Design: A retrospective cohort study

Setting: Two tertiary care centers between 2008-2022

Patients or Participants: All women operated due to suspected cutaneous endometriosis that was confirmed on histopathology between February 2008 to July 2022.

Interventions: Women's demographics, medical history, obstetrical and gynecological characteristics were collected from the women's electronic medical files. Data regarding presenting symptoms and duration, associated symptoms, imaging, size of the lesion, associated pelvic endometriosis or any pelvic pathology was collected from the pre-surgical clinical evaluation. Management, operation characteristics and histopathological diagnosis for confirmation was collected the operative and the pathological reports.

Measurements and Main Results: A total of 69 women met inclusion criteria. Median age was 36 (IQR30-40) years with median BMI of 29(IQR26-33) kg/m². 62 (90%) of the women did not have previous diagnosis of endometriosis. Most of the women seek intervention due to cyclic pain (n=63,91%). All patients except two presented with lesion suspected at a cesarean scar, among them 38% (n=26) were following one surgery. The median time from last Cesarean delivery was 72(IQR43-96) months. The median estimation of the lesion maximal diameter was comparable between ultrasound, CT and MRI examination. Sub-analysis by the number of previous cesarean deliveries reveled similar patient's and lesion's characteristics. Median follow up was 18(12-25) days post-surgery. Complete resolution of symptoms was reported in 50% of the women.

Conclusion: Cutaneous endometriosis should be suspected when characteristics symptoms are present even in the absence of previous diagnosis of endometriosis. Cesarean delivery is a known risk factor, and the number of previous surgeries was not found to be associated with difference in the lesion characteristics.