Ann Dermatol.  2020 Apr;32(2):93-100. 10.5021/ad.2020.32.2.93.

Optimal Timing of Surgical Excision in Pediatric Pilomatricoma: Association between Clinicopathological Features and Cosmetic Outcomes

• Oh YW
• Suh HS
• Choi YS

• KMID: 2471334
• DOI: http://doi.org/10.5021/ad.2020.32.2.93

Abstract

BACKGROUND
The treatment of choice for pilomatricomas is surgical excision; however, data for the optimal timing of treatment and cosmetic outcomes are limited.
OBJECTIVE
This study aimed to investigate the optimal timing of treatment in pilomatricomas by considering clinicopathological findings and cosmetic outcomes.
METHODS
Seventy-three pilomatricomas patients aged ≤15 years were retrospectively reviewed. Patients were classified into early excision (disease duration ≤12 months, group A) and delayed excision groups (disease duration >12 months, group B). Tumor characteristics, and histopathological features with evolutionary stages were assessed. Cosmetic outcomes were evaluated by the Modified Vancouver Scar Scale (MVSS), 5-point patient satisfaction score, and complication rates.
RESULTS
Group A showed better cosmetic outcomes than group B in the MVSS (1.53±1.22 vs. 3.68±1.84), 5-point patient satisfaction score (4.08±0.89 vs. 3.18±1.01), and complication rates (11.8% vs. 36.4%), respectively (p<0.05). Secondary anetoderma, tent sign, calcification, and late regressive stage (evolutionary stage IV) were more common in group B, (p<0.05). Moreover, evolutionary stages showed a positive correlation with mean MVSS (r=0.670, p<0.05).
CONCLUSION
Early excision (disease duration ≤12 months) provides superior cosmetic outcomes compared to delayed procedures. Early recognition, diagnosis, and management for pediatric pilomatricomas is important to improve overall cosmetic outcomes.

Keyword

Cosmetic outcomes; Evolutionary stages; Pilomatricoma; Surgical excision; Surgical outcomes

MeSH Terms

Anetoderma
Cicatrix
Diagnosis
Humans
Patient Satisfaction
Pilomatrixoma*
Retrospective Studies

Figure

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  Fig. 1 Flow and distribution of patients according to disease duration. Group A: early excision group, group B: delayed excision group.

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  Fig. 2 Percentage of patients according to the evolutionary stages in both groups. The number of patients within each evolutionary stage is shown. Group A: early excision group, group B: delayed excision group.

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  Fig. 3 Positive correlation between the mean Modified Vancouver Scar Scale (MVSS) score and the evolutionary stages in all patients (r=0.670, p<0.05). The mean modified vancouver scar scale score in each evolutionary stage is shown.

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  Fig. 4 Representative serial photographs of a patient in group A before surgery (A) and 6 months after surgery (B) on the left cheek. Group A: early excision group.

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  Fig. 5 Representative serial photographs of a patient in group B before surgery (A) and 6 months after surgery (B) on the right cheek. Group B: delayed excision group.

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