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Abstract: Trichilemmal cyst is a benign tumor, developed from hair follicle, located mainly at the scalp. We report a clinical case of unusual location at the finger pulp confirmed by histology. The main differential diagnosis in this reported case was a whitlow. The origin of this cyst is probably the nail matrix whose keratinization is trichilemmal. Surgical excision biopsy allowed a good clinical outcome. [Copyright &y& Elsevier]

Introduction: Surgery for pharmacoresistant epilepsy is well accepted as an efficient treatment for children suffering the debilitating consequences of repetitive seizures. The goal of this study was to analyse seizure control and complications after epilepsy surgery in our center. Methods: Data were retrospectively reviewed from 73 patients aged from 5 months to 16years old who underwent epilepsy surgery at the Geneva University Hospital and Lausanne University Hospital between 1997 and 2011. Epilepsy surgery included temporal surgery (29 cases), extra-temporal surgery (32 cases) and hemispherotomies (12 cases). Three aged groups were identified: under 3years old (18 cases), between 4 and 12years old (35 cases) and between 13 and 17years old (20 cases). Mean follow-up was 27.25months (range 4–96months). Results: The overall seizure-free rate at the time of follow up was 65.7% (48 out of 73 cases). Interestingly in children under 3years old, the seizure free rate after surgery was 83.3% (15 out of 18 cases). Also, the seizure free outcome was significantly better for temporal epilepsy (79.3%) compared to extra-temporal epilepsy (56.2%) (p =0.028, < 0.05). At least 50.6% of patients (37 out of 73 cases) had a reduction in their post-operative antiepileptic medication. Complications included five transient hemiparesis, two wound infections, one cerebral oedema after hemispherotomy, one extradural hematoma, one subdural hematoma after insertion of subdural grids and one intraventricular hematoma after hemispherotomy. Conclusions: These data highlight the good outcome and significant seizure free rate of epilepsy surgery at a very young age (children under 3y/o). Efforts to promote epilepsy surgery in children are crucial since it significantly impacts on the cognitive development of these children. A better understanding of extra-temporal epilepsy is needed to help improving seizure free outcome in this large group of patients. [ABSTRACT FROM AUTHOR]