Bullous Pilomatricoma: A Report of Clinical and Pathologic Findings and Review of Dermal Bullous Disorders

Abstract

Bullous pilomatricoma has rarely been described. A common pathological feature in this type of pilomatricoma is the presence of dilated lymphatics. Bullous morphea associated with dermal lymphatic dilation has also been described. In both bullous pilomatricoma and morphea, it is possible that individual pathological features of the lesion lead to obstruction and congestion of the dermal lymphatics thereby inducing enough dilation and edema to form a dermal bulla.

Anetodermic pilomatricoma

“…The skin overlying the tumor may have a normal, yellowish, erythematous or bluish‐red color or be semitransparent and can be atrophic, anetodermic, ulcerated, perforating, bullous, telangiectatic or keratotic (mimetizing spindle cell carcinomas and keratoacanthomas) in appearance. In addition to the classical alterations in the structure of the tumor, acantholysis, cellular atypia and malignant transformation have also been described 5–10,17,20–22 . The alterations in the tissue overlying the pilomatricoma described in our case, where the skin surface resembles a small scrotum, have also been observed by other authors.…”

“…It should be noted that the overlying skin can vary in color and aspect and may have a normal, yellowish, erythematous or bluish‐red color or be semitransparent. It may be atrophic, anetodermic, ulcerated, bullous, teleangiectatic or keratotic (mimicking spindle cell carcinomas or keratoacanthomas) in appearance 6–10 . Lesions located in the subcutis are palpable rather than visible.…”

Pilomatricoma with bullous appearance: a case report and review of literature

“…A total of 16 cases (including our case) of pilomatricoma with bullous appearance have been reported. [1][2][3][4][5][6][7][8][9][10][11][12][13] The clinical and pathological features of these 16 cases were analyzed and summarized.…”

Image Gallery: Maggot on my shoulder

“…Anetodermic pilomatricoma is a rare variant commonly affecting the shoulder, trunk and proximal arm . The suggested mechanisms of its development include trauma, mechanical obstruction to lymphatic drainage and release of elastolytic enzymes by the tumour per se …”