Self-Healing Juvenile Cutaneous Mucinosis: A Report of Two Cases With Differing Evolution.

ABSTRACT: Self-healing juvenile cutaneous mucinosis is a rare entity, characterized by the presence of subcutaneous nodules together with frequent nonspecific systemic symptoms, which occurs in the pediatric age and characteristically resolves spontaneously. Although the diagnostic criteria do not require a biopsy to be performed, it is frequently performed, and an abundant dermal mucin deposition will be observed together with other features such as fibroblastic proliferation. Although the prognosis is benign, follow-up is required for the eventual development of a rheumatologic disease.We present 2 clinical cases, describing the clinical findings and their histopathologic correlation. Comparatively, the outcome in both cases was different: in one case, the mucinosis resolved without any related event in the follow-up, and in the other case, the resolution was accompanied by the subsequent development of idiopathic juvenile arthritis.

Sentinel node biopsy for melanoma. Analysis of our experience (125 patients).

INTRODUCTION: The objective of this study is to analyze our experience in the use of sentinel node biopsy (SNB) in melanoma and identify the predictive factors of positive SNB and multiple drainage. MATERIAL AND METHODS: Retrospective study of patients who underwent SNB for melanoma between August of 2000 and February of 2013. RESULTS: SNB was performed in 125 patients with a median of age of 55,6 (±15) years. The anatomic distribution was: 44 (35,2%) in legs, 24 (19,2%) in arms, 53 (42,4%) trunk and 3 (2,4%) in head and neck. The median Breslow index was 1,81 (0,45-5). Between 1 and 6 nodes were isolated. The drainage was unique in 98 (78,4%) and multiple in 27 (21,6%). The trunk was the localization of 25 (92,6%) nodes with multiple drainage. The definitive result of sentinel node (SN) was positive in 18 cases (7,1%). Breslow thickness (p=0,01) was statistically significant predictor of a positive SNB. CONCLUSIONS: The SNB allows patients to be selected for lymphadenectomy. Melanoma of the trunk was the principle location of multiple drainage. The only predictive factor of positive SNB was Breslow thickness.

Reconstrucción de gran defecto de pared abdominal: utilizando el colgajo VRAM en forma bilateral / Reconstruction of extensive compromise of abdominal wal: using bilateral VRAP flap

Presentamos el caso de extenso defecto con compromiso total de pared abdominal lateral, de 27 cm² x 25 cm², resultado de la resección de fibrohistiocitoma maligno, cuya reconstrucción fue realizada en forma inmediata, utilizando el epiplón mayor para el aislamiento del contenido abdominal, sobre el cual fue colocada y fijada una malla de polipropilero Prolite R, y finalmente se procedió al cierre completo del defecto utilizando el colgajo tipo músculo cutáneo vertical de recto abdominal bilateralmente.

We present a case of an extensive compromise lateral and total abdominal wall defect of 25 cm² x 27cm² result thickness, after resection of a malignant fibrohystiocytoma. The reconstruction was done immediately utilizing the greater omemtum to isolate the abdominal content, with a polypropilene Prolite R mesh placed and it is fixed on top, and finally we procedure to complete closure of the extends defect, it was achieved by using a bilateral vertical rectus abdominis musculocutaneous flap.

La ecosonografía como método auxiliar en el diagnóstico de la piomiositis / Ecosonography as an auxiliary method in the diagnosis of piomyositis

El presente trabajo es un estudio prospectivo realizado en el servicio de infectología del Hospital de Niños J.M. de los Ríos entre agosto y noviembre 89. Se incluyeron 11 pacientes, 8 varones y 3 hembras con edad promedio de 4.8 años en los cuales se planteó dudas en el diagnóstico de piomiositis al momento del ingreso; a todos estos pacientes se les realizó estudio ecosonográfico con equipo de alta resolución con técnica de tiempo real y al mismo tiempo se les hizo punción diagnóstica orientada por ecosonografía. Los resultados encontrados fueron: 1) El diagnóstico de piomiositis planteado al ingreso en un 45 por ciento de los casos se elevó a un 73 por ciento posterior a la realización del ecosonograma; 2)Obtuvimos positividad en 80 por ciento de las punciones realizadas a nivel de partes blandas dirigidas por eco; en las piomiositis este valor fue de 75 por ciento; 3) El estafilococo aureus meticilino sensible representó el 62,5 por ciento en las piomisitis, siguiendo luego el Estreptococo piógenesis en un 12 por ciento del total de las punciones en esta entidad. Nosotros recomendamos el ecosonograma como método diagnóstico etiológico, ya que mejora el porcentaje de positividad de la punción