Case report Pilomatricoma with a bullous appearance

fying epithelioma of Malherbe, is the most common adnexal tumour in children and young adults. It typical­ ly occurs on the head, neck or upper limb. Here, we report a case of bul­ lous variant of pilomatricoma. A male adult presented a firm nodule covered by a sequent bulla on the left shoul­ der. Pathological examination showed the tumour was composed of irregu­ larly shaped epithelial islands which in cluded two cell types: basophilic cells and eosinophilic shadow cells. No cel­ lular atypia or abnormal mitotic fig­ ures were observed. These findings were consistent with a diagnosis of pi­ lomatricoma. The bulla was attributed to lymphatic obstruction that resulted in the dilation of lymphatic vessels. Our pilomatricoma had the unusual fea ture of a cross­shaped, giant bulla measuring 10 cm × 5 cm overlying the tumour. To our knowledge, it was the largest bullous pilomatricoma in the literature. After surgical resection, there was no recurrence.