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Stefano, S. Apa, B. Balancini" "autores" => array:3 [ 0 => array:4 [ "nombre" => "P." "apellidos" => "Stefano" "email" => array:1 [ 0 => "paoladermatologia@yahoo.com.ar" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "S." "apellidos" => "Apa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "B." "apellidos" => "Balancini" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Nacional de Pediatría Dr. Prof. JP Garrahan, Buenos Aires, Argentina" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Cirugía Plástica, Hospital Nacional de Pediatría Dr. Prof. JP Garrahan, Buenos Aires, Argentina" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Diagnóstico por Imágenes, Hospital Nacional de Pediatría Dr. Prof. JP Garrahan, Buenos Aires, Argentina" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Pilomatrixoma gigante y ulcerado en un niño" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 952 "Ancho" => 951 "Tamanyo" => 146298 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Nuclear magnetic resonance imaging: exophytic formation with a heterogeneous nodule surrounded by a hypointense halo and abundant vascularity in the stalk.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report the case of a 7 year-old boy who presented with a lesion on the left arm that had developed 2 years earlier and had suddenly increased in size in the preceding month. A Doppler ultrasound performed 1 month earlier revealed an echogenic mass of 1.6 × 1.7 × 1<span class="elsevierStyleHsp" style=""></span>cm with posterior acoustic shadowing.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Examination revealed a stony-hard, exophytic, pedunculated tumor of 8<span class="elsevierStyleHsp" style=""></span>cm in diameter on the patient's left arm. The overlying skin was absent, exposing an eroded surface and a bleeding tumor bed with a crater-like appearance (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Nuclear magnetic resonance imaging (MRI) and magnetic resonance angiography showed an exophytic formation consisting of a heterogeneous nodule with a hypointense halo surrounded by hyperintense tissue, and a large number of tortuous vessels in the stalk (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The tumor was excised and the defect reconstructed with a Dufourmentel flap. Histopathology revealed the presence of lobules of basaloid cells showing maturation toward the surface, the formation of cells with abundant eosinophilic cytoplasm, sheets of eosinophilic keratinous debris, and pilar keratinization. The lobules were surrounded by a fibrous stroma with mononuclear, histiocytic inflammatory infiltrate and foreign body-type multinucleated giant cells. Numerous foci of dystrophic calcification were observed. These findings were consistent with a diagnosis of giant pilomatrixoma with foreign-body giant-cell reaction (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). The patient progressed favorably and there was no recurrence after 1 year of follow-up.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Pilomatrixoma is a benign adnexal tumor with differentiation towards hair matrix cells, and is most common in children and those over 60.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Although the etiology of this tumor is unknown, in 75% of cases a mutation has been identified in <span class="elsevierStyleItalic">CTNNB1</span>, the gene encoding beta-catenin, a signaling protein involved in hair follicle development.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Pilomatrixomas are slow-growing nodules measuring 1 to 1.5<span class="elsevierStyleHsp" style=""></span>cm across; they frequently calcify, giving rise to bluish discoloration of the overlying skin, which may extrude calcific material.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Nodules can be multiple or solitary. Solitary tumors have been described in genetic syndromes such as Turner syndrome, Sotos syndrome, myotonic dystrophy, Rubinstein-Taybi syndrome, Gardner syndrome, trisomy 9, basal cell nevus syndrome, and xeroderma pigmentosum.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Multiple pilomatrixomas have been reported in healthy patients.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Other clinicopathologic variants have also been described, including blistering, anetodermic, perforating/ulcerated, lymphangiectasic, and malignant forms.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Pilomatrixomas of over 5<span class="elsevierStyleHsp" style=""></span>cm in diameter are considered giant. Only 4 cases of giant pilomatrixoma have been described, all in adults<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6,7</span></a>: 2 ulcerated and 2 with areas of erosion. Two cases of giant pilomatrixoma associated with hypercalcemia have also been described, both of which resolved after resection.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The differential diagnosis includes dermatofibrosarcoma protuberans, calcinosis cutis, osteoma cutis, cutaneous lymphomas, sarcomas, squamous carcinoma, and cutaneous metastases.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The giant, ulcerated clinical form must be differentiated from the malignant form, and should be suspected in cases of sudden growth of a pre-existing lesion with ulceration and bleeding. Indicators of malignancy include necrosis, atypical mitotic figures, perineural or perivascular invasion, and the degree and extent of infiltration.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Ultrasound reveals an echogenic lesion with posterior acoustic shadowing. In the present case the extension of the lesion was evaluated by MRI, which revealed an exophytic formation with hypervascularization, as described in a previous case of giant pilomatrixoma.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The pilomatrixoma case described here is of interest due to the sudden increase in the size of the lesion; while this characteristic suggested a malignant tumor, malignancy was subsequently ruled out by histopathology.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Stefano P, Apa S, Balancini B. Pilomatrixoma gigante y ulcerado en un niño. Actas Dermosifiliogr. 2013;104:924–925.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 713 "Ancho" => 951 "Tamanyo" => 97187 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Pedunculated exophytic tumor with eroded and bleeding surface.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 952 "Ancho" => 951 "Tamanyo" => 146298 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Nuclear magnetic resonance imaging: exophytic formation with a heterogeneous nodule surrounded by a hypointense halo and abundant vascularity in the stalk.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 713 "Ancho" => 951 "Tamanyo" => 182697 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Histology: lobules of basaloid cells with maturation toward the surface and ghost cell formation (hematoxylin-eosin, original magnification ×100).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "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. 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Ketty" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Am J Dermopathol" "fecha" => "2007" "volumen" => "29" "paginaInicial" => "286" "paginaFinal" => "289" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack69007" "titulo" => "Acknowledgments" "texto" => "<p id="par0050" class="elsevierStylePara elsevierViewall">We thank the doctors in the Hospital Nacional de Pediatría Prof. Dr. JP Garrahan who were involved in the handling and resolution of this case: Dr. Adrián Martín Pierini, Dr. Amelia Laterza, and Dr. Fabiana Lubieniecki.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010400000010/v1_201311281142/S1578219013002448/v1_201311281142/en/main.assets" "Apartado" => array:4 [ "identificador" => "6157" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case and Research Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010400000010/v1_201311281142/S1578219013002448/v1_201311281142/en/main.pdf?idApp=UINPBA000044&text.app=https://www.actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219013002448?idApp=UINPBA000044" ]
Year/Month | Html | Total | |
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2024 October | 72 | 58 | 130 |
2024 September | 62 | 24 | 86 |
2024 August | 95 | 60 | 155 |
2024 July | 82 | 37 | 119 |
2024 June | 91 | 60 | 151 |
2024 May | 79 | 33 | 112 |
2024 April | 64 | 16 | 80 |
2024 March | 77 | 25 | 102 |
2024 February | 87 | 46 | 133 |
2024 January | 52 | 31 | 83 |
2023 December | 65 | 13 | 78 |
2023 November | 93 | 29 | 122 |
2023 October | 80 | 17 | 97 |
2023 September | 78 | 29 | 107 |
2023 August | 66 | 20 | 86 |
2023 July | 58 | 35 | 93 |
2023 June | 54 | 26 | 80 |
2023 May | 87 | 29 | 116 |
2023 April | 75 | 25 | 100 |
2023 March | 60 | 20 | 80 |
2023 February | 57 | 16 | 73 |
2023 January | 50 | 25 | 75 |
2022 December | 58 | 36 | 94 |
2022 November | 42 | 22 | 64 |
2022 October | 41 | 19 | 60 |
2022 September | 36 | 27 | 63 |
2022 August | 21 | 42 | 63 |
2022 July | 28 | 38 | 66 |
2022 June | 30 | 31 | 61 |
2022 May | 47 | 46 | 93 |
2022 April | 53 | 33 | 86 |
2022 March | 53 | 50 | 103 |
2022 February | 57 | 27 | 84 |
2022 January | 75 | 28 | 103 |
2021 December | 45 | 38 | 83 |
2021 November | 52 | 55 | 107 |
2021 October | 101 | 55 | 156 |
2021 September | 66 | 47 | 113 |
2021 August | 84 | 31 | 115 |
2021 July | 29 | 37 | 66 |
2021 June | 68 | 39 | 107 |
2021 May | 85 | 38 | 123 |
2021 April | 176 | 61 | 237 |
2021 March | 97 | 28 | 125 |
2021 February | 75 | 22 | 97 |
2021 January | 49 | 18 | 67 |
2020 December | 32 | 17 | 49 |
2020 November | 24 | 14 | 38 |
2020 October | 27 | 11 | 38 |
2020 September | 29 | 8 | 37 |
2020 August | 27 | 16 | 43 |
2020 July | 42 | 12 | 54 |
2020 June | 38 | 20 | 58 |
2020 May | 28 | 23 | 51 |
2020 April | 29 | 26 | 55 |
2020 March | 33 | 28 | 61 |
2020 February | 2 | 0 | 2 |
2020 January | 4 | 4 | 8 |
2019 December | 8 | 4 | 12 |
2019 November | 4 | 1 | 5 |
2019 October | 0 | 1 | 1 |
2019 September | 10 | 3 | 13 |
2019 August | 4 | 1 | 5 |
2019 July | 4 | 8 | 12 |
2019 June | 4 | 17 | 21 |
2019 May | 6 | 20 | 26 |
2019 April | 2 | 15 | 17 |
2019 March | 0 | 18 | 18 |
2019 February | 4 | 1 | 5 |
2019 January | 0 | 6 | 6 |
2018 December | 1 | 7 | 8 |
2018 November | 2 | 0 | 2 |
2018 October | 3 | 0 | 3 |
2018 September | 4 | 0 | 4 |
2018 June | 0 | 3 | 3 |
2018 May | 0 | 4 | 4 |
2018 April | 0 | 5 | 5 |
2018 March | 2 | 3 | 5 |
2018 February | 42 | 8 | 50 |
2018 January | 42 | 7 | 49 |
2017 December | 53 | 7 | 60 |
2017 November | 35 | 10 | 45 |
2017 October | 53 | 11 | 64 |
2017 September | 34 | 6 | 40 |
2017 August | 43 | 10 | 53 |
2017 July | 62 | 7 | 69 |
2017 June | 43 | 8 | 51 |
2017 May | 46 | 6 | 52 |
2017 April | 54 | 8 | 62 |
2017 March | 38 | 35 | 73 |
2017 February | 112 | 5 | 117 |
2017 January | 49 | 14 | 63 |
2016 December | 63 | 4 | 67 |
2016 November | 69 | 5 | 74 |
2016 October | 127 | 10 | 137 |
2016 September | 164 | 3 | 167 |
2016 August | 163 | 6 | 169 |
2016 July | 61 | 8 | 69 |
2016 June | 15 | 8 | 23 |
2016 May | 12 | 5 | 17 |
2016 April | 14 | 5 | 19 |
2016 March | 18 | 2 | 20 |
2016 February | 17 | 8 | 25 |
2016 January | 9 | 10 | 19 |
2015 December | 15 | 3 | 18 |
2015 November | 15 | 1 | 16 |
2015 October | 12 | 2 | 14 |
2015 September | 12 | 0 | 12 |
2015 August | 14 | 1 | 15 |
2015 July | 97 | 8 | 105 |
2015 June | 63 | 6 | 69 |
2015 May | 51 | 4 | 55 |
2015 April | 55 | 9 | 64 |
2015 March | 66 | 8 | 74 |
2015 February | 71 | 2 | 73 |
2015 January | 67 | 5 | 72 |
2014 December | 48 | 4 | 52 |
2014 November | 35 | 6 | 41 |
2014 October | 53 | 3 | 56 |
2014 September | 35 | 2 | 37 |
2014 August | 33 | 3 | 36 |
2014 July | 55 | 8 | 63 |
2014 June | 68 | 2 | 70 |
2014 May | 58 | 7 | 65 |
2014 April | 41 | 5 | 46 |
2014 March | 45 | 6 | 51 |
2014 February | 37 | 5 | 42 |
2014 January | 40 | 4 | 44 |
2013 December | 30 | 9 | 39 |
2013 November | 0 | 1 | 1 |