Treatment of Multiple Dermal Cylindromas with the Carbon Dioxide Laser

Abstract

The management of multiple cylindromas presents a therapeutic challenge to the clinician. The condition has significant cosmetic implications, and malignant degeneration can occur. Reported treatments include excision and repair of individual lesions, high-dose radiation, and complete scalp removal with grafting. We review the proposed histogenesis of this tumor, discuss its associations, and report the first use of the carbon dioxide laser as a successful treatment.

Comparing Ablative Fractionated Resurfacing, Photodynamic Therapy, and Topical Imiquimod in the Treatment of Trichoblastomas of Brooke-Spiegler Syndrome: A Case Study

“…Although local excision has commonly been employed in the treatment of solitary adnexal tumors of the face, head, and neck, alternative treatments, including electrosurgery, cryosurgery, and ablation with neodymium‐doped YAG and carbon dioxide (CO 2 ) laser therapy have also been described 7–11 . Rallan and Harland reported the treatment of multiple facial trichoepitheliomata, tumors with similar histologic characteristics to trichblastomas, using a combination of Er:YAG and CO 2 laser ablation 12 .…”

“…Although local excision has commonly been employed in the treatment of solitary adnexal tumors of the face, head, and neck, alternative treatments, including electrosurgery, cryosurgery, and ablation with neodymium-doped YAG and carbon dioxide (CO 2 ) laser therapy have also been described. [7][8][9][10][11] Rallan and Harland reported the treatment of multiple facial trichoepitheliomata, tumors with similar histologic characteristics to trichblastomas, using a combination of Er:YAG and CO 2 laser ablation. 12 To our knowledge, this is the first documented case of the use of Er:YAG laser ablation and PDT to treat trichoblastomas and the first comparative study of Er:YAG resurfacing, imiquimod, and PDT in the treatment of these neoplasms.…”

Cylindroma Treated by Mohs Micrographic Surgery

“…Besides surgical excision, other treatment modalities for cylindroma reported in the literature include radiation therapy, 14 electrocautery, 15 cryosurgery, 15 dermabrasion, 16 and carbon dioxide laser surgery 17 . Unfortunately, cylindromas are not very radiosensitive and only marginal results are afforded with large doses of radiation.…”

Angiofibromas in Tuberous Sclerosis: Comparison of Treatment by Carbon Dioxide and Argon Laser

“…It destroys tissue in a controlled manner when the emission is absorbed by water‐containing tissue. It can be utilized for vaporization of tissue 17–18 . In theory, the CO 2 laser is more efficient than the argon laser in multiple angiofibromas (adenoma sebaceum), as it can vaporize large quantities of tissue while sealing small blood vessels of angiofibromas of up to 0.5 mm.…”