(Pilomatrixoma, Malherbe calcified epithelioma)

Small, benign, slowly growing skin tumor, developing into the dermis from primitive cells of the hair matrix. Frequent in children. It is sometimes sensitive to pressure and contains one or several calcifications in 80% of cases. The tumor is in general hard or firm, and mobile; It is often isolated and located on the arms, face, neck or thigh. In the absence of ulceration, the skin overlying the lesion is often bluish. Very rare cases of malignancy have been described.

The presence of several pilomatricoma has been reported in cases of myotonic dystrophy, Turner, Gardner, Rubinstein Taybi or Sotos syndromes and trisomy 19.

At histogic examination: two types of cells: basal nuclear cells at the periphery and anuclear phantom cells at the center of the tumor.

Anesthetic implications:

superficial  short-lasting surgery of short duration; search for one of the above mentioned syndromes in case of multiple tumors

References : 

-        Li Y-R, Lin K-J, Hsu T-Y. 
Auricle pilomatricoma. 
J  Pediatrics 2011; 158: 511-2

-        Pulvermacker B, Seroussi D, Haddad R, Mitrofanoff M. 
Pilomatricome ou épithélioma calcifié de Malherbe : à propos d’une série de 89 cas chez l’enfant.
Ann Chir Plast Esth 2007 ; 52 : 39-42. 

-        Jeong J, Kim Y, Choi YS.
Nodular mass in the ear lobe of an 18 month-old-girl.
JAMA Otolaryngology-Head & Neck Surgery 2021; 147 : 824-5.

Updated: October 2021