Clinicopathologic Features of Facial Dermatofibromas, a Cohort Study, and a Systematic Review of Literature
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作者:
Alsawas, Mouaz
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Univ Iowa Hosp & Clin, Dept Pathol, Iowa City, IA 52242 USA
Mayo Clin, Mayo Clin Evidence Based Practice Ctr, Rochester, MN USAUniv Iowa Hosp & Clin, Dept Pathol, Iowa City, IA 52242 USA
Alsawas, Mouaz
[1
,2
]
Dundar, Bilge
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Univ Iowa Hosp & Clin, Dept Pathol, Iowa City, IA 52242 USAUniv Iowa Hosp & Clin, Dept Pathol, Iowa City, IA 52242 USA
Dundar, Bilge
[1
]
Prokop, Larry
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Mayo Clin, Mayo Clin Lib, Rochester, MN USAUniv Iowa Hosp & Clin, Dept Pathol, Iowa City, IA 52242 USA
Prokop, Larry
[3
]
Murad, M. Hassan
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Mayo Clin, Mayo Clin Evidence Based Practice Ctr, Rochester, MN USAUniv Iowa Hosp & Clin, Dept Pathol, Iowa City, IA 52242 USA
Murad, M. Hassan
[2
]
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Swick, Brian
[1
,4
]
机构:
[1] Univ Iowa Hosp & Clin, Dept Pathol, Iowa City, IA 52242 USA
[2] Mayo Clin, Mayo Clin Evidence Based Practice Ctr, Rochester, MN USA
[3] Mayo Clin, Mayo Clin Lib, Rochester, MN USA
[4] Univ Iowa Hosp & Clin, Dept Dermatol, Iowa City, IA 52242 USA
Background: Dermatofibromas are common skin tumors that typically occur on the extremities and trunk and demonstrate benign behavior, frequent recurrences, and very rare metastasis. Facial dermatofibromas are rare and not well studied. We analyzed clinicopathologic features of facial dermatofibromas. Design: Considering the rarity of the condition, we conducted a cohort study and a systematic review. We queried medical records of a single tertiary care center for dermatofibromas from January 1, 2000, to July 1, 2021. A systematic review of multiple databases was conducted through October 27, 2021, to include studies reporting facial dermatofibromas. Random-effects meta-analysis was used to estimate pooled odds ratio and proportions with associated 95% confidence interval (CI). Results: The cohort study identified 2858 cases of dermatofibromas, of which, 23 cases from 18 patients were on the face (1%). The mean age was 52.7 +/- 17.8 years. Fifty-six percent of the cases were women. The most common location was the forehead (6 cases). The mean follow-up was 54 months. Forty-four percent of the cases had subcutaneous involvement, and 39% were the cellular type. Margins were positive in 89% of the cases, recurrence rate was 22%, and no metastases were observed. The systematic review included 10 studies (119 patients). Meta-analyses showed that facial dermatofibromas were 2% of all dermatofibromas (95% CI: 1%-3%). The local recurrence rate was 14% (95% CI: 6%-26%). Facial dermatofibromas with subcutaneous involvement were more likely to recur [odds ratio 4.53 (95% CI: 1.12-18.24)]. Before histopathologic examination, clinical differential diagnosis included dermatofibromas in only 9% of the cases (95% CI: 2%-19%). Conclusion: Facial dermatofibromas are rare and are difficult to fully excise. Cellular type and subcutaneous or muscular involvement are common in these cases and tend to have higher local recurrence rate than other nonfacial dermatofibromas. Wider excisions might be necessary for complete excision.
机构:
King Saud Univ, Coll Dent, Dept Oral & Maxillofacial Radiol Oral Med & Diagn, Riyadh, Saudi Arabia
Univ Alberta, Sch Dent, Dept Med & Dent, Edmonton, AB, CanadaKing Saud Univ, Coll Dent, Dept Oral & Maxillofacial Radiol Oral Med & Diagn, Riyadh, Saudi Arabia
Alsufyani, Noura
Aldosary, Reem
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Gen Dentist, Riyadh, Saudi ArabiaKing Saud Univ, Coll Dent, Dept Oral & Maxillofacial Radiol Oral Med & Diagn, Riyadh, Saudi Arabia
Aldosary, Reem
Alrasheed, Rasha
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King Saud Univ, Dent Univ Hosp, Coll Dent, Dept Oral Med & Pathol, Riyadh, Saudi ArabiaKing Saud Univ, Coll Dent, Dept Oral & Maxillofacial Radiol Oral Med & Diagn, Riyadh, Saudi Arabia
Alrasheed, Rasha
Alsufyani, Mohammed
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Prince Sultan Mil Med City, Dept Dermatol & Dermatol Surg, Riyadh, Saudi ArabiaKing Saud Univ, Coll Dent, Dept Oral & Maxillofacial Radiol Oral Med & Diagn, Riyadh, Saudi Arabia
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Univ Sao Paulo, Med Sch Ribeirao Preto, Dept Neurosci & Behav, Sao Paulo, Brazil
Coordinat Improvement Higher Level Personnel CAPS, Sao Paulo, BrazilUniv Sao Paulo, Med Sch Ribeirao Preto, Dept Neurosci & Behav, Sao Paulo, Brazil
Donadon, Mariana Fortunata
Osorio, Flavia de Lima
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Univ Sao Paulo, Med Sch Ribeirao Preto, Dept Neurosci & Behav, Sao Paulo, Brazil
Technol Inst Translat Med, Sao Paulo, Brazil
Agcy Sao Paulo Res Fdn, Sao Paulo, BrazilUniv Sao Paulo, Med Sch Ribeirao Preto, Dept Neurosci & Behav, Sao Paulo, Brazil
机构:
NYU Langone Hlth, Hansjorg Wyss Dept Plast Surg, 222 E 41st St,6th Floor, New York, NY 10017 USANYU Langone Hlth, Hansjorg Wyss Dept Plast Surg, 222 E 41st St,6th Floor, New York, NY 10017 USA
Wolfe, Erin M.
Najera-Sweeney, Guillermo
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NYU Langone Hlth, Hansjorg Wyss Dept Plast Surg, 222 E 41st St,6th Floor, New York, NY 10017 USANYU Langone Hlth, Hansjorg Wyss Dept Plast Surg, 222 E 41st St,6th Floor, New York, NY 10017 USA
Najera-Sweeney, Guillermo
Berman, Zoe P.
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NYU Langone Hlth, Hansjorg Wyss Dept Plast Surg, 222 E 41st St,6th Floor, New York, NY 10017 USANYU Langone Hlth, Hansjorg Wyss Dept Plast Surg, 222 E 41st St,6th Floor, New York, NY 10017 USA
Berman, Zoe P.
Alfonso, Allyson R.
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NYU Langone Hlth, Hansjorg Wyss Dept Plast Surg, 222 E 41st St,6th Floor, New York, NY 10017 USANYU Langone Hlth, Hansjorg Wyss Dept Plast Surg, 222 E 41st St,6th Floor, New York, NY 10017 USA
Alfonso, Allyson R.
Diep, Gustave K.
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NYU Langone Hlth, Hansjorg Wyss Dept Plast Surg, 222 E 41st St,6th Floor, New York, NY 10017 USANYU Langone Hlth, Hansjorg Wyss Dept Plast Surg, 222 E 41st St,6th Floor, New York, NY 10017 USA
Diep, Gustave K.
Ramly, Elie P.
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NYU Langone Hlth, Hansjorg Wyss Dept Plast Surg, 222 E 41st St,6th Floor, New York, NY 10017 USANYU Langone Hlth, Hansjorg Wyss Dept Plast Surg, 222 E 41st St,6th Floor, New York, NY 10017 USA
Ramly, Elie P.
Rodriguez, Eduardo D.
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NYU Langone Hlth, Hansjorg Wyss Dept Plast Surg, 222 E 41st St,6th Floor, New York, NY 10017 USANYU Langone Hlth, Hansjorg Wyss Dept Plast Surg, 222 E 41st St,6th Floor, New York, NY 10017 USA