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Published on: January 17, 2019
Minimally invasive surgical treatment of pilomatrixoma
Bapesh Krishna Bollu1,2, Michael Collin1, Albert Shun1
1Department of Paediatric Surgery, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
Insights
Incision and curettage (I&C) offers a cosmetically superior alternative for pediatric pilomatrixoma removal. This minimally invasive technique for the benign skin tumor shows no recurrence and high patient satisfaction.
Area of Science:
- Dermatology
- Pediatric Surgery
- Oncology
Background:
- Pilomatrixoma is a common benign skin tumor in children, typically on the head and neck.
- Traditional wide local excision can result in significant scarring.
- Improved cosmetic outcomes are desirable for pediatric surgical procedures.
Purpose of the Study:
- To evaluate the efficacy and cosmetic results of the incision and curettage (I&C) technique for pilomatrixoma removal.
- To assess recurrence rates and patient satisfaction following I&C.
- To present I&C as a viable alternative to traditional excision.
Main Methods:
- Retrospective review of pediatric patients undergoing I&C for pilomatrixoma (January 2010 - June 2020).
- I&C technique involves small incision and piecemeal tumor removal.
- Post-operative follow-up included clinical assessment and patient/family surveys for recurrence, complications, and satisfaction.
Main Results:
- Twenty pilomatrixomas were removed from 11 pediatric patients (7 female).
- Most lesions (11) were located on the face.
- Mean follow-up of 6 years showed no recurrences, with high parental satisfaction regarding cosmetic results.
Conclusions:
- Incision and curettage (I&C) is an effective method for pilomatrixoma removal in children.
- The I&C technique yields excellent cosmetic outcomes and low recurrence rates.
- I&C represents a cosmetically advantageous approach for pediatric pilomatrixoma management.
Background:
Pilomatrixoma is a benign skin tumour often presenting as a firm irregular mass in the paediatric population. The most common site is on the head and neck. Traditionally, a wide local excision has been the method of management. We propose an incision and curettage (I&C) technique for an improved cosmetic outcome.
Methods:
A retrospective review of children who underwent I&C for pilomatrixoma was done between January 2010 and June 2020. The I&C technique involved making a small incision over or near the lesion in a discrete location such as behind the hairline and removing the tumour piecemeal. Four to six weeks of routine post-operative follow-up was conducted. Patients and families were also subsequently contacted via a survey to assess for late recurrence, any other complications and ascertain their level of satisfaction with the outcome.
Results:
Twenty lesions were removed in 11 patients over this time with a female predominance (seven) and most lesions were on the face (11). No patients had a recurrence in a mean follow-up time of 6 years (1-10 years). All parents are very satisfied with the cosmetic result.
Conclusion:
I&C may be an effective and cosmetically pleasing method to removing pilomatrixoma.
