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Sin embargo&#44; existe escasa informaci&#243;n acerca de los signos post-tratamiento inmediatos&#44; o la detecci&#243;n y manejo de las recidivas&#46; Nuestro objetivo es describir a nuestros pacientes tratados con imiquimod para LM&#44; con respecto a las modalidades de tratamiento&#44; los resultados cl&#237;nicos&#44; las recidivas y los efectos adversos asociados&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Pacientes y m&#233;todos</span><p id="par0015" class="elsevierStylePara elsevierViewall">Incluimos a todos los pacientes de 2006 a 2019 de la Unidad de Melanoma de nuestro hospital con confirmaci&#243;n histol&#243;gica de LM o LMM&#44; tratados con imiquimod 5&#37;&#44; en solitario o como adyuvante&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">A todos los pacientes se les hab&#237;a prescrito imiquimod t&#243;pico&#44; una vez al d&#237;a&#44; aplicado sobre la lesi&#243;n y 1 cm alrededor de la misma&#44; y 1 cm alrededor de la cicatriz en lesiones resecadas&#46; La duraci&#243;n del tratamiento vari&#243; de cinco a 11 semanas&#44; hasta lograr al menos el nivel deseado de inflamaci&#243;n &#40;eritema con erosiones y costras&#41; y&#44; de no lograrse&#44; se a&#241;adi&#243; tazaroteno gel al 0&#44;05&#37; para incrementarla&#46; Un dermat&#243;logo &#40;JB&#41; realiz&#243; el seguimiento de los pacientes cada dos semanas durante el periodo de tratamiento&#44; y posteriormente cada seis meses&#46; En cada visita&#44; se someti&#243; a los pacientes a una estrecha exploraci&#243;n cl&#237;nica&#44; controles fotogr&#225;ficos y dermatoscopia digital&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Las variables recopiladas fueron los datos cl&#237;nicos &#40;sexo&#44; edad&#44; localizaci&#243;n&#41;&#44; estatus quir&#250;rgico&#44; r&#233;gimen de imiquimod&#44; reacci&#243;n inflamatoria&#44; duraci&#243;n del seguimiento&#44; y reaparici&#243;n de la pigmentaci&#243;n &#40;recidiva o hiperpigmentaci&#243;n postinflamatoria&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">En todos los casos informamos a los pacientes que la prescripci&#243;n de imiquimod era fuera de indicaci&#243;n&#44; as&#237; como de los diferentes tratamientos alternativos disponibles&#46; Se obtuvo consentimiento informado de todos los pacientes&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Resultados</span><p id="par0035" class="elsevierStylePara elsevierViewall">Incluimos 14 casos en nuestro estudio&#46; La <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> presenta las caracter&#237;sticas de la muestra&#46; Once pacientes &#40;78&#44;6&#37;&#41; eran mujeres&#46; La edad media al inicio de la enfermedad fue de 69&#44;5 a&#241;os&#46; Las lesiones aparecieron con m&#225;s frecuencia en la nariz &#40;35&#44;7&#37;&#41; y mejillas &#40;28&#44;6&#37;&#41;&#46; Doce participantes &#40;85&#44;7&#37;&#41; ten&#237;an diagn&#243;stico histol&#243;gico de LM y dos de LMM &#40;14&#44;3&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Ocho pacientes &#40;57&#44;1&#37;&#41; recibieron imiquimod sin cirug&#237;a&#46; De ellos&#44; tres &#40;37&#44;5&#37;&#41; requirieron tazaroteno gel al 0&#44;05&#37;&#46; Seis pacientes &#40;42&#44;9&#37;&#44; 4 LM y 2 LMM&#41; fueron sometidos a resecci&#243;n de margen estrecho &#40;incluyendo el componente infiltrativo de LMM&#41; y seguidamente recibieron tratamiento con imiquimod&#46; Un paciente recibi&#243; tazaroteno&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Imiquimod fue aplicado durante una media de siete semanas&#46; Un efecto adverso frecuente fue la aparici&#243;n de eritema intenso con costras &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>A-D&#41;&#46; Cuatro pacientes &#40;28&#44;6&#37;&#41; tuvieron conjuntivitis no infecciosa y un caso present&#243; un ectropi&#243;n transitorio debido a la inflamaci&#243;n&#46; Los l&#233;ntigos solares desaparecieron en las zonas de piel tratada&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">El seguimiento post-tratamiento medio fue de 66&#44;4 meses&#46; Se observaron cuatro casos de hiperpigmentaci&#243;n postinflamatoria &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>E-G&#41;&#44; que se resolvieron espont&#225;neamente en pocas semanas&#46; Adem&#225;s&#44; detectamos dos recidivas histol&#243;gicamente confirmadas&#44; ambas en pacientes con r&#233;gimen de monoterapia de imiquimod&#46; El tiempo medio hasta la recidiva fue de 10 meses&#46; Las recidivas &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>H-I&#41; fueron manejadas exitosamente con un margen de extirpaci&#243;n de un mil&#237;metro&#44; y retratamiento con imiquimod durante siete semanas&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Discusi&#243;n</span><p id="par0055" class="elsevierStylePara elsevierViewall">Actualmente imiquimod no ha sido aprobado para el tratamiento de LM&#44; aunque ha sido descrito como tratamiento fuera de indicaci&#243;n para lesiones incompletamente extirpadas<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;3</span></a>&#46; Imiquimod no es una monoterapia recomendada en los casos de LMM debido al riesgo de met&#225;stasis<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a>&#44; pero es una opci&#243;n tras la extirpaci&#243;n del componente infiltrativo&#46; En nuestros pacientes&#44; imiquimod mostr&#243; alta eficacia en las diversas modalidades de tratamiento&#44; siendo escasas las recidivas observadas &#40;2&#47;14 pacientes&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Nuestros resultados son consistentes con los datos reportados sobre la eficacia de imiquimod para LM&#46; Dos revisiones sistem&#225;ticas sobre imiquimod como monoterapia&#44; describieron una tasa de respuesta cl&#237;nica del 78&#37;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">8&#44;10</span></a>&#46; Una revisi&#243;n sistem&#225;tica de tratamientos no quir&#250;rgicos para LM report&#243; tasas de recidiva del 11&#44;5&#37; para radioterapia&#44; el 24&#44;5&#37; para imiquimod&#44; y el 34&#44;4&#37; para la terapia de l&#225;ser<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a>&#46; Un estudio con imiquimod en solitario o como tratamiento adyuvante report&#243; una tasa de respuesta cl&#237;nica del 72&#44;7 y el 94&#44;4&#37;&#44; respectivamente<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Creemos que imiquimod podr&#237;a ser &#250;til en pacientes con LM que rechazan una cirug&#237;a completa&#44; debido a la no aceptaci&#243;n de sus resultados cosm&#233;ticos&#44; o aquellos pacientes con comorbilidades&#46; Nosotros proponemos la resecci&#243;n de la lesi&#243;n dermatosc&#243;picamente visible sin m&#225;rgenes&#46; Si dicha zona fuera demasiado grande&#44; extirpamos la zona m&#225;s oscura &#250;nicamente&#46; Por &#250;ltimo&#44; prescribimos imiquimod 5&#37;&#46; De otro modo&#44; en los pacientes que rechazan cualquier cirug&#237;a&#44; utilizamos imiquimod como monoterapia&#46; El r&#233;gimen del tratamiento con imiquimod var&#237;a de dos a 84 semanas&#44; seg&#250;n los estudios reportados en la literatura<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">5&#44;8&#44;10</span></a>&#46; Nuestro objetivo inicial fue lograr una reacci&#243;n inflamatoria intensa&#44; realizando seguidamente tratamiento continuo durante diversas semanas&#44; con una duraci&#243;n total de seis a ocho semanas&#46; Se a&#241;adi&#243; tazaroteno t&#243;pico al 0&#44;05&#37; cuando la reacci&#243;n inflamatoria inicial fue insuficiente&#46; El seguimiento quincenal con eliminaci&#243;n de las costras durante el tratamiento mejor&#243; la absorci&#243;n de imiquimod&#44; tranquiliz&#243; al paciente y mejor&#243; el cumplimiento del tratamiento&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">El seguimiento dermatosc&#243;pico estrecho es esencial para detectar tempranamente las recidivas&#46; Una pigmentaci&#243;n pardusca sugiere recidiva cuando aparece durante los primeros dos a&#241;os de tratamiento&#44; aunque a mayor plazo podr&#237;a ser indicativa de nuevos lentigos solares en la zona&#46; En nuestros pacientes&#44; otro hallazgo dermatosc&#243;pico orientativo de recidiva fue la distribuci&#243;n perifolicular de la pigmentaci&#243;n&#46; Un color de fondo azul-gris&#225;ceo es indicativo de hiperpigmentaci&#243;n postinflamatoria transitoria&#44; que se produce transcurridas unas pocas semanas de tratamiento&#44; y guarda relaci&#243;n histol&#243;gica con melanofagia&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">La microscop&#237;a confocal de reflectancia &#40;MCR&#41; es una buena alternativa a los estudios histol&#243;gicos para monotorizar la lesi&#243;n&#46; Nosotros creemos que el seguimiento estrecho con fotograf&#237;a cl&#237;nica y dermatosc&#243;pica digital puede constituir un sustituto v&#225;lido de la MCR&#44; cuando no se dispone de esta&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">El manejo de la recidiva de LM con imiquimod es controvertido&#46; Nuestra serie incluy&#243; dos casos de recidiva local re-tratados conservadoramente con margen estrecho de resecci&#243;n e imiquimod&#44; con buenos resultados&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Las limitaciones principales del estudio incluyen la ausencia de grupo control&#44; el peque&#241;o n&#250;mero de pacientes&#44; y la heterogeneidad de las modalidades de tratamiento&#46; Ello restringe la generalizaci&#243;n de nuestros resultados&#44; aunque la pr&#225;ctica cl&#237;nica real es as&#237;&#46; Los puntos fuertes de nuestro estudio residen en el hecho de que el seguimiento de los pacientes fue realizado durante un periodo extenso &#40;de tres a 12 a&#241;os&#41; por el mismo dermat&#243;logo&#44; y la existencia de controles fotogr&#225;ficos cada seis meses para monitorizaci&#243;n&#46; Ello permiti&#243; la r&#225;pida detecci&#243;n de las recidivas y la documentaci&#243;n de los cambios post-inflamatorios tempranos y transitorios&#46; Nuestros datos tambi&#233;n contribuyen a la evidencia cient&#237;fica sobre las diferentes modalidades&#44; en ausencia de ensayos cl&#237;nicos aleatorizados prospectivos&#46; De igual modo&#44; permite que los cl&#237;nicos consideren diversas opciones&#44; cuando no pueden practicarse resecciones adecuadas&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conflicto de intereses</span><p id="par0090" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Imiquimod t&#243;pico ha sido utilizado como monoterapia o tratamiento adyuvante fuera de indicaci&#243;n para el lentigo maligno &#40;LM&#41;&#46; Nuestro objetivo es describir las modalidades de tratamiento&#44; los resultados cl&#237;nicos y el manejo de la recidiva en los pacientes que reciben imiquimod para lentigo maligno&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se incluy&#243; en este estudio a los pacientes de nuestra unidad con lentigo maligno o lentigo maligno melanoma tratados con imiquimod 5&#37; en r&#233;gimen de monoterapia o junto con cirug&#237;a&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se seleccionaron 14 casos &#40;el 85&#44;7&#37; de lentigo maligno y el 14&#44;3&#37; de lentigo maligno melanoma&#41;&#46; Ocho pacientes &#40;57&#44;1&#37;&#41; recibieron imiquimod sin cirug&#237;a&#44; y seis &#40;42&#44;9&#37;&#41; fueron sometidos a resecci&#243;n antes de iniciar el tratamiento&#46; Durante el periodo de seguimiento&#44; reapareci&#243; la pigmentaci&#243;n en seis pacientes &#40;cuatro con hiperpigmentaci&#243;n postinflamatoria y dos recidivas&#41;&#46; Las recidivas fueron tratadas con un margen de resecci&#243;n muy estrecho &#40;1 mm&#41; y retratamiento con imiquimod 5&#37;&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Todas las modalidades de imiquimod reflejaron buena tolerancia de efectos secundarios y bajas tasas de recidiva&#46; Imiquimod parece ser una opci&#243;n muy vers&#225;til para tratar LM en candidatos id&#243;neos&#46;</p></span>"
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Topical imiquimod has been used off-label as monotherapy or adjuvant treatment for lentigo maligna&#46; Our aim is to describe treatment modalities&#44; clinical outcomes&#44; and management of recurrence in patients receiving imiquimod for lentigo maligna&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Patients from our unit with lentigo maligna or lentigo maligna melanoma treated with imiquimod 5&#37; as monotherapy or in combination with surgery were included in this study&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Fourteen cases were recruited &#40;85&#46;7&#37; lentigo maligna and 14&#46;3&#37; lentigo maligna melanoma&#41;&#46; Eight patients &#40;57&#46;1&#37;&#41; received imiquimod without surgery&#44; and six &#40;42&#46;9&#37;&#41; underwent narrow excision before beginning treatment&#46; During the follow-up period&#44; pigmentation reappeared in 6 patients &#40;4 postinflammatory hyperpigmentation and 2 relapses&#41;&#46; Relapses were managed with very narrow excision &#40;1 mm margin&#41; and retreatment with imiquimod 5&#37;&#46;</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">All imiquimod modalities showed well-tolerated side effects and low recurrence rates&#44; with long periods of follow-up&#46; Imiquimod appears to be a versatile option for treating LM in suitable candidates&#46;</p></span>"
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Tratamiento con imiquimod de lentigo maligno localizado en la punta de la nariz de una paciente de 77 a&#241;os de edad &#40;paciente 1&#44; <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#58; <span class="elsevierStyleBold">A&#41;</span> Pretratamiento&#59; <span class="elsevierStyleBold">B&#41;</span> Reacci&#243;n inflamatoria intensa durante el tratamiento&#44; con costra hemorr&#225;gica negra espesa&#59; <span class="elsevierStyleBold">C&#41;</span> Eritema intenso y edema tras eliminar las costras&#59; <span class="elsevierStyleBold">D&#41;</span> Resoluci&#243;n tras la finalizaci&#243;n del tratamiento&#46; Aparece una cicatriz residual debido a la biopsia cut&#225;nea previa&#46; Mujer de 76 a&#241;os de edad&#44; quien recibi&#243; tratamiento con imiquimod 5&#37; en r&#233;gimen de monoterapia para lesi&#243;n de lentigo maligno en mejilla derecha con hiperpigmentaci&#243;n postinflamatoria autolimitada &#40;paciente 2&#44; <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#58; <span class="elsevierStyleBold">E&#41;</span> Ligera pigmentaci&#243;n gris&#44; flecha negra&#59; <span class="elsevierStyleBold">F&#41;</span> En esta fotograf&#237;a dermatosc&#243;pica aparecen estructuras anulares-granulares gris&#225;ceas alrededor de los fol&#237;culos &#40;salpicado&#41;&#59; <span class="elsevierStyleBold">G&#41;</span> Desaparici&#243;n espont&#225;nea de la pigmentaci&#243;n tras diversas semanas&#44; flecha negra&#46; Var&#243;n de 76 a&#241;os de edad con recidiva de lentigo maligno transcurridos dos meses de la finalizaci&#243;n del tratamiento con imiquimod 5&#37; en r&#233;gimen de monoterapia &#40;paciente 7&#44; <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#58; <span class="elsevierStyleBold">H&#41;</span> Pigmentaci&#243;n moteada marr&#243;n de distribuci&#243;n irregular en la regi&#243;n paranasal izquierda&#59; <span class="elsevierStyleBold">I<span class="elsevierStyleSmallCaps">&#41;</span></span> Fotograf&#237;a dermatosc&#243;pica que muestra pigmentaci&#243;n marr&#243;n perifolicular asim&#233;trica&#46;</p>"
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                  \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">Otros tratamientos&nbsp;\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">R&#233;gimen de imiquimod&nbsp;\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">Seguimiento post-tratamiento &#40;meses&#41;&nbsp;\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">Evoluci&#243;n y manejo de recidivas&nbsp;\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" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\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  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Monoterapia con imiquimod 5&#37;</span></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"><span class="elsevierStyleHsp" style=""></span>1&nbsp;\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">M&nbsp;\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">63&nbsp;\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">Nariz&nbsp;\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">No&nbsp;\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">No&nbsp;\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">Diario8 semanas&nbsp;\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">147&nbsp;\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">&#8212;&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>2&nbsp;\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">M&nbsp;\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">76&nbsp;\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">Mejilla derecha&nbsp;\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">No&nbsp;\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">tazaroteno 0&#44;05&#37; gel&nbsp;\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">Diario7 semanas&nbsp;\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&nbsp;\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">Hiperpigmentaci&#243;n postinflamatoria autolimitada&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>3&nbsp;\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">M&nbsp;\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">84&nbsp;\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">Mejilla izquierda&nbsp;\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">No&nbsp;\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">tazaroteno 0&#44;05&#37; gel&nbsp;\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">Diario6 semanas&nbsp;\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">55&nbsp;\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">&#8212;&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>4&nbsp;\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">M&nbsp;\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">68&nbsp;\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">Espalda&nbsp;\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">No&nbsp;\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">No&nbsp;\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">Diario8 semanas&nbsp;\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">131&nbsp;\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">&#8212;&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>5&nbsp;\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">V&nbsp;\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">53&nbsp;\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">Nariz&nbsp;\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">No&nbsp;\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">No&nbsp;\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">Diario8 semanas&nbsp;\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">6854 seguimiento re-tratamiento&nbsp;\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">Recidiva a los 18 meses&#59; tratada con margen de resecci&#243;n ajustado &#43; 7 semanas de imiquimod 5&#37;&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>6&nbsp;\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">M&nbsp;\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">77&nbsp;\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">Nariz&nbsp;\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">No&nbsp;\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">No&nbsp;\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">Diario5 semanas&nbsp;\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">85&nbsp;\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">&#8212;&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>7&nbsp;\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">V&nbsp;\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">76&nbsp;\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">Regi&#243;n paranasal izquierda&nbsp;\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">No&nbsp;\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">No&nbsp;\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">Diario6 semanas&nbsp;\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">3736 seguimiento re-tratamiento&nbsp;\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">Recidiva a los 2 meses&#59; tratada con margen de resecci&#243;n ajustado &#43; 7 semanas de imiquimod 5&#37;&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>8&nbsp;\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">M&nbsp;\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">72&nbsp;\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">Nariz&nbsp;\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">No&nbsp;\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">tazaroteno 0&#44;05&#37; gel&nbsp;\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">Diario11 semanas&nbsp;\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">37&nbsp;\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">Hiperpigmentaci&#243;n postinflamatoria auto-limitada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="9" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\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  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Imiquimod 5&#37;&#43; margen de resecci&#243;n estrecho</span></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"><span class="elsevierStyleHsp" style=""></span>9&nbsp;\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">M&nbsp;\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">81&nbsp;\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">Mejilla derecha&nbsp;\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">S&#237;0&#44;47 mm&nbsp;\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">No&nbsp;\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">Diario7 semanas&nbsp;\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">58&nbsp;\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">Hiperpigmentaci&#243;n postinflamatoria autolimitada&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>10&nbsp;\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">M&nbsp;\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">67&nbsp;\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">Mejilla izquierda&nbsp;\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">No&nbsp;\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">No&nbsp;\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">Diario6 semanas&nbsp;\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">44&nbsp;\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">Hiperpigmentaci&#243;n postinflamatoria autolimitada&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>11&nbsp;\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">V&nbsp;\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">67&nbsp;\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">Nariz&nbsp;\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">No&nbsp;\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">No&nbsp;\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">Diario8 semanas&nbsp;\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&nbsp;\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">&#8212;&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>12&nbsp;\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">M&nbsp;\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&nbsp;\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">Sien derecha&nbsp;\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">No&nbsp;\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">No&nbsp;\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">Diario6 semanas&nbsp;\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">80&nbsp;\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">&#8212;&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>13&nbsp;\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">FM&nbsp;\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">66&nbsp;\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">Sien izquierda&nbsp;\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">No&nbsp;\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">tazaroteno 0&#44;05&#37; gel&nbsp;\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">Diario8 semanas&nbsp;\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">36&nbsp;\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">&#8212;&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>14&nbsp;\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">M&nbsp;\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">75&nbsp;\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">Labio superior&nbsp;\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">S&#237;0&#44;2 mm&nbsp;\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">No&nbsp;\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">Diario5 semanas&nbsp;\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">38&nbsp;\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">&#8212;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2917553.png"
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        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Serie de casos de imiquimod en lentigo maligno&#58; modalidades de tratamiento y caracter&#237;sticas de los pacientes</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rate of recurrence of lentigo maligna treated with off-label neoadjuvant topical imiquimod&#44; 5&#37;&#44; cream prior to conservatively staged excision"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Donigan"
                            1 => "M&#46;A&#46; Hyde"
                            2 => "D&#46;E&#46; Goldgar"
                            3 => "M&#46;L&#46; Hadley"
                            4 => "M&#46; Bowling"
                            5 => "G&#46;M&#46; Bowen"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "JAMA Dermatol&#46;"
                        "fecha" => "2018"
                        "volumen" => "15"
                        "paginaInicial" => "885"
                        "paginaFinal" => "889"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Effectiveness of 5&#37; Topical Imiquimod for Lentigo Maligna Treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "D&#46;C&#46;K&#46;S&#46; Tio"
                            1 => "C&#46; van Montfrans"
                            2 => "C&#46;G&#46;H&#46; Ruijter"
                            3 => "R&#46; Hoekzema"
                            4 => "M&#46;W&#46; Bekkenk"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2340/00015555-3241"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Derm Venereol&#46;"
                        "fecha" => "2019"
                        "volumen" => "99"
                        "paginaInicial" => "884"
                        "paginaFinal" => "888"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31233181"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "3"
              "referencia" => array:1 [
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COMUNICACIÓN BREVE
Serie de 14 casos de tratamiento con imiquimod tópico al 5% en lentigo maligno: modalidades terapéuticas y claves para detectar recidivas
Series of Fourteen Cases of Topical Imiquimod 5% in Lentigo Maligna: Treatment Modalities and Clues for Detecting Recurrences
I. Poveda-Montoyoa,
Corresponding author
inespovedamontoyo@gmail.com

Autor para correspondencia.
, P. Álvarez-Chinchillaa, L. Schneller-Pavelescua, P. Hispán-Ocetea, J. Bañuls-Rocaa,b
a Departamento de Dermatología, Hospital General Universitario de Alicante, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Alicante, España
b Unidad de Dermatología Área, Departamento de Medicina Clínica, Universidad Miguel Hernández, Sant Joan de Alicante, Alicante, España
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              "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Imiquimod treatment in a lentigo maligna located on the nasal tip in a 77-year-old female &#40;patient 1&#44; see <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#58; &#40;A&#41; Pretreatment&#59; &#40;B&#41; Intense inflammatory reaction during treatment with a thick black hemorrhagic crust&#59; &#40;C&#41; Intense erythema and edema after removing scabs&#59; &#40;D&#41; Resolution following the end of treatment&#46; A residual scar due to the previous skin biopsy is present&#46; 76-year-old female&#44; who had received treatment with 5&#37; imiquimod in monotherapy for a lentigo maligna lesion on her right cheek with self-limited postinflammatory hyperpigmentation &#40;patient 2&#44; see <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#58; &#40;E&#41; Slight gray pigmentation&#44; black arrow&#59; &#40;F&#41; In this dermoscopic photograph&#44; grayish annular&#8211;granular structures around the follicles &#40;peppering&#41;&#59; &#40;G&#41; Spontaneous disappearance of pigmentation after several weeks&#44; black arrow&#46; 76-year-old man who had a relapse of lentigo maligna at 2 months after finishing treatment with imiquimod 5&#37; in monotherapy &#40;patient 7&#44; see <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#58; &#40;H&#41; Mottled brown pigmentation of irregular distribution on his left paranasal region&#59; &#40;I&#41; Dermoscopic photograph&#44; showing asymmetrical perifollicular brown pigmentation&#46;</p>"
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    "titulo" => " Serie de 14 casos de tratamiento con imiquimod t&#243;pico al 5&#37; en lentigo maligno&#58; modalidades terap&#233;uticas y claves para detectar recidivas"
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          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Tratamiento con imiquimod de lentigo maligno localizado en la punta de la nariz de una paciente de 77 a&#241;os de edad &#40;paciente 1&#44; <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#58; <span class="elsevierStyleBold">A&#41;</span> Pretratamiento&#59; <span class="elsevierStyleBold">B&#41;</span> Reacci&#243;n inflamatoria intensa durante el tratamiento&#44; con costra hemorr&#225;gica negra espesa&#59; <span class="elsevierStyleBold">C&#41;</span> Eritema intenso y edema tras eliminar las costras&#59; <span class="elsevierStyleBold">D&#41;</span> Resoluci&#243;n tras la finalizaci&#243;n del tratamiento&#46; Aparece una cicatriz residual debido a la biopsia cut&#225;nea previa&#46; Mujer de 76 a&#241;os de edad&#44; quien recibi&#243; tratamiento con imiquimod 5&#37; en r&#233;gimen de monoterapia para lesi&#243;n de lentigo maligno en mejilla derecha con hiperpigmentaci&#243;n postinflamatoria autolimitada &#40;paciente 2&#44; <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#58; <span class="elsevierStyleBold">E&#41;</span> Ligera pigmentaci&#243;n gris&#44; flecha negra&#59; <span class="elsevierStyleBold">F&#41;</span> En esta fotograf&#237;a dermatosc&#243;pica aparecen estructuras anulares-granulares gris&#225;ceas alrededor de los fol&#237;culos &#40;salpicado&#41;&#59; <span class="elsevierStyleBold">G&#41;</span> Desaparici&#243;n espont&#225;nea de la pigmentaci&#243;n tras diversas semanas&#44; flecha negra&#46; Var&#243;n de 76 a&#241;os de edad con recidiva de lentigo maligno transcurridos dos meses de la finalizaci&#243;n del tratamiento con imiquimod 5&#37; en r&#233;gimen de monoterapia &#40;paciente 7&#44; <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#58; <span class="elsevierStyleBold">H&#41;</span> Pigmentaci&#243;n moteada marr&#243;n de distribuci&#243;n irregular en la regi&#243;n paranasal izquierda&#59; <span class="elsevierStyleBold">I<span class="elsevierStyleSmallCaps">&#41;</span></span> Fotograf&#237;a dermatosc&#243;pica que muestra pigmentaci&#243;n marr&#243;n perifolicular asim&#233;trica&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introducci&#243;n</span><p id="par0095" class="elsevierStylePara elsevierViewall">El lentigo maligno &#40;LM&#41; es la fase preinvasiva del lentigo maligno melanoma &#40;LMM&#41;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a>&#44; consider&#225;ndose la cirug&#237;a el tratamiento est&#225;ndar<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;3</span></a>&#46; Las principales t&#233;cnicas no quir&#250;rgicas para LM son radioterapia&#44; l&#225;ser&#44; crioterapia e imiquimod<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;4</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Imiquimod ha sido utilizado fuera de indicaci&#243;n para LM&#44; como monoterapia o tratamiento adyuvante<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1&#8211;9</span></a>&#46; Sin embargo&#44; existe escasa informaci&#243;n acerca de los signos post-tratamiento inmediatos&#44; o la detecci&#243;n y manejo de las recidivas&#46; Nuestro objetivo es describir a nuestros pacientes tratados con imiquimod para LM&#44; con respecto a las modalidades de tratamiento&#44; los resultados cl&#237;nicos&#44; las recidivas y los efectos adversos asociados&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Pacientes y m&#233;todos</span><p id="par0015" class="elsevierStylePara elsevierViewall">Incluimos a todos los pacientes de 2006 a 2019 de la Unidad de Melanoma de nuestro hospital con confirmaci&#243;n histol&#243;gica de LM o LMM&#44; tratados con imiquimod 5&#37;&#44; en solitario o como adyuvante&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">A todos los pacientes se les hab&#237;a prescrito imiquimod t&#243;pico&#44; una vez al d&#237;a&#44; aplicado sobre la lesi&#243;n y 1 cm alrededor de la misma&#44; y 1 cm alrededor de la cicatriz en lesiones resecadas&#46; La duraci&#243;n del tratamiento vari&#243; de cinco a 11 semanas&#44; hasta lograr al menos el nivel deseado de inflamaci&#243;n &#40;eritema con erosiones y costras&#41; y&#44; de no lograrse&#44; se a&#241;adi&#243; tazaroteno gel al 0&#44;05&#37; para incrementarla&#46; Un dermat&#243;logo &#40;JB&#41; realiz&#243; el seguimiento de los pacientes cada dos semanas durante el periodo de tratamiento&#44; y posteriormente cada seis meses&#46; En cada visita&#44; se someti&#243; a los pacientes a una estrecha exploraci&#243;n cl&#237;nica&#44; controles fotogr&#225;ficos y dermatoscopia digital&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Las variables recopiladas fueron los datos cl&#237;nicos &#40;sexo&#44; edad&#44; localizaci&#243;n&#41;&#44; estatus quir&#250;rgico&#44; r&#233;gimen de imiquimod&#44; reacci&#243;n inflamatoria&#44; duraci&#243;n del seguimiento&#44; y reaparici&#243;n de la pigmentaci&#243;n &#40;recidiva o hiperpigmentaci&#243;n postinflamatoria&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">En todos los casos informamos a los pacientes que la prescripci&#243;n de imiquimod era fuera de indicaci&#243;n&#44; as&#237; como de los diferentes tratamientos alternativos disponibles&#46; Se obtuvo consentimiento informado de todos los pacientes&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Resultados</span><p id="par0035" class="elsevierStylePara elsevierViewall">Incluimos 14 casos en nuestro estudio&#46; La <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> presenta las caracter&#237;sticas de la muestra&#46; Once pacientes &#40;78&#44;6&#37;&#41; eran mujeres&#46; La edad media al inicio de la enfermedad fue de 69&#44;5 a&#241;os&#46; Las lesiones aparecieron con m&#225;s frecuencia en la nariz &#40;35&#44;7&#37;&#41; y mejillas &#40;28&#44;6&#37;&#41;&#46; Doce participantes &#40;85&#44;7&#37;&#41; ten&#237;an diagn&#243;stico histol&#243;gico de LM y dos de LMM &#40;14&#44;3&#37;&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Ocho pacientes &#40;57&#44;1&#37;&#41; recibieron imiquimod sin cirug&#237;a&#46; De ellos&#44; tres &#40;37&#44;5&#37;&#41; requirieron tazaroteno gel al 0&#44;05&#37;&#46; Seis pacientes &#40;42&#44;9&#37;&#44; 4 LM y 2 LMM&#41; fueron sometidos a resecci&#243;n de margen estrecho &#40;incluyendo el componente infiltrativo de LMM&#41; y seguidamente recibieron tratamiento con imiquimod&#46; Un paciente recibi&#243; tazaroteno&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Imiquimod fue aplicado durante una media de siete semanas&#46; Un efecto adverso frecuente fue la aparici&#243;n de eritema intenso con costras &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>A-D&#41;&#46; Cuatro pacientes &#40;28&#44;6&#37;&#41; tuvieron conjuntivitis no infecciosa y un caso present&#243; un ectropi&#243;n transitorio debido a la inflamaci&#243;n&#46; Los l&#233;ntigos solares desaparecieron en las zonas de piel tratada&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">El seguimiento post-tratamiento medio fue de 66&#44;4 meses&#46; Se observaron cuatro casos de hiperpigmentaci&#243;n postinflamatoria &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>E-G&#41;&#44; que se resolvieron espont&#225;neamente en pocas semanas&#46; Adem&#225;s&#44; detectamos dos recidivas histol&#243;gicamente confirmadas&#44; ambas en pacientes con r&#233;gimen de monoterapia de imiquimod&#46; El tiempo medio hasta la recidiva fue de 10 meses&#46; Las recidivas &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>H-I&#41; fueron manejadas exitosamente con un margen de extirpaci&#243;n de un mil&#237;metro&#44; y retratamiento con imiquimod durante siete semanas&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Discusi&#243;n</span><p id="par0055" class="elsevierStylePara elsevierViewall">Actualmente imiquimod no ha sido aprobado para el tratamiento de LM&#44; aunque ha sido descrito como tratamiento fuera de indicaci&#243;n para lesiones incompletamente extirpadas<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;3</span></a>&#46; Imiquimod no es una monoterapia recomendada en los casos de LMM debido al riesgo de met&#225;stasis<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a>&#44; pero es una opci&#243;n tras la extirpaci&#243;n del componente infiltrativo&#46; En nuestros pacientes&#44; imiquimod mostr&#243; alta eficacia en las diversas modalidades de tratamiento&#44; siendo escasas las recidivas observadas &#40;2&#47;14 pacientes&#41;&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Nuestros resultados son consistentes con los datos reportados sobre la eficacia de imiquimod para LM&#46; Dos revisiones sistem&#225;ticas sobre imiquimod como monoterapia&#44; describieron una tasa de respuesta cl&#237;nica del 78&#37;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">8&#44;10</span></a>&#46; Una revisi&#243;n sistem&#225;tica de tratamientos no quir&#250;rgicos para LM report&#243; tasas de recidiva del 11&#44;5&#37; para radioterapia&#44; el 24&#44;5&#37; para imiquimod&#44; y el 34&#44;4&#37; para la terapia de l&#225;ser<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a>&#46; Un estudio con imiquimod en solitario o como tratamiento adyuvante report&#243; una tasa de respuesta cl&#237;nica del 72&#44;7 y el 94&#44;4&#37;&#44; respectivamente<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Creemos que imiquimod podr&#237;a ser &#250;til en pacientes con LM que rechazan una cirug&#237;a completa&#44; debido a la no aceptaci&#243;n de sus resultados cosm&#233;ticos&#44; o aquellos pacientes con comorbilidades&#46; Nosotros proponemos la resecci&#243;n de la lesi&#243;n dermatosc&#243;picamente visible sin m&#225;rgenes&#46; Si dicha zona fuera demasiado grande&#44; extirpamos la zona m&#225;s oscura &#250;nicamente&#46; Por &#250;ltimo&#44; prescribimos imiquimod 5&#37;&#46; De otro modo&#44; en los pacientes que rechazan cualquier cirug&#237;a&#44; utilizamos imiquimod como monoterapia&#46; El r&#233;gimen del tratamiento con imiquimod var&#237;a de dos a 84 semanas&#44; seg&#250;n los estudios reportados en la literatura<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">5&#44;8&#44;10</span></a>&#46; Nuestro objetivo inicial fue lograr una reacci&#243;n inflamatoria intensa&#44; realizando seguidamente tratamiento continuo durante diversas semanas&#44; con una duraci&#243;n total de seis a ocho semanas&#46; Se a&#241;adi&#243; tazaroteno t&#243;pico al 0&#44;05&#37; cuando la reacci&#243;n inflamatoria inicial fue insuficiente&#46; El seguimiento quincenal con eliminaci&#243;n de las costras durante el tratamiento mejor&#243; la absorci&#243;n de imiquimod&#44; tranquiliz&#243; al paciente y mejor&#243; el cumplimiento del tratamiento&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">El seguimiento dermatosc&#243;pico estrecho es esencial para detectar tempranamente las recidivas&#46; Una pigmentaci&#243;n pardusca sugiere recidiva cuando aparece durante los primeros dos a&#241;os de tratamiento&#44; aunque a mayor plazo podr&#237;a ser indicativa de nuevos lentigos solares en la zona&#46; En nuestros pacientes&#44; otro hallazgo dermatosc&#243;pico orientativo de recidiva fue la distribuci&#243;n perifolicular de la pigmentaci&#243;n&#46; Un color de fondo azul-gris&#225;ceo es indicativo de hiperpigmentaci&#243;n postinflamatoria transitoria&#44; que se produce transcurridas unas pocas semanas de tratamiento&#44; y guarda relaci&#243;n histol&#243;gica con melanofagia&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">La microscop&#237;a confocal de reflectancia &#40;MCR&#41; es una buena alternativa a los estudios histol&#243;gicos para monotorizar la lesi&#243;n&#46; Nosotros creemos que el seguimiento estrecho con fotograf&#237;a cl&#237;nica y dermatosc&#243;pica digital puede constituir un sustituto v&#225;lido de la MCR&#44; cuando no se dispone de esta&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">El manejo de la recidiva de LM con imiquimod es controvertido&#46; Nuestra serie incluy&#243; dos casos de recidiva local re-tratados conservadoramente con margen estrecho de resecci&#243;n e imiquimod&#44; con buenos resultados&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Las limitaciones principales del estudio incluyen la ausencia de grupo control&#44; el peque&#241;o n&#250;mero de pacientes&#44; y la heterogeneidad de las modalidades de tratamiento&#46; Ello restringe la generalizaci&#243;n de nuestros resultados&#44; aunque la pr&#225;ctica cl&#237;nica real es as&#237;&#46; Los puntos fuertes de nuestro estudio residen en el hecho de que el seguimiento de los pacientes fue realizado durante un periodo extenso &#40;de tres a 12 a&#241;os&#41; por el mismo dermat&#243;logo&#44; y la existencia de controles fotogr&#225;ficos cada seis meses para monitorizaci&#243;n&#46; Ello permiti&#243; la r&#225;pida detecci&#243;n de las recidivas y la documentaci&#243;n de los cambios post-inflamatorios tempranos y transitorios&#46; Nuestros datos tambi&#233;n contribuyen a la evidencia cient&#237;fica sobre las diferentes modalidades&#44; en ausencia de ensayos cl&#237;nicos aleatorizados prospectivos&#46; De igual modo&#44; permite que los cl&#237;nicos consideren diversas opciones&#44; cuando no pueden practicarse resecciones adecuadas&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Conflicto de intereses</span><p id="par0090" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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          "palabras" => array:6 [
            0 => "Lentigo maligno"
            1 => "Melanoma"
            2 => "Imiquimod"
            3 => "Tratamiento"
            4 => "Recidiva"
            5 => "Dermatoscopia"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1518653"
          "palabras" => array:6 [
            0 => "Lentigo maligna"
            1 => "Melanoma"
            2 => "Imiquimod"
            3 => "Treatment"
            4 => "Recurrence"
            5 => "Dermoscopy"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Imiquimod t&#243;pico ha sido utilizado como monoterapia o tratamiento adyuvante fuera de indicaci&#243;n para el lentigo maligno &#40;LM&#41;&#46; Nuestro objetivo es describir las modalidades de tratamiento&#44; los resultados cl&#237;nicos y el manejo de la recidiva en los pacientes que reciben imiquimod para lentigo maligno&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se incluy&#243; en este estudio a los pacientes de nuestra unidad con lentigo maligno o lentigo maligno melanoma tratados con imiquimod 5&#37; en r&#233;gimen de monoterapia o junto con cirug&#237;a&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se seleccionaron 14 casos &#40;el 85&#44;7&#37; de lentigo maligno y el 14&#44;3&#37; de lentigo maligno melanoma&#41;&#46; Ocho pacientes &#40;57&#44;1&#37;&#41; recibieron imiquimod sin cirug&#237;a&#44; y seis &#40;42&#44;9&#37;&#41; fueron sometidos a resecci&#243;n antes de iniciar el tratamiento&#46; Durante el periodo de seguimiento&#44; reapareci&#243; la pigmentaci&#243;n en seis pacientes &#40;cuatro con hiperpigmentaci&#243;n postinflamatoria y dos recidivas&#41;&#46; Las recidivas fueron tratadas con un margen de resecci&#243;n muy estrecho &#40;1 mm&#41; y retratamiento con imiquimod 5&#37;&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Todas las modalidades de imiquimod reflejaron buena tolerancia de efectos secundarios y bajas tasas de recidiva&#46; Imiquimod parece ser una opci&#243;n muy vers&#225;til para tratar LM en candidatos id&#243;neos&#46;</p></span>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Topical imiquimod has been used off-label as monotherapy or adjuvant treatment for lentigo maligna&#46; Our aim is to describe treatment modalities&#44; clinical outcomes&#44; and management of recurrence in patients receiving imiquimod for lentigo maligna&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Patients from our unit with lentigo maligna or lentigo maligna melanoma treated with imiquimod 5&#37; as monotherapy or in combination with surgery were included in this study&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Fourteen cases were recruited &#40;85&#46;7&#37; lentigo maligna and 14&#46;3&#37; lentigo maligna melanoma&#41;&#46; Eight patients &#40;57&#46;1&#37;&#41; received imiquimod without surgery&#44; and six &#40;42&#46;9&#37;&#41; underwent narrow excision before beginning treatment&#46; During the follow-up period&#44; pigmentation reappeared in 6 patients &#40;4 postinflammatory hyperpigmentation and 2 relapses&#41;&#46; Relapses were managed with very narrow excision &#40;1 mm margin&#41; and retreatment with imiquimod 5&#37;&#46;</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">All imiquimod modalities showed well-tolerated side effects and low recurrence rates&#44; with long periods of follow-up&#46; Imiquimod appears to be a versatile option for treating LM in suitable candidates&#46;</p></span>"
      ]
    ]
    "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" => 750
            "Ancho" => 1000
            "Tamanyo" => 164636
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Tratamiento con imiquimod de lentigo maligno localizado en la punta de la nariz de una paciente de 77 a&#241;os de edad &#40;paciente 1&#44; <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#58; <span class="elsevierStyleBold">A&#41;</span> Pretratamiento&#59; <span class="elsevierStyleBold">B&#41;</span> Reacci&#243;n inflamatoria intensa durante el tratamiento&#44; con costra hemorr&#225;gica negra espesa&#59; <span class="elsevierStyleBold">C&#41;</span> Eritema intenso y edema tras eliminar las costras&#59; <span class="elsevierStyleBold">D&#41;</span> Resoluci&#243;n tras la finalizaci&#243;n del tratamiento&#46; Aparece una cicatriz residual debido a la biopsia cut&#225;nea previa&#46; Mujer de 76 a&#241;os de edad&#44; quien recibi&#243; tratamiento con imiquimod 5&#37; en r&#233;gimen de monoterapia para lesi&#243;n de lentigo maligno en mejilla derecha con hiperpigmentaci&#243;n postinflamatoria autolimitada &#40;paciente 2&#44; <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#58; <span class="elsevierStyleBold">E&#41;</span> Ligera pigmentaci&#243;n gris&#44; flecha negra&#59; <span class="elsevierStyleBold">F&#41;</span> En esta fotograf&#237;a dermatosc&#243;pica aparecen estructuras anulares-granulares gris&#225;ceas alrededor de los fol&#237;culos &#40;salpicado&#41;&#59; <span class="elsevierStyleBold">G&#41;</span> Desaparici&#243;n espont&#225;nea de la pigmentaci&#243;n tras diversas semanas&#44; flecha negra&#46; Var&#243;n de 76 a&#241;os de edad con recidiva de lentigo maligno transcurridos dos meses de la finalizaci&#243;n del tratamiento con imiquimod 5&#37; en r&#233;gimen de monoterapia &#40;paciente 7&#44; <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#58; <span class="elsevierStyleBold">H&#41;</span> Pigmentaci&#243;n moteada marr&#243;n de distribuci&#243;n irregular en la regi&#243;n paranasal izquierda&#59; <span class="elsevierStyleBold">I<span class="elsevierStyleSmallCaps">&#41;</span></span> Fotograf&#237;a dermatosc&#243;pica que muestra pigmentaci&#243;n marr&#243;n perifolicular asim&#233;trica&#46;</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="spar0055" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleSup">&#8224;</span> sex&#58; M&#58; mujer&#44; V&#58; var&#243;n&#46;</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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\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">Sexo<span class="elsevierStyleSup">&#8224;</span>&nbsp;\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 &#40;a&#241;os&#41;&nbsp;\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">Sitio del tumor&nbsp;\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">Componente infiltrativo asociado&nbsp;\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">Otros tratamientos&nbsp;\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">R&#233;gimen de imiquimod&nbsp;\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">Seguimiento post-tratamiento &#40;meses&#41;&nbsp;\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">Evoluci&#243;n y manejo de recidivas&nbsp;\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" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\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  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Monoterapia con imiquimod 5&#37;</span></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"><span class="elsevierStyleHsp" style=""></span>1&nbsp;\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">M&nbsp;\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">63&nbsp;\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">Nariz&nbsp;\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">No&nbsp;\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">No&nbsp;\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">Diario8 semanas&nbsp;\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">147&nbsp;\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">&#8212;&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>2&nbsp;\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">M&nbsp;\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">76&nbsp;\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">Mejilla derecha&nbsp;\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">No&nbsp;\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">tazaroteno 0&#44;05&#37; gel&nbsp;\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">Diario7 semanas&nbsp;\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&nbsp;\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">Hiperpigmentaci&#243;n postinflamatoria autolimitada&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>3&nbsp;\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">M&nbsp;\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">84&nbsp;\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">Mejilla izquierda&nbsp;\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">No&nbsp;\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">tazaroteno 0&#44;05&#37; gel&nbsp;\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">Diario6 semanas&nbsp;\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">55&nbsp;\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">&#8212;&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>4&nbsp;\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">M&nbsp;\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">68&nbsp;\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">Espalda&nbsp;\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">No&nbsp;\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">No&nbsp;\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">Diario8 semanas&nbsp;\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">131&nbsp;\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">&#8212;&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>5&nbsp;\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">V&nbsp;\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">53&nbsp;\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">Nariz&nbsp;\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">No&nbsp;\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">No&nbsp;\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">Diario8 semanas&nbsp;\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">6854 seguimiento re-tratamiento&nbsp;\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">Recidiva a los 18 meses&#59; tratada con margen de resecci&#243;n ajustado &#43; 7 semanas de imiquimod 5&#37;&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>6&nbsp;\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">M&nbsp;\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">77&nbsp;\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">Nariz&nbsp;\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">No&nbsp;\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">No&nbsp;\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">Diario5 semanas&nbsp;\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">85&nbsp;\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">&#8212;&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>7&nbsp;\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">V&nbsp;\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">76&nbsp;\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">Regi&#243;n paranasal izquierda&nbsp;\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">No&nbsp;\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">No&nbsp;\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">Diario6 semanas&nbsp;\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">3736 seguimiento re-tratamiento&nbsp;\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">Recidiva a los 2 meses&#59; tratada con margen de resecci&#243;n ajustado &#43; 7 semanas de imiquimod 5&#37;&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>8&nbsp;\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">M&nbsp;\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">72&nbsp;\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">Nariz&nbsp;\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">No&nbsp;\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">tazaroteno 0&#44;05&#37; gel&nbsp;\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">Diario11 semanas&nbsp;\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">37&nbsp;\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">Hiperpigmentaci&#243;n postinflamatoria auto-limitada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="9" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\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  " colspan="8" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Imiquimod 5&#37;&#43; margen de resecci&#243;n estrecho</span></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"><span class="elsevierStyleHsp" style=""></span>9&nbsp;\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">M&nbsp;\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">81&nbsp;\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">Mejilla derecha&nbsp;\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">S&#237;0&#44;47 mm&nbsp;\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">No&nbsp;\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">Diario7 semanas&nbsp;\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">58&nbsp;\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">Hiperpigmentaci&#243;n postinflamatoria autolimitada&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>10&nbsp;\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">M&nbsp;\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">67&nbsp;\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">Mejilla izquierda&nbsp;\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">No&nbsp;\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">No&nbsp;\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">Diario6 semanas&nbsp;\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">44&nbsp;\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">Hiperpigmentaci&#243;n postinflamatoria autolimitada&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>11&nbsp;\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">V&nbsp;\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">67&nbsp;\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">Nariz&nbsp;\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">No&nbsp;\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">No&nbsp;\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">Diario8 semanas&nbsp;\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&nbsp;\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">&#8212;&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>12&nbsp;\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">M&nbsp;\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&nbsp;\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">Sien derecha&nbsp;\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">No&nbsp;\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">No&nbsp;\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">Diario6 semanas&nbsp;\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">80&nbsp;\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
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                  \t\t\t\t">&#8212;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>13&nbsp;\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">FM&nbsp;\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">66&nbsp;\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
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                  \t\t\t\t">Sien izquierda&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">tazaroteno 0&#44;05&#37; gel&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">Diario8 semanas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">36&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&#8212;&nbsp;\t\t\t\t\t\t\n
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                  \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"><span class="elsevierStyleHsp" style=""></span>14&nbsp;\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
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                  \t\t\t\t">M&nbsp;\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">75&nbsp;\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
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                  \t\t\t\t">Labio superior&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">S&#237;0&#44;2 mm&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">38&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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Idiomas
Actas Dermo-Sifiliográficas
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