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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">Se estima que entre el 6 y el 30&#37; de los motivos de consulta en las consultas de pediatr&#237;a se producen por trastornos dermatol&#243;gicos<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; De la misma forma&#44; se calcula que entre el 10 y el 15&#37; de los pacientes atendidos en las consultas de dermatolog&#237;a son menores de 16 a&#241;os<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">3&#8211;5</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">En la infancia las manifestaciones cut&#225;neas de muchas enfermedades var&#237;an con respecto a las manifestaciones de las mismas enfermedades en la edad adulta&#44; y su manejo y tratamiento tambi&#233;n pueden diferir&#46; Asimismo&#44; existen m&#250;ltiples afecciones dermatol&#243;gicas propias o incluso exclusivas de la edad infantil&#46; Dicha variedad de posibles diagn&#243;sticos y necesidad de manejo espec&#237;fico ha llevado a la creaci&#243;n de consultas dedicadas exclusivamente a la dermatolog&#237;a pedi&#225;trica<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">6&#44;7</span></a>&#46; En Espa&#241;a la dermatolog&#237;a pedi&#225;trica no est&#225; reconocida como subespecialidad&#44; como s&#237; lo est&#225; en otros pa&#237;ses<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">7</span></a>&#44; lo que ha hecho que algunos autores se planteen itinerarios docentes para su reconocimiento como tal<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">8</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Algunos de los casos remitidos desde atenci&#243;n primaria a las consultas de dermatolog&#237;a tienen un diagn&#243;stico sencillo que ha sido bien realizado en las consultas de pediatr&#237;a&#44; y los pacientes son remitidos para optimizar su manejo &#40;como ocurre por ejemplo en muchos casos de dermatitis at&#243;pica&#44; vit&#237;ligo&#44; psoriasis&#44; hemangiomas infantiles&#44; infecciones cut&#225;neas como verrugas v&#237;ricas o moluscos contagiosos&#44; lesiones qu&#237;sticas de diversa &#237;ndole&#8230;&#41;&#46; Sin embargo&#44; otros casos son remitidos a dermatolog&#237;a para confirmar su naturaleza o sin haberse llegado a un diagn&#243;stico de sospecha claro&#46; Entre estos &#250;ltimos&#44; algunos casos precisar&#225;n de otras pruebas complementarias por parte del dermat&#243;logo para su confirmaci&#243;n diagn&#243;stica&#44; como puede ser un an&#225;lisis histol&#243;gico &#40;previa cirug&#237;a adaptada a la poblaci&#243;n pedi&#225;trica<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">9</span></a>&#41; o la solicitud de un estudio gen&#233;tico&#44; correspondiendo en ocasiones a casos de diagn&#243;sticos excepcionales&#44; y muchos de ellos ser&#225;n finalmente remitidos para su seguimiento en consultas monogr&#225;ficas de dermatolog&#237;a pedi&#225;trica<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">10</span></a>&#46; A pesar de ello&#44; no existen estudios multic&#233;ntricos nacionales que hayan evaluado estos motivos de consulta&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">El estudio DIADERM tuvo por finalidad analizar los diagn&#243;sticos realizados en las consultas de dermatolog&#237;a m&#233;dico-quir&#250;rgica y venereolog&#237;a &#40;DMQyV&#41; de los miembros de la Academia Espa&#241;ola de Dermatolog&#237;a y Venereolog&#237;a &#40;AEDV&#41; en Espa&#241;a<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">5</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Mediante este trabajo queremos estimar la demanda de atenci&#243;n ambulatoria en los pacientes en edad pedi&#225;trica&#44; por los dermat&#243;logos en Espa&#241;a&#44; a partir de los diagn&#243;sticos codificados de la actividad de &#8212;y por&#8212; los propios dermat&#243;logos&#46; Asimismo&#44; se pretende analizar las posibles diferencias existentes en estos diagn&#243;sticos en funci&#243;n del &#225;rea geogr&#225;fica&#44; origen de la consulta y su destino en funci&#243;n del &#225;mbito p&#250;blico y privado&#44; as&#237; como de otros factores&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Material y m&#233;todo</span><p id="par0030" class="elsevierStylePara elsevierViewall">Estudio observacional de corte transversal para describir los diagn&#243;sticos realizados por los dermat&#243;logos en 2 per&#237;odos de tiempo &#40;19 a 21 de enero y 18 a 20 de mayo de 2016&#41;&#46; Dichos datos se obtuvieron a trav&#233;s de la encuesta an&#243;nima DIADERM&#44; realizada a una muestra aleatoria de dermat&#243;logos&#44; estratificada por secciones de la AEDV&#44; y representativa de los dermat&#243;logos de Espa&#241;a&#46; La metodolog&#237;a y caracter&#237;sticas de dicha encuesta &#40;incluyendo los datos recogidos y c&#243;mo se realiz&#243; la codificaci&#243;n de los diagn&#243;sticos&#41; se encuentra descrita en detalle en el primer manuscrito del proyecto<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">5</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Se incluyeron las variables previamente recogidas en el estudio&#46; Para el an&#225;lisis espec&#237;fico de las dermatosis en la edad pedi&#225;trica&#44; se seleccionaron todos los diagn&#243;sticos codificados en los menores de 18 a&#241;os&#44; que se agruparon en categor&#237;as diagn&#243;sticas relacionadas para facilitar su an&#225;lisis y comparaci&#243;n &#40;<a class="elsevierStyleCrossRef" href="#sec0050">tabla suplementaria 1</a>&#41;&#46; Para tratar de aproximarse a la frecuencia de los diagn&#243;sticos en una semana de trabajo&#44; se calcularon en base al n&#250;mero de diagn&#243;sticos estimados en una semana de 5 d&#237;as laborables&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">El an&#225;lisis estad&#237;stico se realiz&#243; teniendo en cuenta el dise&#241;o empleado para recoger la muestra&#44; utilizando el m&#243;dulo <span class="elsevierStyleItalic">survey</span> de Stata<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">11</span></a>&#46; El m&#243;dulo tiene en cuenta la obtenci&#243;n de errores est&#225;ndar para datos correlacionados&#46; Adem&#225;s&#44; no hizo falta la correcci&#243;n del ajuste para poblaciones finitas&#44; considerando el n&#250;mero real de dermat&#243;logos por cada secci&#243;n de la AEDV&#44; al estar pr&#243;xima a 1&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">El estudio fue sido clasificado como estudio no-postautorizaci&#243;n &#40;No-EPA&#41; por la Agencia Espa&#241;ola del Medicamento y Productos Sanitarios y aprobado por el Comit&#233; de &#201;tica de Investigaci&#243;n de la provincia de Granada &#40;8 de octubre de 2014&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Resultados</span><p id="par0050" class="elsevierStylePara elsevierViewall">Durante la recogida de datos del estudio DIADERM&#44; un total de 20&#46;097 diagn&#243;sticos fueron efectuados en pacientes menores de 18 a&#241;os&#44; lo que supone un 12&#37; del total de todos los codificados &#40;en 2016&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> refleja la estimaci&#243;n de frecuencia de diagn&#243;sticos en una semana laboral de los pacientes menores de 18 a&#241;os&#58; las infecciones v&#237;ricas&#44; el acn&#233; y la dermatitis at&#243;pica fueron&#44; en orden de frecuencia&#44; los diagn&#243;sticos m&#225;s comunes&#44; representando un 43&#44;9&#37; de todos los diagn&#243;sticos&#46; El diagn&#243;stico menos frecuente fue el de los tumores cut&#225;neos malignos&#44; codificados bajo los ep&#237;grafes C44 &#40;otros tumores malignos de la piel&#41; y C83 &#40;linfoma no folicular&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> muestra la distribuci&#243;n de frecuencia de diagn&#243;sticos en funci&#243;n del tipo de consulta general o monogr&#225;fica y del &#225;mbito asistencial p&#250;blico o privado&#46; Sin que se encontraran diferencias estad&#237;sticamente significativas entre &#225;mbitos p&#250;blico y privado&#44; los 3 grupos diagn&#243;sticos definidos m&#225;s frecuentes en el p&#250;blico fueron el acn&#233; y cuadros relacionados &#40;16&#44;6&#37;&#41;&#44; las infecciones v&#237;ricas &#40;14&#44;9&#37;&#41; y los nevos melanoc&#237;ticos &#40;12&#44;5&#37;&#41;&#46; En el &#225;mbito privado&#44; las infecciones v&#237;ricas &#40;18&#44;6&#37;&#41;&#44; el acn&#233; y cuadros relacionados &#40;14&#44;9&#37;&#41; y la dermatitis at&#243;pica &#40;12&#44;7&#37;&#41;&#46; Aunque en algunos casos aparentes&#44; las diferencias en la proporci&#243;n de diagn&#243;sticos atendidos en las consultas monogr&#225;ficas frente a las generales&#44; as&#237; como en los registrados en el &#225;mbito p&#250;blico frente al privado&#44; no fueron estad&#237;sticamente significativas&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Tampoco se apreciaron diferencias estad&#237;sticamente significativas entre las consultas generales y monogr&#225;ficas &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41; atendiendo a factores como el &#237;ndice de pacientes nuevos&#47;revisiones&#44; la financiaci&#243;n&#44; el origen y destino de los pacientes y la fase de administraci&#243;n de la encuesta &#40;enero o mayo de 2016&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Por &#250;ltimo&#44; tampoco hubo diferencias significativas &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;31&#41; en los diagn&#243;sticos codificados en funci&#243;n de la estaci&#243;n del a&#241;o &#40;fase de la encuesta enero o mayo&#41;&#44; registrados en la <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discusi&#243;n</span><p id="par0075" class="elsevierStylePara elsevierViewall">En el presente estudio se han revisado los datos de la encuesta DIADERM relativos a los pacientes pedi&#225;tricos&#44; que supon&#237;an &#40;en 2016&#41; un 12&#37; de la carga asistencial de los m&#233;dicos especialistas en dermatolog&#237;a m&#233;dico-quir&#250;rgica y venereolog&#237;a en Espa&#241;a&#46; Los diagn&#243;sticos m&#225;s comunes en este grupo de poblaci&#243;n fueron las infecciones v&#237;ricas&#44; el acn&#233; y trastornos relacionados y la dermatitis at&#243;pica&#46;La cifra del 12&#37; de pacientes &#171;pedi&#225;tricos&#187; en las consultas de dermatolog&#237;a resulta inferior a la descrita en la serie de Taberner et al&#46; de 2010 &#40;17&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">12</span></a>&#44; pero superponible a la hallada por estudios previos como el de Casanova et al&#46; en 2008 &#40;12&#44;1&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">3</span></a> y muy pr&#243;xima a la de Goh y Akarapanth en 1994 &#40;12&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">4</span></a>&#44; si bien en los 3 art&#237;culos el l&#237;mite de edad para considerar un paciente pedi&#225;trico fue de 16 a&#241;os&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Los resultados de manuscritos previos muestran c&#243;mo las frecuencias de los diagn&#243;sticos var&#237;an&#44; por lo que no concuerdan totalmente con la casu&#237;stica observada en nuestro trabajo&#46; Las consultas &#171;monogr&#225;ficas&#187; del &#225;mbito p&#250;blico recogidas en la encuesta DIADERM s&#237; que coinciden en los 3 primeros diagn&#243;sticos en frecuencia con los m&#225;s comunes en 1984 en las consultas externas de pediatr&#237;a de un centro estadounidense<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">13</span></a>&#58; dermatosis infecciosas&#44; dermatitis at&#243;pica y acn&#233;&#44; lo cual podr&#237;a poner sobre la pista de una colaboraci&#243;n m&#225;s estrecha entre pediatr&#237;a y dermatolog&#237;a pedi&#225;trica en algunos casos &#40;o que m&#225;s bien pueda deberse a una mayor facilidad de acceder al dermat&#243;logo directamente en el &#225;mbito privado&#41;&#46; Una revisi&#243;n publicada en Espa&#241;a en 2005<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">14</span></a> describ&#237;a que las dermatosis m&#225;s frecuentes en pediatr&#237;a de atenci&#243;n primaria eran las infecciosas &#40;con las bacterianas como las m&#225;s habituales&#41;&#44; seguidas de la dermatitis del pa&#241;al &#40;a d&#237;a de hoy&#44; gracias a los nuevos dise&#241;os de los pa&#241;ales&#44; la incidencia de esta &#250;ltima es claramente menor&#41; y la at&#243;pica &#40;a partir de datos publicados en 1985<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">15</span></a>&#41;&#46; A su vez&#44; las m&#225;s frecuentes en las consultas de dermatolog&#237;a pedi&#225;trica eran las infecciones &#40;m&#225;s com&#250;nmente por hongos&#44; cuya incidencia claramente ha bajado actualmente gracias a las mejores condiciones de higiene&#44; mayor control veterinario&#8230;&#41;&#44; seguidas de la dermatitis at&#243;pica y el acn&#233; vulgar &#40;seg&#250;n datos publicados en 1983<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">16</span></a>&#41;&#46; Las dermatosis pedi&#225;tricas m&#225;s habituales en urgencias de dermatolog&#237;a de un hospital nacional de tercer nivel seg&#250;n un trabajo de 2004 incluyeron las infecciones y los eczemas&#44; si bien se describ&#237;an las picaduras&#47;prurigo como el tercer motivo de consulta m&#225;s frecuente<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">17</span></a>&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Profundizando en los datos presentados&#44; destacamos los vertidos en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#44; que recalcan la importancia de realizar formaci&#243;n para atenci&#243;n primaria&#44; que podr&#237;a evitar la derivaci&#243;n de casos para evaluaci&#243;n dermatol&#243;gica&#46; Con respecto a lo reflejado en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#44; subrayamos los siguientes diagn&#243;sticos m&#225;s frecuentes en las consultas monogr&#225;ficas p&#250;blicas&#58; el acn&#233; &#40;creemos que en parte por motivos pecuniarios&#58; financiaci&#243;n de las prescripciones de isotretino&#237;na&#44; as&#237; como de los an&#225;lisis de sangre&#41;&#59; las anomal&#237;as vasculares &#40;tambi&#233;n por motivos cremat&#237;sticos&#44; aunque adem&#225;s podr&#237;a relacionarse a la mayor facilidad de acceso a comit&#233;s multidisciplinares&#44; solicitud de pruebas diagn&#243;sticas espec&#237;ficas y acceso a tratamientos avanzados&#41;&#46; Inversamente&#44; la dermatitis at&#243;pica&#44; las infecciones v&#237;ricas y otras dermatitis son proporcionalmente m&#225;s frecuentes en el &#225;mbito privado &#40;puede verse influido por la mayor facilidad en lograr una cita directa y&#47;o m&#225;s temprana&#41;&#46; Nos ha resultado llamativa la diferencia de proporci&#243;n de diagn&#243;sticos de nevos melanoc&#237;ticos en el &#225;mbito p&#250;blico frente al privado&#44; que podr&#237;a estar motivada por la falta de sensaci&#243;n de urgencia&#44; con menor problema a la hora de esperar para una cita en la sanidad p&#250;blica&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Con respecto a las consultas monogr&#225;ficas&#44; el trabajo de Torrelo y Zambrano de 2002<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">2</span></a> describiendo las frecuencias de diagn&#243;sticos su centro obtuvo como los m&#225;s frecuentes&#44; por orden&#58; el eczema&#44; las dermatosis infecciosas y los nevos&#46; Creemos que los datos de las consultas &#171;monogr&#225;ficas&#187; del estudio DIADERM no coinciden completamente con los del Servicio de Dermatolog&#237;a Pedi&#225;trica del Hospital Universitario Ni&#241;o Jes&#250;s&#44; pues la clasificaci&#243;n en la encuesta como tales no iba referida <span class="elsevierStyleItalic">sensu stricto</span> a las de dermatolog&#237;a pedi&#225;trica&#44; sino a cualquier consulta monogr&#225;fica de dermatolog&#237;a&#46; Quiz&#225; este hecho pueda explicar el n&#250;mero relativamente alto de tumores malignos entre los diagn&#243;sticos&#44; m&#225;s prevalentes en otras consultas monogr&#225;ficas no pedi&#225;tricas&#46; Por otra parte&#44; en nuestro caso se han dividido las dermatosis infecciosas en varios bloques&#44; v&#237;ricas y otras&#44; y los eczemas en dermatitis at&#243;pica y otras dermatitis &#40;si se uniesen&#44; los resultados ser&#237;an bastante similares&#41;&#46; La mayor diferencia estar&#237;a en el acn&#233;&#44; que actualmente es un motivo muy frecuente de consulta en nuestro medio&#46; El trabajo m&#225;s reciente describiendo la casu&#237;stica en consultas de dermatolog&#237;a pedi&#225;trica es una serie griega cuyos diagn&#243;sticos m&#225;s frecuentes fueron eczema&#44; infecciones v&#237;ricas y trastornos pigmentarios &#40;independientes de nevos melanoc&#237;ticos&#44; que fue el cuarto diagnostico m&#225;s frecuente&#41;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">10</span></a>&#46; Comparando nuestros datos con los de este &#250;ltimo trabajo&#44; nos encontramos con que el acn&#233; en nuestra casu&#237;stica fue mucho m&#225;s frecuente&#46; Esto podr&#237;a deberse a la edad m&#225;s amplia incluida en nuestro estudio&#44; as&#237; como a factores culturales de aquel pa&#237;s &#40;que lleven a una menor demanda de consulta al respecto&#41; e incluso a factores como la gen&#233;tica&#44; la dieta o el estilo de vida&#44; que pueda favorecer una menor prevalencia de acn&#233; en estas &#225;reas&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Asimismo&#44; el que no se hayan detectado diferencias estad&#237;sticamente significativas &#40;aunque s&#237; tendencias&#41; en nuestros datos de consultas generales frente a monogr&#225;ficas puede deberse al n&#250;mero limitado de casos o a que lo que diferencia &#8212;<span class="elsevierStyleItalic">grosso modo&#8212;</span> las consultas monogr&#225;ficas es la gravedad&#44; m&#225;s que el diagn&#243;stico&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Aunque se registraron m&#225;s diagn&#243;sticos en enero que en mayo de 2016 durante la fase de recogida de datos de DIADERM&#44; no hemos podido observar diferencias significativas en la distribuci&#243;n relativa de las dermatosis identificadas entre ambos per&#237;odos&#46; El &#250;nico estudio previo que hemos identificado que analizase la concentraci&#243;n de dermatosis en funci&#243;n del mes del a&#241;o tampoco encontr&#243; claras diferencias<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">13</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">El estudio presenta algunas limitaciones&#44; como el hecho de considerar a la poblaci&#243;n pedi&#225;trica como la de menos de 18 a&#241;os &#40;cuando en algunos trabajos se habla de menores de 16 o con edad igual o menor a 16 a&#241;os&#41; y la imposibilidad de identificar las consultas monogr&#225;ficas de dermatolog&#237;a pedi&#225;trica &#40;la clasificaci&#243;n de consulta &#171;monogr&#225;fica&#187; en el estudio DIADERM no se refer&#237;a &#250;nicamente a las consultas monogr&#225;ficas de dermatolog&#237;a pedi&#225;trica&#41;&#46; Tampoco hemos tenido posibilidad de valorar por periodos m&#225;s espec&#237;ficos de edad&#44; ni por sexos&#46; Adicionalmente&#44; los dos per&#237;odos de recogida de datos &#40;enero y mayo&#41; no permiten identificar bien la estacionalidad &#40;por ejemplo&#44; en verano podr&#237;a ser esperable que existiera m&#225;s incidencia de imp&#233;tigo y menos de brotes de dermatitis at&#243;pica&#41;&#44; que a su vez puede estar en parte influida por la lista de espera&#46; Por &#250;ltimo&#44; cabe rese&#241;ar que los datos recabados en el estudio son de 2016 y que cabe la posibilidad de que la pandemia por SARS-CoV-2 haya hecho que lo registrado en la encuesta DIADERM requiera una nueva edici&#243;n para conocer la situaci&#243;n pospand&#233;mica&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">A pesar de ello&#44; el estudio tiene fortalezas&#44; como la metodolog&#237;a empleada&#44; representativa de la actividad de los dermat&#243;logos en Espa&#241;a&#44; y el gran tama&#241;o muestral que permite precisi&#243;n en los resultados&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusiones</span><p id="par0115" class="elsevierStylePara elsevierViewall">La atenci&#243;n a pacientes pedi&#225;tricos por parte de dermat&#243;logos en Espa&#241;a supone una proporci&#243;n significativa de su actividad habitual&#44; y el conocimiento de su prevalencia y distribuci&#243;n es de gran importancia para poder plantear estrategias de mejora&#46; Las dermatosis infecciosas&#44; la dermatitis at&#243;pica y el acn&#233; son los diagn&#243;sticos m&#225;s com&#250;nmente registrados en menores de 18 a&#241;os&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Consideramos que los hallazgos descritos permiten descubrir &#225;reas de mejoras en la comunicaci&#243;n y la formaci&#243;n de los pediatras de atenci&#243;n primaria&#44; como el refuerzo de actividades formativas dirigidas al mejor manejo de acn&#233; y lesiones pigmentadas en atenci&#243;n primaria&#46; Creemos conveniente la realizaci&#243;n de nuevos estudios espec&#237;ficamente centrados en la edad pedi&#225;trica que nos permitan obtener m&#225;s informaci&#243;n&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Financiaci&#243;n</span><p id="par0125" class="elsevierStylePara elsevierViewall">El estudio DIADERM fue promovido por la Fundaci&#243;n Piel Sana de la AEDV&#44; que recibi&#243; ayuda econ&#243;mica de Novartis&#46; La compa&#241;&#237;a farmac&#233;utica no particip&#243; en la recogida de datos&#44; ni en el an&#225;lisis de los datos&#44; ni en la interpretaci&#243;n de los resultados&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Autor&#237;as</span><p id="par0130" class="elsevierStylePara elsevierViewall">Martin-Gorgojo y J&#46; del Boz Contribuyen de manera equivalente como primeros autores&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflicto de intereses</span><p id="par0135" 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 [
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            1 => "Consulta externa hospitalaria"
            2 => "Actividad ambulatoria"
            3 => "Dermatolog&#237;a"
            4 => "Enfermedades cut&#225;neas"
            5 => "Pediatr&#237;a"
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            1 => "Hospital outpatient clinics"
            2 => "Ambulatory care"
            3 => "Dermatology"
            4 => "Skin diseases"
            5 => "Pediatrics"
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    "resumen" => array:2 [
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introducci&#243;n</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Los motivos de consulta de &#237;ndole dermatol&#243;gico son muy frecuentes en las consultas de pediatr&#237;a de atenci&#243;n primaria&#44; e igualmente muchos de los pacientes atendidos en consultas de dermatolog&#237;a son ni&#241;os y adolescentes&#46; A pesar de ello&#44; faltan estudios sobre la prevalencia real de estas consultas y sus caracter&#237;sticas&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Material y m&#233;todo</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional de corte transversal de 2 per&#237;odos de tiempo describiendo los diagn&#243;sticos realizados en consultas externas dermatol&#243;gicas&#44; obtenidos a trav&#233;s de la encuesta an&#243;nima DIADERM&#44; realizada a una muestra aleatoria y representativa de dermat&#243;logos&#46; A partir de la codificaci&#243;n de diagn&#243;sticos CIE-10&#44; se seleccionaron todos los diagn&#243;sticos codificados en los menores de 18 a&#241;os &#40;84 diagn&#243;sticos codificados en los 2 per&#237;odos&#41;&#44; que se agruparon en 14 categor&#237;as diagn&#243;sticas relacionadas para facilitar su an&#225;lisis y comparaci&#243;n&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Un total de 20&#46;097 diagn&#243;sticos fueron efectuados en pacientes menores de 18 a&#241;os&#44; lo que supone un 12&#37; del total de los codificados en DIADERM&#46; Las infecciones v&#237;ricas&#44; el acn&#233; y la dermatitis at&#243;pica fueron los diagn&#243;sticos m&#225;s comunes &#40;43&#44;9&#37; de todos los diagn&#243;sticos&#41;&#46; No se observaron diferencias estad&#237;sticamente significativas en la proporci&#243;n de diagn&#243;sticos atendidos en las consultas monogr&#225;ficas frente a las generales&#44; as&#237; como en los registrados en el &#225;mbito p&#250;blico frente al privado&#46; Tampoco las hubo en los diagn&#243;sticos en funci&#243;n de la &#233;poca de la encuesta &#40;enero y mayo&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La atenci&#243;n a pacientes pedi&#225;tricos por parte de dermat&#243;logos en Espa&#241;a supone una proporci&#243;n significativa de la actividad habitual&#46; Estos datos nos permiten descubrir &#225;reas de mejora en la comunicaci&#243;n y la formaci&#243;n de los pediatras de atenci&#243;n primaria&#44; como la necesidad del refuerzo de actividades formativas dirigidas al mejor tratamiento de acn&#233; y lesiones pigmentadas &#40;y manejo b&#225;sico de la dermatoscopia&#41; en este &#225;mbito asistencial&#46;</p></span>"
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            "titulo" => "Material y m&#233;todo"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Background</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Visits for skin conditions are very common in pediatric primary care&#44; and many of the patients seen in outpatient dermatology clinics are children or adolescents&#46; Little&#44; however&#44; has been published about the true prevalence of these visits or about their characteristics&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Material and methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Observational cross-sectional study of diagnoses made in outpatient dermatology clinics during 2 data-collection periods in the anonymous DIADERM National Random Survey of dermatologists across Spain&#46; All entries with an International Classification of Diseases&#44; Tenth Revision code related to dermatology in the 2 periods &#40;84 diagnoses&#41; were collected for patients younger than 18 years and classified into 14 categories to facilitate analysis and comparison&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In total&#44; the search found 20&#160;097 diagnoses made in patients younger than 18 years &#40;12&#37; of all coded diagnoses in the DIADERM database&#41;&#46; Viral infections&#44; acne&#44; and atopic dermatitis were the most common&#44; accounting for 43&#46;9&#37; of all diagnoses&#46; No significant differences were observed in the proportions of diagnoses in the respective caseloads of specialist vs&#46; general dermatology clinics or public vs&#46; private clinics&#46; Seasonal differences in diagnoses &#40;January vs&#46; May&#41; were also nonsignificant&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusions</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Pediatric care accounts for a significant proportion of the dermatologist&#39;s caseload in Spain&#46; Our findings are useful for identifying opportunities for improving communication and training in pediatric primary care and for designing training focused on the optimal treatment of acne and pigmented lesions &#40;with instruction on basic dermoscopy use&#41; in these settings&#46;</p></span>"
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                  <table border="0" frame="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Diagn&#243;stico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">IC 95&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Infecciones v&#237;ricas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;259&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">1&#46;578-4&#46;940&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">16&#44;22&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Acn&#233; y cuadros relacionados&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;722-4&#46;728&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">16&#44;05&#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
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                  \t\t\t\t">Otros&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;652&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="char" valign="\n
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                  \t\t\t\t">976-4&#46;328&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="char" valign="\n
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                  \t\t\t\t">13&#44;19&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Dermatitis at&#243;pica&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;354&nbsp;\t\t\t\t\t\t\n
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                  \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">Nevos melanoc&#237;ticos&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;095&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;067-3&#46;123&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;42&#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">Otras dermatitis&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;402&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">498-2&#46;307&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;98&#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">Otros tumores benignos&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;346&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">503-2&#46;188&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;70&#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">Infecciones bacterianas&#44; f&#250;ngicas&#44; ven&#233;reas e infestaciones&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">939&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">146-1&#46;731&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;67&#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">Cuadros tricol&#243;gicos&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">849&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">213-1&#46;484&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;22&#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">Anomal&#237;as vasculares &#40;tumores y malformaciones&#41;&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">553&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">146-962&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;75&#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">Discrom&#237;as&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">547&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0-1&#46;108&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;72&#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">Liquen plano y otros trastornos papuloescamosos&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">414&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">161-668&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;06&#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">Psoriasis&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">407&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">163-652&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;03&#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">Tumores cut&#225;neos malignos&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="char" 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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0-145&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;27&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3325490.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">5 d&#237;as&#58; n&#250;mero de diagn&#243;sticos estimados en una semana de 5 d&#237;as laborables&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Frecuencia estimada de diagn&#243;sticos en una semana laboral de los pacientes menores de 18 a&#241;os en toda Espa&#241;a</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "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">&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  " colspan="6" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P&#250;blica</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="6" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Privada</th></tr><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Diagn&#243;stico&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  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">General</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Monogr&#225;fica</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">General</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Monogr&#225;fica</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&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">N&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">&#37;&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">N&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">&#37;&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">N&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">&#37;&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">N&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">&#37;&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">N&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">&#37;&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">N&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">&#37;&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-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">Acn&#233; y cuadros relacionados&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;658&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="char" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">14&#44;88&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">Cuadros tricol&#243;gicos&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="char" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">5&#44;35&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">Dermatitis at&#243;pica&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="char" valign="\n
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                  \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">Discrom&#237;as&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">3&#44;92&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">Infecciones bacterianas&#44; f&#250;ngicas&#44; ven&#233;reas e infestaciones&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="char" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">454&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="char" valign="\n
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                  \t\t\t\t">6&#44;71&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">Infecciones v&#237;ricas&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="char" valign="\n
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                  \t\t\t\t">530&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">27&#44;63&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;258&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="char" valign="\n
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                  \t\t\t\t">18&#44;60&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">Lesiones vasculares &#40;tumores y malformaciones&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#44;55&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&#44;97&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">3&#44;58&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">171&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;53&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">Liquen plano y otros trastornos papuloescamosos&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="char" valign="\n
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                  \t\t\t\t">190&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&#44;03&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">128&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="char" valign="\n
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                  \t\t\t\t">3&#44;61&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&#44;46&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">64&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#44;10&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#44;18&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">Nevo melanoc&#237;tico&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="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">6&#44;74&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">Otras dermatitis&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \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">Otros&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">675&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">Otros tumores benignos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  """
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                  \t\t\t\t">1&#46;419 &#40;15&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">121 &#40;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">4&#46;743 &#40;51&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;537 &#40;44&#41;&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><span class="elsevierStyleItalic">Otro especialista</span>&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">728 &#40;8&#41;&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="char" valign="\n
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                  \t\t\t\t">445 &#40;13&#41;&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
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">2&#46;397 &#40;26&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;413 &#40;40&#41;&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="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Origen del paciente</span>&#44; <span class="elsevierStyleItalic">&#225;mbito privado</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;42</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
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                  \t\t\t\t">4&#46;053 &#40;73&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">647 &#40;70&#41;&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><span class="elsevierStyleItalic">M&#233;dico de atenci&#243;n primaria</span>&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\ttop\n
                  \t\t\t\t">548 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">143 &#40;16&#41;&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><span class="elsevierStyleItalic">Otro especialista</span>&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">203 &#40;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">48 &#40;5&#41;&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><span class="elsevierStyleItalic">Otro dermat&#243;logo</span>&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">751 &#40;13&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">80 &#40;9&#41;&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="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Destino del paciente</span>&#44; <span class="elsevierStyleItalic">&#225;mbito p&#250;blico</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="5" align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;47</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><span class="elsevierStyleItalic">Alta</span>&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;461 &#40;28&#41;&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="char" valign="\n
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                  \t\t\t\t">592 &#40;17&#41;&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><span class="elsevierStyleItalic">M&#233;dico de atenci&#243;n primaria</span>&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="char" valign="\n
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                  \t\t\t\t">723 &#40;8&#41;&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="char" valign="\n
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                  \t\t\t\t">474 &#40;14&#41;&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><span class="elsevierStyleItalic">Otro especialista</span>&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="char" valign="\n
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                  \t\t\t\t">175 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">78 &#40;2&#41;&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
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                  \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">5&#46;585 &#40;62&#41;&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">2&#46;323 &#40;67&#41;&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="3" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Destino del paciente</span>&#44; <span class="elsevierStyleItalic">&#225;mbito p&#250;blico</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;72</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><span class="elsevierStyleItalic">Alta</span>&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="char" valign="\n
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                  \t\t\t\t">1&#46;290 &#40;24&#41;&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="char" valign="\n
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                  \t\t\t\t">282 &#40;31&#41;&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><span class="elsevierStyleItalic">M&#233;dico de atenci&#243;n primaria</span>&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">33 &#40;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0 &#40;0&#41;&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><span class="elsevierStyleItalic">Otro especialista</span>&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="char" valign="\n
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                  \t\t\t\t">113 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">0 &#40;0&#41;&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><span class="elsevierStyleItalic">Dermat&#243;logo</span>&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#46;044 &#40;74&#41;&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="char" valign="\n
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                  \t\t\t\t">621 &#40;69&#41;&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="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Per&#237;odo de la encuesta</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="3" align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;74</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><span class="elsevierStyleItalic">Enero</span>&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;378 &#40;60&#41;&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="char" valign="\n
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                  \t\t\t\t">2&#46;424 &#40;54&#41;&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><span class="elsevierStyleItalic">Mayo</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">6&#46;245 &#40;40&#41;&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="char" valign="\n
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                  \t\t\t\t">2&#46;041 &#40;46&#41;&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="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Secci&#243;n territorial de la Academia Espa&#241;ola de Dermatolog&#237;a y Venereolog&#237;a</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="11" align="char" valign="\n
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                  \t\t\t\t">0&#44;14</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>Andaluza&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="char" valign="\n
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                  \t\t\t\t">2&#46;145 &#40;14&#41;&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">593 &#40;13&#41;&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
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Vasco-Navarro-Aragonesa-Riojana&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Cuadros tricol&#243;gicos&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">Dermatitis at&#243;pica&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">Discrom&#237;as&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\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">Infecciones bacterianas&#44; f&#250;ngicas&#44; ven&#233;reas e infestaciones&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">Infecciones v&#237;ricas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">1&#46;901 &#40;16&#41;&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">Lesiones vasculares &#40;tumores y malformaciones&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\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">Liquen plano y otros trastornos papuloescamosos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">208 &#40;3&#41;&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">Nevo melanoc&#237;tico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;180 &#40;10&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">915 &#40;11&#41;&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">Otras dermatitis&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">899 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \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">Otros&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#46;666 &#40;14&#41;&nbsp;\t\t\t\t\t\t\n
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¿Cuánta carga asistencial suponen las dermatosis pediátricas en la actividad ambulatoria en la dermatología española? Resultados del muestreo aleatorio nacional DIADERM
What Proportion of the Spanish Dermatology Caseload Corresponds to Pediatric Dermatoses? Results From the DIADERM National Random Sampling Survey
A. Martin-Gorgojoa,b,
Corresponding author
alejandromartingorgojo@aedv.es

Autor para correspondencia.
, J. Del Bozb,c, M.Á. Descalzo-Gallegob, S. Arias-Santiagod, A. Molina-Leyvad, Y. Gilabertee, P. Fernández-Crehuetf, H. Husein-ElAhmedg, A. Viera-Ramírezh, P. Fernández-Peñasi, R. Tabernerj, A. Buendía-Eismank, I. García-Dovalb
a Servicio de ITS/Dermatología, Sección de Especialidades Médicas. Ayuntamiento de Madrid, Madrid, España
b Unidad de Investigación. Fundación Piel Sana AEDV, Madrid, España
c Servicio de Dermatología, Hospital Regional Universitario de Málaga, Málaga, España
d Servicio de Dermatología. Hospital Virgen de las Nieves, Granada, España
e Servicio de Dermatología. Hospital Universitario Miguel Servet, IIS Aragón, Zaragoza, España
f Servicio de Dermatología. Hospital Universitario Reina Sofía, Córdoba, España
g Servicio de Dermatología. Hospital General de Baza, Granada, España
h Servicio de Dermatología. Hospital Santa Catalina, Las Palmas de Gran Canaria, España
i The University of Sydney, Department of Dermatology, Westmead Hospital, Westmead, New South Wales, Australia
j Departamento de Dermatología. Hospital de Son Llàtzer, Palma de Mallorca, España
k Facultad de Medicina, Universidad de Granada, Granada, España
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">Se estima que entre el 6 y el 30&#37; de los motivos de consulta en las consultas de pediatr&#237;a se producen por trastornos dermatol&#243;gicos<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; De la misma forma&#44; se calcula que entre el 10 y el 15&#37; de los pacientes atendidos en las consultas de dermatolog&#237;a son menores de 16 a&#241;os<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">3&#8211;5</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">En la infancia las manifestaciones cut&#225;neas de muchas enfermedades var&#237;an con respecto a las manifestaciones de las mismas enfermedades en la edad adulta&#44; y su manejo y tratamiento tambi&#233;n pueden diferir&#46; Asimismo&#44; existen m&#250;ltiples afecciones dermatol&#243;gicas propias o incluso exclusivas de la edad infantil&#46; Dicha variedad de posibles diagn&#243;sticos y necesidad de manejo espec&#237;fico ha llevado a la creaci&#243;n de consultas dedicadas exclusivamente a la dermatolog&#237;a pedi&#225;trica<a class="elsevierStyleCrossRefs" href="#bib0115"><span class="elsevierStyleSup">6&#44;7</span></a>&#46; En Espa&#241;a la dermatolog&#237;a pedi&#225;trica no est&#225; reconocida como subespecialidad&#44; como s&#237; lo est&#225; en otros pa&#237;ses<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">7</span></a>&#44; lo que ha hecho que algunos autores se planteen itinerarios docentes para su reconocimiento como tal<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">8</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Algunos de los casos remitidos desde atenci&#243;n primaria a las consultas de dermatolog&#237;a tienen un diagn&#243;stico sencillo que ha sido bien realizado en las consultas de pediatr&#237;a&#44; y los pacientes son remitidos para optimizar su manejo &#40;como ocurre por ejemplo en muchos casos de dermatitis at&#243;pica&#44; vit&#237;ligo&#44; psoriasis&#44; hemangiomas infantiles&#44; infecciones cut&#225;neas como verrugas v&#237;ricas o moluscos contagiosos&#44; lesiones qu&#237;sticas de diversa &#237;ndole&#8230;&#41;&#46; Sin embargo&#44; otros casos son remitidos a dermatolog&#237;a para confirmar su naturaleza o sin haberse llegado a un diagn&#243;stico de sospecha claro&#46; Entre estos &#250;ltimos&#44; algunos casos precisar&#225;n de otras pruebas complementarias por parte del dermat&#243;logo para su confirmaci&#243;n diagn&#243;stica&#44; como puede ser un an&#225;lisis histol&#243;gico &#40;previa cirug&#237;a adaptada a la poblaci&#243;n pedi&#225;trica<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">9</span></a>&#41; o la solicitud de un estudio gen&#233;tico&#44; correspondiendo en ocasiones a casos de diagn&#243;sticos excepcionales&#44; y muchos de ellos ser&#225;n finalmente remitidos para su seguimiento en consultas monogr&#225;ficas de dermatolog&#237;a pedi&#225;trica<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">10</span></a>&#46; A pesar de ello&#44; no existen estudios multic&#233;ntricos nacionales que hayan evaluado estos motivos de consulta&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">El estudio DIADERM tuvo por finalidad analizar los diagn&#243;sticos realizados en las consultas de dermatolog&#237;a m&#233;dico-quir&#250;rgica y venereolog&#237;a &#40;DMQyV&#41; de los miembros de la Academia Espa&#241;ola de Dermatolog&#237;a y Venereolog&#237;a &#40;AEDV&#41; en Espa&#241;a<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">5</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Mediante este trabajo queremos estimar la demanda de atenci&#243;n ambulatoria en los pacientes en edad pedi&#225;trica&#44; por los dermat&#243;logos en Espa&#241;a&#44; a partir de los diagn&#243;sticos codificados de la actividad de &#8212;y por&#8212; los propios dermat&#243;logos&#46; Asimismo&#44; se pretende analizar las posibles diferencias existentes en estos diagn&#243;sticos en funci&#243;n del &#225;rea geogr&#225;fica&#44; origen de la consulta y su destino en funci&#243;n del &#225;mbito p&#250;blico y privado&#44; as&#237; como de otros factores&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Material y m&#233;todo</span><p id="par0030" class="elsevierStylePara elsevierViewall">Estudio observacional de corte transversal para describir los diagn&#243;sticos realizados por los dermat&#243;logos en 2 per&#237;odos de tiempo &#40;19 a 21 de enero y 18 a 20 de mayo de 2016&#41;&#46; Dichos datos se obtuvieron a trav&#233;s de la encuesta an&#243;nima DIADERM&#44; realizada a una muestra aleatoria de dermat&#243;logos&#44; estratificada por secciones de la AEDV&#44; y representativa de los dermat&#243;logos de Espa&#241;a&#46; La metodolog&#237;a y caracter&#237;sticas de dicha encuesta &#40;incluyendo los datos recogidos y c&#243;mo se realiz&#243; la codificaci&#243;n de los diagn&#243;sticos&#41; se encuentra descrita en detalle en el primer manuscrito del proyecto<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">5</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Se incluyeron las variables previamente recogidas en el estudio&#46; Para el an&#225;lisis espec&#237;fico de las dermatosis en la edad pedi&#225;trica&#44; se seleccionaron todos los diagn&#243;sticos codificados en los menores de 18 a&#241;os&#44; que se agruparon en categor&#237;as diagn&#243;sticas relacionadas para facilitar su an&#225;lisis y comparaci&#243;n &#40;<a class="elsevierStyleCrossRef" href="#sec0050">tabla suplementaria 1</a>&#41;&#46; Para tratar de aproximarse a la frecuencia de los diagn&#243;sticos en una semana de trabajo&#44; se calcularon en base al n&#250;mero de diagn&#243;sticos estimados en una semana de 5 d&#237;as laborables&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">El an&#225;lisis estad&#237;stico se realiz&#243; teniendo en cuenta el dise&#241;o empleado para recoger la muestra&#44; utilizando el m&#243;dulo <span class="elsevierStyleItalic">survey</span> de Stata<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">11</span></a>&#46; El m&#243;dulo tiene en cuenta la obtenci&#243;n de errores est&#225;ndar para datos correlacionados&#46; Adem&#225;s&#44; no hizo falta la correcci&#243;n del ajuste para poblaciones finitas&#44; considerando el n&#250;mero real de dermat&#243;logos por cada secci&#243;n de la AEDV&#44; al estar pr&#243;xima a 1&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">El estudio fue sido clasificado como estudio no-postautorizaci&#243;n &#40;No-EPA&#41; por la Agencia Espa&#241;ola del Medicamento y Productos Sanitarios y aprobado por el Comit&#233; de &#201;tica de Investigaci&#243;n de la provincia de Granada &#40;8 de octubre de 2014&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Resultados</span><p id="par0050" class="elsevierStylePara elsevierViewall">Durante la recogida de datos del estudio DIADERM&#44; un total de 20&#46;097 diagn&#243;sticos fueron efectuados en pacientes menores de 18 a&#241;os&#44; lo que supone un 12&#37; del total de todos los codificados &#40;en 2016&#41;&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> refleja la estimaci&#243;n de frecuencia de diagn&#243;sticos en una semana laboral de los pacientes menores de 18 a&#241;os&#58; las infecciones v&#237;ricas&#44; el acn&#233; y la dermatitis at&#243;pica fueron&#44; en orden de frecuencia&#44; los diagn&#243;sticos m&#225;s comunes&#44; representando un 43&#44;9&#37; de todos los diagn&#243;sticos&#46; El diagn&#243;stico menos frecuente fue el de los tumores cut&#225;neos malignos&#44; codificados bajo los ep&#237;grafes C44 &#40;otros tumores malignos de la piel&#41; y C83 &#40;linfoma no folicular&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> muestra la distribuci&#243;n de frecuencia de diagn&#243;sticos en funci&#243;n del tipo de consulta general o monogr&#225;fica y del &#225;mbito asistencial p&#250;blico o privado&#46; Sin que se encontraran diferencias estad&#237;sticamente significativas entre &#225;mbitos p&#250;blico y privado&#44; los 3 grupos diagn&#243;sticos definidos m&#225;s frecuentes en el p&#250;blico fueron el acn&#233; y cuadros relacionados &#40;16&#44;6&#37;&#41;&#44; las infecciones v&#237;ricas &#40;14&#44;9&#37;&#41; y los nevos melanoc&#237;ticos &#40;12&#44;5&#37;&#41;&#46; En el &#225;mbito privado&#44; las infecciones v&#237;ricas &#40;18&#44;6&#37;&#41;&#44; el acn&#233; y cuadros relacionados &#40;14&#44;9&#37;&#41; y la dermatitis at&#243;pica &#40;12&#44;7&#37;&#41;&#46; Aunque en algunos casos aparentes&#44; las diferencias en la proporci&#243;n de diagn&#243;sticos atendidos en las consultas monogr&#225;ficas frente a las generales&#44; as&#237; como en los registrados en el &#225;mbito p&#250;blico frente al privado&#44; no fueron estad&#237;sticamente significativas&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">Tampoco se apreciaron diferencias estad&#237;sticamente significativas entre las consultas generales y monogr&#225;ficas &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41; atendiendo a factores como el &#237;ndice de pacientes nuevos&#47;revisiones&#44; la financiaci&#243;n&#44; el origen y destino de los pacientes y la fase de administraci&#243;n de la encuesta &#40;enero o mayo de 2016&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Por &#250;ltimo&#44; tampoco hubo diferencias significativas &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;31&#41; en los diagn&#243;sticos codificados en funci&#243;n de la estaci&#243;n del a&#241;o &#40;fase de la encuesta enero o mayo&#41;&#44; registrados en la <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discusi&#243;n</span><p id="par0075" class="elsevierStylePara elsevierViewall">En el presente estudio se han revisado los datos de la encuesta DIADERM relativos a los pacientes pedi&#225;tricos&#44; que supon&#237;an &#40;en 2016&#41; un 12&#37; de la carga asistencial de los m&#233;dicos especialistas en dermatolog&#237;a m&#233;dico-quir&#250;rgica y venereolog&#237;a en Espa&#241;a&#46; Los diagn&#243;sticos m&#225;s comunes en este grupo de poblaci&#243;n fueron las infecciones v&#237;ricas&#44; el acn&#233; y trastornos relacionados y la dermatitis at&#243;pica&#46;La cifra del 12&#37; de pacientes &#171;pedi&#225;tricos&#187; en las consultas de dermatolog&#237;a resulta inferior a la descrita en la serie de Taberner et al&#46; de 2010 &#40;17&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">12</span></a>&#44; pero superponible a la hallada por estudios previos como el de Casanova et al&#46; en 2008 &#40;12&#44;1&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">3</span></a> y muy pr&#243;xima a la de Goh y Akarapanth en 1994 &#40;12&#44;4&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">4</span></a>&#44; si bien en los 3 art&#237;culos el l&#237;mite de edad para considerar un paciente pedi&#225;trico fue de 16 a&#241;os&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Los resultados de manuscritos previos muestran c&#243;mo las frecuencias de los diagn&#243;sticos var&#237;an&#44; por lo que no concuerdan totalmente con la casu&#237;stica observada en nuestro trabajo&#46; Las consultas &#171;monogr&#225;ficas&#187; del &#225;mbito p&#250;blico recogidas en la encuesta DIADERM s&#237; que coinciden en los 3 primeros diagn&#243;sticos en frecuencia con los m&#225;s comunes en 1984 en las consultas externas de pediatr&#237;a de un centro estadounidense<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">13</span></a>&#58; dermatosis infecciosas&#44; dermatitis at&#243;pica y acn&#233;&#44; lo cual podr&#237;a poner sobre la pista de una colaboraci&#243;n m&#225;s estrecha entre pediatr&#237;a y dermatolog&#237;a pedi&#225;trica en algunos casos &#40;o que m&#225;s bien pueda deberse a una mayor facilidad de acceder al dermat&#243;logo directamente en el &#225;mbito privado&#41;&#46; Una revisi&#243;n publicada en Espa&#241;a en 2005<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">14</span></a> describ&#237;a que las dermatosis m&#225;s frecuentes en pediatr&#237;a de atenci&#243;n primaria eran las infecciosas &#40;con las bacterianas como las m&#225;s habituales&#41;&#44; seguidas de la dermatitis del pa&#241;al &#40;a d&#237;a de hoy&#44; gracias a los nuevos dise&#241;os de los pa&#241;ales&#44; la incidencia de esta &#250;ltima es claramente menor&#41; y la at&#243;pica &#40;a partir de datos publicados en 1985<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">15</span></a>&#41;&#46; A su vez&#44; las m&#225;s frecuentes en las consultas de dermatolog&#237;a pedi&#225;trica eran las infecciones &#40;m&#225;s com&#250;nmente por hongos&#44; cuya incidencia claramente ha bajado actualmente gracias a las mejores condiciones de higiene&#44; mayor control veterinario&#8230;&#41;&#44; seguidas de la dermatitis at&#243;pica y el acn&#233; vulgar &#40;seg&#250;n datos publicados en 1983<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">16</span></a>&#41;&#46; Las dermatosis pedi&#225;tricas m&#225;s habituales en urgencias de dermatolog&#237;a de un hospital nacional de tercer nivel seg&#250;n un trabajo de 2004 incluyeron las infecciones y los eczemas&#44; si bien se describ&#237;an las picaduras&#47;prurigo como el tercer motivo de consulta m&#225;s frecuente<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">17</span></a>&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Profundizando en los datos presentados&#44; destacamos los vertidos en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#44; que recalcan la importancia de realizar formaci&#243;n para atenci&#243;n primaria&#44; que podr&#237;a evitar la derivaci&#243;n de casos para evaluaci&#243;n dermatol&#243;gica&#46; Con respecto a lo reflejado en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#44; subrayamos los siguientes diagn&#243;sticos m&#225;s frecuentes en las consultas monogr&#225;ficas p&#250;blicas&#58; el acn&#233; &#40;creemos que en parte por motivos pecuniarios&#58; financiaci&#243;n de las prescripciones de isotretino&#237;na&#44; as&#237; como de los an&#225;lisis de sangre&#41;&#59; las anomal&#237;as vasculares &#40;tambi&#233;n por motivos cremat&#237;sticos&#44; aunque adem&#225;s podr&#237;a relacionarse a la mayor facilidad de acceso a comit&#233;s multidisciplinares&#44; solicitud de pruebas diagn&#243;sticas espec&#237;ficas y acceso a tratamientos avanzados&#41;&#46; Inversamente&#44; la dermatitis at&#243;pica&#44; las infecciones v&#237;ricas y otras dermatitis son proporcionalmente m&#225;s frecuentes en el &#225;mbito privado &#40;puede verse influido por la mayor facilidad en lograr una cita directa y&#47;o m&#225;s temprana&#41;&#46; Nos ha resultado llamativa la diferencia de proporci&#243;n de diagn&#243;sticos de nevos melanoc&#237;ticos en el &#225;mbito p&#250;blico frente al privado&#44; que podr&#237;a estar motivada por la falta de sensaci&#243;n de urgencia&#44; con menor problema a la hora de esperar para una cita en la sanidad p&#250;blica&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Con respecto a las consultas monogr&#225;ficas&#44; el trabajo de Torrelo y Zambrano de 2002<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">2</span></a> describiendo las frecuencias de diagn&#243;sticos su centro obtuvo como los m&#225;s frecuentes&#44; por orden&#58; el eczema&#44; las dermatosis infecciosas y los nevos&#46; Creemos que los datos de las consultas &#171;monogr&#225;ficas&#187; del estudio DIADERM no coinciden completamente con los del Servicio de Dermatolog&#237;a Pedi&#225;trica del Hospital Universitario Ni&#241;o Jes&#250;s&#44; pues la clasificaci&#243;n en la encuesta como tales no iba referida <span class="elsevierStyleItalic">sensu stricto</span> a las de dermatolog&#237;a pedi&#225;trica&#44; sino a cualquier consulta monogr&#225;fica de dermatolog&#237;a&#46; Quiz&#225; este hecho pueda explicar el n&#250;mero relativamente alto de tumores malignos entre los diagn&#243;sticos&#44; m&#225;s prevalentes en otras consultas monogr&#225;ficas no pedi&#225;tricas&#46; Por otra parte&#44; en nuestro caso se han dividido las dermatosis infecciosas en varios bloques&#44; v&#237;ricas y otras&#44; y los eczemas en dermatitis at&#243;pica y otras dermatitis &#40;si se uniesen&#44; los resultados ser&#237;an bastante similares&#41;&#46; La mayor diferencia estar&#237;a en el acn&#233;&#44; que actualmente es un motivo muy frecuente de consulta en nuestro medio&#46; El trabajo m&#225;s reciente describiendo la casu&#237;stica en consultas de dermatolog&#237;a pedi&#225;trica es una serie griega cuyos diagn&#243;sticos m&#225;s frecuentes fueron eczema&#44; infecciones v&#237;ricas y trastornos pigmentarios &#40;independientes de nevos melanoc&#237;ticos&#44; que fue el cuarto diagnostico m&#225;s frecuente&#41;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">10</span></a>&#46; Comparando nuestros datos con los de este &#250;ltimo trabajo&#44; nos encontramos con que el acn&#233; en nuestra casu&#237;stica fue mucho m&#225;s frecuente&#46; Esto podr&#237;a deberse a la edad m&#225;s amplia incluida en nuestro estudio&#44; as&#237; como a factores culturales de aquel pa&#237;s &#40;que lleven a una menor demanda de consulta al respecto&#41; e incluso a factores como la gen&#233;tica&#44; la dieta o el estilo de vida&#44; que pueda favorecer una menor prevalencia de acn&#233; en estas &#225;reas&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Asimismo&#44; el que no se hayan detectado diferencias estad&#237;sticamente significativas &#40;aunque s&#237; tendencias&#41; en nuestros datos de consultas generales frente a monogr&#225;ficas puede deberse al n&#250;mero limitado de casos o a que lo que diferencia &#8212;<span class="elsevierStyleItalic">grosso modo&#8212;</span> las consultas monogr&#225;ficas es la gravedad&#44; m&#225;s que el diagn&#243;stico&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Aunque se registraron m&#225;s diagn&#243;sticos en enero que en mayo de 2016 durante la fase de recogida de datos de DIADERM&#44; no hemos podido observar diferencias significativas en la distribuci&#243;n relativa de las dermatosis identificadas entre ambos per&#237;odos&#46; El &#250;nico estudio previo que hemos identificado que analizase la concentraci&#243;n de dermatosis en funci&#243;n del mes del a&#241;o tampoco encontr&#243; claras diferencias<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">13</span></a>&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">El estudio presenta algunas limitaciones&#44; como el hecho de considerar a la poblaci&#243;n pedi&#225;trica como la de menos de 18 a&#241;os &#40;cuando en algunos trabajos se habla de menores de 16 o con edad igual o menor a 16 a&#241;os&#41; y la imposibilidad de identificar las consultas monogr&#225;ficas de dermatolog&#237;a pedi&#225;trica &#40;la clasificaci&#243;n de consulta &#171;monogr&#225;fica&#187; en el estudio DIADERM no se refer&#237;a &#250;nicamente a las consultas monogr&#225;ficas de dermatolog&#237;a pedi&#225;trica&#41;&#46; Tampoco hemos tenido posibilidad de valorar por periodos m&#225;s espec&#237;ficos de edad&#44; ni por sexos&#46; Adicionalmente&#44; los dos per&#237;odos de recogida de datos &#40;enero y mayo&#41; no permiten identificar bien la estacionalidad &#40;por ejemplo&#44; en verano podr&#237;a ser esperable que existiera m&#225;s incidencia de imp&#233;tigo y menos de brotes de dermatitis at&#243;pica&#41;&#44; que a su vez puede estar en parte influida por la lista de espera&#46; Por &#250;ltimo&#44; cabe rese&#241;ar que los datos recabados en el estudio son de 2016 y que cabe la posibilidad de que la pandemia por SARS-CoV-2 haya hecho que lo registrado en la encuesta DIADERM requiera una nueva edici&#243;n para conocer la situaci&#243;n pospand&#233;mica&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">A pesar de ello&#44; el estudio tiene fortalezas&#44; como la metodolog&#237;a empleada&#44; representativa de la actividad de los dermat&#243;logos en Espa&#241;a&#44; y el gran tama&#241;o muestral que permite precisi&#243;n en los resultados&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusiones</span><p id="par0115" class="elsevierStylePara elsevierViewall">La atenci&#243;n a pacientes pedi&#225;tricos por parte de dermat&#243;logos en Espa&#241;a supone una proporci&#243;n significativa de su actividad habitual&#44; y el conocimiento de su prevalencia y distribuci&#243;n es de gran importancia para poder plantear estrategias de mejora&#46; Las dermatosis infecciosas&#44; la dermatitis at&#243;pica y el acn&#233; son los diagn&#243;sticos m&#225;s com&#250;nmente registrados en menores de 18 a&#241;os&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Consideramos que los hallazgos descritos permiten descubrir &#225;reas de mejoras en la comunicaci&#243;n y la formaci&#243;n de los pediatras de atenci&#243;n primaria&#44; como el refuerzo de actividades formativas dirigidas al mejor manejo de acn&#233; y lesiones pigmentadas en atenci&#243;n primaria&#46; Creemos conveniente la realizaci&#243;n de nuevos estudios espec&#237;ficamente centrados en la edad pedi&#225;trica que nos permitan obtener m&#225;s informaci&#243;n&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Financiaci&#243;n</span><p id="par0125" class="elsevierStylePara elsevierViewall">El estudio DIADERM fue promovido por la Fundaci&#243;n Piel Sana de la AEDV&#44; que recibi&#243; ayuda econ&#243;mica de Novartis&#46; La compa&#241;&#237;a farmac&#233;utica no particip&#243; en la recogida de datos&#44; ni en el an&#225;lisis de los datos&#44; ni en la interpretaci&#243;n de los resultados&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Autor&#237;as</span><p id="par0130" class="elsevierStylePara elsevierViewall">Martin-Gorgojo y J&#46; del Boz Contribuyen de manera equivalente como primeros autores&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflicto de intereses</span><p id="par0135" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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            1 => "Consulta externa hospitalaria"
            2 => "Actividad ambulatoria"
            3 => "Dermatolog&#237;a"
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            1 => "Hospital outpatient clinics"
            2 => "Ambulatory care"
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    "resumen" => array:2 [
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        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Introducci&#243;n</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Los motivos de consulta de &#237;ndole dermatol&#243;gico son muy frecuentes en las consultas de pediatr&#237;a de atenci&#243;n primaria&#44; e igualmente muchos de los pacientes atendidos en consultas de dermatolog&#237;a son ni&#241;os y adolescentes&#46; A pesar de ello&#44; faltan estudios sobre la prevalencia real de estas consultas y sus caracter&#237;sticas&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Material y m&#233;todo</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional de corte transversal de 2 per&#237;odos de tiempo describiendo los diagn&#243;sticos realizados en consultas externas dermatol&#243;gicas&#44; obtenidos a trav&#233;s de la encuesta an&#243;nima DIADERM&#44; realizada a una muestra aleatoria y representativa de dermat&#243;logos&#46; A partir de la codificaci&#243;n de diagn&#243;sticos CIE-10&#44; se seleccionaron todos los diagn&#243;sticos codificados en los menores de 18 a&#241;os &#40;84 diagn&#243;sticos codificados en los 2 per&#237;odos&#41;&#44; que se agruparon en 14 categor&#237;as diagn&#243;sticas relacionadas para facilitar su an&#225;lisis y comparaci&#243;n&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Un total de 20&#46;097 diagn&#243;sticos fueron efectuados en pacientes menores de 18 a&#241;os&#44; lo que supone un 12&#37; del total de los codificados en DIADERM&#46; Las infecciones v&#237;ricas&#44; el acn&#233; y la dermatitis at&#243;pica fueron los diagn&#243;sticos m&#225;s comunes &#40;43&#44;9&#37; de todos los diagn&#243;sticos&#41;&#46; No se observaron diferencias estad&#237;sticamente significativas en la proporci&#243;n de diagn&#243;sticos atendidos en las consultas monogr&#225;ficas frente a las generales&#44; as&#237; como en los registrados en el &#225;mbito p&#250;blico frente al privado&#46; Tampoco las hubo en los diagn&#243;sticos en funci&#243;n de la &#233;poca de la encuesta &#40;enero y mayo&#41;&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La atenci&#243;n a pacientes pedi&#225;tricos por parte de dermat&#243;logos en Espa&#241;a supone una proporci&#243;n significativa de la actividad habitual&#46; Estos datos nos permiten descubrir &#225;reas de mejora en la comunicaci&#243;n y la formaci&#243;n de los pediatras de atenci&#243;n primaria&#44; como la necesidad del refuerzo de actividades formativas dirigidas al mejor tratamiento de acn&#233; y lesiones pigmentadas &#40;y manejo b&#225;sico de la dermatoscopia&#41; en este &#225;mbito asistencial&#46;</p></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Background</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Visits for skin conditions are very common in pediatric primary care&#44; and many of the patients seen in outpatient dermatology clinics are children or adolescents&#46; Little&#44; however&#44; has been published about the true prevalence of these visits or about their characteristics&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Material and methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Observational cross-sectional study of diagnoses made in outpatient dermatology clinics during 2 data-collection periods in the anonymous DIADERM National Random Survey of dermatologists across Spain&#46; All entries with an International Classification of Diseases&#44; Tenth Revision code related to dermatology in the 2 periods &#40;84 diagnoses&#41; were collected for patients younger than 18 years and classified into 14 categories to facilitate analysis and comparison&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In total&#44; the search found 20&#160;097 diagnoses made in patients younger than 18 years &#40;12&#37; of all coded diagnoses in the DIADERM database&#41;&#46; Viral infections&#44; acne&#44; and atopic dermatitis were the most common&#44; accounting for 43&#46;9&#37; of all diagnoses&#46; No significant differences were observed in the proportions of diagnoses in the respective caseloads of specialist vs&#46; general dermatology clinics or public vs&#46; private clinics&#46; Seasonal differences in diagnoses &#40;January vs&#46; May&#41; were also nonsignificant&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Conclusions</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Pediatric care accounts for a significant proportion of the dermatologist&#39;s caseload in Spain&#46; Our findings are useful for identifying opportunities for improving communication and training in pediatric primary care and for designing training focused on the optimal treatment of acne and pigmented lesions &#40;with instruction on basic dermoscopy use&#41; in these settings&#46;</p></span>"
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                  \t\t\t\t">Infecciones v&#237;ricas&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;259&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;578-4&#46;940&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#44;22&#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">Acn&#233; y cuadros relacionados&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;225&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;722-4&#46;728&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#44;05&#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">Otros&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;652&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">976-4&#46;328&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;19&#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">Dermatitis at&#243;pica&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;354&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;251-3&#46;457&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;71&#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">Nevos melanoc&#237;ticos&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;095&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;067-3&#46;123&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;42&#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">Otras dermatitis&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;402&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">498-2&#46;307&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;98&#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">Otros tumores benignos&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;346&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">503-2&#46;188&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;70&#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">Infecciones bacterianas&#44; f&#250;ngicas&#44; ven&#233;reas e infestaciones&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">939&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">146-1&#46;731&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;67&#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">Cuadros tricol&#243;gicos&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">849&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">213-1&#46;484&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;22&#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">Anomal&#237;as vasculares &#40;tumores y malformaciones&#41;&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">553&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">146-962&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;75&#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">Discrom&#237;as&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">547&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0-1&#46;108&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;72&#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">Liquen plano y otros trastornos papuloescamosos&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">414&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">161-668&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;06&#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">Psoriasis&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">407&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">163-652&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;03&#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">Tumores cut&#225;neos malignos&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="char" 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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0-145&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;27&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3325490.png"
              ]
            ]
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          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">5 d&#237;as&#58; n&#250;mero de diagn&#243;sticos estimados en una semana de 5 d&#237;as laborables&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Frecuencia estimada de diagn&#243;sticos en una semana laboral de los pacientes menores de 18 a&#241;os en toda Espa&#241;a</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabla 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "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">&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  " colspan="6" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P&#250;blica</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="6" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Privada</th></tr><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Diagn&#243;stico&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  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">General</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Monogr&#225;fica</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">General</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Monogr&#225;fica</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&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">N&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">&#37;&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">N&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">&#37;&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">N&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">&#37;&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">N&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">&#37;&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">N&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">&#37;&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">N&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">&#37;&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-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">Acn&#233; y cuadros relacionados&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;658&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#44;73&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">484&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;64&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;142&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#44;60&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">943&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#44;15&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="char" 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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;83&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;006&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&#44;88&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">Cuadros tricol&#243;gicos&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">361&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;86&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">95&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">456&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">346&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;93&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;73&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">362&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;35&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">Dermatitis at&#243;pica&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">877&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">606&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&#44;08&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;483&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&#44;50&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">552&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;45&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">304&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#44;94&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">856&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#44;66&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">Discrom&#237;as&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">176&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;88&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">267&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;07&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">265&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;54&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;00&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">265&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;92&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">Infecciones bacterianas&#44; f&#250;ngicas&#44; ven&#233;reas e infestaciones&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">331&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;54&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">123&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;47&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">454&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;52&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">423&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</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">6&#44;71&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">Infecciones v&#237;ricas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">18&#44;60&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">Lesiones vasculares &#40;tumores y malformaciones&#41;&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="char" valign="\n
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                  \t\t\t\t">145&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#44;55&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">6&#44;71&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">383&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#44;97&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2&#44;53&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">Liquen plano y otros trastornos papuloescamosos&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  " align="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">128&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="char" valign="\n
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                  \t\t\t\t">3&#44;61&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#44;10&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1&#44;18&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">Nevo melanoc&#237;tico&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="char" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">6&#44;74&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">Otras dermatitis&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="char" valign="\n
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                  \t\t\t\t">8&#44;33&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">Otros&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">Otros tumores benignos&nbsp;\t\t\t\t\t\t\n
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                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3325492.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Frecuencias absolutas y relativas de los diagn&#243;sticos en funci&#243;n del tipo de consulta general o monogr&#225;fica y del &#225;mbito asistencial p&#250;blico o privado</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Tabla 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
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                0 => """
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variable&#47;respuesta&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Consulta general&#40;frecuencia &#91;&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Consulta monogr&#225;fica&#40;frecuencia &#91;&#37;&#93;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">9&#46;677 &#40;62&#41;&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\ttop\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;837 &#40;38&#41;&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">918 &#40;21&#41;&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
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#46;348 &#40;62&#41;&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#46;547 &#40;79&#41;&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="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Origen del paciente</span>&#44; <span class="elsevierStyleItalic">&#225;mbito p&#250;blico</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;18</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
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;419 &#40;15&#41;&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">121 &#40;3&#41;&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><span class="elsevierStyleItalic">M&#233;dico de atenci&#243;n primaria</span>&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\ttop\n
                  \t\t\t\t">4&#46;743 &#40;51&#41;&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;537 &#40;44&#41;&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><span class="elsevierStyleItalic">Otro especialista</span>&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\ttop\n
                  \t\t\t\t">728 &#40;8&#41;&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">445 &#40;13&#41;&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
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                  \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\ttop\n
                  \t\t\t\t">2&#46;397 &#40;26&#41;&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\ttop\n
                  \t\t\t\t">1&#46;413 &#40;40&#41;&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="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Origen del paciente</span>&#44; <span class="elsevierStyleItalic">&#225;mbito privado</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="5" align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;42</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \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\ttop\n
                  \t\t\t\t">4&#46;053 &#40;73&#41;&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">647 &#40;70&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">M&#233;dico de atenci&#243;n primaria</span>&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\ttop\n
                  \t\t\t\t">548 &#40;10&#41;&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">143 &#40;16&#41;&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><span class="elsevierStyleItalic">Otro especialista</span>&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">203 &#40;4&#41;&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="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48 &#40;5&#41;&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><span class="elsevierStyleItalic">Otro dermat&#243;logo</span>&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">751 &#40;13&#41;&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">80 &#40;9&#41;&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="3" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Destino del paciente</span>&#44; <span class="elsevierStyleItalic">&#225;mbito p&#250;blico</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;47</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
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">2&#46;461 &#40;28&#41;&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">592 &#40;17&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">M&#233;dico de atenci&#243;n primaria</span>&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">723 &#40;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">474 &#40;14&#41;&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><span class="elsevierStyleItalic">Otro especialista</span>&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">175 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">78 &#40;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">5&#46;585 &#40;62&#41;&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">2&#46;323 &#40;67&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Destino del paciente</span>&#44; <span class="elsevierStyleItalic">&#225;mbito p&#250;blico</span></td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">1&#46;290 &#40;24&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">282 &#40;31&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">M&#233;dico de atenci&#243;n primaria</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">33 &#40;1&#41;&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">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \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><span class="elsevierStyleItalic">Otro especialista</span>&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">113 &#40;2&#41;&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">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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ISSN: 00017310
Original language: Spanish
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