Case and Research Letter
Two Cases of Darier Disease Efficiently Treated With Combination of Oral Retinoids and Diclofenac Sodium 3% Gel
Dos casos de enfermedad de Darier eficazmente tratados con una combinación de retinoides orales y gel de diclofenaco sódico al 3%
P.M. Garridoa,
, C. Queirósa, L. Soares-de-Almeidaa,b,c, J. Borges-Costaa,b,c,d
Corresponding author
a Dermatology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
b Dermatology Universitary Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
c Dermatology Research Unit, Instituto de Medicina Molecular (IMM), University of Lisbon, Lisbon, Portugal
d Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa – Lisbon, Portugal
Read
3789
Timeswas read the article
1325
Total PDF
2464
Total HTML
Share statistics
array:24 [ "pii" => "S0001731022006287" "issn" => "00017310" "doi" => "10.1016/j.ad.2021.07.026" "estado" => "S300" "fechaPublicacion" => "2023-05-01" "aid" => "3135" "copyright" => "AEDV" "copyrightAnyo" => "2022" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2023;114:456-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S0001731023002430" "issn" => "00017310" "doi" => "10.1016/j.ad.2023.04.005" "estado" => "S300" "fechaPublicacion" => "2023-05-01" "aid" => "3440" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2023;114:T456-T457" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta Científico-Clínica</span>" "titulo" => " Dos casos de enfermedad de Darier eficazmente tratados con una combinación de retinoides orales y gel de diclofenaco sódico al 3%" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "T456" "paginaFinal" => "T457" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Two Cases of Darier Disease Efficiently Treated with Combination of Oral Retinoids and Diclofenac Sodium 3% Gel" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1239 "Ancho" => 1875 "Tamanyo" => 273342 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Enfermedad de Darier, paciente 1. A-C) Pretratamiento; D-F) Mejoría tras 10 semanas de tratamiento con acitretina 25<span class="elsevierStyleHsp" style=""></span>mg y gel de diclofenaco sódico al 3%/2 veces al día.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "P.M. Garrido, C. Queirós, L. Soares-de-Almeida, J. Borges-Costa" "autores" => array:4 [ 0 => array:2 [ "nombre" => "P.M." "apellidos" => "Garrido" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Queirós" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Soares-de-Almeida" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Borges-Costa" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731023002430?idApp=UINPBA000044" "url" => "/00017310/0000011400000005/v2_202306061222/S0001731023002430/v2_202306061222/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0001731023002879" "issn" => "00017310" "doi" => "10.1016/j.ad.2023.04.011" "estado" => "S300" "fechaPublicacion" => "2023-05-01" "aid" => "3449" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2023;114:T452-T455" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>" "titulo" => " Acral Lesions With a Nodular Appearance: A Case Report Illustrating a Complex Differential Diagnosis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "T452" "paginaFinal" => "T455" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Lesiones acrales de aspecto nodular. Un caso que muestra la complejidad del diagnóstico diferencial" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1022 "Ancho" => 757 "Tamanyo" => 52335 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinical image. Note the lesions with a nodular appearance at the juncture of the palmar and dorsal skin of the left hand.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "I.Y. Osorio-Aragón, J.J. Salazar del Valle, G.I. Quintero Valle, R. Arenas, M.E. Vega-Memije" "autores" => array:5 [ 0 => array:2 [ "nombre" => "I.Y." "apellidos" => "Osorio-Aragón" ] 1 => array:2 [ "nombre" => "J.J." "apellidos" => "Salazar del Valle" ] 2 => array:2 [ "nombre" => "G.I." "apellidos" => "Quintero Valle" ] 3 => array:2 [ "nombre" => "R." "apellidos" => "Arenas" ] 4 => array:2 [ "nombre" => "M.E." "apellidos" => "Vega-Memije" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731023002879?idApp=UINPBA000044" "url" => "/00017310/0000011400000005/v2_202306061222/S0001731023002879/v2_202306061222/en/main.assets" ] "asociados" => array:1 [ 0 => array:18 [ "pii" => "S0001731023002430" "issn" => "00017310" "doi" => "10.1016/j.ad.2023.04.005" "estado" => "S300" "fechaPublicacion" => "2023-05-01" "aid" => "3440" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2023;114:T456-T457" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta Científico-Clínica</span>" "titulo" => " Dos casos de enfermedad de Darier eficazmente tratados con una combinación de retinoides orales y gel de diclofenaco sódico al 3%" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "T456" "paginaFinal" => "T457" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Two Cases of Darier Disease Efficiently Treated with Combination of Oral Retinoids and Diclofenac Sodium 3% Gel" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1239 "Ancho" => 1875 "Tamanyo" => 273342 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Enfermedad de Darier, paciente 1. A-C) Pretratamiento; D-F) Mejoría tras 10 semanas de tratamiento con acitretina 25<span class="elsevierStyleHsp" style=""></span>mg y gel de diclofenaco sódico al 3%/2 veces al día.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "P.M. Garrido, C. Queirós, L. Soares-de-Almeida, J. Borges-Costa" "autores" => array:4 [ 0 => array:2 [ "nombre" => "P.M." "apellidos" => "Garrido" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Queirós" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Soares-de-Almeida" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Borges-Costa" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731023002430?idApp=UINPBA000044" "url" => "/00017310/0000011400000005/v2_202306061222/S0001731023002430/v2_202306061222/es/main.assets" ] ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>" "titulo" => "Two Cases of Darier Disease Efficiently Treated With Combination of Oral Retinoids and Diclofenac Sodium 3% Gel" "tieneTextoCompleto" => true "saludo" => "To the Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "456" "paginaFinal" => "457" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "P.M. Garrido, C. Queirós, L. Soares-de-Almeida, J. Borges-Costa" "autores" => array:4 [ 0 => array:4 [ "nombre" => "P.M." "apellidos" => "Garrido" "email" => array:1 [ 0 => "pedro.mi.garrido@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "C." "apellidos" => "Queirós" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "L." "apellidos" => "Soares-de-Almeida" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "J." "apellidos" => "Borges-Costa" "referencia" => array:4 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Dermatology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Dermatology Universitary Clinic, Faculty of Medicine, University of Lisbon, Lisbon, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Dermatology Research Unit, Instituto de Medicina Molecular (IMM), University of Lisbon, Lisbon, Portugal" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa – Lisbon, Portugal" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Dos casos de enfermedad de Darier eficazmente tratados con una combinación de retinoides orales y gel de diclofenaco sódico al 3%" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 666 "Ancho" => 1005 "Tamanyo" => 84208 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Darier disease, patient 2. (A) Pretreatment; (B) Improvement after 12 weeks of treatment with isotretinoin 30<span class="elsevierStyleHsp" style=""></span>mg and diclofenac sodium 3% gel twice daily.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Darier disease (DD) is an uncommon autosomal dominant genodermatosis caused by mutations of the ATP2A2 gene, which encodes the sarcoplasmic/endoplasmic reticulum calcium-ATPase isoform 2 (SERCA2). Disfunction of this pump disturbs intracellular Ca<span class="elsevierStyleSup">2+</span> signaling, compromising keratinocyte differentiation and intercellular adhesion.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">1</span></a> Although many therapeutic modalities have been investigated, treatment of DD remains challenging, as their efficacy is often unsatisfactory. We describe two cases of DD efficiently treated with oral retinoids in association with topical diclofenac sodium 3% gel.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Patient 1 was a 68-year-old woman, with DD diagnosed at 20 years of age, who presented with multiple hyperkeratotic papules on her neck, trunk and back and moisty, fissured plaques on her axillae, submammary folds and groin. She had been treated with topical therapies, including steroids, retinoids, calcineurin inhibitors and urea cream, with unsatisfactory control. During an extensive exacerbation, acitretin 25<span class="elsevierStyleHsp" style=""></span>mg treatment was started with mild improvement after three months. Recalcitrant disease led us to combine acitretin with topical diclofenac sodium 3% gel, which was applied twice daily. There was a dramatic improvement in the first two weeks, and complete remission was obtained after a further 8 weeks (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The patient remained asymptomatic for the following six months. As maintenance therapy, diclofenac sodium 3% gel application was reduced to once a day without relapse during a six-month follow-up period.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Patient 2 was a 41-year-old woman, daughter of patient 1, who suffered from therapy-resistant DD for 23 years. She presented with numerous coalescent hyperkeratotic papules on her trunk. Conventional topical treatments were not successful and isotretinoin 30<span class="elsevierStyleHsp" style=""></span>mg once daily only during three months resulted in slight improvement. Based on the satisfying response observed in her mother, diclofenac sodium 3% gel was started twice daily, in association with isotretinoin. There was a significant improvement after 12 weeks and the patient remained well-controlled for the following 9 months without noticeable side effects (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Diclofenac sodium is a nonsteroidal anti-inflammatory drug (NSAID) that suppresses inflammation by inhibiting the activity of cyclooxygenase enzymes (COX-1 and COX-2). Kamijo et al. supported the role of COX-2 in the pathogenesis of DD by showing that its expression induced by ultraviolet B (UVB) reduces both ATP2A2 gene expression and SERCA2 production in keratinocytes. Furthermore, COX-2 inhibition was shown to increase ATP2A2 mRNA expression and SERCA2 levels both in ultraviolet (UV)-irradiated and non-UV-irradiated normal human keratinocytes.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Recently, four cases of successful treatment of DD with diclofenac sodium 3% gel and one case with diclofenac sodium 1% gel have been reported.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">4–7</span></a> To the best of our knowledge, this is the first report of successful combination of this therapy with oral retinoids.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In both patients, diclofenac sodium seemed to potentiate the improvement observed with oral retinoid treatment. Indeed, diclofenac sodium and retinoids may share a mechanism of action and present synergic effects, as retinoids also suppress COX-2 production.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">8</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">To date, no reports of successful treatment of DD with oral NSAIDs have been published. Nevertheless, topical administration is a more attractive route, as it can achieve high skin concentrations and avoid potential systemic side effects.</p><p id="par0040" class="elsevierStylePara elsevierViewall">In conclusion, the combination of oral retinoids and diclofenac sodium 3% gel could be an effective and safe alternative for DD patients who do not respond to or are intolerant to conventional treatments.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 929 "Ancho" => 1405 "Tamanyo" => 188091 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Darier disease, patient 1. (A–C) Pretreatment; (D–F) Improvement after 10 weeks of treatment with acitretin 25<span class="elsevierStyleHsp" style=""></span>mg and diclofenac sodium 3% gel twice daily.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 666 "Ancho" => 1005 "Tamanyo" => 84208 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Darier disease, patient 2. (A) Pretreatment; (B) Improvement after 12 weeks of treatment with isotretinoin 30<span class="elsevierStyleHsp" style=""></span>mg and diclofenac sodium 3% gel twice daily.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0045" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Darier disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Takagi" 1 => "M. Kamijo" 2 => "S. Ikeda" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/1346-8138.13230" "Revista" => array:6 [ "tituloSerie" => "J Dermatol" "fecha" => "2016" "volumen" => "43" "paginaInicial" => "275" "paginaFinal" => "279" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26945535" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0050" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cyclooxygenase-2 inhibition restores ultraviolet B-induced downregulation of ATP2A2/SERCA2 in keratinocytes: Possible therapeutic approach of cyclooxygenase-2 inhibition for treatment of Darier disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Kamijo" 1 => "C. Nishiyama" 2 => "A. Takagi" 3 => "N. Nakano" 4 => "M. Hara" 5 => "S. Ikeda" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2133.2011.10789.x" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2012" "volumen" => "166" "paginaInicial" => "1017" "paginaFinal" => "1022" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22413864" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0055" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prostaglandin E receptor 4 inhibition restores UVB-induced downregulation of ATP2A2/SERCA2 in cultured normal human keratinocytes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Kamijo" 1 => "A. Wada" 2 => "R. Mineki" 3 => "T. Sakanishi" 4 => "S. Ikeda" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jdermsci.2015.10.010" "Revista" => array:6 [ "tituloSerie" => "J Dermatol Sci" "fecha" => "2016" "volumen" => "81" "paginaInicial" => "69" "paginaFinal" => "71" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26596216" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0060" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Improvement of Darier disease with diclofenac sodium 3% gel" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F. Millán-Parrilla" 1 => "B. Rodrigo-Nicolás" 2 => "P. Molés-Poveda" 3 => "M. Armengot-Carbó" 4 => "E. Quecedo-Estébanez" 5 => "E. Gimeno-Carpio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2013.11.033" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2014" "volumen" => "70" "paginaInicial" => "89" "paginaFinal" => "90" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24355263" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0065" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diclofenac sodium 3% gel for darier's disease treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Santos-Alarcon" 1 => "C. Sanchis-Sanchez" 2 => "A. Mateu-Puchades" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Dermatol Online J" "fecha" => "2016" "volumen" => "22" "paginaInicial" => "13030" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0070" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of Darier's disease with diclofenac sodium 3% gel" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "I. Palacios-Álvarez" 1 => "I. Andrés-Ramos" 2 => "M.Y. Silva" 3 => "G. Simal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/dth.12478" "Revista" => array:6 [ "tituloSerie" => "Dermatol Ther" "fecha" => "2017" "volumen" => "30" "paginaInicial" => "1" "paginaFinal" => "3" "itemHostRev" => array:3 [ "pii" => "S0090825818311314" "estado" => "S300" "issn" => "00908258" ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0075" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Successful treatment with diclofenac sodium 1% gel of a case of suspected Darier disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Kaga-Kamijo" 1 => "S. Ikeda" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ced.13727" "Revista" => array:7 [ "tituloSerie" => "Clin Exp Dermatol" "fecha" => "2019" "volumen" => "44" "paginaInicial" => "447" "paginaFinal" => "449" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30178504" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0090825812001503" "estado" => "S300" "issn" => "00908258" ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0080" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Retinoids suppress phorbol ester-mediated induction of cyclooxygenase-2" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.R. Mestre" 1 => "K. Subbaramaiah" 2 => "P.G. Sacks" 3 => "S.P. Schantz" 4 => "T. Tanabe" 5 => "H. Inoue" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Cancer Res" "fecha" => "1997" "volumen" => "57" "paginaInicial" => "1081" "paginaFinal" => "1085" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9067275" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0090825816300087" "estado" => "S300" "issn" => "00908258" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/00017310/0000011400000005/v2_202306061222/S0001731022006287/v2_202306061222/en/main.assets" "Apartado" => array:4 [ "identificador" => "6160" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Cartas científico-clínicas" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/00017310/0000011400000005/v2_202306061222/S0001731022006287/v2_202306061222/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731022006287?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 19 | 10 | 29 |
| 2024 October | 104 | 66 | 170 |
| 2024 September | 139 | 38 | 177 |
| 2024 August | 144 | 75 | 219 |
| 2024 July | 113 | 43 | 156 |
| 2024 June | 110 | 42 | 152 |
| 2024 May | 121 | 47 | 168 |
| 2024 April | 96 | 45 | 141 |
| 2024 March | 86 | 56 | 142 |
| 2024 February | 74 | 55 | 129 |
| 2024 January | 61 | 43 | 104 |
| 2023 December | 90 | 27 | 117 |
| 2023 November | 57 | 49 | 106 |
| 2023 October | 81 | 64 | 145 |
| 2023 September | 89 | 52 | 141 |
| 2023 August | 158 | 31 | 189 |
| 2023 July | 121 | 37 | 158 |
| 2023 June | 83 | 47 | 130 |
| 2023 May | 138 | 59 | 197 |
| 2023 April | 55 | 22 | 77 |
| 2023 March | 78 | 29 | 107 |
| 2023 February | 64 | 32 | 96 |
| 2023 January | 57 | 53 | 110 |
| 2022 December | 60 | 41 | 101 |
| 2022 November | 63 | 53 | 116 |
| 2022 October | 65 | 35 | 100 |
| 2022 September | 65 | 65 | 130 |
| 2022 August | 48 | 48 | 96 |
| 2022 July | 25 | 61 | 86 |
Show all
