Martin Theiler1,2, Kathrin Neuhaus3, Katrin Kerl4, Lisa Weibel5,4. 1. Department of Pediatric Dermatology, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland. martin.theiler@kispi.uzh.ch. 2. Department of Dermatology, University Hospital Zurich, Gloriastrasse 31, 8091, Zurich, Switzerland. martin.theiler@kispi.uzh.ch. 3. Department of Plastic and Reconstructive Surgery, Pediatric Burn Center, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zürich, Switzerland. 4. Department of Dermatology, University Hospital Zurich, Gloriastrasse 31, 8091, Zurich, Switzerland. 5. Department of Pediatric Dermatology, University Children's Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland.
Abstract
Little is known about the spectrum of pediatric skin disorders requiring biopsy/excision, their indication, impact on further management, and the accuracy of clinical diagnosis. We aimed to address these questions in the patient population seen at our Swiss University referral center for Pediatric Dermatology and Plastic Surgery. All skin biopsies/excisions performed in patients aged ≤ 16 years over a period of 2 years were retrospectively analyzed. A total of 506 samples were included. The majority of biopsies/excisions (n = 413, 82%) was performed for tumors, cysts, and hamartomas and 18% for other skin conditions. Malignant tumors were found in 12 samples (2%) from four patients. In 121 (24%) patients, the histopathology had an important impact on patient management. In 80 (16%) cases, the pathology did not match with the clinical diagnosis. In 382 (75%) cases, excision was the treatment of choice. Of these, the indication for surgery was based on patient's request in 181 (47%) cases. CONCLUSION: Surgical interventions for pediatric skin disorders are performed for diagnostic and therapeutic reasons. In this cohort, histopathology was essential for treatment in one quarter of cases. Skin tumors, cysts, and hamartomas often require excision during childhood, with families' request and esthetic considerations playing an important role. What is Known: • The spectrum of pediatric skin conditions has been studied in outpatient, inpatient, and emergency settings. • In contrast, no data exist on the spectrum of pediatric skin disorders undergoing biopsy/excision specifically. What is New: • We analyze biopsies/excisions in children, focusing on diagnosis, indication, and impact on patient management. • Surgical interventions for skin disorders in children are often performed for tumors and hamartomas with esthetic considerations playing a relevant role. If used for diagnostic purposes, they are often performed to confirm or rule out severe skin disease.
Little is known about the spectrum of pediatric skin disorders requiring biopsy/excision, their indication, impact on further management, and the accuracy of clinical diagnosis. We aimed to address these questions in the patient population seen at our Swiss University referral center for Pediatric Dermatology and Plastic Surgery. All skin biopsies/excisions performed in patients aged ≤ 16 years over a period of 2 years were retrospectively analyzed. A total of 506 samples were included. The majority of biopsies/excisions (n = 413, 82%) was performed for tumors, cysts, and hamartomas and 18% for other skin conditions. Malignant tumors were found in 12 samples (2%) from four patients. In 121 (24%) patients, the histopathology had an important impact on patient management. In 80 (16%) cases, the pathology did not match with the clinical diagnosis. In 382 (75%) cases, excision was the treatment of choice. Of these, the indication for surgery was based on patient's request in 181 (47%) cases. CONCLUSION: Surgical interventions for pediatric skin disorders are performed for diagnostic and therapeutic reasons. In this cohort, histopathology was essential for treatment in one quarter of cases. Skin tumors, cysts, and hamartomas often require excision during childhood, with families' request and esthetic considerations playing an important role. What is Known: • The spectrum of pediatric skin conditions has been studied in outpatient, inpatient, and emergency settings. • In contrast, no data exist on the spectrum of pediatric skin disorders undergoing biopsy/excision specifically. What is New: • We analyze biopsies/excisions in children, focusing on diagnosis, indication, and impact on patient management. • Surgical interventions for skin disorders in children are often performed for tumors and hamartomas with esthetic considerations playing a relevant role. If used for diagnostic purposes, they are often performed to confirm or rule out severe skin disease.
Authors: Flávia Regina Ferreira; Luiz Fernando Costa Nascimento; Denise Camargo Cirvidiu Journal: An Bras Dermatol Date: 2011 May-Jun Impact factor: 1.896
Authors: Marta Valdivielso-Ramos; Antonio Torrelo; Minia Campos; Marta Feito; Reyes Gamo; Jose Luis Rodriguez-Peralto Journal: Pediatr Dermatol Date: 2014 Nov-Dec Impact factor: 1.588
Authors: Suzanne N Leech; Hazel Bell; Niamh Leonard; Sue Lewis Jones; Deirdre Geurin; Philip H McKee; Clifford M Lawrence Journal: Arch Dermatol Date: 2004-01
Authors: Eoin R Storan; Marian T McEvoy; David A Wetter; Rokea A el-Azhary; Jennifer L Hand; Dawn M R Davis; Alina G Bridges; Michael J Camilleri; Mark D P Davis Journal: Pediatr Dermatol Date: 2013-02-14 Impact factor: 1.588