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Villegas-Romero, C. Collantes-Rodríguez, S. Valenzuela-Ubiña, D. Jiménez-Gallo" "autores" => array:4 [ 0 => array:4 [ "nombre" => "I." "apellidos" => "Villegas-Romero" "email" => array:1 [ 0 => "imvr91@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Collantes-Rodríguez" ] 2 => array:2 [ "nombre" => "S." "apellidos" => "Valenzuela-Ubiña" ] 3 => array:2 [ "nombre" => "D." "apellidos" => "Jiménez-Gallo" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Unidad de Gestión Clínica de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Puerta del Mar, Cádiz, España" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondencia." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Moderate to Severe Hidradenitis Suppurativa Successfully Treated With Secukinumab" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1024 "Ancho" => 1304 "Tamanyo" => 158645 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A y B. Axilas izquierda y derecha con nódulos y fístulas supurativas previas al inicio del tratamiento. C yD. Axilas izquierda y derecha con lesiones residuales tras 4 meses con secukinumab 300<span class="elsevierStyleHsp" style=""></span>mg.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">La hidradenitis supurativa (HS) es una enfermedad inflamatoria crónica y recurrente del infundíbulo folicular que afecta principalmente a las áreas intertriginosas. La prevalencia estimada es del 1%. Los linfocitos T-helper (Th)-17 y los neutrófilos son la fuente principal de las citocinas proinflamatorias implicadas en la patogénesis de la HS<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">1</span></a>.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Describimos a continuación nuestra experiencia con 3 pacientes con una HS de moderada a grave tratados con secukinumab 300<span class="elsevierStyleHsp" style=""></span>mg subcutáneo según la pauta de inducción y mantenimiento indicada en la psoriasis. Todos los pacientes firmaron el consentimiento informado de uso fuera de indicación. Los pacientes fueron evaluados antes y después del tratamiento utilizando las escalas de gravedad clínica de Hurley, <span class="elsevierStyleItalic">International Hidradenitis Suppurativa Severity Scores System</span>, <span class="elsevierStyleItalic">Modified Hidradenitis Suppurativa Score</span> (mHSS). Como parámetro de inflamación sistémica se evaluaron los niveles séricos de proteína C reactiva antes y después del tratamiento. Evaluamos el cumplimiento del objetivo terapéutico <span class="elsevierStyleItalic">Hidradenitis Suppurativa Clinical Response</span> (HiSCR). Además, realizamos una valoración de la calidad de vida con el <span class="elsevierStyleItalic">Dermatology Life Quality Index</span> (DLQI). También se recogieron datos de tratamientos previos, concomitantes, tiempo de respuesta y tiempo de tratamiento con el secukinumab. Todos estos datos los recogemos en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> y aportamos iconografía de una de las pacientes en la <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Los 3 pacientes presentaron un grado <span class="elsevierStyleSmallCaps">iii</span> en la escala de Hurley, un DLQI de 10, 28 y 32, un <span class="elsevierStyleItalic">International Hidradenitis Suppurativa Severity Scores System</span> de 12, 13 y 15, y un mHSS de 48, 56 y 59, previos al inicio del tratamiento (<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>). El tiempo de respuesta fue de 4, 8 y 12 semanas. Todos los pacientes alcanzaron una reducción del 53% del DLQI, del 85% del IHS, del 94,7% del mHSS y todos mostraron mejoría en la escala de Hurley (<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>). Los niveles de proteína C reactiva descendieron más del 70% en todos los casos (74%, 81% y 85%). Todos cumplieron el objetivo terapéutico HiSCR. Durante el tratamiento no se observaron efectos adversos.</p><p id="par0020" class="elsevierStylePara elsevierViewall">La HS es una enfermedad inflamatoria sistémica en cuya patogénesis participan principalmente linfocitos Th-17 y neutrófilos<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">2</span></a>. La IL-23, producida por las células dendríticas, favorece la diferenciación hacia linfocito Th-17. El linfocito Th-17 promueve el reclutamiento de neutrófilos implicados en la respuesta inflamatoria de la HS<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">2</span></a>. El secukinumab es un anticuerpo monoclonal humano que inhibe tanto la IL-17A como la interacción de las citoquinas con los receptores IL-17. La IL-17 regula la expresión de los péptidos antimicrobianos, y se encuentra sobreexpresada tanto en las lesiones de HS como en la piel de la HS perilesional, lo cual podría justificar la eficacia de fármacos anti-IL-17 en HS<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">2</span></a>.</p><p id="par0025" class="elsevierStylePara elsevierViewall">El tratamiento de la HS constituye un desafío para el dermatólogo e incluye un abordaje médico y quirúrgico. El tratamiento médico se basa en esquemas escalonados de antibióticos, retinoides y biológicos<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">3</span></a>. Actualmente el adalimumab es el único fármaco biológico aprobado tanto por la <span class="elsevierStyleItalic">Food and Drug Administration</span> como por la <span class="elsevierStyleItalic">European Medicines Agency</span><a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">1,3</span></a>. Sin embargo, en los últimos años se han publicado trabajos sobre la eficacia del secukinumab en HS de moderada a grave<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">4–9</span></a>.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Hasta el momento el secukinumab ha demostrado su efectividad en 5 informes de casos<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">4–8</span></a> y solo en un ensayo abierto con 9 pacientes<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a>, entre los cuales no ha sido posible establecer relaciones comparables debido a la falta de unanimidad en el uso de escalas de severidad.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Presentamos nuestra experiencia en 3 pacientes con HS de moderada a grave tratados con el secukinumab fuera de indicación. Los 3 pacientes cumplieron el objetivo HiSCR y no objetivamos efectos adversos durante el tratamiento. Nuestros resultados, sumados a los casos publicados en la literatura, apoyan la necesidad de ensayos aleatorios fase <span class="elsevierStyleSmallCaps">iii</span> para evaluar la eficacia y seguridad de secukinumab en HS.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicto de intereses</span><p id="par0040" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ningún conflicto de intereses.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicto de intereses" ] 1 => array:1 [ "titulo" => "Bibliografía" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1024 "Ancho" => 1304 "Tamanyo" => 158645 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A y B. Axilas izquierda y derecha con nódulos y fístulas supurativas previas al inicio del tratamiento. C yD. Axilas izquierda y derecha con lesiones residuales tras 4 meses con secukinumab 300<span class="elsevierStyleHsp" style=""></span>mg.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Tabla 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Tabla " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">DLQI: <span class="elsevierStyleItalic">Dermatology Life Quality Index</span>; F: femenino; HiSCR: <span class="elsevierStyleItalic">Hidradenitis Suppurativa Clinical Response</span>; IHS4: <span class="elsevierStyleItalic">International Hidradenitis Suppurativa Severity Scores System</span>; M: masculino; mHSS: <span class="elsevierStyleItalic">Modified Hidradenitis Suppurativa Score</span>; PCR: proteína C reactiva.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Casos \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Edad y sexo \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Tratamiento previo \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Tratamiento concomitante \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Tiempo de respuesta \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Tiempo de tratamiento \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Hurley previo \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Hurley posterior \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">DLQIprevio \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">DLQIposterior \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">IHS4 previo \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">IHS4posterior \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">mHSSprevio \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">mHSSposterior \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">HiSCR \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PCR previo \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PCRposterior \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Paciente 1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">46, F \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Antibióticos orales,isotretinoína, acitretina, glucocorticoides, sulfasalazina,metotrexato, infliximab, anakinra, adalimumab. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Triamcinolona intralesional \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 semanas \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 meses \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">III \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">59 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sí \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Paciente 2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21, F \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Antibióticos orales, nicotinamida, adalimumab \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dapsona 100<span class="elsevierStyleHsp" style=""></span>mg/día \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 semanas \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 meses \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">III \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">56 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sí \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Paciente 3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">45, M \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Antibióticos orales, acitretina, adalimumab, infliximab \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cirugía de pliegue abdominal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 semanas \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 meses \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">III \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">II \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">48 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sí \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2391709.png" ] ] ] ] "descripcion" => array:1 [ "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Características clínicas y escalas de valoración de los 3 casos</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0050" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Increased interleukin (IL)-17 serum levels in patients with hidradenitis suppurativa: Implications for treatment with anti-IL-17 agents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Ł. Matusiak" 1 => "J. Szczęch" 2 => "A. Bieniek" 3 => "D. Nowicka-Suszko" 4 => "J.C. Szepietowski" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2016.10.042" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2017" "volumen" => "76" "paginaInicial" => "670" "paginaFinal" => "675" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28041632" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0055" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Association of hidradenitis suppurativa with T helper 1/T helper 17 phenotypes: A semantic map analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Thomi" 1 => "S. Cazzaniga" 2 => "S.M. Seyed Jafari" 3 => "C. Schlapbach" 4 => "R.E. 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Year/Month | Html | Total | |
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2024 November | 25 | 11 | 36 |
2024 October | 151 | 42 | 193 |
2024 September | 123 | 32 | 155 |
2024 August | 162 | 65 | 227 |
2024 July | 225 | 37 | 262 |
2024 June | 214 | 53 | 267 |
2024 May | 187 | 37 | 224 |
2024 April | 238 | 43 | 281 |
2024 March | 230 | 38 | 268 |
2024 February | 298 | 48 | 346 |
2024 January | 290 | 28 | 318 |
2023 December | 311 | 29 | 340 |
2023 November | 353 | 52 | 405 |
2023 October | 366 | 45 | 411 |
2023 September | 342 | 51 | 393 |
2023 August | 257 | 33 | 290 |
2023 July | 313 | 46 | 359 |
2023 June | 275 | 34 | 309 |
2023 May | 322 | 40 | 362 |
2023 April | 285 | 25 | 310 |
2023 March | 257 | 40 | 297 |
2023 February | 286 | 41 | 327 |
2023 January | 277 | 38 | 315 |
2022 December | 176 | 39 | 215 |
2022 November | 254 | 52 | 306 |
2022 October | 263 | 43 | 306 |
2022 September | 302 | 56 | 358 |
2022 August | 215 | 60 | 275 |
2022 July | 246 | 61 | 307 |
2022 June | 245 | 42 | 287 |
2022 May | 267 | 57 | 324 |
2022 April | 241 | 34 | 275 |
2022 March | 250 | 54 | 304 |
2022 February | 223 | 41 | 264 |
2022 January | 292 | 61 | 353 |
2021 December | 205 | 47 | 252 |
2021 November | 199 | 48 | 247 |
2021 October | 273 | 67 | 340 |
2021 September | 183 | 49 | 232 |
2021 August | 201 | 34 | 235 |
2021 July | 226 | 30 | 256 |
2021 June | 152 | 29 | 181 |
2021 May | 162 | 57 | 219 |
2021 April | 253 | 78 | 331 |
2021 March | 96 | 48 | 144 |
2021 February | 80 | 29 | 109 |
2021 January | 61 | 34 | 95 |
2020 December | 76 | 29 | 105 |
2020 November | 174 | 56 | 230 |
2020 October | 130 | 74 | 204 |
2020 September | 38 | 30 | 68 |
2020 August | 51 | 50 | 101 |
2020 July | 41 | 49 | 90 |
2020 June | 29 | 51 | 80 |