Pilomatrixoma on the Forehead of a 5-Month-Old Girl

A 0.5-cm mass with overlying erythema on the forehead of a 5-month-old girl was first noticed after she had been hit on the head with a rattle. Excision of the mass was deferred because it was considered to be a hemangioma.

The lesion gradually grew (A). When the child was 18 months old, her mother requested that the lesion be removed. The child was given a local anesthetic and a sedative, and the excision was performed without difficulty. Robert P. Blereau, MD of Morgan City, La, writes that the nodule measured slightly over 1 cm (B). Pathologic examination confirmed the diagnosis of a pilomatrixoma.

The benign tumor is also known as pilomatricoma and calcifying epithelioma of Malherbe. About 20% of all pilar tumors are pilomatrixomas.¹ Typically, these usually solitary growths occur on the head, neck, and upper extremities. Approximately 60% arise during the first 2 decades of life, and as many as 66% calcify. Recurrence is rare even if excision is inadequate.¹

REFERENCE:1. Weedon D. Skin Pathology. London: Churchill Livingstone; 1997:722-723.