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. 2020 Apr;32(2):93-100.
doi: 10.5021/ad.2020.32.2.93. Epub 2020 Mar 11.

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

Yong Woo Oh  1 , Ho Seok Suh  1 , Yu Sung Choi  1
Affiliations

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

Yong Woo Oh et al. Ann Dermatol. 2020 Apr.

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.

Keywords: Cosmetic outcomes; Evolutionary stages; Pilomatricoma; Surgical excision; Surgical outcomes.

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Conflict of interest statement

CONFLICTS OF INTEREST: The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1. Flow and distribution of patients according to disease duration. Group A: early excision group, group B: delayed excision group.
Fig. 2
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.
Fig. 3
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.
Fig. 4
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.
Fig. 5
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.
See this image and copyright information in PMC

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