Epidermal cyst on the face of a child, clinically and dermoscopically mimicking pilomatricoma

We present a case of an epidermal cyst on the face of a child, clinically and dermoscopically mimicking pilomatricoma. Pilomatricoma, also called pilomatrixoma or calcifying epithelioma of Malherbe, is a benign skin tumor and one of the most common causes of superficial head and neck masses in children and young adults [1]. It usually manifests as a solitary, asymptomatic, firm nodule on the face (especially eyelids and eyebrows), scalp, neck, or arms [1]. Common differential diagnoses for head and neck pilomatricoma include sebaceous cyst, ossifying hematoma, giant cell tumor, chondroma, dermoid cyst, foreign body reaction, degenerating fibroxanthoma, metastatic bone formation, and osteoma cutis [1]. Pilomatricoma-like changes have been described in epidermoid cysts in patients with Gardner syndrome [1]. Surgical excision of the pilomatricoma is the treatment of choice, with wide resection margins to minimize the risk of recurrences [2].