title: A novel therapeutic strategy for turban tumor: scalp excision and combined reconstruction with artificial dermis and split skin graft.
abstract: BACKGROUND
  Brooke-Spiegler syndrome is a hereditary tumor predisposition disorder characterized by the development of cylindromas, trichoepitheliomas, and spiradenomas. Predilection sites of the disease are hair follicles and sweat glands of the head and neck. In some patients, the tumors can coalesce to so-called turban tumors, which then usually cause cosmetic, psychological, and functional impairment. A curative therapy is not yet available, and thus total scalp excision followed by split skin graft is evolving as a frequently applied therapy. However, this treatment can lead to the formation of a thin and vulnerable skin, which hampers wearing a wig. Therefore, a more robust and functional solution is preferable. Here, we report on a woman with a turban tumor who suffered enormously from the disease and had secluded herself from social life.
  
  
  METHODS
  We treated her with a total scalp excision down to the periosteum, followed by sequential combined reconstruction with an artificial dermal template and split skin grafts.
  
  
  RESULTS
  The treatment resulted in formation of a robust and flexible skin.
  
  
  CONCLUSIONS
  Treatment of turban tumor is a challenge considering the localization and extensiveness of the tumor masses. This novel therapy for turban tumor leads to a very good cosmetic and functional outcome.
authors.affiliation: Department of Dermatology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
authors.forename: Lizelotte J M T
authors.initials: LJ
authors.lastname: Parren
authors.forename: Patrick
authors.initials: P
authors.lastname: Ferdinandus
authors.forename: René
authors.initials: R
authors.lastname: van der Hulst
authors.forename: Jorge
authors.initials: J
authors.lastname: Frank
authors.forename: Stefania
authors.initials: S
authors.lastname: Tuinder
mesh_terms: D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D009386:Neoplastic Syndromes, Hereditary / Q000601:surgery*; D012535:Scalp / Q000601:surgery*; D012878:Skin Neoplasms / Q000601:surgery*; D016038:Skin Transplantation; D017768:Skin, Artificial