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Observation of Dog-Ear Regression by Anatomical Location
Thomas A Jennings1, James C Keane, Rajat Varma
1*Department of Dermatology, University of Alabama Medical Center, Birmingham, Alabama; †Department of Dermatology, University of Arkansas for Medical Sciences, Little Rock, Arkansas; ‡Department of Dermatology, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Background:
When an excision is performed by a method other than elliptical excision, direct primary wound closure can result in standing cones or "dog-ears." In 2008, Lee and colleagues noted that dog-ears of <8 mm in height have a statistically greater tendency to resolve without further surgical correction than larger dog-ears.
Objective:
To stratify dog-ears by anatomic location and inform on the need for correction at the time of surgery.
Materials And Methods:
After tumor extirpation, patients were counseled that primary closure of the surgical wound would result in dog-ears at the wound apices. Dog-ears were left uncorrected in participating patients. At 6 months, patients were assessed for resolution of the dog-ears and asked to rate the appearance of the scar.
Results:
A total of 140 dog-ears were observed in the study period. Anatomical locations included the hand/foot, trunk, limb, and head/neck. Among these dog-ears, 114/140 (81%) showed complete resolution. Patient satisfaction with the scar appearance correlated well with the dog-ear resolution, with most patients rating the appearance of the scar as good to excellent.
Conclusion:
This study suggests that dog-ears on the hand and dog-ears ≤4 mm on the trunk may be observed without any final cosmetic penalty.
