Morphea following radiation therapy in a patient with breast cancer.

If we compare the dermatoscopic characteristics of our lesion with those reported for nonanetodermic pilomatrixomas in the study by Zaballos et al., we find that irregular white structures, homogeneous red areas, and irregular linear vessels are common features. The dilated vessels and hemorrhages observed in pathology may correspond to the linear vessels and homogeneous reddish areas present in the dermatoscopic image. The ultrasound image of conventional pilomatrixoma shows a lesion with a hypoechoic halo and a central hyperechoic region (corresponding to calcification) that generates the posterior shadow. In 1999, Hughes et al. published a retrospective preoperative ultrasound study of 28 suspected conventional pilomatrixomas. In 20 of these, the ultrasound findings supported the suspected clinical diagnosis and in 16 of these 20 lesions, histological study confirmed diagnosis of pilomatrixoma. In the literature that we reviewed, we could not find a description of skin ultrasound of anetodermic pilomatrixoma. Differential diagnosis should include basal cell carcinoma (BCC) and melanoma, and in both cases, the dermatoscopic and ultrasound studies can help in the preoperative diagnosis. From the ultrasound point of view, BCC and melanoma are also considered hypoechoic lesions. The characteristics that can help differentiate these lesions from pilomatroxima are the presence of small hyperechoic nodules in the lesion characteristic of BCC and an irregular border with abundant vascularization within the tumor in characteristic melanoma lesions. In conclusion, we present the clinical description and the first dermatoscopic and ultrasound findings for anetodermic pilomatrixoma. References