eMedicine Specialties > Dermatology > Benign Neoplasms

Pilomatrixoma

Author: Jaggi Rao, MD, Associate Clinical Professor of Medicine, Division of Dermatology and Cutaneous Sciences, University of Alberta; Consulting Staff, Dermatology and Dermatologic Surgery, University of Alberta and Acne Clinics of Canada
Coauthor(s): Andrei I Metelitsa, MD, Chief Resident, Division of Dermatology and Cutaneous Sciences, University of Alberta, Canada; Andrew Lin, MD, FRCPC, Associate Professor, Department of Internal Medicine, Division of Dermatology, University of Alberta
Contributor Information and Disclosures

Updated: Mar 12, 2009

Introduction

Background

A pilomatrixoma is a benign appendageal tumor with differentiation toward hair cells. It usually manifests as a solitary, asymptomatic, firm nodule. It has long been considered a rare tumor, but it may be more common than previously realized. It is more common in children, but occurrence in adults is increasingly being recognized.1,2,3,4,5,6,7,8,9,10,11,12,13,14 Recommended treatment is surgical excision. Multiple pilomatrixomas have been observed, mainly in association with myotonic dystrophy.15,16,17,18,19,20,21,22 Pilomatrix carcinoma is a rare condition.23,24,25,26,27,28,29,30,31,32,33,34,35,36,37

Pathophysiology

In one study of 10 pilomatrixoma lesions, all immunostaining results were strongly positive for BCL2.38 This is a proto-oncogene that helps suppress apoptosis in benign and malignant tumors; these data suggest that faulty suppression of apoptosis contributes to the pathogenesis of these tumors.

More recently, investigators have demonstrated that the proliferating cells of human pilomatrixomas show prominent staining with antibodies directed against LEF-1 (a marker for hair matrix cells). Evidence also indicates that S100 proteins can be used as biochemical markers in characterization of pilomatrixomas.39 These data provide biochemical support of morphological evidence that these tumors are derived from hair matrix cells. Furthermore, investigators have shown that at least 75% of persons with pilomatrixomas who have examined have mutations in the gene CTNNB1; these data directly implicate beta-catenin/LEF misregulation as the major cause of hair matrix cell tumorigenesis in humans.40,41,42

Frequency

United States

Pilomatrixomas have long been considered uncommon cutaneous tumors; however, they may be more common than is realized, especially in children and young adults. In one American dermatopathology laboratory, pilomatrical neoplasms were considered the most common solid cutaneous tumors in patients aged 20 years or younger.

International

In one dermatopathology laboratory in the United Kingdom, pilomatrixomas accounted for 1 in 500 histologic specimens. Investigators found 37 cases published in Japanese dental journals between 1977 and 1994.43 In Turkey, 15 patients were seen in a pediatric surgery clinic from 1984-1994.3 In France, a retrospective study of records in one surgery clinic revealed 33 patients who had undergone surgery for pilomatrixomas between 1989 and 1997.4

Mortality/Morbidity

Pilomatrixomas are not associated with mortality. Very large tumors (£ 18 cm) can cause considerable discomfort but are uncommon. Pilomatrix carcinomas are also uncommon, but they are locally invasive and can cause visceral metastases and death.

Race

Most reported cases have occurred in white persons. Whether this represents publication bias or a true racial predisposition is unclear.

Sex

Most studies report a slight preponderance in females. In one retrospective study of 209 cases, the female-to-male ratio was 1.5:1.

Age

Most reported cases have occurred in children. Lesions are often discovered in the first 2 years of life; however, in a retrospective study of 209 cases published in 1998, investigators found the age of presentation showed a bimodal pattern, with the first peak being 5-15 years and the second being 50-65 years.44

Clinical

History

  • Patients usually present with a solitary nodule that has been slowly growing over several months or years.
  • Patients are usually asymptomatic, but some report pain during episodes of inflammation or ulceration.
  • Rapid growth is rare, but reports indicate one lesion reaching 35 mm in 8 months and another reaching 1 cm in 2 weeks.
  • Occurrence in more than one member of the same family is rare and is usually observed in association with myotonic dystrophy.

Physical

  • Approximately 50% of the lesions occur on the head and neck, especially the cheek, preauricular area, eyelids, forehead, scalp, and lateral and posterior neck.45,46,47
    • Lesions can also occur on the upper and lower extremities and trunk.48
    • One lesion was observed in the middle ear and another in the ovary.49,50
  • Most lesions measure 0.5-3 cm, but, rarely, giant lesions up to 15 cm are reported.
  • Patients usually have a single, firm, stony, hard nodule.
  • Lesions are usually the color of the normal skin, but reddish-purple lesions have been observed (probably resulting from hemorrhage).
  • Stretching of the overlying skin can give the lesion a multifaceted, angulated appearance known as the "tent sign," likely due to calcification in the lesion.
  • One lesion showed the "dimple sign," which is often associated with dermatofibromas.
  • Unusual morphological variants include perforating, cystic, bullous, lymphangiectatic, hornlike, keratoacanthomalike, pigmented, and lesions that show anetodermalike changes on the surface.51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67

Causes

Investigators in one study showed that at least 75% of the lesions studied had mutations in the gene CTNNB1; these data directly implicate beta-catenin/LEF misregulation as the major cause of hair matrix cell tumorigenesis in humans.

More on Pilomatrixoma

Overview: Pilomatrixoma
Differential Diagnoses & Workup: Pilomatrixoma
Treatment & Medication: Pilomatrixoma
Follow-up: Pilomatrixoma
Multimedia: Pilomatrixoma
References
[ CLOSE WINDOW ]

References

  1. Ahmad M, Khan IU, Khan AH, Rehman SB, Zubairi AM. Pilomatricoma: a retrospective study. Int J Dermatol. Oct 1992;31(10):703-5. [Medline].

  2. Behnke N, Schulte K, Ruzicka T, Megahed M. Pilomatricoma in elderly individuals. Dermatology. 1998;197(4):391-3. [Medline].

  3. Demircan M, Balik E. Pilomatricoma in children: a prospective study. Pediatr Dermatol. Nov-Dec 1997;14(6):430-2. [Medline].

  4. Duflo S, Nicollas R, Roman S, Magalon G, Triglia JM. Pilomatrixoma of the head and neck in children: a study of 38 cases and a review of the literature. Arch Otolaryngol Head Neck Surg. Nov 1998;124(11):1239-42. [Medline].

  5. Hernandez-Perez E, Cestoni-Parducci RF. Pilomatricoma (calcifying epithelioma): a study of 100 cases in El Salvador. Int J Dermatol. Sep 1981;20(7):491-4. [Medline].

  6. Inglefield CJ, Muir IF, Gray ES. Aggressive pilomatricoma in childhood. Ann Plast Surg. Dec 1994;33(6):656-8. [Medline].

  7. Kaddu S, Soyer HP, Cerroni L, Salmhofer W, Hodl S. Clinical and histopathologic spectrum of pilomatricomas in adults. Int J Dermatol. Oct 1994;33(10):705-8. [Medline].

  8. Marrogi AJ, Wick MR, Dehner LP. Pilomatrical neoplasms in children and young adults. Am J Dermatopathol. Apr 1992;14(2):87-94. [Medline].

  9. Patel RV, Mehta MH. Calcifying epithelioma (pilomatrixoma) of Malherbe. Indian J Pediatr. Jul-Aug 1993;60(4):609-10. [Medline].

  10. Rao PL, Ramnarayan K. Pilomatricoma: report of two cases in children. J Pediatr Surg. Dec 1992;27(12):1496-7. [Medline].

  11. Shaw A. Pilomatrixomas in two children. J Pediatr Surg. Aug 1993;28(8):1083. [Medline].

  12. Taaffe A, Wyatt EH, Bury HP. Pilomatricoma (Malherbe). A clinical and histopathologic survey of 78 cases. Int J Dermatol. Sep 1988;27(7):477-80. [Medline].

  13. Toppare MF, Kitapci F, Senses DA, Kaya IS, Dilmen U, Gedikoglu G. Pilomatrixoma: patient report of a common childhood tumor. Clin Pediatr (Phila). Dec 1993;32(12):749-50. [Medline].

  14. Wells NJ, Blair GK, Magee JF, Whiteman DM. Pilomatrixoma: a common, benign childhood skin tumour. Can J Surg. Dec 1994;37(6):483-6. [Medline].

  15. Aslan G, Erdogan B, Akoz T, Gorgu M, Seckin S, Terzioglu A. Multiple occurrence of pilomatrixoma. Plast Reconstr Surg. Sep 1996;98(3):510-3. [Medline].

  16. Berberian BJ, Colonna TM, Battaglia M, Sulica VI. Multiple pilomatricomas in association with myotonic dystrophy and a family history of melanoma. J Am Acad Dermatol. Aug 1997;37(2 Pt 1):268-9. [Medline].

  17. Black SJ, Marple BF, Vuitch F. Multiple giant pilomatrix carcinomas of the head and neck. Otolaryngol Head Neck Surg. Sep 1993;109(3 Pt 1):543-7. [Medline].

  18. Farrell AM, Ross JS, Barton SE, Bunker CB. Multiple pilomatricomas and myotonic dystrophy in a patient with AIDS. Clin Exp Dermatol. Sep 1995;20(5):423-4. [Medline].

  19. Geh JL, Moss AL. Multiple pilomatrixomata and myotonic dystrophy: a familial association. Br J Plast Surg. Mar 1999;52(2):143-5. [Medline].

  20. Graells J, Servitje O, Badell A, Notario J, Peyri J. Multiple familial pilomatricomas associated with myotonic dystrophy. Int J Dermatol. Oct 1996;35(10):732-3. [Medline].

  21. Salerni E, Bonatti ML, D'Aurizio C, Baldassarre M, D'Alessandro E, Prencipe M. Multiple pilomatrixomas and myotonic dystrophy: a case report. Riv Neurol. May-Jun 1988;58(3):124-6. [Medline].

  22. Schlechter R, Hartsough NA, Guttman FM. Multiple pilomatricomas (calcifying epitheliomas of Malherbe). Pediatr Dermatol. Jul 1984;2(1):23-5. [Medline].

  23. Bremnes RM, Kvamme JM, Stalsberg H, Jacobsen EA. Pilomatrix carcinoma with multiple metastases: report of a case and review of the literature. Eur J Cancer. Mar 1999;35(3):433-7. [Medline].

  24. Krugman ME, Bansberg S, Strout E. Pilomatrical carcinoma. Plast Reconstr Surg. Aug 1990;86(2):340-3. [Medline].

  25. Martelli G, Giardini R. Pilomatrix carcinoma: a case report and review of the literature. Eur J Surg Oncol. Dec 1994;20(6):703-4. [Medline].

  26. McCulloch TA, Singh S, Cotton DW. Pilomatrix carcinoma and multiple pilomatrixomas. Br J Dermatol. Feb 1996;134(2):368-71. [Medline].

  27. Miyahara H, Imayama S, Hashizume T, Takeishi M, Hori Y, Kohda H. Two cases of pilomatrix carcinoma. J Dermatol. May 1990;17(5):322-5. [Medline].

  28. Monchy D, McCarthy SW, Dubourdieu D. Malignant pilomatrixoma of the scalp. Pathology. Apr 1995;27(2):201-3. [Medline].

  29. Panico L, Manivel JC, Pettinato G, De Rosa N, Ruggiero A, De Rosa G. Pilomatrix carcinoma. A case report with immunohistochemical findings, flow cytometric comparison with benign pilomatrixoma and review of the literature. Tumori. Aug 31 1994;80(4):309-14. [Medline].

  30. Sabharwal BD, Malhotra V. Pilomatrix carcinoma--calcifying epitheliocarcinoma of Malherbe (a case report). Indian J Pathol Microbiol. Dec 1994;37 Suppl:S45-6. [Medline].

  31. Sable D, Snow SN. Pilomatrix carcinoma of the back treated by mohs micrographic surgery. Dermatol Surg. Aug 2004;30(8):1174-6. [Medline].

  32. Sassmannshausen J, Chaffins M. Pilomatrix carcinoma: a report of a case arising from a previously excised pilomatrixoma and a review of the literature. J Am Acad Dermatol. Feb 2001;44(2 Suppl):358-61. [Medline].

  33. Tateyama H, Eimoto T, Tada T, Niwa T. Malignant pilomatricoma. An immunohistochemical study with antihair keratin antibody. Cancer. Jan 1 1992;69(1):127-32. [Medline].

  34. Vico P, Rahier I, Ghanem G, Nagypal P, Deraemaecker R. Pilomatrix carcinoma. Eur J Surg Oncol. Aug 1997;23(4):370-1. [Medline].

  35. Waxtein L, Vega E, Alvarez L, Cortes-Franco R, Hojyo T, Dominguez-Soto L. Malignant pilomatricoma: a case report. Int J Dermatol. Jul 1998;37(7):538-40. [Medline].

  36. Wood MG, Parhizgar B, Beerman H. Malignant pilomatricoma. Arch Dermatol. Jun 1984;120(6):770-3. [Medline].

  37. Zagarella SS, Kneale KL, Stern HS. Pilomatrix carcinoma of the scalp. Australas J Dermatol. 1992;33(1):39-42. [Medline].

  38. Farrier S, Morgan M. bcl-2 expression in pilomatricoma. Am J Dermatopathol. Jun 1997;19(3):254-7. [Medline].

  39. Kizawa K, Toyoda M, Ito M, Morohashi M. Aberrantly differentiated cells in benign pilomatrixoma reflect the normal hair follicle: immunohistochemical analysis of Ca-binding S100A2, S100A3 and S100A6 proteins. Br J Dermatol. Feb 2005;152(2):314-20. [Medline].

  40. Chan EF, Gat U, McNiff JM, Fuchs E. A common human skin tumour is caused by activating mutations in beta-catenin. Nat Genet. Apr 1999;21(4):410-3. [Medline].

  41. Kajino Y, Yamaguchi A, Hashimoto N, Matsuura A, Sato N, Kikuchi K. beta-Catenin gene mutation in human hair follicle-related tumors. Pathol Int. Jul 2001;51(7):543-8. [Medline].

  42. Lazar AJ, Calonje E, Grayson W, et al. Pilomatrix carcinomas contain mutations in CTNNB1, the gene encoding beta-catenin. J Cutan Pathol. Feb 2005;32(2):148-57. [Medline].

  43. Yoshimura Y, Obara S, Mikami T, Matsuda S. Calcifying epithelioma (pilomatrixoma) of the head and neck: analysis of 37 cases. Br J Oral Maxillofac Surg. Dec 1997;35(6):429-32. [Medline].

  44. Julian CG, Bowers PW. A clinical review of 209 pilomatricomas. J Am Acad Dermatol. Aug 1998;39(2 Pt 1):191-5. [Medline].

  45. Rotenberg M, Laccourreye O, Cauchois R, Laccourreye L, Putterman M, Brasnu D. Head and neck pilomatrixoma. Am J Otolaryngol. Mar-Apr 1996;17(2):133-5. [Medline].

  46. Shields JA, Shields CL, Eagle RC Jr, Mulvey L. Pilomatrixoma of the eyelid. J Pediatr Ophthalmol Strabismus. Jul-Aug 1995;32(4):260-1. [Medline].

  47. Strobl H, Emshoff R. Pilomatrixoma of the cheek: report of case. J Oral Maxillofac Surg. Nov 1995;53(11):1355-7. [Medline].

  48. Schweitzer WJ, Goldin HM, Bronson DM, Brody PE. Solitary hard nodule on the forearm. Pilomatricoma. Arch Dermatol. Jun 1989;125(6):828-9, 832. [Medline].

  49. Alfsen GC, Strom EH. Pilomatrixoma of the ovary: a rare variant of mature teratoma. Histopathology. Feb 1998;32(2):182-3. [Medline].

  50. Sevin K, Can Z, Yilmaz S, Saray A, Yormuk E. Pilomatrixoma of the earlobe. Dermatol Surg. Mar 1995;21(3):245-6. [Medline].

  51. Alli N, Gungor E, Artuz F. Perforating pilomatricoma. J Am Acad Dermatol. Jul 1996;35(1):116-8. [Medline].

  52. Arnold M, McGuire LJ. Perforating pilomatricoma--difficulty in diagnosis. J Am Acad Dermatol. Apr 1988;18(4 Pt 1):754-5. [Medline].

  53. Bayle P, Bazex J, Lamant L, Lauque D, Durieu C, Albes B. Multiple perforating and non perforating pilomatricomas in a patient with Churg-Strauss syndrome and Rubinstein-Taybi syndrome. J Eur Acad Dermatol Venereol. Sep 2004;18(5):607-10. [Medline].

  54. Cooper PH, Fechner RE. Pilomatricoma-like changes in the epidermal cysts of Gardner's syndrome. J Am Acad Dermatol. May 1983;8(5):639-44. [Medline].

  55. de la Torre JP, Saiz A, Garcia-Arpa M, Rodriguez-Peralto JL. Pilomatricomal horn: a new superficial variant of pilomatricoma. Am J Dermatopathol. Oct 2006;28(5):426-8. [Medline].

  56. del Pozo J, Martinez W, Yebra-Pimentel MT, Fonseca E. Lymphangiectatic variant of pilomatricoma. J Eur Acad Dermatol Venereol. Sep 2004;18(5):575-6. [Medline].

  57. Faust HB, Clark RE, Kamino H. Hyperkeratotic nodule. Keratoacanthomalike pilomatricoma. Arch Dermatol. May 1996;132(5):573, 576. [Medline].

  58. Fender AB, Reale VF, Scott GA. Anetodermic pilomatricoma with perforation. J Am Acad Dermatol. Mar 2008;58(3):535-6. [Medline].

  59. Inui S, Kanda R, Hata S. Pilomatricoma with a bullous appearance. J Dermatol. Jan 1997;24(1):57-9. [Medline].

  60. Jones CC, Tschen JA. Anetodermic cutaneous changes overlying pilomatricomas. J Am Acad Dermatol. Dec 1991;25(6 Pt 1):1072-6. [Medline].

  61. Lee WS, Yoo MS, Ahn SK. Anetodermic cutaneous changes overlying pilomatricoma. Int J Dermatol. Feb 1995;34(2):144-5. [Medline].

  62. Lo JS, Guitart J, Bergfeld WF, Benedetto EA, Mehle AL. Perforating pilomatricoma: a case report. Cutis. Aug 1989;44(2):130-2. [Medline].

  63. Nakayama H, Mihara M, Shimao S. Acantholytic pilomatricoma. Dermatologica. 1990;181(4):314-6. [Medline].

  64. Poorten HJ, Sharbaugh AH. Extruding pilomatricoma. Report of a case. Cutis. Jul 1978;22(1):47-9. [Medline].

  65. Spitz D, Fisher D, Friedman RJ, Kopf AW. Pigmented Pilomatricoma. A clinical simulator of malignant melanoma. J Dermatol Surg Oncol. Nov 1981;7(11):903-6. [Medline].

  66. Uchiyama N, Shindo Y, Saida T. Perforating pilomatricoma. J Cutan Pathol. Aug 1986;13(4):312-8. [Medline].

  67. Zulaica A, Peteiro C, Quintas C, Pereiro M Jr, Toribio J. Perforating pilomatricoma. J Cutan Pathol. Dec 1988;15(6):409-11. [Medline].

  68. Ali MZ, Ali FZ. Pilomatrixoma breast mimicking carcinoma. J Coll Physicians Surg Pak. Apr 2005;15(4):248-9. [Medline].

  69. Reynaud P, Orliaguet T, Robin YM, et al. [Mammary pilomatrixoma clinically mimicking carcinoma]. Ann Pathol. Jul 1997;17(3):213-4. [Medline].

  70. Hughes J, Lam A, Rogers M. Use of ultrasonography in the diagnosis of childhood pilomatrixoma. Pediatr Dermatol. Sep-Oct 1999;16(5):341-4. [Medline].

  71. Hoffmann V, Roeren T, Moller P, Heuschen G. MR imaging of a pilomatrixoma. Pediatr Radiol. Apr 1998;28(4):272. [Medline].

  72. Ichikawa T, Nakajima Y, Fujimoto H, et al. Giant calcifying epithelioma of Malherbe (pilomatrixoma): imaging features. Skeletal Radiol. Oct 1997;26(10):602-5. [Medline].

  73. Domanski HA, Domanski AM. Cytology of pilomatrixoma (calcifying epithelioma of Malherbe) in fine needle aspirates. Acta Cytol. May-Jun 1997;41(3):771-7. [Medline].

  74. Kumar N, Verma K. Fine needle aspiration (FNA) cytology of pilomatrixoma. Cytopathology. Apr 1996;7(2):125-31. [Medline].

  75. Ortiz J, Garcia Macias C, Abad M, Flores T, Paz JI, Bullon A. Pilomatrixoma: a description of two cases diagnosed by fine-needle aspiration. Diagn Cytopathol. Mar 1995;12(2):155-7. [Medline].

  76. Thinakaran V, Singh SK, Simples P, Nadimpalli V. Fine needle aspiration diagnosis of pilomatrixoma. A case report. Acta Cytol. May-Jun 1998;42(3):769-71. [Medline].

  77. Wong MP, Yuen ST, Collins RJ. Fine-needle aspiration biopsy of pilomatrixoma: still a diagnostic trap for the unwary. Diagn Cytopathol. 1994;10(4):365-9; discussion 369-70. [Medline].

  78. Kaddu S, Soyer HP, Hodl S, Kerl H. Morphological stages of pilomatricoma. Am J Dermatopathol. Aug 1996;18(4):333-8. [Medline].

  79. Morales A, McGoey J. Pilomatricoma: treatment by incision and curettement. J Am Acad Dermatol. Jan 1980;2(1):44-6. [Medline].

  80. Thomas RW, Perkins JA, Ruegemer JL, Munaretto JA. Surgical excision of pilomatrixoma of the head and neck: a retrospective review of 26 cases. Ear Nose Throat J. Aug 1999;78(8):541, 544-6, 548. [Medline].

  81. Cambiaghi S, Ermacora E, Brusasco A, Canzi L, Caputo R. Multiple pilomatricomas in Rubinstein-Taybi syndrome: a case report. Pediatr Dermatol. Mar 1994;11(1):21-5. [Medline].

  82. Masuno M, Imaizumi K, Ishii T, Kuroki Y, Baba N, Tanaka Y. Pilomatrixomas in Rubinstein-Taybi syndrome. Am J Med Genet. Apr 28 1998;77(1):81-2. [Medline].

  83. Noguchi H, Kayashima K, Nishiyama S, Ono T. Two cases of pilomatrixoma in Turner's syndrome. Dermatology. 1999;199(4):338-40. [Medline].

  84. Pujol RM, Casanova JM, Egido R, Pujol J, de Moragas JM. Multiple familial pilomatricomas: a cutaneous marker for Gardner syndrome?. Pediatr Dermatol. Dec 1995;12(4):331-5. [Medline].

  85. Fink AM, Berkowitz RG. Sonography in preauricular pilomatrixoma of childhood. Ann Otol Rhinol Laryngol. Feb 1997;106(2):167-9. [Medline].

  86. Greene RM, McGuff HS, Miller FR. Pilomatrixoma of the face: a benign skin appendage mimicking squamous cell carcinoma. Otolaryngol Head Neck Surg. Apr 2004;130(4):483-5. [Medline].

  87. Kaddu S, Soyer HP, Wolf IH, Kerl H. Proliferating pilomatricoma. A histopathologic simulator of matrical carcinoma. J Cutan Pathol. Apr 1997;24(4):228-34. [Medline].

  88. Noguchi H, Hayashibara T, Ono T. A statistical study of calcifying epithelioma, focusing on the sites of origin. J Dermatol. Jan 1995;22(1):24-7. [Medline].

  89. Parlette EC, Parlette HL 3rd, Patterson JW. Pilomatricoma: an alarming presentation. Cutis. Nov 1998;62(5):227-30. [Medline].

  90. Som PM, Shugar JM, Silvers AR. CT of pilomatrixoma in the cheek. AJNR Am J Neuroradiol. Aug 1998;19(7):1219-20. [Medline].

  91. Swerlick RA, Cooper PH, Mackel SE. Rapid enlargement of pilomatricoma. J Am Acad Dermatol. Jul 1982;7(1):54-6. [Medline].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

calcifying epithelioma of Malherbe, Malherbe epithelioma, pilomatricoma, trichomatrioma, benign calcifying epithelioma, hair cell tumor, Malherbe tumor, pilomatrix epithelioma, pilomatrix tumor, pilomatrical neoplasm, pilomatrix carcinoma, myotonic dystrophy, hair matrix cell tumorigenesis, hair matrix cell tumor

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Jaggi Rao, MD, Associate Clinical Professor of Medicine, Division of Dermatology and Cutaneous Sciences, University of Alberta; Consulting Staff, Dermatology and Dermatologic Surgery, University of Alberta and Acne Clinics of Canada
Jaggi Rao, MD is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery, American Society for Laser Medicine and Surgery, Canadian Dermatology Association, Canadian Medical Association, Canadian Medical Protective Association, Pacific Dermatologic Association, and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Coauthor(s)

Andrei I Metelitsa, MD, Chief Resident, Division of Dermatology and Cutaneous Sciences, University of Alberta, Canada
Andrei I Metelitsa, MD is a member of the following medical societies: American Academy of Dermatology, American Society for Dermatologic Surgery, Canadian Dermatology Association, and Canadian Medical Protective Association
Disclosure: Nothing to disclose.

Andrew Lin, MD, FRCPC, Associate Professor, Department of Internal Medicine, Division of Dermatology, University of Alberta
Andrew Lin, MD, FRCPC is a member of the following medical societies: American Academy of Dermatology and Royal College of Physicians and Surgeons of Canada
Disclosure: Nothing to disclose.

Medical Editor

Smeena Khan, MD, Private Practice, Adult and Pediatric Dermatology Associates
Smeena Khan, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Pharmacy Editor

Richard P Vinson, MD, Assistant Clinical Professor, Department of Dermatology, Texas Tech University School of Medicine; Consulting Staff, Mountain View Dermatology, PA
Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Association of Military Dermatologists, Texas Dermatological Society, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Warren R Heymann, MD, Head, Division of Dermatology, Professor, Department of Internal Medicine, University of Medicine and Dentistry of New Jersey
Warren R Heymann, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and Society for Investigative Dermatology
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.