Clinical and Dermoscopic Features of Pilomatricoma in Darker Skin Phototypes: A Case Series from Morocco
TL;DR
In this series of predominantly dark phototypes, structureless gray-blue areas and the rainbow pattern were prominent dermoscopic features, with a relative absence of classic vascular patterns, which suggest potential phototype-related differences in the dermoscopic appearance of pilomatricoma.
Abstract
Background: Pilomatricoma is a benign adnexal tumor derived from hair follicle matrix cells. Although its clinical and dermoscopic features have been described mainly in fair-skinned populations, data in darker phototypes remain scarce. Objective: To describe the clinical and dermoscopic characteristics of histologically confirmed pilomatricomas in patients with darker skin phototypes (Fitzpatrick III–V) at a tertiary dermatology center in Morocco. Methods: Descriptive single-center study including all patients with histologically confirmed pilomatricoma, examined with polarized-light dermoscopy between 2022 and 2024. Results: Fifteen patients were included. The mean age was 43.03 years (range 9–65 years), with a female predominance (male-to-female ratio 0.6:1). The cervicofacial region was the most frequent site (86.7%). Most patients had Fitzpatrick phototype IV (73.3%). The skin fold sign was present in 80% of cases. The most frequent dermoscopic features were reddish homogeneous areas (77.8%), yellow-whitish structures (76.9%), structureless gray-blue areas (73.3%), and the rainbow pattern (80%). Dotted and hairpin vessels were absent. Conclusion: In this series of predominantly dark phototypes, structureless gray-blue areas (73.3%) and the rainbow pattern (80%) were prominent dermoscopic features, with a relative absence of classic vascular patterns. These findings suggest potential phototype-related differences in the dermoscopic appearance of pilomatricoma.