Not a blackhead on his neck: A pilomatricoma!
This patient usually sees one of my physician assistants, to treat his acne, but he came in to see me for what we thought was a cyst that was bothering him on his right neck. Well, it didn't end up being a cyst, but something a little less common (but not worrisome): a pilomatricoma. At the end of the video you will see what this growth looks like under the microscope... this is how we make the diagnosis!
A Pilomatricoma (aka Calcifying Epithelioma of Malherbe, or pilomatrixoma) is a benign growth derived from hair matrix cells. Usually occurs as a single lesion on the face, neck or upper arms. They cause no pain, but are firm bumps under the skin. The diagnosis is usually made only after looking at the tissue under the microscope. We look for “shadow cells” under the microscope. Calcification and ossification can occur (calcium and bone can develop within) which can make these very firm and hard, much like a pebble or little jagged rock under the skin. These are benign and don’t need to be removed, but if someone requests removal, a surgical excision is needed.
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Periscope: Dr. Sandra Lee
This video may contain dermatologic surgical and/or procedural content. The content seen in this video is provided only for medical education purposes and is not intended to be a substitute for professional medical advice, diagnosis, or treatment.
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