Abstract
Melanocytic matricoma is a rare recently reported entity. It usually presents as pigmented, dark-papular, crusted lesion on sun-damaged skin of adult patients. Histopathologically, these lesions consist of well-circumscribed nodules with groups of “shadow cells” or “ghost cells” (matrical/supramatrical cells) and prominent pigmented dendritic melanocytes. It differs from matricomas and pilomatricomas by its lack of calcification, cyst formation, granulomas, and connections to the epidermis and other adnexal structures. The clinical differential diagnosis includes hemangioma, pigmented basal cell carcinoma, and melanoma. Melanocytic matricoma presumably is the representation of an epithelial-melanocytic interaction in the anagen phase of the hair cycle, and the melanization is due to normal melanocytes colonizing a neoplastic proliferation. A extensive search of the medical literature revealed 5 reports of benign melanocytic matricomas and 2 malignant counterparts. We present 2 additional cases of melanocytic matricoma with clinicopathologic correlation. The first case is from the dorsum of the hand of a 70-year-old white male and the second from the preauricular area of an 82-year-old white male, both with prior history of skin cancer. The small size, well-circumscribed appearance, and the symptom-free nature signifies benignity. However, if cytologic atypia is present, it is indicative of malignant behavior. Correct interpretation of melanocytic matricoma is extremely important due to its clinical and histopathologic overlap with other more ominous lesions.
Published Version
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