Picture of the Month—Diagnosis | Dermatology | JAMA Pediatrics | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
Citations 0
Special Feature
October 5, 2009

Picture of the Month—Diagnosis

Arch Pediatr Adolesc Med. 2009;163(10):956. doi:10.1001/archpediatrics.2009.163-b

Both lesions underwent surgical excision (Figure 2), and histopathologic examination revealed well-demarcated tumors with distinct regions of darkly stained basophilic cells and pale-staining anuclear cells in both cases. There were also focal calcium deposits within the tumors.

The images depict pilomatricomas involving the eyelid. Pilomatricomas, also referred to as pilomatrixomas and calcifying epitheliomas of Malherbe, represent benign tumors of hair follicle origin. They were first described in 1880 by Malherbe and Chenantais.1Although they can occur in any age group, they are most common in children and adolescents.2They typically appear as solitary, firm, painless dermal papules or nodules on the head and neck. Pilomatricomas may have a bluish coloration or may have central ulceration revealing underlying calcification (Figure 3). When palpated, they often exhibit the so-called teeter-totter sign, as pressure on one edge of the lesion causes elevation of the opposite side. When excised, these lesions are often larger than they appear on the surface.