Hair Follicle Differentiation

Pilomatrix carcinoma (PC) is a rare tumor that originates in the hair cortex. Most lesions arise de novo and not from pre-existing benign pilomatrixoma. The tumor presents in the fourth and fifth decade of life and predominates in men (ratio 3:1). Approximately 57% of cases affect the head and neck (Fig. 30) followed by the chest

Figure 30 Pilomatrix carcinoma in the neck of an elderly man. The lesion started as a small subcutaneous nodule that later increased in size. The keratotic surface indicates epidermal involvement. It is worth remembering that various malignant adnexal tumors may present in such a noncharacteristic fashion.

Figure 30 Pilomatrix carcinoma in the neck of an elderly man. The lesion started as a small subcutaneous nodule that later increased in size. The keratotic surface indicates epidermal involvement. It is worth remembering that various malignant adnexal tumors may present in such a noncharacteristic fashion.

(13%), back (11%), and upper (11%) and lower extremities (9%). Metastases occur in only 9% of patients, usually to lungs, bone, and lymph nodes (171). Histopatho-logical examination shows infiltrating sheets and islands of basaloid cells extending deep into dermis and subcutaneous tissue. Two populations of cells are clearly identified: basophilic cells with indistinct borders and ghost cells with a well-defined border and nonstaining nuclei.

PC is difficult to cure using traditional surgical excision. Recurrence rates are 26% for conservative excision and 23% for wide excision (172). Only three reported cases were treated with surgery followed by radiation. One developed distant metastases. Mohs' micrographic surgery has not been employed but may prove useful.

How To Reduce Acne Scarring

How To Reduce Acne Scarring

Acne is a name that is famous in its own right, but for all of the wrong reasons. Most teenagers know, and dread, the very word, as it so prevalently wrecks havoc on their faces throughout their adolescent years.

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