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          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Resultados del cuestionario sobre planificaci&#243;n familiar &#40;cuestiones de la 19 a la 27&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La psoriasis afecta negativamente la calidad de vida de los pacientes<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">1</span></a>&#46; En Espa&#241;a&#44; la prevalencia es de 2&#44;3&#37;&#44; con aproximadamente un mill&#243;n de pacientes y una prevalencia similar entre g&#233;neros<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">2</span></a>&#46; El debut ocurre entre la segunda y cuarta d&#233;cadas de la vida en 75&#37; de los casos&#46; Por lo tanto&#44; su aparici&#243;n coincide con los a&#241;os reproductivos de la mujer&#44; lo que puede plantearle miedos e incertidumbres sobre la maternidad<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">3&#44;4</span></a> por falta de informaci&#243;n sobre la planificaci&#243;n familiar&#44; el embarazo o la lactancia<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">5&#44;6</span></a>&#46; Seg&#250;n el registro BIOBADADERM&#44; las mujeres con psoriasis moderada-grave en Espa&#241;a tienen menores tasas de embarazo<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">7</span></a> y son menos proclives a la lactancia materna que la poblaci&#243;n general<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">8</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">La evoluci&#243;n de la psoriasis durante el embarazo es imprevisible&#46; Aproximadamente la mitad de las mujeres mejoran de sus s&#237;ntomas&#44; otras mantienen una actividad similar y en m&#225;s de 20&#37; hay una exacerbaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">3</span></a>&#46; Adem&#225;s&#44; 65&#37; de las pacientes empeoran de los s&#237;ntomas en el posparto<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">9</span></a>&#46; La psoriasis no controlada en el embarazo se asocia a complicaciones tanto maternas como fetales<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">3&#44;10&#8211;12</span></a>&#46; Aunque hay numerosos tratamientos para la psoriasis potencialmente teratog&#233;nicos<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">13&#8211;15</span></a>&#44; en la actualidad disponemos de opciones terap&#233;uticas compatibles con el embarazo y la lactancia<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">5&#44;16&#8211;18</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El objetivo principal del estudio fue determinar el impacto de la enfermedad sobre el deseo gestacional y la lactancia&#44; saber m&#225;s de las inquietudes y miedos de las mujeres con psoriasis antes&#44; durante o despu&#233;s del embarazo&#44; as&#237; como la informaci&#243;n sobre planificaci&#243;n familiar&#44; embarazo y lactancia que reciben en las consultas&#44; con el fin de que en un futuro puedan recibir informaci&#243;n m&#225;s completa&#44; seg&#250;n sus necesidades por parte de su dermat&#243;logo&#46; Como objetivos secundarios se evalu&#243; si existen diferencias en el impacto de la enfermedad&#44; las preocupaciones o la informaci&#243;n en funci&#243;n de haber tenido alg&#250;n embarazo&#47;hijo&#44; el tratamiento con biol&#243;gicos&#44; o la actividad de la enfermedad seg&#250;n el m&#233;dico o la paciente&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos</span><p id="par0020" class="elsevierStylePara elsevierViewall">Estudio observacional&#44; descriptivo&#44; transversal y multic&#233;ntrico&#46; La selecci&#243;n de las pacientes se realiz&#243; en consultas de dermatolog&#237;a de centros espa&#241;oles&#46; La inclusi&#243;n de pacientes se realiz&#243; entre marzo del 2020 y octubre del 2021&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Poblaci&#243;n de estudio</span><p id="par0025" class="elsevierStylePara elsevierViewall">Se incluyeron mujeres con psoriasis en placas&#44; de 18-45 a&#241;os&#44; candidatas a recibir tratamiento sist&#233;mico y que estaban de acuerdo en participar en el estudio&#46; Se excluyeron pacientes con artritis psori&#225;sica &#40;para centrarnos en el dominio cut&#225;neo de la psoriasis y minimizar la variabilidad&#41; y pacientes que no quer&#237;an participar o no pod&#237;an escribir o leer apropiadamente&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Variables y recogida de datos</span><p id="par0030" class="elsevierStylePara elsevierViewall">Se recogieron variables cl&#237;nicas&#44; incluyendo <span class="elsevierStyleItalic">Psoriasis Area Severity Index</span> &#40;PASI&#41;&#44; <span class="elsevierStyleItalic">Body Surface Area</span> &#40;BSA&#41;&#44; percepci&#243;n de la actividad de la psoriasis por parte del m&#233;dico en una escala visual anal&#243;gica &#40;EVA&#41; de 0-10&#44; comorbilidades y tratamientos previos y actuales&#46; Se evalu&#243; la calidad de vida con una escala cualitativa &#40;<a class="elsevierStyleCrossRef" href="#sec0090">material suplementario</a>&#41; y por medio del <span class="elsevierStyleItalic">Dermatology Life Quality Index</span> &#40;DLQI&#41;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">19</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Las pacientes respondieron an&#243;nimamente en papel un cuestionario con datos sociodemogr&#225;ficos y percepci&#243;n de la actividad de la psoriasis&#46; Cumplimentaron un cuestionario de 27 preguntas sobre planificaci&#243;n familiar dise&#241;ado para el estudio &#40;<a class="elsevierStyleCrossRef" href="#sec0090">material suplementario</a>&#41;&#46; Los investigadores elaboraron el cuestionario <span class="elsevierStyleItalic">ad hoc</span> para este proyecto teniendo en cuenta los objetivos del estudio&#46; Las preocupaciones e informaci&#243;n antes del embarazo&#44; as&#237; como el impacto de la enfermedad se abordaron en los &#237;tems 1-16 y 24&#46; En el &#237;tem 2 se eval&#250;a el impacto de la enfermedad en la vida sexual&#46; Las preocupaciones e informaci&#243;n durante el embarazo se trataron en los &#237;tems 17-21 y despu&#233;s del embarazo en los &#237;tems 22&#44; 23 y 25&#46; Dos &#237;tems adicionales &#40;26 y 27&#41; analizan la informaci&#243;n por parte del m&#233;dico u otros medios&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Con los resultados&#44; se elabor&#243; una tabla con aspectos para tratar en las consultas&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Estudio estad&#237;stico</span><p id="par0045" class="elsevierStylePara elsevierViewall">Las variables se describieron mediante distribuci&#243;n de frecuencias&#44; m&#237;nimo&#44; m&#225;ximo&#44; media y desviaci&#243;n est&#225;ndar &#40;DE&#41; o mediana y rango intercuart&#237;lico &#40;RIC&#41;&#46; Para determinar los objetivos secundarios&#44; se realizaron suban&#225;lisis evaluando diferencias por el hecho de haber tenido alg&#250;n embarazo&#47;hijos&#44; la actividad de la enfermedad &#40;leve&#58; EVA &#61; 0-2 vs<span class="elsevierStyleItalic">&#46;</span> moderada o grave&#58; EVA &#61; 3-10&#41;&#44; y el uso actual de tratamientos biol&#243;gicos&#46; Las comparaciones de variables cualitativas se realizaron mediante la prueba chi-cuadrado y las de variables cuantitativas independientes o pareadas mediante la prueba de Mann-Whitney o de Wilcoxon&#44; respectivamente &#40;nivel de significaci&#243;n&#58; 5&#37;&#59; paquete estad&#237;stico SPSS 25&#46;0 &#91;IBM Corp&#46;&#44; Armonk&#44; NY&#44; EE&#46; UU&#46;&#93;&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Aspectos &#233;ticos</span><p id="par0055" class="elsevierStylePara elsevierViewall">Se sigui&#243; la Declaraci&#243;n de Helsinki y la legislaci&#243;n espa&#241;ola en materia de investigaci&#243;n cl&#237;nica y de protecci&#243;n de datos&#46; Las participantes firmaron un consentimiento informado&#46; El estudio fue aprobado por el Comit&#233; &#201;tico de Investigaci&#243;n Cl&#237;nica del Hospital Ram&#243;n y Cajal &#40;acta N&#176;373&#41;&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Resultados</span><p id="par0060" class="elsevierStylePara elsevierViewall">Se incluyeron 153 mujeres de 11 centros espa&#241;oles &#40;edad media&#58; 35&#44;4 &#177; 8 a&#241;os&#41;&#46; Las caracter&#237;sticas sociodemogr&#225;ficas y cl&#237;nicas se resumen en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; La mayor&#237;a de las pacientes &#40;51&#44;6&#37;&#41; no hab&#237;an estado nunca embarazadas&#46; De las 74 pacientes que hab&#237;an estado embarazadas&#44; la mayor&#237;a hab&#237;an tenido uno o dos hijos &#40;51&#44;4 y 27&#37;&#44; respectivamente&#41;&#44; y 35&#44;1&#37; hab&#237;a sufrido al menos un aborto&#59; 23&#44;9&#37; recibieron atenci&#243;n en unidades de embarazo de alto riesgo&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">La mediana de la duraci&#243;n de enfermedad era de 16 a&#241;os &#40;RIC&#58; 9-22&#59; m&#237;nimo&#58; 1&#59; m&#225;ximo&#58; 41 a&#241;os&#41;&#46; La mayor&#237;a de las pacientes presentaban una enfermedad leve en el momento de la valoraci&#243;n &#40;81&#44;4&#37; BSA &#60; 5&#37;&#41;&#46; Sin embargo&#44; la percepci&#243;n de la gravedad de la enfermedad por las pacientes era moderada-grave &#40;EVA 3-10&#41; en 49&#37; de los casos y de 38&#44;4&#37; casos seg&#250;n los m&#233;dicos&#46; La percepci&#243;n de la actividad era significativamente superior para las pacientes que para los m&#233;dicos &#40;EVA media 3&#44;6 vs&#46; 2&#44;7 y mediana de 2 vs<span class="elsevierStyleItalic">&#46;</span> 1&#44;5&#59; p &#60; 0&#44;001&#41;&#46; Respecto a la calidad de vida&#44; 41&#44;2&#37; refer&#237;a que estaba moderada&#44; muy o extremadamente afectada &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Los resultados del cuestionario sobre planificaci&#243;n familiar se resumen en las <a class="elsevierStyleCrossRefs" href="#fig0005">figuras 1&#44; 2&#44; 3</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Respecto impacto de la enfermedad&#44; m&#225;s de 30&#37; de las pacientes estaba bastante o muy de acuerdo con la afirmaci&#243;n de que la enfermedad puede afectar a su vida sexual &#40;&#237;tem 2&#41;&#46; Para 35&#37;&#44; la enfermedad retrasa o limita su deseo de descendencia &#40;&#237;tems 6-7&#41;&#59; 20&#44;5&#37;&#44; considera que la enfermedad puede limitarle para cuidar un hijo adecuadamente &#40;&#237;tem 24&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Respecto a las preocupaciones&#44; en 55-65&#37; exist&#237;a preocupaci&#243;n de que la enfermedad empeore al tener que retirar o cambiar un f&#225;rmaco antes del embarazo&#44; durante el embarazo o durante la lactancia &#40;&#237;tems 15&#44; 19 y 23&#41;&#46; A alrededor de 60&#37; le preocupaba que los tratamientos puedan da&#241;ar al beb&#233; &#40;&#237;tem 21&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Respecto a la informaci&#243;n recibida&#44; cerca de la mitad de las pacientes consideraba que no se abordan en la consulta temas como la planificaci&#243;n familiar&#44; el deseo gestacional o los tratamientos antes de concebir &#40;&#237;tems 11-13&#41;&#46; Un tercio consideraba que conoc&#237;a los f&#225;rmacos que puede tomar y cu&#225;les no antes del embarazo &#40;&#237;tem 14&#41;&#46; Cerca de 60&#37; era consciente de que la psoriasis tiene que estar controlada antes y durante el embarazo &#40;&#237;tems 16 -17&#41;&#46; Una proporci&#243;n relevante de pacientes no hab&#237;a recibido informaci&#243;n sobre las opciones en el embarazo o la lactancia &#40;&#237;tems 18 y 22&#41;&#46; Casi la mitad estaba bastante o muy de acuerdo con que si recibiera m&#225;s informaci&#243;n por parte del m&#233;dico se replantear&#237;a el deseo de tener hijos&#46;</p><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">An&#225;lisis en funci&#243;n de haber tenido alg&#250;n embarazo&#47;hijo</span><p id="par0090" class="elsevierStylePara elsevierViewall">La actividad de la enfermedad medida por PASI o BSA&#44; as&#237; como la calidad de vida por el DLQI&#44; no era estad&#237;sticamente diferente en pacientes con o sin embarazos&#47;hijos&#46; La percepci&#243;n de la actividad de la enfermedad seg&#250;n la paciente era superior a la percepci&#243;n del m&#233;dico tanto en aquellas que hab&#237;an tenido embarazo&#47;hijos &#40;EVA media de la paciente 4&#44;2 vs&#46; 3&#44;1 del m&#233;dico&#59; p &#61; 0&#44;001&#41; como en las que no &#40;EVA media de la paciente 3&#44;1 vs&#46; 2&#44;3 del m&#233;dico&#59; p &#61; 0&#44;002&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Hab&#237;a diferencias estad&#237;sticamente significativas en nueve cuestiones del cuestionario de planificaci&#243;n familiar entre las pacientes con o sin embarazos&#47;hijos &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46; Las diferencias indican una menor informaci&#243;n de las pacientes sin embarazos&#47;hijos sobre planificaci&#243;n familiar &#40;&#237;tem 11&#41; o sobre la seguridad de los tratamientos antes del embarazo&#44; durante el embarazo o durante la lactancia materna &#40;&#237;tems 14&#44; 20 y 25&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">An&#225;lisis en funci&#243;n del tratamiento actual con o sin biol&#243;gicos</span><p id="par0100" class="elsevierStylePara elsevierViewall">La percepci&#243;n de la actividad de la enfermedad seg&#250;n la paciente era superior a la del m&#233;dico tanto en aquellas pacientes que recib&#237;an tratamiento biol&#243;gico &#40;EVA media de la paciente 2&#44;6 vs&#46; 1&#44;9 del m&#233;dico&#59; p &#61; 0&#44;009&#41; como en las que no &#40;EVA 5&#44;3 vs&#46; 3&#44;9&#59; p &#60; 0&#44;001&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">La percepci&#243;n de la actividad por parte de la paciente y del m&#233;dico&#44; as&#237; como la gravedad medida por PASI y por BSA&#44; era estad&#237;sticamente inferior en las pacientes que recib&#237;an tratamiento biol&#243;gico &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46; La calidad de vida medida por DLQI era significativamente mejor en pacientes en tratamiento con biol&#243;gicos&#46; Cualitativamente tambi&#233;n se observa que la calidad de vida era superior en las pacientes que recib&#237;an tratamiento biol&#243;gico &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">Hubo diferencias estad&#237;sticamente significativas en tres &#237;tems del cuestionario de planificaci&#243;n familiar &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46; Las pacientes sin tratamiento biol&#243;gico refer&#237;an una mayor afectaci&#243;n de la vida sexual &#40;&#237;tem 2&#41; y una mayor necesidad de b&#250;squeda de informaci&#243;n externa &#40;&#237;tem 27&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">An&#225;lisis en funci&#243;n de la actividad de la psoriasis seg&#250;n la paciente</span><p id="par0115" class="elsevierStylePara elsevierViewall">El PASI y la BSA eran estad&#237;sticamente inferiores en el grupo de pacientes que perciben la actividad como leve <span class="elsevierStyleItalic">vs&#46;</span> moderada&#47;intensa &#40;PASI medio 1&#44;5 vs&#46; 4&#44;8 puntos&#59; p &#60; 0&#44;001&#59; BSA medio 1&#44;0 vs&#46; 4&#44;9 puntos&#59; p &#60; 0&#44;001&#41;&#46; La calidad de vida era mejor en el grupo de pacientes que percib&#237;an la actividad como leve &#40;DLQI medio 3&#44;4 vs&#46; 9&#44;9&#59; p &#60; 0&#44;001&#41;&#46; En el cuestionario de planificaci&#243;n familiar solo hubo diferencias en relaci&#243;n con el impacto de la enfermedad en la vida sexual &#40;&#237;tem 2&#41;&#44; siendo mayor en las que presentaban enfermedad moderada&#47;intensa que leve &#40;46 vs<span class="elsevierStyleItalic">&#46;</span> 24&#37;&#44; respectivamente&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">An&#225;lisis en funci&#243;n de la actividad de la psoriasis seg&#250;n el m&#233;dico</span><p id="par0120" class="elsevierStylePara elsevierViewall">El PASI y la BSA fueron estad&#237;sticamente inferiores en el grupo de pacientes con actividad leve vs&#46; actividad moderada&#47;intensa &#40;PASI medio 1&#44;4 vs&#46; 5&#44;9&#59; p &#60; 0&#44;001&#59; BSA medio&#58; 0&#44;8 vs&#46; 6&#44;5&#59; p &#60; 0&#44;001&#41;&#46; La calidad de vida media era mejor en el grupo de pacientes con actividad leve &#40;DLQI medio&#58; 4&#44;4 vs&#46; 10&#59; p &#60; 0&#44;001&#41;&#46; No hubo diferencias significativas en ninguna cuesti&#243;n del cuestionario de planificaci&#243;n familiar&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Discusi&#243;n</span><p id="par0125" class="elsevierStylePara elsevierViewall">Estudios recientes indican que las mujeres con psoriasis moderada-grave en Espa&#241;a tienen menores tasas de embarazo<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">7</span></a> y son menos proclives a la lactancia materna que la poblaci&#243;n general<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">8</span></a>&#46; Las causas de esto pueden ser m&#250;ltiples&#58; causas psicol&#243;gicas&#44; sentimientos de baja autoestima&#44; estigmatizaci&#243;n y disminuci&#243;n de la confianza que conduzca a una disfunci&#243;n sexual&#44; factores sociales y familiares&#44; preocupaci&#243;n por la seguridad de los tratamientos para el feto&#44; etc&#46;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">7&#44;8</span></a> En nuestra encuesta&#44; m&#225;s de 40&#37; de las pacientes consideraban que si recibieran m&#225;s informaci&#243;n por parte del m&#233;dico se replantear&#237;an el deseo de tener hijos&#46; Por ello&#44; en l&#237;nea con consensos recientes<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">13</span></a>&#44; consideramos que se deber&#237;a ser m&#225;s proactivos en facilitar esta informaci&#243;n &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">En mujeres&#44; la psoriasis se diagnostica de media a los 28 a&#241;os y el inicio del tratamiento se produce entre los 28-45 a&#241;os&#44; lo que coinciden con los a&#241;os de m&#225;xima actividad reproductiva<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">5</span></a>&#46; En nuestro estudio&#44; las pacientes tienen una edad media de 35&#44;4 a&#241;os y llevan 16&#44;7 a&#241;os de evoluci&#243;n de la psoriasis&#44; as&#237; que es un grupo representativo de mujeres en plena edad reproductiva&#46; La enfermedad tiene un gran impacto f&#237;sico y emocional en las mujeres y afecta a su calidad de vida &#40;en mayor medida que a los hombres&#41;&#44; a sus relaciones &#237;ntimas y produce mucha incertidumbre sobre los posibles efectos de la enfermedad en la maternidad<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">3&#44;5</span></a>&#46; Estos aspectos son poco conocidos y podr&#237;an estar infravalorados en la pr&#225;ctica cl&#237;nica<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">5&#44;6</span></a>&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Nuestra cohorte re&#250;ne pacientes con una carga significativa de enfermedad&#46; En aproximadamente un 1&#47;3 de las pacientes el impacto de la enfermedad retrasa o limita su deseo de tener hijos&#46; La encuesta pone en evidencia algunas preocupaciones que podr&#237;an explicar estos miedos&#44; relacionados principalmente con la seguridad de los tratamientos&#44; la evoluci&#243;n de la enfermedad y la falta de informaci&#243;n&#46; A la gran mayor&#237;a de las mujeres les preocupaba que los tratamientos pudieran da&#241;ar al beb&#233;&#44; pero tambi&#233;n les preocupaba que la enfermedad empeore al tener que retirar o cambiar el tratamiento antes o durante el embarazo o en la lactancia&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Los datos sugieren que la informaci&#243;n que se da en la consulta de dermatolog&#237;a sobre planificaci&#243;n familiar&#44; deseo gestacional o seguridad de los tratamientos es insuficiente tanto antes de concebir&#44; como durante la gestaci&#243;n o la lactancia&#44; especialmente en mujeres sin embarazos previos&#46; Consideramos que todas las mujeres en edad f&#233;rtil deber&#237;an recibir informaci&#243;n suficiente en la consulta&#46; Adem&#225;s&#44; hasta 50&#37; de los embarazos no son planificados&#44; por ello&#44; en l&#237;nea con otros autores<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">5</span></a>&#44; consideramos que puede ser recomendable un plan de tratamiento compatible con el embarazo en las mujeres en edad f&#233;rtil&#44; independientemente de las intenciones de planificaci&#243;n familiar&#46; Adem&#225;s&#44; ser&#237;a importante capacitar y mejorar el papel informador de los dermat&#243;logos sobre la planificaci&#243;n familiar&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Los resultados sugieren que las mujeres en tratamiento biol&#243;gico est&#225;n mejor controladas y tienen mejor calidad de vida y menos impacto de la enfermedad en la vida sexual que las pacientes sin tratamiento biol&#243;gico&#46; El tratamiento de la psoriasis durante el embarazo y la lactancia supone un reto para el cl&#237;nico<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">3&#44;13&#44;14</span></a>&#46; Aunque hay numerosas terapias con potencial efecto teratog&#233;nico que hay que retirar antes de la concepci&#243;n<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">13</span></a>&#44; existen tratamientos disponibles que se pueden utilizar de forma segura durante el embarazo y la lactancia&#44; y deber&#237;amos informar a las pacientes al respecto&#46; Entre los tratamientos biol&#243;gicos&#44; certolizumab pegol es la opci&#243;n m&#225;s segura tanto en embarazo como en la lactancia&#44; dada su transferencia m&#237;nima o nula a trav&#233;s de la placenta y a la leche materna<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">16&#44;17&#44;20</span></a>&#46; En mujeres embarazadas tratadas con biol&#243;gicos&#44; se puede mantener el tratamiento durante el primer y segundo trimestres y valorar con la paciente los riesgos y beneficios de continuar con ellos durante el tercer trimestre&#46; Sin embargo&#44; las pacientes que reciben certolizumab pegol podr&#237;an usarlo durante todo el embarazo si se considera cl&#237;nicamente necesario&#44; as&#237; como durante la lactancia<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">13</span></a>&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Tanto en mujeres sanas<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">20</span></a> como en mujeres con otras enfermedades cr&#243;nicas<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">21</span></a> existen evidencias de que el comportamiento en relaci&#243;n con el embarazo est&#225; influido por su percepci&#243;n del riesgo<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">22</span></a>&#46; Las diferentes enfermedades cr&#243;nicas introducen diversos riesgos de embarazo y la percepci&#243;n del riesgo es &#250;nica para cada individuo y no se basa &#250;nicamente en informaci&#243;n objetiva sobre el riesgo<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">20</span></a>&#46; Por ello se necesita m&#225;s investigaci&#243;n para comprender las percepciones de riesgo de las mujeres en enfermedades cr&#243;nicas espec&#237;ficas y mejorar la informaci&#243;n que se proporciona a las pacientes sobre los riesgos objetivos<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">20</span></a>&#46; En el caso concreto de la psoriasis existen gu&#237;as recientes para el manejo de las pacientes<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">13</span></a>&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Nuestro estudio tiene limitaciones&#46; Es un estudio observacional&#44; descriptivo y transversal que carece de grupo de control con mujeres sin psoriasis o pacientes con psoriasis varones&#46; Sin embargo&#44; creemos que es una muestra representativa de las mujeres en edad f&#233;rtil atendidas en las consultas de dermatolog&#237;a en Espa&#241;a y que dan algunas claves de sus necesidades e inquietudes en relaci&#243;n con la planificaci&#243;n familiar&#46; Con estos resultados&#44; consideramos fundamental incrementar la informaci&#243;n que se da a las pacientes en las consultas&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conclusiones</span><p id="par0160" class="elsevierStylePara elsevierViewall">Los resultados de nuestro estudio sugieren que la psoriasis tiene un impacto en la planificaci&#243;n familiar y en el deseo gestacional de las pacientes&#46; Existen preocupaciones que podr&#237;an llevar a retrasar o limitar el deseo gestacional&#46; La informaci&#243;n proporcionada sobre estos temas durante el seguimiento no resulta completa&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Financiaci&#243;n</span><p id="par0165" class="elsevierStylePara elsevierViewall">Este estudio estuvo financiado con una beca sin restricciones de la C&#225;tedra Universidad Francisco de Vitoria-UCB en Inflamaci&#243;n y Salud &#211;sea&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conflicto de intereses</span><p id="par0170" class="elsevierStylePara elsevierViewall">Natalia Jim&#233;nez G&#243;mez ha actuado como asesora y&#47;o investigadora y&#47;o ponente para&#58; Abbvie&#44; Almirall&#44; BMS&#44; Celgene&#44; Janssen&#44; LEO Pharma&#44; Lilly&#44; MSD&#44; Novartis y UCB&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Ricardo Ruiz-Villaverde ha recibido honorarios por consultor&#237;a de Abbvie&#44; Novartis&#44; UCB&#44; Celgene y Janssen&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Mar&#237;a Luisa Alonso Pacheco de Abbvie&#44; Novartis&#44; Lilly&#44; LEO Pharma&#44; UCB&#44; Celgene y Janssen&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Rosa Mar&#237;a Izu ha sido consultor&#44; asesor&#44; impartido ponencias o participado en ensayos cl&#237;nicos para Almirall&#44; Novartis&#44; Abbvie&#44; Lilly&#44; LEO Pharma&#44; UCB&#44; Sanofi&#44; Celgene&#44; Pfizer&#44; Janssen y Kyowa-Kirin&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Raquel Rivera-D&#237;az ha recibido honorarios como investigador&#47;consultor para&#58; Abbvie&#44; Boehringer Ingelheim&#44; Celgene&#44; Janssen&#44; LEO Pharma&#44; Lilly&#44; Novartis&#44; Pfizer&#44; Novartis&#44; UCB&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Jordi Mollet Sanchez ha recibido honorarios como investigador&#47;consultor para&#58; Abbvie&#44; Amgen&#44; Boehringer Ingelheim&#44; Celgene&#44; Janssen&#44; LEO Pharma&#44; Lilly&#44; Novartis&#44; Pfizer&#44; Sanofi&#44; UCB&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Mar Llamas-Velasco ha recibido honorarios como investigador&#47;consultor para Abbvie&#44; Boehringer Ingelheim&#44; Celgene&#44; Janssen&#44; LEO Pharma&#44; Lilly&#44; Kyowa Kirin&#44; Novartis&#44; Pfizer&#44; Novartis&#44; UCB&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">&#193;lvaro Gonz&#225;lez-Cantero ha recibido honorarios como investigador&#47;consultor para Abbvie&#44; Amgen&#44; Celgene&#44; Janssen&#44; LEO Pharma&#44; Lilly&#44; Novartis&#44; Novartis&#44; UCB&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Pablo de la Cueva ha actuado como asesor y&#47;o investigador y&#47;o ponente de Abbvie&#44; Almirall&#44; BMS&#44; Boehringer&#44; Celgene&#44; Janssen&#44; LEO Pharma&#44; Lilly&#44; MSD&#44; Novartis&#44; Pfizer&#44; Roche&#44; Sanofi&#44; UCB&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Elena Mart&#237;nez Lorenzo ha recibido honorarios como consultor para Abbvie&#44; Almirall&#44; Janssen&#44; LEO Pharma&#44; Novartis&#44; UCB&#46; Adem&#225;s&#44; ha impartido ponencias o participado en formaciones con Abbvie&#44; Almirall&#44; Celgene&#44; Janssen&#44; LEO Pharma&#44; Lilly&#44; Novartis&#44; Roche&#44; UCB&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">Ofelia Baniandr&#233;s Rodr&#237;guez ha recibido honorarios como investigador&#47;consultor para&#58; Abbvie&#44; Amgen&#44; Celgene&#44; Janssen&#44; LEO Pharma&#44; Lilly&#44; Novartis&#44; Pfizer&#44; UCB&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">Gerard Pitarch Bort ha participado en estudios y ensayos cl&#237;nicos de Abbvie&#44; Janssen&#44; Novartis y UCB&#46; Ha recibido honorarios como ponente de Abbvie&#44; Janssen&#44; LEO Pharma&#44; Novartis y ayudas para formaci&#243;n de Abbvie&#44; Almirall&#44; Janssen&#44; Novartis y UCB&#46;</p></span></span>"
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              "titulo" => "An&#225;lisis en funci&#243;n de haber tenido alg&#250;n embarazo&#47;hijo"
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              "titulo" => "An&#225;lisis en funci&#243;n del tratamiento actual con o sin biol&#243;gicos"
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              "titulo" => "An&#225;lisis en funci&#243;n de la actividad de la psoriasis seg&#250;n la paciente"
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              "titulo" => "An&#225;lisis en funci&#243;n de la actividad de la psoriasis seg&#250;n el m&#233;dico"
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            2 => "Planificaci&#243;n familiar"
            3 => "Anticuerpos monoclonales"
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            1 => "Reproductive health"
            2 => "Family planning"
            3 => "Monoclonal antibodies"
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    "resumen" => array:2 [
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Antecedentes y objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La psoriasis afecta a un gran porcentaje de mujeres en edad f&#233;rtil&#46; Nuestro objetivo fue conocer las inquietudes de las mujeres con psoriasis en relaci&#243;n con la planificaci&#243;n familiar&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional&#44; descriptivo&#44; transversal y multic&#233;ntrico realizado entre marzo del 2020 y octubre del 2021&#46; Se recabaron datos sociodemogr&#225;ficos e inquietudes relacionadas con la planificaci&#243;n familiar de mujeres entre 18-45 a&#241;os con psoriasis en placas y candidatas a recibir tratamiento sist&#233;mico&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se reclutaron 153 pacientes de 11 centros espa&#241;oles &#40;edad media&#58; 35&#44;4 &#177; 8 a&#241;os&#44; duraci&#243;n media de la enfermedad&#58; 16&#44;7 a&#241;os&#41;&#59; 38&#44;4&#37; de los casos ten&#237;an una enfermedad moderada&#47;grave para los m&#233;dicos&#44; aunque la percepci&#243;n de la actividad era significativamente superior para las pacientes&#46; En una de cada tres mujeres&#44; la enfermedad limitaba o retrasaba el deseo gestacional&#46; Exist&#237;a preocupaci&#243;n de que la enfermedad empeorara al tener que retirar o cambiar un f&#225;rmaco o que los tratamientos perjudicaran al beb&#233;&#46; Alrededor de la mitad de las pacientes no hab&#237;a recibido informaci&#243;n sobre planificaci&#243;n familiar en la consulta&#44; especialmente aquellas mujeres sin embarazos previos&#46; Las mujeres con tratamiento biol&#243;gico &#40;58&#44;7&#37;&#41; ten&#237;an mejor situaci&#243;n cl&#237;nica&#44; mejor calidad de vida y menos alteraciones en la esfera sexual que las pacientes sin tratamiento biol&#243;gico&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Las pacientes con psoriasis tienen numerosas preocupaciones relacionadas con la planificaci&#243;n familiar&#46; En algunos casos&#44; estos miedos podr&#237;an llevar a retrasar y&#47;o limitar el deseo gestacional&#46; Ser&#237;a necesario incrementar la informaci&#243;n que se da a las pacientes y mejorar la formaci&#243;n de los dermat&#243;logos en este tema&#46;</p></span>"
        "secciones" => array:4 [
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          1 => array:2 [
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            "titulo" => "Material y m&#233;todos"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Background and objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A significant proportion of women of childbearing age have psoriasis&#46; The aim of this study was to examine family planning concerns in this population&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Observational&#44; descriptive&#44; cross-sectional&#44; multicenter study conducted between March 2020 and October 2021&#46; We collected sociodemographic data and analyzed responses to a family planning questionnaire administered to women aged 18 to 45 years with plaque psoriasis who were candidates for systemic treatment&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We studied 153 patients &#40;mean &#91;SD&#93; age&#44; 35&#46;4 &#91;8&#46;0&#93; years&#59; mean disease duration&#44; 16&#46;7 years&#41; being treated at 11 Spanish hospitals&#46; Overall&#44; 38&#46;4&#37; of women were considered to have moderate to severe psoriasis by their physicians&#59; perceived severity ratings were significantly higher among women&#46; Psoriasis affected the women&#39;s desire to become pregnant or led to their delaying pregnancy in 1 in 3 respondents&#46; They were concerned that their condition might worsen if they had to discontinue or switch treatment or that the treatment might harm the baby&#46; Approximately half of the women had not received family planning counseling from their physicians&#44; and this was more likely to be the case among never-pregnant women&#46; Women on biologic therapy &#40;58&#46;7&#37;&#41; had better psoriasis control and a better quality of life than women on other treatments&#46; Their sexual health was also less affected&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Women with psoriasis have numerous family planning concerns&#44; which in some cases can lead them to delay pregnancy or affect their desire to become pregnant&#46; Dermatologists need to receive better training regarding family planning in women with psoriasis so that they can provide their patients with more and better information&#46;</p></span>"
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                  \t\t\t\t"><span class="elsevierStyleItalic">n</span><span class="elsevierStyleItalic">Edad media &#177; DE &#40;a&#241;os&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">15335&#44;4 &#177; 8&#44;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Nivel de estudios&#44; &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Educaci&#243;n primaria o secundaria&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">28 &#40;18&#44;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
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">125 &#40;81&#44;7&#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
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                  \t\t\t\t"><span class="elsevierStyleItalic">Comorbilidades&#44; n &#40;&#37;&#41;</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus en tratamiento&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4 &#40;2&#44;6&#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
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hipertensi&#243;n en tratamiento&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">11 &#40;7&#44;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
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hiperlipidemia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;11&#44;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
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Obesidad m&#243;rbida &#40;IMC &#8805; 35&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;5&#44;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
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;ndrome metab&#243;lico en tratamiento&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5 &#40;3&#44;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>Enfermedad inflamatoria intestinal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;2&#37;&#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>H&#237;gado graso no alcoh&#243;lico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;2&#44;6&#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>Insuficiencia cardiaca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" 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></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>Insuficiencia renal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" 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></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>Ansiedad &#47; depresi&#243;n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;15&#44;1&#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>Otras comorbilidades&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">26 &#40;17&#44;1&#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="elsevierStyleItalic">Duraci&#243;n media de la psoriasis &#177; DE &#40;a&#241;os&#41;</span><span class="elsevierStyleItalic">Media de PASI &#177; DE</span><span class="elsevierStyleItalic">Media de BSA &#177; DE</span><span class="elsevierStyleItalic">Calidad de vida media &#177; DE &#40;escala DLQI de 0 a 30&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#44;7 &#177; 8&#44;03&#44;1 &#177; 4&#44;02&#44;9 &#177; 4&#44;46&#44;5 &#177; 5&#44;9&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="elsevierStyleItalic">Calidad de vida &#40;cualitativo&#41;&#44; n &#40;&#37;&#41;</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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CV no afectada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;0&#44;7&#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>CV poco afectada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">89 &#40;58&#44;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
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CV moderadamente afectada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35 &#40;22&#44;9&#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>CV muy afectada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;13&#44;7&#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>CV extremadamente afectada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;4&#44;6&#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="elsevierStyleItalic">Percepci&#243;n de la actividad seg&#250;n las pacientes &#40;EVA media &#177; DE&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;6 &#177; 3&#44;2&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="elsevierStyleItalic">Percepci&#243;n de la actividad seg&#250;n los m&#233;dicos &#40;EVA media &#177; DE&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;7 &#177; 2&#44;6&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="elsevierStyleItalic">Actividad de la enfermedad seg&#250;n las pacientes&#44; n &#40;&#37;&#41;</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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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>Leve &#40;EVA&#58; 0-2&#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="left" valign="\n
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                  \t\t\t\t">76 &#40;51&#44;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>Moderada &#40;EVA&#58; 3-7&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 &#40;33&#44;6&#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>Intensa &#40;EVA&#58; 8-10&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;15&#44;4&#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="elsevierStyleItalic">Actividad de la enfermedad seg&#250;n los m&#233;dicos&#44; n &#40;&#37;&#41;</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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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>Leve &#40;EVA&#58; 0-2&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90 &#40;61&#44;6&#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>Moderada &#40;EVA&#58; 3-7&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 &#40;34&#44;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
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Intensa &#40;EVA&#58; 8-10&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;4&#44;1&#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="elsevierStyleItalic">Tratamiento actual&#44; n &#40;&#37;&#41;</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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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>Tratamiento t&#243;pico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73 &#40;48&#44;7&#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>Corticoides sist&#233;micos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;4&#44;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>Tratamiento sist&#233;mico convencional&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;17&#44;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>Apremilast u otros tratamientos orales&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;8&#44;7&#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>Anti-TNF&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29 &#40;19&#44;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>Anti-IL 17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28 &#40;18&#44;7&#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>Anti-IL 23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;6&#44;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>Anti-IL 12&#47;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;14&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  \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="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Nada de acuerdo</th><th class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Poco de acuerdo</th><th class="td" title="\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Muy de acuerdo</th><th class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Con embarazo&#47;hijos&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">Sin embarazo&#47;hijos&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">Con embarazo&#47;hijos&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">Sin embarazo&#47;hijos&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">Con embarazo&#47;hijos&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">Sin embarazo&#47;hijos&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">Con embarazo&#47;hijos&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">Sin embarazo&#47;hijos&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="" 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></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">&#205;tem 3&#46; El tener descendencia es muy importante para m&#237;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;16&#44;9&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;26&#44;6&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;7&#44;7&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;21&#44;5&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;35&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;21&#44;5&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;40&#44;0&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;30&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;025&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">&#205;tem 5&#46; En alg&#250;n momento durante mi enfermedad me he planteado quedarme embarazada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">32 &#40;45&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13 &#40;16&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&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 ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">&#205;tem 11&#46; El tema de planificaci&#243;n familiar &#40;tener descendencia&#41; es un tema que se aborda en consulta&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;047&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#205;tem 13&#46; Antes de intentar concebir&#44; he elaborado junto con mi dermat&#243;logo&#47;a un plan de tratamiento sobre los medicamentos que debo o no debo tomar&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#205;tem 14&#46; Conozco qu&#233; f&#225;rmacos podr&#237;a tomar y cu&#225;les no antes del embarazo&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;012&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#205;tem 18&#46; El dermat&#243;logo&#47;a me ha informado de las opciones acerca de un embarazo&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#205;tem 20&#46; Conozco qu&#233; f&#225;rmacos podr&#237;a tomar y cu&#225;les no durante el embarazo&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#205;tem 22&#46; El dermat&#243;logo&#47;a me ha informado de las opciones sobre lactancia materna&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13 &#40;22&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#177; 5&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" 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
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mediana &#40;RIC&#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">0&#44;5 &#40;0&#44;0-2&#44;0&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;0 &#40;1&#44;0-7&#44;0&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60; 0&#44;001&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="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">DLQI</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&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="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Media &#177; DE&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5&#44;2 &#177; 5&#44;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">8&#44;6 &#177; 6&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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>Mediana &#40;RIC&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;0 &#40;2&#44;0-6&#44;0&#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
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                  \t\t\t\t">7&#44;0 &#40;4&#44;0-11&#44;0&#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="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&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"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Calidad de vida&#44; n &#40;&#37;&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a></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>No afectada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#44;1&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#44;0&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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>Poco afectada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63 &#40;71&#44;6&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;38&#44;7&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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>Moderadamente afectada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;13&#44;6&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;35&#44;5&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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>Muy afectada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;11&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;17&#44;7&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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>Extremadamente afectada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2 &#40;2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;8&#44;1&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \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="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Nada de acuerdo</th><th class="td" title="\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \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">Con biol&#243;gico&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">Sin biol&#243;gico&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">Con biol&#243;gico&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">Sin biol&#243;gico&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">Con biol&#243;gico&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">Sin biol&#243;gico&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">Con biol&#243;gico&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">Sin biol&#243;gico&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="" 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></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">&#205;tem 2&#46; Mi enfermedad afecta a mi vida sexual&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46 &#40;52&#44;9&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;38&#44;3&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;20&#44;7&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;15&#44;0&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;14&#44;9&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;35&#44;0&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;11&#44;5&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;11&#44;7&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;038&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">&#205;tem 11&#46; El tema de planificaci&#243;n familiar &#40;tener descendencia&#41; es un tema que se aborda en consulta&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">26 &#40;32&#44;5&#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="left" valign="\n
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                  \t\t\t\t">13 &#40;24&#44;5&#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="left" valign="\n
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                  \t\t\t\t">21 &#40;26&#44;3&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;9&#44;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="left" valign="\n
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                  \t\t\t\t">13 &#40;16&#44;3&#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="left" valign="\n
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                  \t\t\t\t">16 &#40;30&#44;2&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;25&#44;0&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19 &#40;35&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;024&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
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                  \t\t\t\t">&#205;tem 27&#46; He consultado fuentes de informaci&#243;n externas &#40;web&#44; revistas&#44; televisi&#243;n&#8230;&#41; sobre este tema de planificaci&#243;n familiar&#47;embarazo&#47; lactancia materna en pacientes con mi enfermedad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">35 &#40;45&#44;5&#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="left" valign="\n
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                  \t\t\t\t">25 &#40;50&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">17 &#40;22&#44;1&#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="left" valign="\n
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                  \t\t\t\t">2 &#40;4&#44;0&#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="left" valign="\n
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                  \t\t\t\t">11 &#40;14&#44;3&#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="left" valign="\n
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                  \t\t\t\t">12 &#40;24&#44;0&#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="left" valign="\n
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                  \t\t\t\t">14 &#40;18&#44;2&#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="left" valign="\n
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                  \t\t\t\t">11 &#40;22&#44;0&#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&#44;036&nbsp;\t\t\t\t\t\t\n
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          "es" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Diferencias entre mujeres con o sin tratamiento biol&#243;gico en el cuestionario de planificaci&#243;n familiar</p>"
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          "leyenda" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Fuentes de informaci&#243;n fidedigna sobre la planificaci&#243;n familiar en mujeres con psoriasis &#40;como informaci&#243;n proveniente de sociedades cient&#237;ficas o asociaciones de pacientes con informaci&#243;n contrastadas por especialistas&#41;&#46;</p>"
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                  \t\t\t\t" scope="col">Antes de la concepci&#243;n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col">Relacionados con el embarazo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col">Tras el parto&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8226; Problemas en la esfera sexual relacionados con la psoriasis&#8226; Retrasos o limitaciones en el deseo gestacional debido a la psoriasis o sus tratamientos&#8226; Necesidad de tener la enfermedad controlada antes de la concepci&#243;n&#8226; Tratamientos a evitar antes de la concepci&#243;n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8226; Necesidad de tener la enfermedad controlada durante el embarazo&#8226; Preocupaciones por&#58;&#176; La evoluci&#243;n de la psoriasis durante el embarazo&#176; La evoluci&#243;n de la psoriasis si se retira un tratamiento&#176; Complicaciones para la madre secundarias a la psoriasis o su tratamiento&#176; Complicaciones para el feto secundarias a la psoriasis o su tratamiento&#8226; Tratamientos a evitar durante el embarazo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8226; Evoluci&#243;n de la psoriasis despu&#233;s del embarazo&#8226; Posibilidad de lactancia materna&#8226; Preocupaciones por si los hijos heredan la psoriasis&#8226; Preocupaciones por si la psoriasis limita el cuidado adecuado del hijo&#8226; Tratamientos a evitar durante la lactancia&nbsp;\t\t\t\t\t\t\n
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              "identificador" => "bib0115"
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                0 => array:1 [
                  "referenciaCompleta" => "World Health Organization&#46; Global report on psoriasis &#91;Internet&#93;&#46; Geneva&#58; World Health Organization&#59; 2016&#44; &#91;consultado Mar 5 2022&#93;&#46; Disponible en&#58; <a target="_blank" href="https://apps.who.int/iris/handle/10665/204417">https&#58;&#47;&#47;apps&#46;who&#46;int&#47;iris&#47;handle&#47;10665&#47;204417</a>&#46;"
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                    0 => array:2 [
                      "titulo" => "Prevalence of psoriasis in Spain in the age of biologics"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Ferr&#225;ndiz"
                            1 => "J&#46;M&#46; Carrascosa"
                            2 => "M&#46; Toro"
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                    0 => array:2 [
                      "doi" => "10.1016/j.ad.2013.12.008"
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                        "tituloSerie" => "Actas Dermosifiliogr"
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                        "volumen" => "105"
                        "paginaInicial" => "504"
                        "paginaFinal" => "509"
                        "link" => array:1 [
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24569109"
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                      "titulo" => "Management of psoriasis in pregnancy - a review of the evidence to date"
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                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46; Ferreira"
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                            2 => "M&#46; Nogueira"
                            3 => "T&#46; Torres"
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                    0 => array:2 [
                      "doi" => "10.7573/dic.2019-11-6"
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                        "tituloSerie" => "Drugs Context&#46;"
                        "fecha" => "2020"
                        "volumen" => "9"
                        "paginaInicial" => "2019"
                        "paginaFinal" => "2111"
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                    0 => array:2 [
                      "titulo" => "Update on biologic safety for patients with psoriasis during pregnancy"
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                          "etal" => false
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                            0 => "M&#46;L&#46; Porter"
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                            2 => "A&#46;B&#46; Kimball"
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                    0 => array:2 [
                      "doi" => "10.1016/j.ijwd.2016.12.003"
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                        "tituloSerie" => "Int J Womens Dermatol&#46;"
                        "fecha" => "2017"
                        "volumen" => "3"
                        "paginaInicial" => "21"
                        "paginaFinal" => "25"
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                      "titulo" => "Clinical considerations for the management of psoriasis in women"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;B&#46; Gottlieb"
                            1 => "C&#46; Ryan"
                            2 => "J&#46;E&#46; Murase"
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                    0 => array:2 [
                      "doi" => "10.1016/j.ijwd.2019.04.021"
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                        "tituloSerie" => "Int J Womens Dermatol&#46;"
                        "fecha" => "2019"
                        "volumen" => "5"
                        "paginaInicial" => "141"
                        "paginaFinal" => "150"
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                      "titulo" => "Fears and misconceptions of women with chronic inflammatory diseases on their journey to motherhood"
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                          "autores" => array:5 [
                            0 => "J&#46; Murase"
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                            2 => "R&#46; Fischer-Betz"
                            3 => "C&#46; Ecoffet"
                            4 => "A&#46; Tincani"
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                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2019.06.265"
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                        "tituloSerie" => "J Am Acad Dermatol&#46;"
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                        "paginaInicial" => "AB65"
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                      "titulo" => "Women with moderate to-severe psoriasis in Spain &#40;BIOBADADERM registry&#41; show more than a 50&#37; reduction in age-adjusted fertility rate when compared with the general population"
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                        0 => array:2 [
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                            2 => "R&#46; Rivera"
                            3 => "C&#46; Ferr&#225;ndiz"
                            4 => "E&#46; Daud&#233;n"
                            5 => "P&#46; Cueva"
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                    0 => array:2 [
                      "doi" => "10.1111/bjd.18164"
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                        "tituloSerie" => "Br J Dermatol&#46;"
                        "fecha" => "2019"
                        "volumen" => "181"
                        "paginaInicial" => "1085"
                        "paginaFinal" => "1087"
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Women with moderate-to-severe psoriasis in Spain &#40;BIOBADADERM registry&#41; breastfeed less when compared with general population"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            1 => "M&#46; Llamas-Velasco"
                            2 => "G&#46; Carretero"
                            3 => "D&#46; Ru&#237;z-Genao"
                            4 => "I&#46; Belinch&#243;n"
                            5 => "J&#46; Riera-Monroig"
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ORIGINAL
Percepción de la mujer con psoriasis en la planificación familiar: Estudio descriptivo, transversal y multicéntrico
Family Planning Concerns Among Women With Psoriasis: A Descriptive, Cross-Sectional, Multicenter Study
N. Jiménez Gómeza,b,
Corresponding author
natjgomez@gmail.com

Autor para correspondencia.
, Á. González-Canteroa,b,c, R. Ruiz-Villaverded, M. Llamas-Velascoe, P. de la Cueva Dobaof, R. Rivera Díazg, E. Martínez Lorenzoh, M.L. Alonso Pachecoi, O. Baniandrés Rodríguezj, J. Mollet Sánchezk, G. Pitarch Bortl, R.M. Izu Bellosom, P. Jaén Olasoloa,b
a Hospital Universitario Ramón y Cajal, Madrid, España
b Grupo de Dermatología Pedro Jaén, Madrid, España
c Facultad de Medicina, Universidad Francisco de Vitoria, Madrid, España
d Hospital Universitario San Cecilio Granada, Instituto Biosanitario de Granada (Ibs), Granada, España
e Hospital Universitario de La Princesa, Madrid, España
f Hospital Universitario Infanta Leonor, Madrid, España
g Hospital Universitario 12 de Octubre, Universidad Complutense, Madrid, España
h Hospital Universitario de Toledo, Toledo, España
i Hospital Universitario La Paz, Madrid, España
j Hospital General Universitario Gregorio Marañón, Madrid, España
k Hospital Universitario Vall d’Hebron, Barcelona, España
l Hospital General Universitario de Castellón, Castellón, España
m Hospital Universitario de Basurto, Bilbao, España
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La psoriasis afecta negativamente la calidad de vida de los pacientes<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">1</span></a>&#46; En Espa&#241;a&#44; la prevalencia es de 2&#44;3&#37;&#44; con aproximadamente un mill&#243;n de pacientes y una prevalencia similar entre g&#233;neros<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">2</span></a>&#46; El debut ocurre entre la segunda y cuarta d&#233;cadas de la vida en 75&#37; de los casos&#46; Por lo tanto&#44; su aparici&#243;n coincide con los a&#241;os reproductivos de la mujer&#44; lo que puede plantearle miedos e incertidumbres sobre la maternidad<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">3&#44;4</span></a> por falta de informaci&#243;n sobre la planificaci&#243;n familiar&#44; el embarazo o la lactancia<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">5&#44;6</span></a>&#46; Seg&#250;n el registro BIOBADADERM&#44; las mujeres con psoriasis moderada-grave en Espa&#241;a tienen menores tasas de embarazo<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">7</span></a> y son menos proclives a la lactancia materna que la poblaci&#243;n general<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">8</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">La evoluci&#243;n de la psoriasis durante el embarazo es imprevisible&#46; Aproximadamente la mitad de las mujeres mejoran de sus s&#237;ntomas&#44; otras mantienen una actividad similar y en m&#225;s de 20&#37; hay una exacerbaci&#243;n<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">3</span></a>&#46; Adem&#225;s&#44; 65&#37; de las pacientes empeoran de los s&#237;ntomas en el posparto<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">9</span></a>&#46; La psoriasis no controlada en el embarazo se asocia a complicaciones tanto maternas como fetales<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">3&#44;10&#8211;12</span></a>&#46; Aunque hay numerosos tratamientos para la psoriasis potencialmente teratog&#233;nicos<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">13&#8211;15</span></a>&#44; en la actualidad disponemos de opciones terap&#233;uticas compatibles con el embarazo y la lactancia<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">5&#44;16&#8211;18</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">El objetivo principal del estudio fue determinar el impacto de la enfermedad sobre el deseo gestacional y la lactancia&#44; saber m&#225;s de las inquietudes y miedos de las mujeres con psoriasis antes&#44; durante o despu&#233;s del embarazo&#44; as&#237; como la informaci&#243;n sobre planificaci&#243;n familiar&#44; embarazo y lactancia que reciben en las consultas&#44; con el fin de que en un futuro puedan recibir informaci&#243;n m&#225;s completa&#44; seg&#250;n sus necesidades por parte de su dermat&#243;logo&#46; Como objetivos secundarios se evalu&#243; si existen diferencias en el impacto de la enfermedad&#44; las preocupaciones o la informaci&#243;n en funci&#243;n de haber tenido alg&#250;n embarazo&#47;hijo&#44; el tratamiento con biol&#243;gicos&#44; o la actividad de la enfermedad seg&#250;n el m&#233;dico o la paciente&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">M&#233;todos</span><p id="par0020" class="elsevierStylePara elsevierViewall">Estudio observacional&#44; descriptivo&#44; transversal y multic&#233;ntrico&#46; La selecci&#243;n de las pacientes se realiz&#243; en consultas de dermatolog&#237;a de centros espa&#241;oles&#46; La inclusi&#243;n de pacientes se realiz&#243; entre marzo del 2020 y octubre del 2021&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Poblaci&#243;n de estudio</span><p id="par0025" class="elsevierStylePara elsevierViewall">Se incluyeron mujeres con psoriasis en placas&#44; de 18-45 a&#241;os&#44; candidatas a recibir tratamiento sist&#233;mico y que estaban de acuerdo en participar en el estudio&#46; Se excluyeron pacientes con artritis psori&#225;sica &#40;para centrarnos en el dominio cut&#225;neo de la psoriasis y minimizar la variabilidad&#41; y pacientes que no quer&#237;an participar o no pod&#237;an escribir o leer apropiadamente&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Variables y recogida de datos</span><p id="par0030" class="elsevierStylePara elsevierViewall">Se recogieron variables cl&#237;nicas&#44; incluyendo <span class="elsevierStyleItalic">Psoriasis Area Severity Index</span> &#40;PASI&#41;&#44; <span class="elsevierStyleItalic">Body Surface Area</span> &#40;BSA&#41;&#44; percepci&#243;n de la actividad de la psoriasis por parte del m&#233;dico en una escala visual anal&#243;gica &#40;EVA&#41; de 0-10&#44; comorbilidades y tratamientos previos y actuales&#46; Se evalu&#243; la calidad de vida con una escala cualitativa &#40;<a class="elsevierStyleCrossRef" href="#sec0090">material suplementario</a>&#41; y por medio del <span class="elsevierStyleItalic">Dermatology Life Quality Index</span> &#40;DLQI&#41;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">19</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Las pacientes respondieron an&#243;nimamente en papel un cuestionario con datos sociodemogr&#225;ficos y percepci&#243;n de la actividad de la psoriasis&#46; Cumplimentaron un cuestionario de 27 preguntas sobre planificaci&#243;n familiar dise&#241;ado para el estudio &#40;<a class="elsevierStyleCrossRef" href="#sec0090">material suplementario</a>&#41;&#46; Los investigadores elaboraron el cuestionario <span class="elsevierStyleItalic">ad hoc</span> para este proyecto teniendo en cuenta los objetivos del estudio&#46; Las preocupaciones e informaci&#243;n antes del embarazo&#44; as&#237; como el impacto de la enfermedad se abordaron en los &#237;tems 1-16 y 24&#46; En el &#237;tem 2 se eval&#250;a el impacto de la enfermedad en la vida sexual&#46; Las preocupaciones e informaci&#243;n durante el embarazo se trataron en los &#237;tems 17-21 y despu&#233;s del embarazo en los &#237;tems 22&#44; 23 y 25&#46; Dos &#237;tems adicionales &#40;26 y 27&#41; analizan la informaci&#243;n por parte del m&#233;dico u otros medios&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Con los resultados&#44; se elabor&#243; una tabla con aspectos para tratar en las consultas&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Estudio estad&#237;stico</span><p id="par0045" class="elsevierStylePara elsevierViewall">Las variables se describieron mediante distribuci&#243;n de frecuencias&#44; m&#237;nimo&#44; m&#225;ximo&#44; media y desviaci&#243;n est&#225;ndar &#40;DE&#41; o mediana y rango intercuart&#237;lico &#40;RIC&#41;&#46; Para determinar los objetivos secundarios&#44; se realizaron suban&#225;lisis evaluando diferencias por el hecho de haber tenido alg&#250;n embarazo&#47;hijos&#44; la actividad de la enfermedad &#40;leve&#58; EVA &#61; 0-2 vs<span class="elsevierStyleItalic">&#46;</span> moderada o grave&#58; EVA &#61; 3-10&#41;&#44; y el uso actual de tratamientos biol&#243;gicos&#46; Las comparaciones de variables cualitativas se realizaron mediante la prueba chi-cuadrado y las de variables cuantitativas independientes o pareadas mediante la prueba de Mann-Whitney o de Wilcoxon&#44; respectivamente &#40;nivel de significaci&#243;n&#58; 5&#37;&#59; paquete estad&#237;stico SPSS 25&#46;0 &#91;IBM Corp&#46;&#44; Armonk&#44; NY&#44; EE&#46; UU&#46;&#93;&#41;&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Aspectos &#233;ticos</span><p id="par0055" class="elsevierStylePara elsevierViewall">Se sigui&#243; la Declaraci&#243;n de Helsinki y la legislaci&#243;n espa&#241;ola en materia de investigaci&#243;n cl&#237;nica y de protecci&#243;n de datos&#46; Las participantes firmaron un consentimiento informado&#46; El estudio fue aprobado por el Comit&#233; &#201;tico de Investigaci&#243;n Cl&#237;nica del Hospital Ram&#243;n y Cajal &#40;acta N&#176;373&#41;&#46;</p></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Resultados</span><p id="par0060" class="elsevierStylePara elsevierViewall">Se incluyeron 153 mujeres de 11 centros espa&#241;oles &#40;edad media&#58; 35&#44;4 &#177; 8 a&#241;os&#41;&#46; Las caracter&#237;sticas sociodemogr&#225;ficas y cl&#237;nicas se resumen en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; La mayor&#237;a de las pacientes &#40;51&#44;6&#37;&#41; no hab&#237;an estado nunca embarazadas&#46; De las 74 pacientes que hab&#237;an estado embarazadas&#44; la mayor&#237;a hab&#237;an tenido uno o dos hijos &#40;51&#44;4 y 27&#37;&#44; respectivamente&#41;&#44; y 35&#44;1&#37; hab&#237;a sufrido al menos un aborto&#59; 23&#44;9&#37; recibieron atenci&#243;n en unidades de embarazo de alto riesgo&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">La mediana de la duraci&#243;n de enfermedad era de 16 a&#241;os &#40;RIC&#58; 9-22&#59; m&#237;nimo&#58; 1&#59; m&#225;ximo&#58; 41 a&#241;os&#41;&#46; La mayor&#237;a de las pacientes presentaban una enfermedad leve en el momento de la valoraci&#243;n &#40;81&#44;4&#37; BSA &#60; 5&#37;&#41;&#46; Sin embargo&#44; la percepci&#243;n de la gravedad de la enfermedad por las pacientes era moderada-grave &#40;EVA 3-10&#41; en 49&#37; de los casos y de 38&#44;4&#37; casos seg&#250;n los m&#233;dicos&#46; La percepci&#243;n de la actividad era significativamente superior para las pacientes que para los m&#233;dicos &#40;EVA media 3&#44;6 vs&#46; 2&#44;7 y mediana de 2 vs<span class="elsevierStyleItalic">&#46;</span> 1&#44;5&#59; p &#60; 0&#44;001&#41;&#46; Respecto a la calidad de vida&#44; 41&#44;2&#37; refer&#237;a que estaba moderada&#44; muy o extremadamente afectada &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Los resultados del cuestionario sobre planificaci&#243;n familiar se resumen en las <a class="elsevierStyleCrossRefs" href="#fig0005">figuras 1&#44; 2&#44; 3</a>&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Respecto impacto de la enfermedad&#44; m&#225;s de 30&#37; de las pacientes estaba bastante o muy de acuerdo con la afirmaci&#243;n de que la enfermedad puede afectar a su vida sexual &#40;&#237;tem 2&#41;&#46; Para 35&#37;&#44; la enfermedad retrasa o limita su deseo de descendencia &#40;&#237;tems 6-7&#41;&#59; 20&#44;5&#37;&#44; considera que la enfermedad puede limitarle para cuidar un hijo adecuadamente &#40;&#237;tem 24&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Respecto a las preocupaciones&#44; en 55-65&#37; exist&#237;a preocupaci&#243;n de que la enfermedad empeore al tener que retirar o cambiar un f&#225;rmaco antes del embarazo&#44; durante el embarazo o durante la lactancia &#40;&#237;tems 15&#44; 19 y 23&#41;&#46; A alrededor de 60&#37; le preocupaba que los tratamientos puedan da&#241;ar al beb&#233; &#40;&#237;tem 21&#41;&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Respecto a la informaci&#243;n recibida&#44; cerca de la mitad de las pacientes consideraba que no se abordan en la consulta temas como la planificaci&#243;n familiar&#44; el deseo gestacional o los tratamientos antes de concebir &#40;&#237;tems 11-13&#41;&#46; Un tercio consideraba que conoc&#237;a los f&#225;rmacos que puede tomar y cu&#225;les no antes del embarazo &#40;&#237;tem 14&#41;&#46; Cerca de 60&#37; era consciente de que la psoriasis tiene que estar controlada antes y durante el embarazo &#40;&#237;tems 16 -17&#41;&#46; Una proporci&#243;n relevante de pacientes no hab&#237;a recibido informaci&#243;n sobre las opciones en el embarazo o la lactancia &#40;&#237;tems 18 y 22&#41;&#46; Casi la mitad estaba bastante o muy de acuerdo con que si recibiera m&#225;s informaci&#243;n por parte del m&#233;dico se replantear&#237;a el deseo de tener hijos&#46;</p><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">An&#225;lisis en funci&#243;n de haber tenido alg&#250;n embarazo&#47;hijo</span><p id="par0090" class="elsevierStylePara elsevierViewall">La actividad de la enfermedad medida por PASI o BSA&#44; as&#237; como la calidad de vida por el DLQI&#44; no era estad&#237;sticamente diferente en pacientes con o sin embarazos&#47;hijos&#46; La percepci&#243;n de la actividad de la enfermedad seg&#250;n la paciente era superior a la percepci&#243;n del m&#233;dico tanto en aquellas que hab&#237;an tenido embarazo&#47;hijos &#40;EVA media de la paciente 4&#44;2 vs&#46; 3&#44;1 del m&#233;dico&#59; p &#61; 0&#44;001&#41; como en las que no &#40;EVA media de la paciente 3&#44;1 vs&#46; 2&#44;3 del m&#233;dico&#59; p &#61; 0&#44;002&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Hab&#237;a diferencias estad&#237;sticamente significativas en nueve cuestiones del cuestionario de planificaci&#243;n familiar entre las pacientes con o sin embarazos&#47;hijos &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46; Las diferencias indican una menor informaci&#243;n de las pacientes sin embarazos&#47;hijos sobre planificaci&#243;n familiar &#40;&#237;tem 11&#41; o sobre la seguridad de los tratamientos antes del embarazo&#44; durante el embarazo o durante la lactancia materna &#40;&#237;tems 14&#44; 20 y 25&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">An&#225;lisis en funci&#243;n del tratamiento actual con o sin biol&#243;gicos</span><p id="par0100" class="elsevierStylePara elsevierViewall">La percepci&#243;n de la actividad de la enfermedad seg&#250;n la paciente era superior a la del m&#233;dico tanto en aquellas pacientes que recib&#237;an tratamiento biol&#243;gico &#40;EVA media de la paciente 2&#44;6 vs&#46; 1&#44;9 del m&#233;dico&#59; p &#61; 0&#44;009&#41; como en las que no &#40;EVA 5&#44;3 vs&#46; 3&#44;9&#59; p &#60; 0&#44;001&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">La percepci&#243;n de la actividad por parte de la paciente y del m&#233;dico&#44; as&#237; como la gravedad medida por PASI y por BSA&#44; era estad&#237;sticamente inferior en las pacientes que recib&#237;an tratamiento biol&#243;gico &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46; La calidad de vida medida por DLQI era significativamente mejor en pacientes en tratamiento con biol&#243;gicos&#46; Cualitativamente tambi&#233;n se observa que la calidad de vida era superior en las pacientes que recib&#237;an tratamiento biol&#243;gico &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">Hubo diferencias estad&#237;sticamente significativas en tres &#237;tems del cuestionario de planificaci&#243;n familiar &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46; Las pacientes sin tratamiento biol&#243;gico refer&#237;an una mayor afectaci&#243;n de la vida sexual &#40;&#237;tem 2&#41; y una mayor necesidad de b&#250;squeda de informaci&#243;n externa &#40;&#237;tem 27&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">An&#225;lisis en funci&#243;n de la actividad de la psoriasis seg&#250;n la paciente</span><p id="par0115" class="elsevierStylePara elsevierViewall">El PASI y la BSA eran estad&#237;sticamente inferiores en el grupo de pacientes que perciben la actividad como leve <span class="elsevierStyleItalic">vs&#46;</span> moderada&#47;intensa &#40;PASI medio 1&#44;5 vs&#46; 4&#44;8 puntos&#59; p &#60; 0&#44;001&#59; BSA medio 1&#44;0 vs&#46; 4&#44;9 puntos&#59; p &#60; 0&#44;001&#41;&#46; La calidad de vida era mejor en el grupo de pacientes que percib&#237;an la actividad como leve &#40;DLQI medio 3&#44;4 vs&#46; 9&#44;9&#59; p &#60; 0&#44;001&#41;&#46; En el cuestionario de planificaci&#243;n familiar solo hubo diferencias en relaci&#243;n con el impacto de la enfermedad en la vida sexual &#40;&#237;tem 2&#41;&#44; siendo mayor en las que presentaban enfermedad moderada&#47;intensa que leve &#40;46 vs<span class="elsevierStyleItalic">&#46;</span> 24&#37;&#44; respectivamente&#41;&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">An&#225;lisis en funci&#243;n de la actividad de la psoriasis seg&#250;n el m&#233;dico</span><p id="par0120" class="elsevierStylePara elsevierViewall">El PASI y la BSA fueron estad&#237;sticamente inferiores en el grupo de pacientes con actividad leve vs&#46; actividad moderada&#47;intensa &#40;PASI medio 1&#44;4 vs&#46; 5&#44;9&#59; p &#60; 0&#44;001&#59; BSA medio&#58; 0&#44;8 vs&#46; 6&#44;5&#59; p &#60; 0&#44;001&#41;&#46; La calidad de vida media era mejor en el grupo de pacientes con actividad leve &#40;DLQI medio&#58; 4&#44;4 vs&#46; 10&#59; p &#60; 0&#44;001&#41;&#46; No hubo diferencias significativas en ninguna cuesti&#243;n del cuestionario de planificaci&#243;n familiar&#46;</p></span></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Discusi&#243;n</span><p id="par0125" class="elsevierStylePara elsevierViewall">Estudios recientes indican que las mujeres con psoriasis moderada-grave en Espa&#241;a tienen menores tasas de embarazo<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">7</span></a> y son menos proclives a la lactancia materna que la poblaci&#243;n general<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">8</span></a>&#46; Las causas de esto pueden ser m&#250;ltiples&#58; causas psicol&#243;gicas&#44; sentimientos de baja autoestima&#44; estigmatizaci&#243;n y disminuci&#243;n de la confianza que conduzca a una disfunci&#243;n sexual&#44; factores sociales y familiares&#44; preocupaci&#243;n por la seguridad de los tratamientos para el feto&#44; etc&#46;<a class="elsevierStyleCrossRefs" href="#bib0145"><span class="elsevierStyleSup">7&#44;8</span></a> En nuestra encuesta&#44; m&#225;s de 40&#37; de las pacientes consideraban que si recibieran m&#225;s informaci&#243;n por parte del m&#233;dico se replantear&#237;an el deseo de tener hijos&#46; Por ello&#44; en l&#237;nea con consensos recientes<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">13</span></a>&#44; consideramos que se deber&#237;a ser m&#225;s proactivos en facilitar esta informaci&#243;n &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">En mujeres&#44; la psoriasis se diagnostica de media a los 28 a&#241;os y el inicio del tratamiento se produce entre los 28-45 a&#241;os&#44; lo que coinciden con los a&#241;os de m&#225;xima actividad reproductiva<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">5</span></a>&#46; En nuestro estudio&#44; las pacientes tienen una edad media de 35&#44;4 a&#241;os y llevan 16&#44;7 a&#241;os de evoluci&#243;n de la psoriasis&#44; as&#237; que es un grupo representativo de mujeres en plena edad reproductiva&#46; La enfermedad tiene un gran impacto f&#237;sico y emocional en las mujeres y afecta a su calidad de vida &#40;en mayor medida que a los hombres&#41;&#44; a sus relaciones &#237;ntimas y produce mucha incertidumbre sobre los posibles efectos de la enfermedad en la maternidad<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">3&#44;5</span></a>&#46; Estos aspectos son poco conocidos y podr&#237;an estar infravalorados en la pr&#225;ctica cl&#237;nica<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">5&#44;6</span></a>&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Nuestra cohorte re&#250;ne pacientes con una carga significativa de enfermedad&#46; En aproximadamente un 1&#47;3 de las pacientes el impacto de la enfermedad retrasa o limita su deseo de tener hijos&#46; La encuesta pone en evidencia algunas preocupaciones que podr&#237;an explicar estos miedos&#44; relacionados principalmente con la seguridad de los tratamientos&#44; la evoluci&#243;n de la enfermedad y la falta de informaci&#243;n&#46; A la gran mayor&#237;a de las mujeres les preocupaba que los tratamientos pudieran da&#241;ar al beb&#233;&#44; pero tambi&#233;n les preocupaba que la enfermedad empeore al tener que retirar o cambiar el tratamiento antes o durante el embarazo o en la lactancia&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Los datos sugieren que la informaci&#243;n que se da en la consulta de dermatolog&#237;a sobre planificaci&#243;n familiar&#44; deseo gestacional o seguridad de los tratamientos es insuficiente tanto antes de concebir&#44; como durante la gestaci&#243;n o la lactancia&#44; especialmente en mujeres sin embarazos previos&#46; Consideramos que todas las mujeres en edad f&#233;rtil deber&#237;an recibir informaci&#243;n suficiente en la consulta&#46; Adem&#225;s&#44; hasta 50&#37; de los embarazos no son planificados&#44; por ello&#44; en l&#237;nea con otros autores<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">5</span></a>&#44; consideramos que puede ser recomendable un plan de tratamiento compatible con el embarazo en las mujeres en edad f&#233;rtil&#44; independientemente de las intenciones de planificaci&#243;n familiar&#46; Adem&#225;s&#44; ser&#237;a importante capacitar y mejorar el papel informador de los dermat&#243;logos sobre la planificaci&#243;n familiar&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Los resultados sugieren que las mujeres en tratamiento biol&#243;gico est&#225;n mejor controladas y tienen mejor calidad de vida y menos impacto de la enfermedad en la vida sexual que las pacientes sin tratamiento biol&#243;gico&#46; El tratamiento de la psoriasis durante el embarazo y la lactancia supone un reto para el cl&#237;nico<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">3&#44;13&#44;14</span></a>&#46; Aunque hay numerosas terapias con potencial efecto teratog&#233;nico que hay que retirar antes de la concepci&#243;n<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">13</span></a>&#44; existen tratamientos disponibles que se pueden utilizar de forma segura durante el embarazo y la lactancia&#44; y deber&#237;amos informar a las pacientes al respecto&#46; Entre los tratamientos biol&#243;gicos&#44; certolizumab pegol es la opci&#243;n m&#225;s segura tanto en embarazo como en la lactancia&#44; dada su transferencia m&#237;nima o nula a trav&#233;s de la placenta y a la leche materna<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">16&#44;17&#44;20</span></a>&#46; En mujeres embarazadas tratadas con biol&#243;gicos&#44; se puede mantener el tratamiento durante el primer y segundo trimestres y valorar con la paciente los riesgos y beneficios de continuar con ellos durante el tercer trimestre&#46; Sin embargo&#44; las pacientes que reciben certolizumab pegol podr&#237;an usarlo durante todo el embarazo si se considera cl&#237;nicamente necesario&#44; as&#237; como durante la lactancia<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">13</span></a>&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Tanto en mujeres sanas<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">20</span></a> como en mujeres con otras enfermedades cr&#243;nicas<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">21</span></a> existen evidencias de que el comportamiento en relaci&#243;n con el embarazo est&#225; influido por su percepci&#243;n del riesgo<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">22</span></a>&#46; Las diferentes enfermedades cr&#243;nicas introducen diversos riesgos de embarazo y la percepci&#243;n del riesgo es &#250;nica para cada individuo y no se basa &#250;nicamente en informaci&#243;n objetiva sobre el riesgo<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">20</span></a>&#46; Por ello se necesita m&#225;s investigaci&#243;n para comprender las percepciones de riesgo de las mujeres en enfermedades cr&#243;nicas espec&#237;ficas y mejorar la informaci&#243;n que se proporciona a las pacientes sobre los riesgos objetivos<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">20</span></a>&#46; En el caso concreto de la psoriasis existen gu&#237;as recientes para el manejo de las pacientes<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">13</span></a>&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Nuestro estudio tiene limitaciones&#46; Es un estudio observacional&#44; descriptivo y transversal que carece de grupo de control con mujeres sin psoriasis o pacientes con psoriasis varones&#46; Sin embargo&#44; creemos que es una muestra representativa de las mujeres en edad f&#233;rtil atendidas en las consultas de dermatolog&#237;a en Espa&#241;a y que dan algunas claves de sus necesidades e inquietudes en relaci&#243;n con la planificaci&#243;n familiar&#46; Con estos resultados&#44; consideramos fundamental incrementar la informaci&#243;n que se da a las pacientes en las consultas&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Conclusiones</span><p id="par0160" class="elsevierStylePara elsevierViewall">Los resultados de nuestro estudio sugieren que la psoriasis tiene un impacto en la planificaci&#243;n familiar y en el deseo gestacional de las pacientes&#46; Existen preocupaciones que podr&#237;an llevar a retrasar o limitar el deseo gestacional&#46; La informaci&#243;n proporcionada sobre estos temas durante el seguimiento no resulta completa&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Financiaci&#243;n</span><p id="par0165" class="elsevierStylePara elsevierViewall">Este estudio estuvo financiado con una beca sin restricciones de la C&#225;tedra Universidad Francisco de Vitoria-UCB en Inflamaci&#243;n y Salud &#211;sea&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conflicto de intereses</span><p id="par0170" class="elsevierStylePara elsevierViewall">Natalia Jim&#233;nez G&#243;mez ha actuado como asesora y&#47;o investigadora y&#47;o ponente para&#58; Abbvie&#44; Almirall&#44; BMS&#44; Celgene&#44; Janssen&#44; LEO Pharma&#44; Lilly&#44; MSD&#44; Novartis y UCB&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Ricardo Ruiz-Villaverde ha recibido honorarios por consultor&#237;a de Abbvie&#44; Novartis&#44; UCB&#44; Celgene y Janssen&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Mar&#237;a Luisa Alonso Pacheco de Abbvie&#44; Novartis&#44; Lilly&#44; LEO Pharma&#44; UCB&#44; Celgene y Janssen&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Rosa Mar&#237;a Izu ha sido consultor&#44; asesor&#44; impartido ponencias o participado en ensayos cl&#237;nicos para Almirall&#44; Novartis&#44; Abbvie&#44; Lilly&#44; LEO Pharma&#44; UCB&#44; Sanofi&#44; Celgene&#44; Pfizer&#44; Janssen y Kyowa-Kirin&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Raquel Rivera-D&#237;az ha recibido honorarios como investigador&#47;consultor para&#58; Abbvie&#44; Boehringer Ingelheim&#44; Celgene&#44; Janssen&#44; LEO Pharma&#44; Lilly&#44; Novartis&#44; Pfizer&#44; Novartis&#44; UCB&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Jordi Mollet Sanchez ha recibido honorarios como investigador&#47;consultor para&#58; Abbvie&#44; Amgen&#44; Boehringer Ingelheim&#44; Celgene&#44; Janssen&#44; LEO Pharma&#44; Lilly&#44; Novartis&#44; Pfizer&#44; Sanofi&#44; UCB&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">Mar Llamas-Velasco ha recibido honorarios como investigador&#47;consultor para Abbvie&#44; Boehringer Ingelheim&#44; Celgene&#44; Janssen&#44; LEO Pharma&#44; Lilly&#44; Kyowa Kirin&#44; Novartis&#44; Pfizer&#44; Novartis&#44; UCB&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">&#193;lvaro Gonz&#225;lez-Cantero ha recibido honorarios como investigador&#47;consultor para Abbvie&#44; Amgen&#44; Celgene&#44; Janssen&#44; LEO Pharma&#44; Lilly&#44; Novartis&#44; Novartis&#44; UCB&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">Pablo de la Cueva ha actuado como asesor y&#47;o investigador y&#47;o ponente de Abbvie&#44; Almirall&#44; BMS&#44; Boehringer&#44; Celgene&#44; Janssen&#44; LEO Pharma&#44; Lilly&#44; MSD&#44; Novartis&#44; Pfizer&#44; Roche&#44; Sanofi&#44; UCB&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Elena Mart&#237;nez Lorenzo ha recibido honorarios como consultor para Abbvie&#44; Almirall&#44; Janssen&#44; LEO Pharma&#44; Novartis&#44; UCB&#46; Adem&#225;s&#44; ha impartido ponencias o participado en formaciones con Abbvie&#44; Almirall&#44; Celgene&#44; Janssen&#44; LEO Pharma&#44; Lilly&#44; Novartis&#44; Roche&#44; UCB&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">Ofelia Baniandr&#233;s Rodr&#237;guez ha recibido honorarios como investigador&#47;consultor para&#58; Abbvie&#44; Amgen&#44; Celgene&#44; Janssen&#44; LEO Pharma&#44; Lilly&#44; Novartis&#44; Pfizer&#44; UCB&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">Gerard Pitarch Bort ha participado en estudios y ensayos cl&#237;nicos de Abbvie&#44; Janssen&#44; Novartis y UCB&#46; Ha recibido honorarios como ponente de Abbvie&#44; Janssen&#44; LEO Pharma&#44; Novartis y ayudas para formaci&#243;n de Abbvie&#44; Almirall&#44; Janssen&#44; Novartis y UCB&#46;</p></span></span>"
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              "titulo" => "An&#225;lisis en funci&#243;n de haber tenido alg&#250;n embarazo&#47;hijo"
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              "titulo" => "An&#225;lisis en funci&#243;n del tratamiento actual con o sin biol&#243;gicos"
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              "titulo" => "An&#225;lisis en funci&#243;n de la actividad de la psoriasis seg&#250;n la paciente"
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              "titulo" => "An&#225;lisis en funci&#243;n de la actividad de la psoriasis seg&#250;n el m&#233;dico"
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    "fechaRecibido" => "2023-03-30"
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            1 => "Salud reproductiva"
            2 => "Planificaci&#243;n familiar"
            3 => "Anticuerpos monoclonales"
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            1 => "Reproductive health"
            2 => "Family planning"
            3 => "Monoclonal antibodies"
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Antecedentes y objetivos</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La psoriasis afecta a un gran porcentaje de mujeres en edad f&#233;rtil&#46; Nuestro objetivo fue conocer las inquietudes de las mujeres con psoriasis en relaci&#243;n con la planificaci&#243;n familiar&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio observacional&#44; descriptivo&#44; transversal y multic&#233;ntrico realizado entre marzo del 2020 y octubre del 2021&#46; Se recabaron datos sociodemogr&#225;ficos e inquietudes relacionadas con la planificaci&#243;n familiar de mujeres entre 18-45 a&#241;os con psoriasis en placas y candidatas a recibir tratamiento sist&#233;mico&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se reclutaron 153 pacientes de 11 centros espa&#241;oles &#40;edad media&#58; 35&#44;4 &#177; 8 a&#241;os&#44; duraci&#243;n media de la enfermedad&#58; 16&#44;7 a&#241;os&#41;&#59; 38&#44;4&#37; de los casos ten&#237;an una enfermedad moderada&#47;grave para los m&#233;dicos&#44; aunque la percepci&#243;n de la actividad era significativamente superior para las pacientes&#46; En una de cada tres mujeres&#44; la enfermedad limitaba o retrasaba el deseo gestacional&#46; Exist&#237;a preocupaci&#243;n de que la enfermedad empeorara al tener que retirar o cambiar un f&#225;rmaco o que los tratamientos perjudicaran al beb&#233;&#46; Alrededor de la mitad de las pacientes no hab&#237;a recibido informaci&#243;n sobre planificaci&#243;n familiar en la consulta&#44; especialmente aquellas mujeres sin embarazos previos&#46; Las mujeres con tratamiento biol&#243;gico &#40;58&#44;7&#37;&#41; ten&#237;an mejor situaci&#243;n cl&#237;nica&#44; mejor calidad de vida y menos alteraciones en la esfera sexual que las pacientes sin tratamiento biol&#243;gico&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Las pacientes con psoriasis tienen numerosas preocupaciones relacionadas con la planificaci&#243;n familiar&#46; En algunos casos&#44; estos miedos podr&#237;an llevar a retrasar y&#47;o limitar el deseo gestacional&#46; Ser&#237;a necesario incrementar la informaci&#243;n que se da a las pacientes y mejorar la formaci&#243;n de los dermat&#243;logos en este tema&#46;</p></span>"
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          1 => array:2 [
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Background and objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">A significant proportion of women of childbearing age have psoriasis&#46; The aim of this study was to examine family planning concerns in this population&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Observational&#44; descriptive&#44; cross-sectional&#44; multicenter study conducted between March 2020 and October 2021&#46; We collected sociodemographic data and analyzed responses to a family planning questionnaire administered to women aged 18 to 45 years with plaque psoriasis who were candidates for systemic treatment&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">We studied 153 patients &#40;mean &#91;SD&#93; age&#44; 35&#46;4 &#91;8&#46;0&#93; years&#59; mean disease duration&#44; 16&#46;7 years&#41; being treated at 11 Spanish hospitals&#46; Overall&#44; 38&#46;4&#37; of women were considered to have moderate to severe psoriasis by their physicians&#59; perceived severity ratings were significantly higher among women&#46; Psoriasis affected the women&#39;s desire to become pregnant or led to their delaying pregnancy in 1 in 3 respondents&#46; They were concerned that their condition might worsen if they had to discontinue or switch treatment or that the treatment might harm the baby&#46; Approximately half of the women had not received family planning counseling from their physicians&#44; and this was more likely to be the case among never-pregnant women&#46; Women on biologic therapy &#40;58&#46;7&#37;&#41; had better psoriasis control and a better quality of life than women on other treatments&#46; Their sexual health was also less affected&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Women with psoriasis have numerous family planning concerns&#44; which in some cases can lead them to delay pregnancy or affect their desire to become pregnant&#46; Dermatologists need to receive better training regarding family planning in women with psoriasis so that they can provide their patients with more and better information&#46;</p></span>"
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Educaci&#243;n primaria o secundaria&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">28 &#40;18&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">125 &#40;81&#44;7&#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
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Diabetes mellitus en tratamiento&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">4 &#40;2&#44;6&#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"><span class="elsevierStyleHsp" style=""></span>Hipertensi&#243;n en tratamiento&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">11 &#40;7&#44;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
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Hiperlipidemia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;11&#44;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
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Obesidad m&#243;rbida &#40;IMC &#8805; 35&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8 &#40;5&#44;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>S&#237;ndrome metab&#243;lico en tratamiento&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;3&#44;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>Enfermedad inflamatoria intestinal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;2&#37;&#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>H&#237;gado graso no alcoh&#243;lico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;2&#44;6&#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>Insuficiencia cardiaca&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" 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></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>Insuficiencia renal&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&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>Ansiedad &#47; depresi&#243;n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;15&#44;1&#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>Otras comorbilidades&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;17&#44;1&#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="elsevierStyleItalic">Duraci&#243;n media de la psoriasis &#177; DE &#40;a&#241;os&#41;</span><span class="elsevierStyleItalic">Media de PASI &#177; DE</span><span class="elsevierStyleItalic">Media de BSA &#177; DE</span><span class="elsevierStyleItalic">Calidad de vida media &#177; DE &#40;escala DLQI de 0 a 30&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&#44;7 &#177; 8&#44;03&#44;1 &#177; 4&#44;02&#44;9 &#177; 4&#44;46&#44;5 &#177; 5&#44;9&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="elsevierStyleItalic">Calidad de vida &#40;cualitativo&#41;&#44; n &#40;&#37;&#41;</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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CV no afectada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;0&#44;7&#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>CV poco afectada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">89 &#40;58&#44;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
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>CV moderadamente afectada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35 &#40;22&#44;9&#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>CV muy afectada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;13&#44;7&#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>CV extremadamente afectada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;4&#44;6&#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="elsevierStyleItalic">Percepci&#243;n de la actividad seg&#250;n las pacientes &#40;EVA media &#177; DE&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;6 &#177; 3&#44;2&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="elsevierStyleItalic">Percepci&#243;n de la actividad seg&#250;n los m&#233;dicos &#40;EVA media &#177; DE&#41;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;7 &#177; 2&#44;6&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="elsevierStyleItalic">Actividad de la enfermedad seg&#250;n las pacientes&#44; n &#40;&#37;&#41;</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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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>Leve &#40;EVA&#58; 0-2&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76 &#40;51&#44;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>Moderada &#40;EVA&#58; 3-7&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 &#40;33&#44;6&#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>Intensa &#40;EVA&#58; 8-10&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;15&#44;4&#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="elsevierStyleItalic">Actividad de la enfermedad seg&#250;n los m&#233;dicos&#44; n &#40;&#37;&#41;</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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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>Leve &#40;EVA&#58; 0-2&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90 &#40;61&#44;6&#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>Moderada &#40;EVA&#58; 3-7&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">50 &#40;34&#44;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
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Intensa &#40;EVA&#58; 8-10&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;4&#44;1&#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="elsevierStyleItalic">Tratamiento actual&#44; n &#40;&#37;&#41;</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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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>Tratamiento t&#243;pico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">73 &#40;48&#44;7&#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>Corticoides sist&#233;micos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;4&#44;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>Tratamiento sist&#233;mico convencional&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;17&#44;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>Apremilast u otros tratamientos orales&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;8&#44;7&#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>Anti-TNF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29 &#40;19&#44;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>Anti-IL 17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28 &#40;18&#44;7&#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>Anti-IL 23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;6&#44;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>Anti-IL 12&#47;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;14&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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                  \t\t\t\t\tvoid\n
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                  \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
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                  \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">Nada de acuerdo</th><th class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Poco de acuerdo</th><th class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Bastante de acuerdo</th><th class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Muy de acuerdo</th><th class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">p&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Con embarazo&#47;hijos&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">Sin embarazo&#47;hijos&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">Con embarazo&#47;hijos&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">Sin embarazo&#47;hijos&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">Con embarazo&#47;hijos&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">Sin embarazo&#47;hijos&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">Con embarazo&#47;hijos&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">Sin embarazo&#47;hijos&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="" 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></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">&#205;tem 3&#46; El tener descendencia es muy importante para m&#237;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;16&#44;9&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;26&#44;6&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;7&#44;7&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;21&#44;5&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;35&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17 &#40;21&#44;5&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;40&#44;0&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;30&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;025&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">&#205;tem 5&#46; En alg&#250;n momento durante mi enfermedad me he planteado quedarme embarazada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15 &#40;21&#44;1&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49 &#40;62&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6 &#40;8&#44;5&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;9&#44;0&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;25&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;11&#44;5&#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="left" valign="\n
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                  \t\t\t\t">32 &#40;45&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13 &#40;16&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60; 0&#44;001&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">&#205;tem 11&#46; El tema de planificaci&#243;n familiar &#40;tener descendencia&#41; es un tema que se aborda en consulta&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;047&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#205;tem 13&#46; Antes de intentar concebir&#44; he elaborado junto con mi dermat&#243;logo&#47;a un plan de tratamiento sobre los medicamentos que debo o no debo tomar&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#205;tem 14&#46; Conozco qu&#233; f&#225;rmacos podr&#237;a tomar y cu&#225;les no antes del embarazo&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;012&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#205;tem 18&#46; El dermat&#243;logo&#47;a me ha informado de las opciones acerca de un embarazo&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#205;tem 20&#46; Conozco qu&#233; f&#225;rmacos podr&#237;a tomar y cu&#225;les no durante el embarazo&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#205;tem 22&#46; El dermat&#243;logo&#47;a me ha informado de las opciones sobre lactancia materna&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#205;tem 25&#46; Conozco qu&#233; f&#225;rmacos podr&#237;a tomar y cu&#225;les no durante la lactancia materna&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">DLQI</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&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"><span class="elsevierStyleHsp" style=""></span>Media &#177; DE&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;2 &#177; 5&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;6 &#177; 6&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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>Mediana &#40;RIC&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;0 &#40;2&#44;0-6&#44;0&#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="left" valign="\n
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                  \t\t\t\t">7&#44;0 &#40;4&#44;0-11&#44;0&#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="left" valign="\n
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                  \t\t\t\t">&#60; 0&#44;001&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Calidad de vida&#44; n &#40;&#37;&#41;</span><a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a></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>No afectada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;1&#44;1&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0 &#40;0&#44;0&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>Poco afectada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">63 &#40;71&#44;6&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24 &#40;38&#44;7&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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>Moderadamente afectada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;13&#44;6&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22 &#40;35&#44;5&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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>Muy afectada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;11&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11 &#40;17&#44;7&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></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
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Extremadamente afectada&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2 &#40;2&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;8&#44;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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \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="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Nada de acuerdo</th><th class="td" title="\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">p&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \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">Con biol&#243;gico&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">Sin biol&#243;gico&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">Con biol&#243;gico&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">Sin biol&#243;gico&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">Con biol&#243;gico&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">Sin biol&#243;gico&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">Con biol&#243;gico&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">Sin biol&#243;gico&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="" 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></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">&#205;tem 2&#46; Mi enfermedad afecta a mi vida sexual&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">46 &#40;52&#44;9&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23 &#40;38&#44;3&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18 &#40;20&#44;7&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9 &#40;15&#44;0&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13 &#40;14&#44;9&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21 &#40;35&#44;0&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10 &#40;11&#44;5&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7 &#40;11&#44;7&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;038&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">&#205;tem 11&#46; El tema de planificaci&#243;n familiar &#40;tener descendencia&#41; es un tema que se aborda en consulta&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">26 &#40;32&#44;5&#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="left" valign="\n
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                  \t\t\t\t">13 &#40;24&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">21 &#40;26&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5 &#40;9&#44;4&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">13 &#40;16&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">16 &#40;30&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">20 &#40;25&#44;0&#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="left" valign="\n
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                  \t\t\t\t">19 &#40;35&#44;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="left" valign="\n
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                  \t\t\t\t">0&#44;024&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#205;tem 27&#46; He consultado fuentes de informaci&#243;n externas &#40;web&#44; revistas&#44; televisi&#243;n&#8230;&#41; sobre este tema de planificaci&#243;n familiar&#47;embarazo&#47; lactancia materna en pacientes con mi enfermedad&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">35 &#40;45&#44;5&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">17 &#40;22&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2 &#40;4&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11 &#40;14&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">14 &#40;18&#44;2&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11 &#40;22&#44;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;036&nbsp;\t\t\t\t\t\t\n
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          "leyenda" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Fuentes de informaci&#243;n fidedigna sobre la planificaci&#243;n familiar en mujeres con psoriasis &#40;como informaci&#243;n proveniente de sociedades cient&#237;ficas o asociaciones de pacientes con informaci&#243;n contrastadas por especialistas&#41;&#46;</p>"
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                  \t\t\t\t" scope="col">Antes de la concepci&#243;n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8226; Problemas en la esfera sexual relacionados con la psoriasis&#8226; Retrasos o limitaciones en el deseo gestacional debido a la psoriasis o sus tratamientos&#8226; Necesidad de tener la enfermedad controlada antes de la concepci&#243;n&#8226; Tratamientos a evitar antes de la concepci&#243;n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8226; Necesidad de tener la enfermedad controlada durante el embarazo&#8226; Preocupaciones por&#58;&#176; La evoluci&#243;n de la psoriasis durante el embarazo&#176; La evoluci&#243;n de la psoriasis si se retira un tratamiento&#176; Complicaciones para la madre secundarias a la psoriasis o su tratamiento&#176; Complicaciones para el feto secundarias a la psoriasis o su tratamiento&#8226; Tratamientos a evitar durante el embarazo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8226; Evoluci&#243;n de la psoriasis despu&#233;s del embarazo&#8226; Posibilidad de lactancia materna&#8226; Preocupaciones por si los hijos heredan la psoriasis&#8226; Preocupaciones por si la psoriasis limita el cuidado adecuado del hijo&#8226; Tratamientos a evitar durante la lactancia&nbsp;\t\t\t\t\t\t\n
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                  "referenciaCompleta" => "World Health Organization&#46; Global report on psoriasis &#91;Internet&#93;&#46; Geneva&#58; World Health Organization&#59; 2016&#44; &#91;consultado Mar 5 2022&#93;&#46; Disponible en&#58; <a target="_blank" href="https://apps.who.int/iris/handle/10665/204417">https&#58;&#47;&#47;apps&#46;who&#46;int&#47;iris&#47;handle&#47;10665&#47;204417</a>&#46;"
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                      "titulo" => "Hormonal effect on psoriasis in pregnancy and post partum"
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ISSN: 00017310
Original language: Spanish
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Idiomas
Actas Dermo-Sifiliográficas
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