Optimal Timing of Surgical Excision in Pediatric Pilomatricoma: Association between Clinicopathological Features and Cosmetic Outcomes

BACKGROUND: The treatment of choice for pilomatricomas is surgical excision; however, data for the optimal timing of treatment and cosmetic outcomes are limited.OBJECTIVE: This study aimed to investigate the optimal timing of treatment in pilomatricomas by considering clinicopathological findings and cosmetic outcomes.METHODS: Seventy-three pilomatricomas patients aged ≤15 years were retrospectively reviewed. Patients were classified into early excision (disease duration ≤12 months, group A) and delayed excision groups (disease duration >12 months, group B). Tumor characteristics, and histopathological features with evolutionary stages were assessed. Cosmetic outcomes were evaluated by the Modified Vancouver Scar Scale (MVSS), 5-point patient satisfaction score, and complication rates.RESULTS: Group A showed better cosmetic outcomes than group B in the MVSS (1.53±1.22 vs. 3.68±1.84), 5-point patient satisfaction score (4.08±0.89 vs. 3.18±1.01), and complication rates (11.8% vs. 36.4%), respectively (p<0.05). Secondary anetoderma, tent sign, calcification, and late regressive stage (evolutionary stage IV) were more common in group B, (p<0.05). Moreover, evolutionary stages showed a positive correlation with mean MVSS (r=0.670, p<0.05).CONCLUSION: Early excision (disease duration ≤12 months) provides superior cosmetic outcomes compared to delayed procedures. Early recognition, diagnosis, and management for pediatric pilomatricomas is important to improve overall cosmetic outcomes.

Caracterización clínica de pacientes con cirrosis hepática en el Hospital Militar Docente Dr. Mario Muñoz, de Matanzas / Clinical characterization of patients with liver cirrhosis in the Teaching Military Hospital Dr. Mario Muñoz, Matanzas

Introducción: la cirrosis hepática se caracteriza por una fase asintomática o compensada, seguida de una rápida progresión por el desarrollo de complicaciones o descompensada, lo que determina diferentes estadios evolutivos. Objetivo: caracterizar los pacientes cirróticos atendidos en el Servicio de Gastroenterología del Hospital Militar Docente Dr. Mario Muñoz Monroy, en el período comprendido entre enero de 2009 a diciembre de 2010. Métodos: se realizó un estudio descriptivo transversal. Se tuvieron en cuenta variables clínicas necesarias para clasificar los pacientes según las etapas contempladas en el consenso de Baveno IV. Se aplicaron procedimientos de la estadística descriptiva. Resultados: se estudiaron 41 pacientes, con predominio de masculinos (82,9 %), con edad promedio de 51,9 ± 9,2 años. La astenia fue el principal motivo de consulta en la fase compensada; los pacientes presentaron una enfermedad compensada en su gran mayoría, de acuerdo al estadio clínico de la enfermedad según criterios de Baveno IV Consenso Metodológico sobre Diagnóstico y Tratamiento de la Hipertensión Portal (56,1 %). Conclusiones: con la aplicación de los criterios del consenso de Baveno IV se logra la adecuada clasificación clínica del paciente cirrótico que permite una terapéutica oportuna en beneficio de estos.

Introduction: liver cirrhosis is characterized by an asymptomatic or compensated stage, followed by a fast progression for the development of complications or decompensated stage, determining different evolutionary stages. Objective: characterizing cirrhotic patients attended at the Gastroenterology Service of the Teaching Military Hospital Dr. Mario Muñoz Monroy, in the period from January 2009 to December 2010. Methods: We carried out a crossed descriptive study, taking into account clinical variables necessary to classify the patients according to the stages contemplated at Baveno IV Consensus. The procedures of the descriptive statistics were applied. Results: 41 patients were studied, with a predomination of the male ones (82,9 %), average age 51,9 ± 9,2 years. Asthenia was the main reason of the consultation in the compensated stage. Most of the patients presented the compensated disease taking into account the clinical stage of the disease according to Baveno VI Methodological Consensus on Diagnostic and Treatment of the Portal Hypertension (56,1 %). Conclusions: with the application of the Baveno IV consensus criteria we arrived to the adequate clinical classification of the cirrhotic patients allowing an opportune therapeutic on behalf of them.