Pilomatricoma


What Is Pilomatricoma?

Pilomatricoma is a non-cancerous skin tumor that occurs in the hair matrix. Others names of this tumor include Malherbe calcifying epithelioma. Pilomatricoma was previously known as pilomatrixoma.

Pilomatricoma 

This growth occurs on your head, neck and other areas of the body where hair follicles are present such as trunk. Pilomatricoma is usually not harmful and does not cause skin cancer. The tumor can be appearing as purple on some people’s skin and it is the most known tumor affecting the hair follicle.

This tumor is found mostly in children, although adults are also affected. Pilomatricoma affects children who are less than 10 year old as well as those under the age of 20. Females are at high risk of developing Pilomatricoma than males. People who are fair in complexion are also prone to this tumor.

Causes

Although studies have not yet found the real cause of Pilomatricoma, there are some factors that can trigger this tumor to develop. They include diseases and mutations in the gene structure as described below:


Genetic factors

Studies have shown that genetics play a role in formation of Pilomatricoma. This tumor is linked to the hyperactivity of a gene known as BCL-2, a proto-oncogene. When proto-oncogene is overactive, it prevents the cells from dying as they are supposed to be; as a result leading to an abnormal growth.

Another gene called CTNNB1 can undergo mutation and destroy the protein complex that controls beta catenin, which can encourage a tumor to develop on your body.

Genetic Diseases

Other genetic disorders can also trigger this Pilomatricoma to develop. These disorders include:

Turner’s syndrome

Turner’s syndrome is a condition that occurs when there is a problem with X chromosome; the chromosome can be partially present or totally missing. It affects girls and women only.6

Normally we are born with a pair of sex chromosome. A girl receives one X chromosome from each of the parents while a boy inherits X chromosome from the mother and Y chromosome from the father.

In case a girl has Turner’s syndrome, it means a pair of X chromosome is missing or has been changed. Genetic changes that can cause Turner’s syndrome include the following:

Monosomy

This is where the X- chromosome is totally absent. This occurs due to problems in the eggs of the mother or fathers sperms. This will make each cell in the body of the affected person to have only one X-chromosome.

Mosaicism

During the initial phase of fetal development, cells may fail to divide properly. As a result causes some cells in the body to have two complete copies of X chromosome. Other cells can have one copy of the X chromosome or have one changed or complete copy.

Y chromosomal material

In these genetic alterations, some cells can have a copy of X chromosome while others have both Y chromosome material and a copy of X chromosomes. Girls with Y chromosome material grow as normal but they are at risk of developing gonadoblastoma cancer.

Changed or missing X chromosome of Turner’s syndrome can affect the fetus from developing properly while in the womb as well as after birth. It can also cause abnormal growth of bones as well trigger immune system disorders. An example of immune system disorder is hypothyroidism which causes thyroid gland to produce low amounts of thyroid hormones that control growth and metabolism.

Gardner syndrome

It is a genetic condition that occurs when a gene called adenomatous polyposis coli is altered (APC). This elevates the risks of an individual developing malignant and non-cancerous tumor in the body. This disorder runs in the family and is passed from family member to another.

In Gardner’s syndrome, only one copy of the gene undergoes mutation. A parent can pass a defective gene or a normal gene to the child. Therefore there a high chance of a child born of these parents to develop Gardner’s syndrome.

Other genetic disorders associated with pilomatricoma include:

  • Rubinstein-Taybi syndrome
  • sarcoidosis
  • Steinert’s syndrome

Symptoms

The tumor feels hard when you touch it because of calcium deposits. The tumors grow slowly and occur as one on the skin. They are red, blue or purple in color

Diagnosis

Several diagnostic tests can be used to confirm the diagnosis of pilomatricoma. Your doctor can examine your skin for a hard growth which can be suspected to be pilomatricoma. The doctor can conduct the following tests to accurate diagnose this tumor:

Ultrasound

This test involves the use of high frequency sound waves to examine the tumor.

X-rays

X-rays are used to determine the features of the tumor.

Biopsy

Your doctor can scratch a sample of your skin on the affected area and observe it under a microscope for any abnormalities. The sample can be analyzed further by a pathologist to determine whether the tumor is cancerous or not.

Treatment

The main aim of managing pilomatricoma is to remove the tumor completely in order to relieve the symptoms. Surgery is the best option to remove the tumor. The following surgical methods can be used:

Surgical excision

This method involves the use of sharp tools or other instruments to remove the tumor on your skin.

During excision method, your doctor will inject a numbing medicine near the tumor. This will help to numb the area and lower pain during the operation. It also helps to raise the tumor so that it is easily seen and removed.

Once this is done, the doctor can use a scalpel or a sharp instrument and cuts the tumor and removes the entire the tumor. The doctor then perform an electro surgery feathering process which uses dermal loop electrode to extract dead cells left during the operation. This can help minimize scarring on the affected area by leveling the edges of the wound and the surrounding skin.

Surgical excision can cause bleeding; your doctor will help you prevent it by applying chemicals such as chloride hexahydrate. An antibiotic ointment will be applied on the wound to prevent infections.

The tumor can reappear if the excision is done improperly.

Reference list

  1. Pilomatricoma. https://cancerwall.com/pilomatricoma-treatment-pictures-symptoms-causes-prognosis/
  2. http://www.wikiwand.com/en/Pilomatricoma
  3. http://atlasgeneticsoncology.org/Tumors/PilomatricomaID5153.html
  4. https://radiopaedia.org/articles/pilomatricoma
  5. http://emedicine.medscape.com/article/1058965-overview
  6. Turner syndrome. http://www.mayoclinic.org/diseases-conditions/turner-syndrome/basics/definition/con-20032572
  7. Gardener Syndrome. Available at http://www.cancer.net/cancer-types/gardner-syndrome/g%29%7Dfunction

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