Background: Nodular hidradenoma is an uncommon, benign, adnexal neoplasm of apocrine origin which is a clinical simulator of other tumours. Objective: The aim of this study was to evaluate the morphological findings of a large series of nodular hidradenomas under dermoscopic observation. Methods: Dermoscopic examination of 28 cases of nodular hidradenomas was performed to evaluate specific dermoscopic criteria and patterns. Results: The most frequently occurring dermoscopic features were: (1) in 96.4% of cases, a homogeneous area that covered the lesion partially or totally, the colour of which was pinkish in 46.4% of cases, bluish in 28.6%, red-blue in 14.3%, and brownish in 10.7%; (2) white structures were found in 89.3% of cases; (3) in 82.1% of cases, vascular structures were also observed, especially arborising telangiectasias (39.3%) and polymorphous atypical vessels (28.6%). Conclusion: Nodular hidradenomas represent a dermoscopic pitfall, being difficult to differentiate clinically and dermoscopically from basal cell carcinomas and melanomas.

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