Optimal Timing of Surgical Excision in Pediatric Pilomatricoma: Association between Clinicopathological Features and Cosmetic Outcomes
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
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.
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.
참고문헌 (26)
- Julian CG, "A clinical review of 209 pilomatricomas", J Am Acad Dermatol, 39(2 Pt 1), pp.191~195 (1998)
- Pirouzmanesh A, "Pilomatrixoma : a review of 346 cases", Plast Reconstr Surg, 112, pp.1784~1789 (2003)
- Srivastava D, "Fitzpatrick’s dermatology in general medicine. Vol 1" (2012), McGraw-Hill Medical
- Jones CD, "Pilomatrixoma : a comprehensive review of the literature", Am J Dermatopathol, 40, pp.631~641 (2018)
- Kaddu S, "Morphological stages of pilomatricoma", Am J Dermatopathol, 18, pp.333~338 (1996)
- Pant I, "Pilomatricoma as a diagnostic pitfall in clinical practice : report of two cases and review of literature", Indian J Dermatol, 55, pp.390~392 (2010)
- Yencha MW, "Head and neck pilomatricoma in the pediatric age group : a retrospective study and literature review", Int J Pediatr Otorhinolaryngol, 57, pp.123~128 (2001)
- Alli N, "Perforating pilomatricoma", J Am Acad Dermatol, 35, pp.116~118 (1996)
- Honda Y, "Perforating pilomatricoma : transepithelial elimination or not", J Dermatol, 29, pp.100~103 (2002)
- Fujioka M, "Secondary anetoderma overlying pilomatrixomas", Dermatology, 207, pp.316~318 (2003)
- Ohnishi T, "Perforating pilomatricoma in a process of total elimination", J Am Acad Dermatol, 49(2 Suppl Case Reports), pp.S146~S147 (2003)
- Miura T, "Perforating pilomatricoma with anetodermic epidermis in an adolescent with lymphoma", Pediatr Dermatol, 30, pp.e68~e69 (2013)
- Cho S, "Pilomatricoma : a clinical and histopathologic study of 13 cases", Ann Dermatol, 12, pp.179~184 (2000)
- Fearmonti R, "A review of scar scales and scar measuring devices", Eplasty, 10, pp.e43~ (2010)
- 배성환, "Analysis of Frequency of Use of Different Scar Assessment Scales Based on the Scar Condition and Treatment Method", Archives of Plastic Surgery, 41(2), pp.111~115 (2014), 대한성형외과학회
- Hernández-Núñez A, "Retrospective study of pilomatricoma : 261tumors in 239 patients", Actas Dermosifiliogr, 105, pp.699~705 (2014)
- Kwon D, "Characteristics of pilomatrixoma in children : a review of 137 patients", Int J Pediatr Otorhinolaryngol, 78, pp.1337~1341 (2014)
- Han G, "Updated view on epidemiology and clinical aspects of pilomatricoma in adults", Int J Dermatol, 56, pp.1032~1036 (2017)
- Kaddu S, "Clinical and histopathologic spectrum of pilomatricomas in adults", Int J Dermatol, 33, pp.705~708 (1994)
- Kim JE, "A clinicoimmunohistopathologic study of anetoderma: is protruding type more advanced in stage than indented type?", J Immunol Res, 2016, pp.4325463~ (2016)
- Venencie PY, "Anetoderma. Clinical findings, associations, and long-term follow-up evaluations", Arch Dermatol, 120, pp.1032~1039 (1984)
- Graham JL, "The tent sign of pilomatricoma", Cutis, 22, pp.577~580 (1978)
- Hwang JY, "The common ultrasonographic features of pilomatricoma", J Ultrasound Med, 24, pp.1397~1402 (2005)
- Touart DM, "Cutaneous deposition diseases. Part II", J Am Acad Dermatol, 39(4 Pt 1), pp.527~544 (1998)
- Walsh JS, "Calcifying disorders of the skin", J Am Acad Dermatol, 33(5 Pt 1), pp.693~706 (1995)
- Reiter N, "Calcinosis cutis: part I. Diagnostic pathway", J Am Acad Dermatol, 65, pp.1~12 (2011)
