Atypical Presentation of Pilomatricoma: A Case Report

background. Malherbe tumors, also known as pilomatricomas, are benign cutaneous tumors of hair matrix origin. objective. To discuss a rare case of multiple pilomatricoma of the head and neck region in a very young patient. methods. A 14-month-old baby presented with two lesions, one appearing on the preauricular region and the other on the nasolabial fold. One of the lesions showed significant ulceration. results. Excisional biopsy was performed for both of the lesions. Although the histopathologic examination suggested pilomatricoma as the diagnosis, the lesion with ulcerations exhibited increased mitosis which made us consider pilomatrix carcinoma in its differential diagnosis. conclusion. Increased mitoses, an uncommon unexpected feature for pilomatricoma, can be a marker for more aggressive biologic behavior.