"I want this thing off my face!"

This is the sad thing my three year old, who has been diagnosed with a 4mm by 6mm pilomatricoma on her right cheek, says to me last night as we are lying in her bed.  And I agree.  But before we get there, we should summarize the last nine months of this "thing's" presence on her face:  It wasn't there, and then it was, and then it stayed. 

I first noticed what looked like a plugged pore around October, and resisted the urge to pick at it.  it was small, like a blackhead but slightly off center to what looked like a small smooth bump underneath it.  Weird.  In February, it flared up, pussed and red and looking like a zit ready to explode.  That should be the end of that, I figured.  Blackhead becomes zit, then goes away.  But it didn't--it returned to about the same state as before, and I was ready to figure out what the heck this thing was.

(picture: very benign looking opening to a cyst or pilomatricoma in February)

Our pediatrician guessed it was a sebaceous cyst, harmless but removable by a dermatologist if we didn't want to wait for it to dissipate on its own.  I waited a few more months to make the dermatologist appointment, then was suprised to hear him say almost immediately that it was a pilomatricoma, or benign hair follicle tumor. What's more, it would continue to grow, calcify and require surgical excision either now or later, but definitely sometime.

(picture: very not-so benign looking cyst or pilomatricoma in May)

The pilomatricoma is about an inch below her eye.  Given the location on the face and proximity to her eyes, I called the pediatric plastic surgeon at University of Michigan Mott Children's Hospital, although the dermatologist was comfortable doing it himself.   In the interim of our wait between dermatologist consult (May 3) and plastic surgeon consult (June 3)  the thing has gotten huge--nearly dime-size and angry red.  The skin has been stretched by its inflammation such that it appears to be flaking off over the top of the bump, and it generally looks like a nasty nasty bug bite (if it was on an adult, it could look like cystic acne, but one doesn't assume this on a three year old).  This inflammation has lasted nearly three weeks, much longer than the February flare up.  The June 3 plastic surgery consult, with Dr. Steven Kasten, can't come soon enough.