The clinical manifestations of pilomatricoma varied and clinical misdiagnosis was common. The clinicians and ultrasound doctors need to improve the knowledge of the disease.
keywords:pilomatricoma  calcified epithelioma  ultrasound  dermoscope  histopathology
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