Pilomatrixomas presenting as vascular tumors on color Doppler ultrasound

Diagnosis of pilomatrixomas may be difficult because they can mimic other clinical conditions. Color Doppler ultrasound had been proven useful in the study of localized lesions of the skin and can both define lesion morphology and determine blood flow changes in real time, and may thus help differentiate primary from secondary vascular skin lesions. We present 3 cases of pilomatrixomas that mimic vascular lesions of the skin on physical examination. Clinical, sonographic, intraoperative, and histologic images are provided to highlight the nature of these challenging cases.