First dermoscopic characterization and histopathological correlation of panfolliculoma: a case report and review of the literature

Panfolliculoma (PF) is a rare benign cutaneous adnexal neoplasm exhibiting panfollicular differentiation, frequently misdiagnosed as basal cell carcinoma (BCC) due to overlapping clinical features. We present the case of a 77-year-old woman with a slow-growing nodule on the nasal tip, initially suspected to be a BCC. Definitive diagnosis of cystic PF was established through histopathological evaluation, while novel dermoscopic characterization revealed characteristic keratin-filled follicular openings and peppercorn-like granules alongside BCC-like vascular structures. This report reviews the clinical characteristics, dermoscopic findings, and histopathological features of PF based on our case and a systematic analysis of 54 globally reported cases. Identifying specific dermoscopic markers of follicular lineage can help distinguish PF from malignant mimics, thereby guiding appropriate clinical management and avoiding unnecessary aggressive surgical interventions.