Multiple pilomatrixomas affecting the eyelid and face.

Area of Science:

• Dermatology
• Pediatric Oncology

Background:

• Pilomatrixomas are benign skin tumors originating from hair matrix cells.
• While often solitary, multiple pilomatrixomas can indicate underlying genetic syndromes.

Observation:

• A 3-year-old girl presented with recurrent pilomatrixomas on the eyelid and nose.
• The lesions were firm, reddish, and fixed to underlying tissues.
• Initial clinical work-up for associated syndromes was negative.

Findings:

• Histopathology confirmed pilomatrixoma, characterized by basophilic hair matrix cells and shadow cells.
• Dystrophic calcification was noted in necrotic areas.
• The findings supported a diagnosis of multiple pilomatrixomas in the absence of syndromic associations.

Implications:

• Multiple periocular and facial pilomatrixomas can manifest in children without Gardner's syndrome, sarcoidosis, or myotonic dystrophy.
• This case highlights the possibility of isolated multiple pilomatrixomas in pediatric patients.
• Further investigation may be warranted for atypical presentations or extensive disease.