The patient had not developed any premalignant or malignant lesions within the treated area. Histopathological examination of a skin biopsy specimen obtained from the patient's lesional skin next to the area that underwent dermabrasion revealed hyperkeratosis, elongated rete ridges with basal hyperpigmentation, and pronounced dermal aggregations of thick, interwoven bands of elastic tissue. By contrast, the skin with signs of XP with dermabrasion showed a flattened epidermis, regular pigmentation, rarefaction of adnexal structures within the dermis, and only mild dermal fibrosis. Despite convincing improvement, the patient decided to postpone any further treatment with dermabrasion. In the present case, the rather mild involvement of the patient's skin at the age of 66 years, as well as the laboratory findings showing a normal excision repair, suggest a diagnosis of XP variant.
Surgical procedures aim at the removal of photodamaged skin that harbors multiple somatic mutations.
This goal can be achieved by excising and resurfacing the skin using grafts taken from sun-protected areas. Dermabrasion is a safe and effective procedure yielding a good cosmetic result if performed appropriately. After removal of the epidermis, regeneration arises from the deeper adnexal structures and mostly occurs without scarring. The regenerated epidermis originates from epithelial cells that were relatively protected from UV exposure. Moreover, dermabrasion may help to treat early skin tumors that are clinically difficult to identify.