Hair Follicle Neoplasms – Pilomatricoma

Pilomatricomas, also called Calcifying Epithelioma of Malherbe, are benign hair follicle neoplasms that arise from the hair matrix cells and I occasionally encounter these skin lesions in both my The Woodlands dermatology and Conroe dermatology clinics.  The most common anatomical location for a Pilomatricoma is the face and neck.  They are occasionally found on the upper arms.  Clinically, a Pilomatricoma is a flesh colored nodule that is feels hard when palpated.  Pilomatricomas have a characteristic physical finding in that they feel like a “see saw.”  When one side of the Pilomatricoma is pushed downward, the other side rises up.  This finding has also been called the “tent sign.”  Pilomatricomas most commonly occur in children under ten and middle age adults in their 50s.   Occasionally, a patient may have multiple Pilomatricomas and this can be a sign of an underlying genetic syndrome.  The treatment of Pilomatricomas is surgical excision.