Non-melanocytic benign skin tumors in children

Background: Dermatologists often attend children with benign skin tumors and cysts. The decision to perform dermatologic surgery in children may be difficult to make, especially in cases of benign tumors. Objective: The objective of this study was to determine the nature of non-melanocytic benign skin tumors amenable to dermatologic surgery in children. Methods: Histopathologic studies of skin tumors in children treated by our department between January 2004 and December 2005 were studied. Malignant and melanocytic tumors were excluded. Age, sex, type of tumor, diagnostic category, site, size, reason for removal, type of anesthesia, and any other associated disorders were recorded. Results: The records revealed that 121 patients presented 129 non-melanocytic benign skin tumors (73 in boys and 56 in girls). A total of 27 different anatomopathologic diagnoses were found. The most frequent was pilomatrixoma with 27 cases (20.9%), followed by infundibular cyst with 14 (10.9%), and molluscum contagiosum with 13 (10.1%). Tumors were located on the head and neck (45.7%), trunk (34.1%), and limbs (20.1%). The most frequently affected age group was children aged 11-14 years, which included 50 patients (38.8%). The main type of anesthesia used was local in 54.6% of the cases, sedation plus local anesthesia in 39.7%, and general anesthesia in 5.7%. The reasons that led to removal of the tumors were: increase in the size of the tumor (49%); various types of discomfort, such as severe itching or pain (30%); parental concern (4%); diagnostic uncertainty (16%); and esthetic reasons (1%). Conclusion: There is a wide diversity of non-melanocytic benign skin tumors in children, some of which require surgical treatment. Pilomatrixomas appear to be the most frequent benign tumors; there are also high frequencies of infundibular cysts, pyogenic granulomas, and viral tumors. Most can be removed under local anesthesia, with or without sedation.