4 Things Parents Need To Know About Pilomatricomas

Pilamatricomas, also called pilomatrixomas, are benign skin tumors that affect children and adolescents. These tumors begin in the walls that line the hair follicles. Here are four things parents need to know about them.

What are the signs of pilomatricomas?

Classically, pilomatricomas present as a single, hard mass on the skin of the head or neck. In rare cases, children develop multiple masses. Pilomatricomas reach an average size of 1 centimeter, which is about the size of a marble. These masses aren't painful, but the skin that covers them may become ulcerated or take on a bluish color.

Most pilomatricomas occur before age 20, though they can also occur during adulthood. If your child develops a mass on their skin, take them to a dermatologist to have it evaluated.

What causes pilomatricomas?

Pilomatricomas are caused by mutations in the CTNNB1 gene. This gene is responsible for regulating the growth of cells within the skin as well as holding the skin cells together. Normally, this gene tells the skin cells to stop multiplying when enough cells are present, but when the gene is mutated, the cells don't get this signal and continue multiplying, which allows masses of extra cells to form.

Are pilomatricomas a concern?

Pilomatricomas aren't serious, but your child may have cosmetic concerns about the mass. Since these masses develop on the head and neck, they are very visible and affected children may feel self conscious.

There is a small risk of malignant transformation, but this usually happens in middle-aged or elderly people, according to the JAMA Network. If the pilomatricomas aren't removed, they may become cancerous later in life, but they're not an immediate risk to your child. To be safe, they need to be removed, but this is just a precaution and there's no reason to worry.

What treatments are available?

These masses don't go away by themselves, and medications to remove them don't work, so surgical removal is the only option. Since these masses have delineated (inexact) borders, it's hard for dermatologists to remove them. To ensure that the entire mass is removed, a margin of up to 2 centimeters of healthy tissue will also be removed. This large margin is necessary to reduce the risk of recurrence. If the mass recurs, the surgery will need to be repeated.

Once your child has healed from their surgery, your dermatologist can offer scar-minimizing treatments, if required. These treatments include laser scar removal and microdermabrasion.

If your child has a hard mass on their skin, take them to a dermatologist, such as Henry E. Wiley, III, M.D.