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Published on: March 31, 2023
Epidemiologic Comparison of Epidermal Cysts and Pilomatrixomas in Pediatric Patients: A 13-Year Single-Institution
Jun Choi1, Seong J Kim, Soo H Lee
1Department of Plastic and Reconstructive Surgery, Inje University Ilsan Paik Hospital, Goyang-si, Gyeonggi-do, Republic of Korea.
Insights
Epidermal cysts and pilomatrixomas are common pediatric skin lesions. Pilomatrixomas are more frequent in younger children (0-9 years) and on extremities, while epidermal cysts show wider age distribution.
Area of Science:
- Dermatology
- Pediatric Pathology
- Epidemiology
Background:
- Epidermal cysts and pilomatrixomas are frequent benign pediatric skin lesions.
- Limited comparative epidemiologic data exists for these common conditions.
- Understanding their distribution is crucial for accurate diagnosis.
Purpose of the Study:
- To evaluate and compare the prevalence and distribution of epidermal cysts and pilomatrixomas in pediatric patients.
- To analyze age, sex, and site-specific patterns for these lesions over a 13-year period.
Main Methods:
- Retrospective review of pediatric patients (0-18 years) with histopathologically confirmed epidermal cysts or pilomatrixomas.
- Data collected from 2012 to 2025 at a single institution.
- Analysis of age distribution (0-4, 5-9, 10-14, 15-18 years) and lesion location (head/neck, upper/lower extremities, trunk).
Main Results:
- 731 pediatric patients included: 118 (16%) with epidermal cysts, 161 (22%) with pilomatrixomas.
- Pilomatrixomas peaked in the 5-9 year age group, unlike epidermal cysts' even distribution.
- Both lesions showed female predominance; head and neck was most common site, but pilomatrixomas were more frequent on upper extremities.
Conclusions:
- This study provides robust epidemiologic data on pediatric epidermal cysts and pilomatrixomas.
- Identified age, sex, and site-specific patterns can aid clinicians in preoperative diagnosis.
- Findings support enhanced diagnostic suspicion and improved patient counseling.
Background/Objectives:
Epidermal cysts and pilomatrixomas are 2 of the most common benign skin lesions in children, yet comprehensive epidemiologic data comparing their distribution remain limited. This study aimed to evaluate the prevalence of these lesions in pediatric patients over a 13-year period at a single institution.
Methods:
A retrospective review was conducted of patients aged 0 to 18 years who underwent excisional biopsy with histopathologic confirmation between 2012 and 2025. Cases diagnosed as epidermal cysts or pilomatrixomas were included for comparative analysis. Age was categorized into 4 groups (0-4, 5-9, 10-14, and 15-18 y), and lesion locations were grouped into head and neck, upper extremities, lower extremities, and trunk.
Results:
Among 731 pediatric patients, 118 (16%) had epidermal cysts, and 161 (22%) had pilomatrixomas. Epidermal cysts demonstrated a relatively even age distribution, whereas pilomatrixomas were concentrated in the first decade of life, particularly in the 5- to 9-year age group. Both lesions showed a female predominance. The head and neck region was the most common site for both lesions; however, pilomatrixomas exhibited a higher proportion of upper-extremity involvement and were rarely observed on the trunk.
Conclusions:
This long-term single-institution study provides internally consistent epidemiologic data on 2 common pediatric skin lesions. Age-, sex-, and site-specific distribution patterns identified in this cohort may assist clinicians in improving preoperative diagnostic suspicion and counseling.
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