Multiple, giant lymphangectatic pilomatricomas: A rare clinical entity

Area of Science:

• Dermatology
• Pathology

Background:

• Pilomatricomas (PMs) are typically benign skin tumors originating from hair follicle matrix cells.
• They commonly present as solitary, firm, subcutaneous nodules, often in pediatric and young adult populations.

Observation:

• This case report details a rare instance of giant, multiple pilomatricomas.
• The lesions exhibited an unusual pseudo-bullous morphology.
• Histopathological examination revealed lymphangiomatous features within the pilomatricomas.

Findings:

• The atypical presentation mimicked cystic or hemorrhagic malignant neoplasms.
• The combination of giant size, multiplicity, pseudo-bullous appearance, and lymphangiomatous changes is highly unusual for pilomatricomas.

Implications:

• Accurate diagnosis of pilomatricomas is crucial to avoid unnecessary aggressive treatment for presumed malignancies.
• Clinicians should include pilomatricomas in the differential diagnosis for atypical subcutaneous lesions.
• This case expands the spectrum of pilomatricoma presentations and emphasizes thorough histopathological evaluation.