Surgical management and oncological follow‐up of cutaneous squamous cell carcinomas arising in epidermolysis bullosa patients

Abstract

Background Hereditary epidermolysis bullosa (EB) is a rare genodermatosis characterized by skin fragility and blistering of the skin and mucous membranes in reaction to minimal traumas. The development of cutaneous squamous cell carcinomas (cSCCs) is one of the most common medical complications in junctional and dystrophic forms of the disease.Complete surgical excision of cutaneous tumors represents the gold standard of treatment.However, not only recognition of cSCCs can be challenging in the affected skin but also wound closure after surgical excision poses a great therapeutic challenge in EB patients.The aim of our study was to analyze the postoperative outcomes of such patients in order to have a better knowledge of the main critical issues in their surgical management and oncological follow-up.Methods We retrospectively identified a cohort of five EB patients treated at Modena University Hospital. Collected data included patient age and sex, date of cSCC diagnosis, relapses/recurrences, site of the neoplasm, number of surgical interventions, use of dermal substitutes, and postoperative infections.Results A total of 26 cSCCs were detected in our cohort. Forty-one surgical interventions were necessary to achieve excision of cSCCs with clear margins, varying from 1 to 4 surgical sessions per cSCC. Dermal substitutes were used in most cases but carried a higher infectious risk.Conclusions EB patients tend to develop numerous cSCCs that often relapse even after complete excision with clear margins. These results stress the importance of early cSCC diagnosis and strict postsurgical follow-up. Materials and methodsA monocentric, retrospective analysis was performed on EB patients treated at the Dermatological Clinic of the Modena University Hospital. We included patients affected by EB with histologically diagnosed cSCCs and treated with surgical excision at our clinic, from inception to the present.We collected the following clinical data for each subject: age and sex, date of cSCC diagnoses, number of cSCCs, relapses, site of the neoplasm, number of surgical interventions needed

Wound Healing after Acellular Dermal Substitute Positioning in Dermato-Oncological Surgery: A Prospective Comparative Study

“…Two collagenic ADMs, Matriderm (MedSkin Solution Dr. Suwelack AG, Billerbeck, Germany) and Integra (Integra LifeSciences, Plainsboro, NJ, USA) are currently commonly used in dermato-oncological reconstructive surgery, and represent the two available options in our center [ 25 , 26 ].…”