PMC6282453_01
Ulcerated lesion in right hemisphere of her scalp. Asterisks mark the areas biopsied.
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fig1
Wig removal showed a giant ulcerated plaque, 21 cm in its greatest diameter, which occupied almost the entire right side of her scalp, from the occipital area to the outer canthus of her right eye (Fig 1). Histopathology mapping with multiple punch biopsy was performed with samples from periphery and central areas of tumor (Fig 1, asterisk).
Decrease in the size of BCC 9 months after starting the treatment with vismodegib. The arrow marks the biopsied section in which areas of BCC were observed, and the asterisk marks the biopsied section in which areas of pilomatricoma were found.
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Only one sample showed persistent BCC (Fig 2, arrow). One peripheral biopsy done in the same area previously biopsied (Fig 2, asterisk) showed fibrotic scarring and 2 epithelial nodules.
Fibrotic scarring and underlying pilomatricoma areas were observed in the biopsy. (Hematoxylin-eosin stain; original magnifications, x10.)
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Foci of calcification were also detected (Fig 3).
Epidermis and epithelial component of pilomatricoma were positive for AE1/AE3 cytokeratin staining. (Original magnifications, x10.)
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Stains for cytokeratin AE1/AE3 (Fig 4) and p63 were positive in epithelial component and supported our diagnosis.