I used to make this design all the time. I haven't in ages. Perhaps I should. Skulls are everywhere, though I have read that they are going out of style. I, for one, love my skull and crossbones shoes, but I have always been partial to the "memento mori" medieval artworks too. We are all mortal after all.
For some reason I loved giving the skull a fedora the most. Once when my brother and I were making things we tried all the styles of hats we could think of, including a fez, a cowboy hat, a bowler, a ball cap; there must have been more. It was hilarious to us and I remember laughing a lot as we tried each of the hats on this head. Go figure.
I was curious as to who would buy this pin and it turned out many times to be retired ladies, giving it as gifts to friends, or to people sick at home or in the hospital! A little bit of black humour goes a long way. I imagine you'd have to know the recipient really well to give them this though. The wrong person could take it really badly.