Punch and Scoop Technique for Removing Pilomatricoma

Surgical experiences in pediatric pilomatricoma: punch incision and elliptical excision

BACKGROUND

As pilomatricoma is a common adnexal skin tumor often occurring in exposed areas, dermatologists focus on minimizing postsurgical scarring.

METHODS

This retrospective study included patients aged < 19 years who underwent surgical treatment for pilomatricoma at a single university hospital from 2015 to 2021. Patient demographics, tumor characteristics, and surgical outcomes were analyzed according to the surgical methods including punch incision and elliptical excision.

RESULTS

Overall, 75 patients and 79 lesions were included in the study. The mean age of the patients was 8.4 years, and 48 patients (64.0%) were females. The face was the most common site of pilomatricoma (51.9%), and within the face, the cheeks were the most common sites. No recurrence was observed in the elliptical excision group, while one case of recurrence (4.5%) was observed in the punch incision group. The mean length of the wound was 2.00 cm in the elliptical excision group, which was longer than that in the punch incision group (0.49 cm; p < .001).

CONCLUSIONS

Considering that surgery is the gold standard treatment for pilomatricoma, punch incision may be useful as an alternative surgical option for pilomatricoma in children.

Minimally invasive surgical treatment of pilomatrixoma

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.