Pilomatricomas: Benign lesions mimicking malignant tumors in older people

Morón-Ocaña, Juan-Manuel; Clavijo-Herrera, Julia; Piédrola-Gordillo, Carlos; Coronel-Pérez, Isabel-María

doi:10.1016/j.regg.2024.101496

array:23 ["pii" => "S0211139X24000301" "issn" => "0211139X" "doi" => "10.1016/j.regg.2024.101496" "estado" => "S300" "fechaPublicacion" => "2024-07-01" "aid" => "101496" "copyright" => "SEGG" "copyrightAnyo" => "2024" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Rev Esp Geriatr Gerontol. 2024;59:" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:17 [ "pii" => "S0211139X24000441" "issn" => "0211139X" "doi" => "10.1016/j.regg.2024.101510" "estado" => "S300" "fechaPublicacion" => "2024-07-01" "aid" => "101510" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "prp" "cita" => "Rev Esp Geriatr Gerontol. 2024;59:" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:9 [ "idiomaDefecto" => true "cabecera" => "In Memoriam" "titulo" => "In memoriam del Dr. Juan José Solano Jaurrieta" "tienePdf" => "es" "tieneTextoCompleto" => "es" "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "In memoriam of Dr. Juan José Solano Jaurrieta" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Leocadio Rodríguez Mañas, Carlos Alberto Cano Gutiérrez" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Leocadio" "apellidos" => "Rodríguez Mañas" ] 1 => array:2 [ "nombre" => "Carlos Alberto" "apellidos" => "Cano Gutiérrez" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211139X24000441?idApp=UINPBA00004N" "url" => "/0211139X/0000005900000004/v1_202407071306/S0211139X24000441/v1_202407071306/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0211139X24000258" "issn" => "0211139X" "doi" => "10.1016/j.regg.2024.101491" "estado" => "S300" "fechaPublicacion" => "2024-07-01" "aid" => "101491" "copyright" => "SEGG" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Rev Esp Geriatr Gerontol. 2024;59:" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "Caso clínico" "titulo" => "Infecciones relacionadas con catéteres vasculares: a propósito de un caso" "tienePdf" => "es" "tieneTextoCompleto" => "es" "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Infections related to vascular catheters: Case report" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 502 "Ancho" => 680 "Tamanyo" => 59090 ] ] "descripcion" => array:1 [ "es" => "A) Lesión con lecho esfacelado y exposición tendinosa en la muñeca izquierda. B) Lesión en resolución con fondo hemático en la muñeca izquierda." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Myriam Teresa Aponte, Sandra Cerviño Camino, Raquel Ramírez-Martín, Alicia Rico Nieto" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Myriam Teresa" "apellidos" => "Aponte" ] 1 => array:2 [ "nombre" => "Sandra" "apellidos" => "Cerviño Camino" ] 2 => array:2 [ "nombre" => "Raquel" "apellidos" => "Ramírez-Martín" ] 3 => array:2 [ "nombre" => "Alicia" "apellidos" => "Rico Nieto" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211139X24000258?idApp=UINPBA00004N" "url" => "/0211139X/0000005900000004/v1_202407071306/S0211139X24000258/v1_202407071306/es/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "Scientific letter" "titulo" => "Pilomatricomas: Benign lesions mimicking malignant tumors in older people" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Juan-Manuel Morón-Ocaña, Julia Clavijo-Herrera, Carlos Piédrola-Gordillo, Isabel-María Coronel-Pérez" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Juan-Manuel" "apellidos" => "Morón-Ocaña" "email" => array:1 [ 0 => "juamoroca@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Julia" "apellidos" => "Clavijo-Herrera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Carlos" "apellidos" => "Piédrola-Gordillo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Isabel-María" "apellidos" => "Coronel-Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Department of Dermatology, University Hospital Ntra. Señora de Valme, Sevilla, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Pathology, University Hospital Ntra. Señora de Valme, Sevilla, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Pilomatricomas: lesiones benignas simulandos tumores malignos en personas mayores" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1432 "Ancho" => 2175 "Tamanyo" => 658924 ] ] "descripcion" => array:1 [ "en" => "(a) Woman 86 years old. Pinkish-violet nodule of cystic consistency with focused vessels and chrysalises located in the left supraciliary area. Merkel cell carcinoma was initially suspected. (b) Male 67 years old. Erythematous-orange rubbery nodule with arboriform telangiectasias and chrysalises on vertex. Leishmaniasis was initially suspected. (c) Woman 77 years old. Solid tumor with white keratin pearls located in the left parietal region. Squamous cell carcinoma was initially suspected." ] ] ] "textoCompleto" => "Pilomatricoma is a benign tumor that arises from the epithelial hair matrix. It typically presents as a solitary, firm, and slow-growing nodule in the skin. A review of the literature shows that pilomatricomas are more commonly in children and young adults below 30 years of age.<a class="elsevierStyleCrossRefs" href="#bib0030">1,2</a> Thus, pilomatricomas are frequently excluded from the clinical differential diagnosis of solitary, firm nodules in older adults.<a class="elsevierStyleCrossRef" href="#bib0040">3</a>We conducted a retrospective study to know the prevalence and characteristics of pilomatricoma among elderly patients (above 65 years-old) diagnosed at our department between 1992 and 2023, aiming to emphasize the significance of including pilomatricoma in the differential diagnosis alongside other benign and malignant neoplasms in this population.We examined and diagnosed by histopathology 304 pilomatricomas surgically removed. Among these cases, 8.55% were patients over 65 years-old, represented by 26 individuals (14 women and 12 men), aged between 65 and 86 years (mean 72.69±6.5 years). The lesions primarily occurred in facial region (36.4%), followed by scalp (22.7%), upper limbs (18.2%), lower limbs (13.6%), and, lastly, trunk and neck (9.1%). The lesion sizes varied between 0.4 and 4cm, with a mean of 1.36±0.8cm. None of the individuals aged 65 or older underwent surgical intervention for multiple pilomatricomas. The majority of our patients presented with subcutaneous nodules (60.9%) non-ulcerated (30.4%) and ulcerated tumor lesions (8.7%) as it is shown in <a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>. Pilomatricoma was not the primary clinical suspicion in any of the patients until the histological diagnosis was made. In 73.9% of cases, other benign lesions were initially suspected, including sebaceous cyst (52.2%), lipomas (17.4%) and glomus tumors (4.3%). In 26.1% of cases, malignant lesions were speculated, represented mainly by basal cell carcinomas (13%), Merkel cell carcinomas (8.7%) and squamous cell carcinomas (4.3%). Only in 2 patients (7.7%) other histological lesions such as infundibular cysts were associated with pilomatricoma.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Pilomatricoma is typically associated with children and young adults. Literature indicates that a significant majority of these tumors develop during the first or second decades of life, accounting for 60–80% of cases.<a class="elsevierStyleCrossRefs" href="#bib0030">1,2</a> Our study highlights the relatively common, but misdiagnosed, presence of pilomatricoma in elderly individuals. This observation is in accordance with those presented by Kaddu et al.<a class="elsevierStyleCrossRef" href="#bib0045">4</a> who also noted a peak of onset of pilomatricomas in elderly adults. In fact, they observed that 30% of patients with pilomatricoma were over 60 years old,<a class="elsevierStyleCrossRef" href="#bib0045">4</a> a prevalence that practically triples the one observed in our study (8.55%). While in individuals under the age of 18, pilomatricomas classically present on cheeks as lobulated tumors, with grayish and whitish areas caused by calcification, they tend to manifest heterogeneously in the elderly.<a class="elsevierStyleCrossRef" href="#bib0045">4</a> In this population, we have observed that pilomatricomas usually present on facial region (36.4%) and scalp (22.7%) as ulcerated nodules, keratotic lesions or vascular abnormalities with hemosiderotic pigment, which leads them to simulate malignant clinical entities. In fact, pilomatricomas are only correctly clinically diagnosed between 15 and 20%.<a class="elsevierStyleCrossRefs" href="#bib0030">1,5</a> This percentage drastically decreases over the oldest patients (0% in our study) in which the suspicion of malignant tumors raises (26.1%) leading to unnecessary extensive surgery. Due to their benign nature, alternative approaches, such as observation, may be contemplated when surgical intervention carries substantial risks due to the patient's overall health status or concurrent medical conditions.<a class="elsevierStyleCrossRef" href="#bib0030">1</a>Pilomatricoma is an entity that should be considered in the elderly. Thorough clinical assessment and a heightened level of suspicion would lead to a precise diagnosis and a suitable treatment. Despite mimicking malignant tumors, they are benign lesions that do not necessitate an aggressive surgical approach, particularly given the fact they most commonly appear in the elderly in the most esthetically visible areas of the body: head and scalp.Ethical considerationsThe authors declare that they have obtained the patient's consent for the publication of this article.Data sharing statementThe data that support the findings of this study are available from the corresponding author, upon reasonable request.The retrospective study was performed by the Department of Dermatology, Hospital Universitario Virgen de Valme, Sevilla, Spain.Author's contributionJuan Manuel Morón Ocaña: preparation and writing of the manuscript; critical literature review. Julia Clavijo-Herrera: manuscript critical review. Carlos Piédrola-Gordillo: manuscript critical review. Isabel-María Coronel-Pérez: approval of the final version of the manuscript; manuscript critical review.Financial supportNone.Conflicts of interestNone." "textoCompletoSecciones" => array:1 [ "secciones" => array:6 [ 0 => array:2 [ "identificador" => "sec1005" "titulo" => "Ethical considerations" ] 1 => array:2 [ "identificador" => "sec0005" "titulo" => "Data sharing statement" ] 2 => array:2 [ "identificador" => "sec0010" "titulo" => "Author's contribution" ] 3 => array:2 [ "identificador" => "sec0015" "titulo" => "Financial support" ] 4 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflicts of interest" ] 5 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1432 "Ancho" => 2175 "Tamanyo" => 658924 ] ] "descripcion" => array:1 [ "en" => "(a) Woman 86 years old. Pinkish-violet nodule of cystic consistency with focused vessels and chrysalises located in the left supraciliary area. Merkel cell carcinoma was initially suspected. (b) Male 67 years old. Erythematous-orange rubbery nodule with arboriform telangiectasias and chrysalises on vertex. Leishmaniasis was initially suspected. (c) Woman 77 years old. Solid tumor with white keratin pearls located in the left parietal region. Squamous cell carcinoma was initially suspected." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pilomatrixoma: a comprehensive review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C.D. Jones" 1 => "W. Ho" 2 => "B.F. Robertson" 3 => "E. Gunn" 4 => "S. Morley" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/DAD.0000000000001118" "Revista" => array:6 [ "tituloSerie" => "Am J Dermatopathol" "fecha" => "2018" "volumen" => "40" "paginaInicial" => "631" "paginaFinal" => "641" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30119102" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Retrospective study of pilomatricoma: 261 tumors in 239 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Hernández-Núñez" 1 => "L. Nájera Botello" 2 => "A. Romero Maté" 3 => "C. Martínez-Sánchez" 4 => "M. Utrera Busquets" 5 => "A. Calderón Komáromy" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ad.2014.01.003" "Revista" => array:7 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2014" "volumen" => "105" "paginaInicial" => "699" "paginaFinal" => "705" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24838222" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1542356517307838" "estado" => "S300" "issn" => "15423565" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pilomatricoma (Malherbe). A clinical and histopathologic survey of 78 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Taaffe" 1 => "E.H. Wyatt" 2 => "H.P. Bury" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-4362.1988.tb00924.x" "Revista" => array:6 [ "tituloSerie" => "Int J Dermatol" "fecha" => "1988" "volumen" => "27" "paginaInicial" => "477" "paginaFinal" => "480" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3220629" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical and histopathologic spectrum of pilomatricomas in adults" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Kaddu" 1 => "H.P. Soyer" 2 => "L. Cerroni" 3 => "W. Salmhofer" 4 => "S. Hödl" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-4362.1994.tb01515.x" "Revista" => array:6 [ "tituloSerie" => "Int J Dermatol" "fecha" => "1994" "volumen" => "33" "paginaInicial" => "705" "paginaFinal" => "708" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8002139" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A clinical review of 209 pilomatricomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.G. Julian" 1 => "P.W. Bowers" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0190-9622(98)70073-8" "Revista" => array:7 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "1998" "volumen" => "39" "numero" => "Pt 1" "paginaInicial" => "191" "paginaFinal" => "195" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9704827" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/0211139X/0000005900000004/v1_202407071306/S0211139X24000301/v1_202407071306/en/main.assets" "Apartado" => array:4 [ "identificador" => "17393" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Carta científica" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/0211139X/0000005900000004/v1_202407071306/S0211139X24000301/v1_202407071306/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0211139X24000301?idApp=UINPBA00004N"]

ISSN: 0211-139X

Revista Española de Geriatría y Gerontología es el Órgano de Expresión de la Sociedad, una de las sociedades que está experimentando mayor crecimiento por lo que respecta al número de afiliados. Revista fundada en 1966, lo que la convierte en la revista decana de la especialidad en lengua castellana. Se publican principalmente artículos Originales de investigación y Revisiones, al igual que Notas clínicas, Informes, Protocolos y Guías de actuación consensuados por la Sociedad. Cubre todas las áreas de la medicina, pero siempre desde el punto de vista de la atención al paciente anciano. Los trabajos siguen un proceso de peer review, revisión por pares externos.

Ver más Opción Open Access

Indexada en:

Excerpta Medica/EMBASE, IBECS, IME, SCOPUS y MEDLINE/PubMed

Artículo

Opciones para acceder a los textos completos de la publicación Revista Española de Geriatría y Gerontología

Suscriptor

Suscriptor de la revista

Si ya tiene sus datos de acceso, clique aquí.

Si olvidó su clave de acceso puede recuperarla clicando aquí y seleccionando la opción "He olvidado mi contraseña".

Suscribirse a:

Revista Española de Geriatría y Gerontología

Más información

Comprar

Comprar acceso al artículo

Comprando el artículo el PDF del mismo podrá ser descargado

Precio 19,34 €

Comprar ahora

Contactar

Teléfono para suscripciones e incidencias

De lunes a viernes de 9h a 18h (GMT+1) excepto los meses de julio y agosto que será de 9 a 15h

Llamadas desde España

932 415 960

Llamadas desde fuera de España

+34 932 415 960

E-mail

atencionalcliente@elsevier.com

Publique en

Revista Española de Geriatría y Gerontología

Artículos destacados

Guía para escribir un artículo científico

Herramientas

Revista Española de Geriatría y Gerontología se adhiere a los principios y procedimientos dictados por el Committee on Publication Ethics (COPE)
www.publicationethics.org.

Artículos de acceso gratuito

Fe de errores sobre artículos publicados en Revista...

Rev Esp Geriatr Gerontol. 2024;59:

In memoriam del Dr. Juan José Solano...

Rev Esp Geriatr Gerontol. 2024;59:

Indexada en:

Síguenos:

Suscribirse:

Artículo

Indexada en:

Síguenos:

Suscribirse:

Artículo

Suscríbase a la newsletter