array:24 [
  "pii" => "S0001731024002047"
  "issn" => "00017310"
  "doi" => "10.1016/j.ad.2024.03.016"
  "estado" => "S300"
  "fechaPublicacion" => "2024-05-01"
  "aid" => "3902"
  "copyright" => "AEDV"
  "copyrightAnyo" => "2023"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "pgl"
  "cita" => "Actas Dermosifiliogr. 2024;115:T475-T492"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S0001731023007998"
    "issn" => "00017310"
    "doi" => "10.1016/j.ad.2023.07.022"
    "estado" => "S300"
    "fechaPublicacion" => "2024-05-01"
    "aid" => "3692"
    "copyright" => "AEDV"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2024;115:493-6"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:14 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">COMUNICACI&#211;N BREVE</span>"
      "titulo" => "Angiomatosis prurigiforme&#58; una nueva entidad propuesta para la proliferaci&#243;n angiomatoide d&#233;rmica prominente subyacente a los cambios epid&#233;rmicos de prurigo nodularis&#47;liquen simple cr&#243;nico"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:3 [
        0 => "es"
        1 => "es"
        2 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "493"
          "paginaFinal" => "496"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Prurigiform Angiomatosis&#58; A New Term for Describing the Prominent Dermal Angiomatoid Proliferation Underlying Epidermal Changes in Prurigo Nodularis&#47;Lichen Simplex Chronicus"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 1
        "multimedia" => array:5 [
          "identificador" => "fig0020"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => false
          "mostrarDisplay" => true
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "fx1.jpeg"
              "Alto" => 662
              "Ancho" => 1333
              "Tamanyo" => 76898
            ]
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "R&#46; Albero-Gonz&#225;lez, D&#46; Rizo-Potau, L&#46; Al&#243;s Hern&#225;ndez, P&#46; Castillo Fern&#225;ndez, A&#46; Garc&#237;a-Herrera"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Albero-Gonz&#225;lez"
            ]
            1 => array:2 [
              "nombre" => "D&#46;"
              "apellidos" => "Rizo-Potau"
            ]
            2 => array:2 [
              "nombre" => "L&#46;"
              "apellidos" => "Al&#243;s Hern&#225;ndez"
            ]
            3 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Castillo Fern&#225;ndez"
            ]
            4 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Garc&#237;a-Herrera"
            ]
          ]
        ]
      ]
      "resumen" => array:1 [
        0 => array:3 [
          "titulo" => "Graphical abstract"
          "clase" => "graphical"
          "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><elsevierMultimedia ident="fig0020"></elsevierMultimedia></p></span>"
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731023007998?idApp=UINPBA000044"
    "url" => "/00017310/0000011500000005/v1_202405030647/S0001731023007998/v1_202405030647/es/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S0001731023009456"
    "issn" => "00017310"
    "doi" => "10.1016/j.ad.2023.11.007"
    "estado" => "S300"
    "fechaPublicacion" => "2024-05-01"
    "aid" => "3756"
    "copyright" => "AEDV"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "pgl"
    "cita" => "Actas Dermosifiliogr. 2024;115:475-92"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "es" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Documento de consenso</span>"
      "titulo" => "Recomendaciones de expertos de la Academia Espa&#241;ola de Dermatolog&#237;a &#40;AEDV&#41; para el manejo de las ectoparasitosis de transmisi&#243;n sexual&#46; Escabiosis y pediculosis p&#250;bica"
      "tienePdf" => "es"
      "tieneTextoCompleto" => "es"
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "475"
          "paginaFinal" => "492"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Spanish Academy of Dermatology and Venereology &#40;AEDV&#41; expert recommendations for the management of sexual transmitted parasitosis&#46; Scabies&#44; and pediculosis pubis"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "es" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figura 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 2947
              "Ancho" => 3000
              "Tamanyo" => 1114312
            ]
          ]
          "descripcion" => array:1 [
            "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Im&#225;genes cl&#237;nicas y microsc&#243;picas de escabiosis&#59; a&#41; forma cl&#225;sica en adulto joven con fototipo 3&#44; con surcos acarinos &#40;flechas&#41; y p&#225;pulas &#40;puntas de flecha&#41; evidentes en localizaciones t&#237;picas de la mano&#59; b&#41; forma costrosa o noruega &#40;hiperinfestaci&#243;n&#41; en anciana encamada con fototipo 2&#44; con alteraci&#243;n ungueal y lesiones costrosas discretas en me&#241;ique&#44; que hacen dif&#237;cil el diagn&#243;stico de sospecha&#59; c&#41; n&#243;dulos y erosiones genitales &#40;flecha&#41; y surco acarino &#40;punta de flecha&#41; en adulto joven con fototipo 5&#59; d&#41; acropustulosis escabi&#243;tica&#44; p&#250;stulas en planta de pie en beb&#233; de 3 meses de fototipo 6&#59; e&#41; forma at&#237;pica con lesiones eccematosas diseminadas &#40;se muestra abdomen&#41; en mujer de edad media y fototipo 3&#59; f&#41; forma cl&#225;sica impetiginizada&#44; p&#250;stulas en localizaci&#243;n t&#237;pica de escabiosis en mano de ni&#241;a de 8 a&#241;os y fototipo 6&#59; g&#41; forma at&#237;pica ampollosa&#44; con ampollas en lateral de mano &#40;flecha&#41; y un surco acarino en pulgar &#40;punta de flecha&#41; en mujer joven con fototipo 3&#59; h&#41; imagen de surco acarino obtenida mediante dermatoscopio manual&#46; En un extremo se visualiza el triangulo oscuro que corresponde a la secci&#243;n anterior del &#225;caro &#40;punta de flecha&#41;&#46; De &#233;l parte el trayecto lineal sinuoso que termina en una imagen triangular &#40;flechas&#41;&#46; Estas estructuras constituyen el &#171;signo de ala delta&#59; i&#41; imagen del &#225;caro &#40;flecha&#41; y sus huevos &#40;puntas de flecha&#41; obtenida mediante microscop&#237;a &#243;ptica del raspado de un surco acarino&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "C&#46; Galv&#225;n-Casas, J&#46; Ortiz-&#193;lvarez, E&#46; Mart&#237;nez-Garc&#237;a, M&#46; Corbacho-Monn&#233;"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Galv&#225;n-Casas"
            ]
            1 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Ortiz-&#193;lvarez"
            ]
            2 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Mart&#237;nez-Garc&#237;a"
            ]
            3 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Corbacho-Monn&#233;"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731023009456?idApp=UINPBA000044"
    "url" => "/00017310/0000011500000005/v1_202405030647/S0001731023009456/v1_202405030647/es/main.assets"
  ]
  "asociados" => array:1 [
    0 => array:18 [
      "pii" => "S0001731023009456"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2023.11.007"
      "estado" => "S300"
      "fechaPublicacion" => "2024-05-01"
      "aid" => "3756"
      "copyright" => "AEDV"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "pgl"
      "cita" => "Actas Dermosifiliogr. 2024;115:475-92"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:13 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Documento de consenso</span>"
        "titulo" => "Recomendaciones de expertos de la Academia Espa&#241;ola de Dermatolog&#237;a &#40;AEDV&#41; para el manejo de las ectoparasitosis de transmisi&#243;n sexual&#46; Escabiosis y pediculosis p&#250;bica"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:2 [
          0 => "es"
          1 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "475"
            "paginaFinal" => "492"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Spanish Academy of Dermatology and Venereology &#40;AEDV&#41; expert recommendations for the management of sexual transmitted parasitosis&#46; Scabies&#44; and pediculosis pubis"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 2947
                "Ancho" => 3000
                "Tamanyo" => 1114312
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Im&#225;genes cl&#237;nicas y microsc&#243;picas de escabiosis&#59; a&#41; forma cl&#225;sica en adulto joven con fototipo 3&#44; con surcos acarinos &#40;flechas&#41; y p&#225;pulas &#40;puntas de flecha&#41; evidentes en localizaciones t&#237;picas de la mano&#59; b&#41; forma costrosa o noruega &#40;hiperinfestaci&#243;n&#41; en anciana encamada con fototipo 2&#44; con alteraci&#243;n ungueal y lesiones costrosas discretas en me&#241;ique&#44; que hacen dif&#237;cil el diagn&#243;stico de sospecha&#59; c&#41; n&#243;dulos y erosiones genitales &#40;flecha&#41; y surco acarino &#40;punta de flecha&#41; en adulto joven con fototipo 5&#59; d&#41; acropustulosis escabi&#243;tica&#44; p&#250;stulas en planta de pie en beb&#233; de 3 meses de fototipo 6&#59; e&#41; forma at&#237;pica con lesiones eccematosas diseminadas &#40;se muestra abdomen&#41; en mujer de edad media y fototipo 3&#59; f&#41; forma cl&#225;sica impetiginizada&#44; p&#250;stulas en localizaci&#243;n t&#237;pica de escabiosis en mano de ni&#241;a de 8 a&#241;os y fototipo 6&#59; g&#41; forma at&#237;pica ampollosa&#44; con ampollas en lateral de mano &#40;flecha&#41; y un surco acarino en pulgar &#40;punta de flecha&#41; en mujer joven con fototipo 3&#59; h&#41; imagen de surco acarino obtenida mediante dermatoscopio manual&#46; En un extremo se visualiza el triangulo oscuro que corresponde a la secci&#243;n anterior del &#225;caro &#40;punta de flecha&#41;&#46; De &#233;l parte el trayecto lineal sinuoso que termina en una imagen triangular &#40;flechas&#41;&#46; Estas estructuras constituyen el &#171;signo de ala delta&#59; i&#41; imagen del &#225;caro &#40;flecha&#41; y sus huevos &#40;puntas de flecha&#41; obtenida mediante microscop&#237;a &#243;ptica del raspado de un surco acarino&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "C&#46; Galv&#225;n-Casas, J&#46; Ortiz-&#193;lvarez, E&#46; Mart&#237;nez-Garc&#237;a, M&#46; Corbacho-Monn&#233;"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Galv&#225;n-Casas"
              ]
              1 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "Ortiz-&#193;lvarez"
              ]
              2 => array:2 [
                "nombre" => "E&#46;"
                "apellidos" => "Mart&#237;nez-Garc&#237;a"
              ]
              3 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Corbacho-Monn&#233;"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731023009456?idApp=UINPBA000044"
      "url" => "/00017310/0000011500000005/v1_202405030647/S0001731023009456/v1_202405030647/es/main.assets"
    ]
  ]
  "en" => array:22 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Documento de consenso</span>"
    "titulo" => " Spanish Academy of Dermatology and Venereology &#40;AEDV&#41; expert recommendations for the management of sexual transmitted parasitosis&#46; Scabies&#44; and pediculosis pubis"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "T475"
        "paginaFinal" => "T492"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "C&#46; Galv&#225;n-Casas, J&#46; Ortiz-&#193;lvarez, E&#46; Mart&#237;nez-Garc&#237;a, M&#46; Corbacho-Monn&#233;"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "C&#46;"
            "apellidos" => "Galv&#225;n-Casas"
            "email" => array:1 [
              0 => "galvancasascristina@gmail.com"
            ]
            "referencia" => array:3 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
              2 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Ortiz-&#193;lvarez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "E&#46;"
            "apellidos" => "Mart&#237;nez-Garc&#237;a"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Corbacho-Monn&#233;"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">e</span>"
                "identificador" => "aff0025"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:5 [
          0 => array:3 [
            "entidad" => "Unidad Skin Neglected Tropical Diseases and Sexually Transmitted Infections&#59; Fundaci&#243; Lluita contra les Infeccions&#44; Badalona&#44; Barcelona&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Dermatolog&#237;a&#44; Hospital Universitario de M&#243;stoles&#44; M&#243;stoles&#44; Madrid&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Servicio de Dermatolog&#237;a&#44; Hospital Universitario Virgen del Roc&#237;o&#44; Sevilla&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Servicio de Dermatolog&#237;a&#44; Hospital Virgen de la Victoria&#44; M&#225;laga&#44; Spain"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
          4 => array:3 [
            "entidad" => "Servicio de Dermatolog&#237;a&#44; Hospital Universitari Parc Taul&#237;&#44; Sabadell&#44; Barcelona&#44; Spain"
            "etiqueta" => "e"
            "identificador" => "aff0025"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Recomendaciones de expertos de la Academia Espa&#241;ola de Dermatolog&#237;a &#40;AEDV&#41; para el manejo de las ectoparasitosis de transmisi&#243;n sexual&#46; Escabiosis y pediculosis p&#250;bica"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2299
            "Ancho" => 2409
            "Tamanyo" => 720785
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Clinical and microscopic images of scabies&#59; a&#41; classical form in a young adult with skin type 3 exhibiting the characteristic burrows &#40;arrows&#41; and papules &#40;arrowheads&#41; evident at typical locations on the hand&#59; b&#41; crusted or Norwegian form &#40;hyperinfestation&#41; in an elderly bedridden woman with skin type 2&#44; nail abnormalities&#44; and discreet crusted lesions on her pinky finger&#44; posing a challenge for diagnosis&#59; c&#41; genital nodules and erosions &#40;arrow&#41; and burrow &#40;arrowhead&#41; in a young man with skin type 5&#59; d&#41; infantile acropustulosis&#44; pustules on the sole of a 3-month-old baby with skin type 6&#59; e&#41; atypical form with disseminated eczematous lesions &#40;abdomen shown&#41; in a middle-aged woman with skin type 3&#59; f&#41; classic impetiginized form&#44; pustules in typical scabies location on the hand of an 8-year-old girl with skin type 6&#59; g&#41; blistering atypical form&#44; with blisters on the side of the hand &#40;arrow&#41; and a burrow on the thumb &#40;arrowhead&#41; in a young woman with skin type 3&#59; h&#41; image of the burrow obtained using a manual dermatoscope&#46; At one end&#44; the dark triangle consistent with the anterior section of the mite can be seen &#40;arrowhead&#41;&#46; The sinuous linear path starting here ends in a triangular image &#40;arrows&#41;&#46; These structures make up the &#8220;delta wing sign&#8221;&#59; i&#41; image of the mite &#40;arrow&#41; and its eggs &#40;arrowheads&#41; obtained through optical microscopy of scraping of one of the burrows&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The aim of this document is to establish expert recommendations from the Spanish Academy of Dermatology and Venereology &#40;AEDV&#41; on the management and control of sexually transmitted ectoparasitic infections &#40;STEIs&#41;&#44; as part of the project of developing AEDV recommendations on the management of sexually transmitted infections &#40;STIs&#41;&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The goals are to adapt these recommendations to the scientific evidence currently available and unify criteria and strategies for prevention&#44; detection&#44; diagnosis&#44; treatment&#44; and individual and community control of STEIs across different demographic&#44; epidemiological&#44; clinical&#44; and health socio-sanitary situations&#46; The document anticipates a plan for updating every 5 years&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">For the effective management of these community-transmitted ectoparasitic infections&#44; a comprehensive approach is required&#44; involving close collaboration among primary care health workforce&#44; dermatologists&#44; infectologists&#44; epidemiologists&#44; and preventive medicine specialists&#44; among others&#44; leading to a coordinated response between them and with those responsible for the surveillance and control policies of communicable diseases&#46; Therefore&#44; this document is not only intended for dermatologists but also for all health care workers who manage scabies and those who establish prevention and control policies&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">As <a class="elsevierStyleCrossRef" href="#sec0160">supplementary data</a>&#44; annexes are provided with information on scabies&#44; its differential diagnosis &#40;<a class="elsevierStyleCrossRef" href="#sec0160">supplementary data&#46; Annex 1</a>&#41;&#44; patient information sheets &#40;<a class="elsevierStyleCrossRef" href="#sec0160">supplementary data&#46; Annex 2</a>&#41;&#44; oral ivermectin dosing &#40;<a class="elsevierStyleCrossRef" href="#sec0160">supplementary data&#46; Annex 3</a>&#41;&#44; information for workers &#40;<a class="elsevierStyleCrossRef" href="#sec0160">supplementary data&#46; Annex 4</a>&#41;&#44; and a checklist &#40;<a class="elsevierStyleCrossRef" href="#sec0160">supplementary data&#46; Annex 5</a>&#41; for affected institutions&#44; frequently asked questions &#40;<a class="elsevierStyleCrossRef" href="#sec0160">supplementary data&#46; Annex 6</a>&#41;&#44; video with audiovisual support material for diagnosis&#44; treatment&#44; and control &#40;<a class="elsevierStyleCrossRef" href="#sec0160">supplementary data&#46; Annex 7</a>&#44; also available at <a href="https://youtu.be/lP8McE90Cz4">https&#58;&#47;&#47;youtu&#46;be&#47;lP8McE90Cz4</a>&#44; English version&#44; and <a href="https://aedv.fundacionpielsana.es/wikiderma/escabiosis">https&#58;&#47;&#47;aedv&#46;fundacionpielsana&#46;es&#47;wikiderma&#47;escabiosis</a>&#44; Spanish version&#41;&#44; and a table with the levels of evidence and grades of recommendation used &#40;<a class="elsevierStyleCrossRef" href="#sec0160">supplementary data&#46; Annex 8</a>&#41;&#46;</p><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Justification</span><p id="par0025" class="elsevierStylePara elsevierViewall">A characteristic of sexually transmitted parasitic infestations such as scabies and pediculosis is their potential for transmission through sexual contact as well as acquisition within the community&#46; Clinical and epidemiological diagnoses are important for individual and sexual contact control and&#44; eventually&#44; community control&#46; Additionally&#44; their presence is suggestive of other possible associated concurrent STIs&#44; including HIV&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Regarding scabies&#44; in recent years&#44; different European countries have reported on a suspected increased incidence and decreased efficacy of treatments indicated in the clinical practice guidelines&#46;<a class="elsevierStyleCrossRefs" href="#bib0490"><span class="elsevierStyleSup">1&#8211;6</span></a> Inadequate therapeutic compliance and prevention measures&#44; and decreased efficacy of scabicides&#44; may be contributing to insufficient control&#46;<a class="elsevierStyleCrossRef" href="#bib0520"><span class="elsevierStyleSup">7</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Pubic lice infestation has not raised alarms of incidence or lack of control&#44; nor has it been demonstrated that it acts as a vector in the transmission of other diseases&#46; However&#44; among affected individuals&#44; an increased incidence of other STIs such as syphilis&#44; gonorrhea&#44; and chlamydia has been reported&#46;<a class="elsevierStyleCrossRefs" href="#bib0525"><span class="elsevierStyleSup">8&#44;9</span></a></p></span></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Methods</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors reviewed the main international guidelines&#44; including guidelines drafted in Europe&#44;<a class="elsevierStyleCrossRefs" href="#bib0530"><span class="elsevierStyleSup">9&#8211;11</span></a> Japan&#44;<a class="elsevierStyleCrossRef" href="#bib0545"><span class="elsevierStyleSup">12</span></a> Germany&#44;<a class="elsevierStyleCrossRef" href="#bib0550"><span class="elsevierStyleSup">13</span></a> the United Kingdom&#44;<a class="elsevierStyleCrossRef" href="#bib0555"><span class="elsevierStyleSup">14</span></a> and the U&#46;S&#46; Centers for Disease Control and Prevention &#40;CDC&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0560"><span class="elsevierStyleSup">15&#44;16</span></a> and protocols from national and local health services and epidemiological surveillance from Spain&#44; published or provided by dermatologists&#46;<a class="elsevierStyleCrossRefs" href="#bib0570"><span class="elsevierStyleSup">17&#8211;27</span></a> Additionally&#44; in August 2023&#44; relevant scientific publications were consulted in the PubMed&#44; EMBASE&#44; and Cochrane databases&#44; without date restrictions&#44; with available abstracts&#44; and written in English&#44; French&#44; or any of the official languages of Spain&#46; Case descriptions were excluded&#46; The obtained works and their citations were reviewed to identify other relevant studies&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Both the levels of evidence and grades of recommendation were evaluated using the criteria established by the Oxford Center for Evidence-Based Medicine&#44; version 2009&#46;<a class="elsevierStyleCrossRef" href="#bib0625"><span class="elsevierStyleSup">28</span></a> &#40;<a class="elsevierStyleCrossRef" href="#sec0160">supplementary data&#46; Annex 8</a>&#41;&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Drug prices were consulted in the nomenclature of pharmaceutical products available in pharmacies of the Spanish Ministry of Health as of September 2023&#46;<a class="elsevierStyleCrossRef" href="#bib0630"><span class="elsevierStyleSup">29</span></a> The approximate price of drugs available in magistral formulation was calculated by requesting a quote from different pharmacies subject to the regulation of magistral formulation of drugs from the Spanish autonomous communities of Andalusia&#44; Cantabria&#44; Castilla-La Mancha&#44; Catalonia&#44; and Madrid&#46;</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">External review</span><p id="par0055" class="elsevierStylePara elsevierViewall">Two experts&#44; one representing the International Alliance for the Control of Scabies &#40;IACS&#41; and the other from the World Health Organization &#40;WHO&#41;&#44; both Spanish speakers&#44; reviewed the document&#46; Their recommendations were carefully analyzed and considered&#46;</p></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Scabies</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">What is scabies&#63;</span><p id="par0060" class="elsevierStylePara elsevierViewall">Human scabies&#44; is a communicable disease resulting from infestation of human skin by a mite of the family <span class="elsevierStyleItalic">Sarcoptidae</span>&#46; References to its existence date back to ancient times&#46;<a class="elsevierStyleCrossRefs" href="#bib0635"><span class="elsevierStyleSup">30&#44;31</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Etiology</span><p id="par0065" class="elsevierStylePara elsevierViewall">The causative agent of scabies is <span class="elsevierStyleItalic">Sarcoptes scabiei</span> var&#46; <span class="elsevierStyleItalic">hominis</span>&#44; a 0&#46;30<span class="elsevierStyleHsp" style=""></span>mm x 0&#46;50<span class="elsevierStyleHsp" style=""></span>mm arthropod &#40;size of adult females&#41; at the limit of human eye visibility&#46;<a class="elsevierStyleCrossRef" href="#bib0645"><span class="elsevierStyleSup">32</span></a> Its complete life cycle&#44; which extends from 9 to 15 days&#44; occurs in humans&#44; who serve as its reservoir&#46; Mated females burrow into the epidermis&#44; where they lay their eggs&#46; Female survival and infectivity in the environment are higher when relative humidity is high&#44; and temperature drops below 20<span class="elsevierStyleHsp" style=""></span>&#176;C&#46;<a class="elsevierStyleCrossRef" href="#bib0650"><span class="elsevierStyleSup">33</span></a> Under normal conditions&#44; the mite can survive for 3 days outside the host&#46;<a class="elsevierStyleCrossRefs" href="#bib0645"><span class="elsevierStyleSup">32&#44;34&#44;35</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Transmission</span><p id="par0070" class="elsevierStylePara elsevierViewall">Transmission occurs through close physical contact for&#44; at least&#44; 20<span class="elsevierStyleHsp" style=""></span>minutes&#44; with another infected individual&#44; typically a sexual partner or a household member&#46;<a class="elsevierStyleCrossRef" href="#bib0665"><span class="elsevierStyleSup">36</span></a> Cases of crusted scabies &#40;see &#8220;Clinical forms&#8221; section below&#41; harbor a high parasite load &#40;hyperinfestation&#41;&#44; where brief contacts may be sufficient for transmission&#46;<a class="elsevierStyleCrossRefs" href="#bib0555"><span class="elsevierStyleSup">14&#44;37</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">The contagious period starts when the parasite is acquired&#46; Transmission via fomites is unlikely&#44;<a class="elsevierStyleCrossRefs" href="#bib0675"><span class="elsevierStyleSup">38&#44;39</span></a> except for cases of hyperinfestation&#44; where it poses a real risk&#46;<a class="elsevierStyleCrossRefs" href="#bib0555"><span class="elsevierStyleSup">14&#44;37&#44;40</span></a></p><p id="par0425" class="elsevierStylePara elsevierViewall">Transitory self-resolving infestations have been reported&#44; but never cross-infestation between humans and other animals that complete the parasite&#39;s life cycle&#46;<a class="elsevierStyleCrossRefs" href="#bib0690"><span class="elsevierStyleSup">41&#8211;44</span></a></p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Pathophysiology</span><p id="par0080" class="elsevierStylePara elsevierViewall">Pruritus&#44; a key symptom&#44; and skin lesions are the result of the host&#39;s immune response to the mite&#44; its excretions&#44; or eggs and may persist for weeks after parasitological cure&#46; The time elapsed between the initial infestation and this reaction ranges between 2 and 6 weeks&#44; which facilitates spread from asymptomatic carriers&#46;<a class="elsevierStyleCrossRefs" href="#bib0675"><span class="elsevierStyleSup">38&#44;45</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">An episode of scabies does not confer immunity against future infestations&#46; Symptoms often appear 1 to 3 days after exposure in infected individuals with previous episodes of scabies&#46;</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Epidemiology</span><p id="par0090" class="elsevierStylePara elsevierViewall">Scabies has a worldwide distribution&#44; with highly variable prevalence across different regions&#46; Scabies has an estimated prevalence of nearly 200 million people each year&#44; and an incidence of 455 million cases per year&#44; which represents a significant global disease burden&#46;<a class="elsevierStyleCrossRef" href="#bib0715"><span class="elsevierStyleSup">46</span></a> Scabies has been categorized as a &#8220;neglected tropical disease&#8221; by the WHO&#44;<a class="elsevierStyleCrossRef" href="#bib0720"><span class="elsevierStyleSup">47</span></a> which prioritizes its control in its 2021-2030 roadmap&#46;<a class="elsevierStyleCrossRef" href="#bib0725"><span class="elsevierStyleSup">48</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Cyclical patterns and seasonal variations of prevalence are described&#44; but no predictive models have ever been confirmed&#46;<a class="elsevierStyleCrossRefs" href="#bib0715"><span class="elsevierStyleSup">46&#44;49&#44;50</span></a> Situations fostering vulnerability&#44; such as migratory movements&#44; can lead to serious situations of very high prevalence&#46;<a class="elsevierStyleCrossRef" href="#bib0740"><span class="elsevierStyleSup">51</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Scabies is not a notifiable disease&#44; with the exception of outbreaks &#40;see the &#8220;Situation Diagnosis&#8221; section below&#41;&#44; which in Spain and other countries&#44; require reporting&#46; This poses a challenge in accurately determining the prevalence and trends of incidence curves&#46;<a class="elsevierStyleCrossRefs" href="#bib0490"><span class="elsevierStyleSup">1&#44;52&#44;53</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">As it happens in other countries&#44; Spain has seen growing reports of rising case numbers and acaricide use in recent years&#46;<a class="elsevierStyleCrossRefs" href="#bib0515"><span class="elsevierStyleSup">6&#44;54</span></a></p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Clinical presentation</span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Clinical forms</span><p id="par0110" class="elsevierStylePara elsevierViewall">Diagnosis is based on history-taking and recognition of the clinical signs associated with scabies&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">The cardinal symptom is intense pruritus&#44; typically sparing the head and face and worsening in the evening hours&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The most specific clinical sign is the burrow&#8212;visible to the naked eye&#8212;a 2<span class="elsevierStyleHsp" style=""></span>mm x 15<span class="elsevierStyleHsp" style=""></span>mm thin&#44; sinuous linear trajectory&#46; Although it is the pathognomonic lesion&#44; it is often hidden by excoriation or superinfection&#46; Other types of lesions&#44; such as papules &#40;<a class="elsevierStyleCrossRef" href="#fig0005">figure 1</a>a&#41; and genital nodules in cases of sexual transmission &#40;<a class="elsevierStyleCrossRef" href="#fig0005">figure 1</a>c&#41;&#44; are more common&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0125" class="elsevierStylePara elsevierViewall">Clinical presentation shares signs and symptoms with other dermatopathies and manifests differently in infants and individuals with a deficient immune response to the mite&#46;<a class="elsevierStyleCrossRefs" href="#bib0760"><span class="elsevierStyleSup">55&#44;56</span></a> Various clinical presentations are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; <a class="elsevierStyleCrossRef" href="#fig0005">Figures 1</a>a-i illustrate several clinical and microscopic images&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Complications</span><p id="par0130" class="elsevierStylePara elsevierViewall">Bacterial superinfection&#44; favored by scratching&#44; is the most common complication&#46; The most widely reported bacteria involved in the infection are <span class="elsevierStyleItalic">Staphylococcus aureus</span> and <span class="elsevierStyleItalic">Streptococcus</span><span class="elsevierStyleItalic">pyogenes</span>&#44; and the usual clinical presentation is impetigo &#40;<a class="elsevierStyleCrossRef" href="#fig0005">figure 1</a>f&#41;&#46; In untreated or weakened patients&#44; it can progress into deep soft tissue infections such as cellulitis and sepsis&#46;<a class="elsevierStyleCrossRefs" href="#bib0760"><span class="elsevierStyleSup">55&#44;57</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">Pruritus prevents rest and&#44; along with the stigma associated with the disease&#44; causes significant psychological distress&#46;<a class="elsevierStyleCrossRef" href="#bib0775"><span class="elsevierStyleSup">58</span></a></p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Diagnosis</span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Diagnostic criteria</span><p id="par0140" class="elsevierStylePara elsevierViewall">The IACS criteria &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#44; which include typical lesions and symptoms&#44; and epidemiological data&#44; allow for standardized diagnosis with varying levels of rigor&#46; This includes confirmed &#40;level A&#41;&#44; clinical &#40;level B&#41;&#44; or suspected scabies &#40;level C&#41;&#46; The utility of the IACS criteria is limited in clinical forms other than the classical presentation&#46;<a class="elsevierStyleCrossRef" href="#bib0780"><span class="elsevierStyleSup">59</span></a></p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0145" class="elsevierStylePara elsevierViewall">The diagnostic gold standard is the visualization of the mite under an optical microscope&#46; The 10x magnification handheld dermatoscope&#8212;a more accessible technique&#8212;allows for the visualization of different structures and non-invasive confirmation diagnosis &#40;<a class="elsevierStyleCrossRef" href="#fig0005">figure 1</a>i&#41;&#46; A brown triangular figure at its distal end is consistent with the anterior section of the mite&#46; This figure &#40;delta&#41;&#44; along with the triangular image at the opposite end and the sinuous path that connects them &#40;trail&#41;&#44; is the &#8220;delta wing sign&#46;&#8221;<a class="elsevierStyleCrossRef" href="#bib0785"><span class="elsevierStyleSup">60</span></a> &#40;<a class="elsevierStyleCrossRef" href="#fig0005">figure 1</a>h&#41;&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Various diagnostic aid techniques have been described<a class="elsevierStyleCrossRef" href="#bib0790"><span class="elsevierStyleSup">61</span></a> &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a> and <a class="elsevierStyleCrossRef" href="#sec0160">supplementary data&#46; Annex 6</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Situation diagnosis</span><p id="par0155" class="elsevierStylePara elsevierViewall">To determine whether there is an outbreak and establish control measures&#44; it is necessary to know if we are dealing with one or multiple cases&#44; classical or hyperinfestation forms&#44; and recognize if vulnerable groups are affected&#44; such as displaced or institutionalized populations &#40;schools&#44; hospitals&#44; refugee camps&#44; nursing homes&#44; penitentiaries&#46;&#46;&#46;&#41; <a class="elsevierStyleCrossRefs" href="#bib0545"><span class="elsevierStyleSup">12&#44;17&#44;21&#44;62</span></a> &#40;<a class="elsevierStyleCrossRef" href="#fig0010">figure 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Cure diagnosis</span><p id="par0160" class="elsevierStylePara elsevierViewall">Cure is defined by the absence of new lesions and the absence of parasites in 2 different tests performed on the remaining lesions over 2 consecutive weeks&#46;<a class="elsevierStyleCrossRefs" href="#bib0545"><span class="elsevierStyleSup">12&#44;13</span></a></p><p id="par0165" class="elsevierStylePara elsevierViewall">After parasitological cure&#44; burrows may still be visible&#44; and dermatitis and itching may still go on for weeks&#46; Topical scabicides are irritants and may contribute to this persistence&#46;<a class="elsevierStyleCrossRef" href="#bib0800"><span class="elsevierStyleSup">63</span></a></p><p id="par0170" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a> illustrates the diagnostic algorithm of scabies&#46;</p></span></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Treatment</span><p id="par0175" class="elsevierStylePara elsevierViewall">Therapeutic goals are to eliminate the parasite and its eggs&#44; resolve the symptoms&#44; eradicate the signs and complications associated with the infestation&#44; and control its spread&#46; Patients should receive written information &#40;level of evidence 5&#44; grade of recommendation D&#41;<a class="elsevierStyleCrossRef" href="#bib0535"><span class="elsevierStyleSup">10</span></a> &#40;<a class="elsevierStyleCrossRef" href="#sec0160">supplementary data&#46; Annex 2</a>&#41;&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">There are currently 2 marketed drugs in Spain&#58; topical permethrin and oral ivermectin&#44; both regarded as first-line therapies&#46; Other treatments&#8212;available by compounding&#8212;include topical sulfur&#44; topical ivermectin&#44; and benzyl benzoate&#46; Drug selection should consider the patient&#39;s preferences and potential contraindications&#46; Not all contacts involved need to use the same scabicide&#46; Since the mite&#39;s life cycle occurs in the stratum corneum&#44; topical treatment is effective in most cases&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">Topical treatments should be applied as described in <a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#44; regardless of the infection route or the location of signs and symptoms&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0190" class="elsevierStylePara elsevierViewall">The most relevant information on drugs available in Spain is shown in <a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0195" class="elsevierStylePara elsevierViewall">Treatment recommendations differ depending on the form of scabies&#44; the patient&#39;s clinical condition&#44; and the epidemiological situation &#40;<a class="elsevierStyleCrossRef" href="#fig0015">figure 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Drugs in the pipeline&#44; or still not available in Spain</span><p id="par0200" class="elsevierStylePara elsevierViewall">Several macrocyclic lactones are in the pipeline&#46; Moxidectin&#44; which has a good safety profile&#44; has been approved by the U&#46;S&#46; Food and Drug Administration &#40;FDA&#41; to treat onchocerciasis in humans&#46; Compared to ivermectin&#44; moxidectin has greater in vitro scabicidal activity&#44; cutaneous bioavailability&#44; and half-life &#40;20 to 40 days&#44; which is longer than the parasite&#39;s life cycle&#41;&#44; which would allow for single-dose treatment&#46;<a class="elsevierStyleCrossRefs" href="#bib0805"><span class="elsevierStyleSup">64&#44;65</span></a></p><p id="par0205" class="elsevierStylePara elsevierViewall">Spinosad&#44; in a 0&#46;9&#37; topical suspension&#44; is an insecticide that has been approved in the United States to treat scabies&#46; It has a high safety profile&#46;<a class="elsevierStyleCrossRef" href="#bib0815"><span class="elsevierStyleSup">66</span></a></p><p id="par0210" class="elsevierStylePara elsevierViewall">Malathion&#44; crotamiton&#44; and lindane are no longer available in Spain&#44; the latter having been withdrawn due to its neurological toxicity&#46;</p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Combined therapies</span><p id="par0215" class="elsevierStylePara elsevierViewall">The combination of topical permethrin plus oral ivermectin in a single dose of 200<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;kg was more effective than monotherapy to treat classical scabies&#46; However&#44; the methodology of the only study in which it has been evaluated does not allow us to determine the level of evidence or grade of recommendation of this combination&#46;<a class="elsevierStyleCrossRef" href="#bib0820"><span class="elsevierStyleSup">67</span></a></p><p id="par0220" class="elsevierStylePara elsevierViewall">For hyperinfestation&#44; a combination of topical and oral scabicides is advised&#46; Topical treatment is repeated daily for a week and then every 48<span class="elsevierStyleHsp" style=""></span>hours until definitive cure&#46; Oral ivermectin is administered on days 1&#44; 2&#44; and 8 in mild cases and on days 1&#44; 2&#44; 8&#44; 9&#44; 15&#44; 22&#44; and 29 or until a definitive cure has been achieved in most severe cases &#40;level of evidence <a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">4</span></a>&#44; grade of recommendation C&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0535"><span class="elsevierStyleSup">10</span></a> Additionally&#44; in the presence of crusts or hyperkeratosis&#44; keratolytics should be added to the scabicides&#46;<a class="elsevierStyleCrossRefs" href="#bib0545"><span class="elsevierStyleSup">12&#44;14&#44;68</span></a></p><p id="par0225" class="elsevierStylePara elsevierViewall">In high-risk patients&#44; such as immunocompromised individuals with classical scabies&#44; combined treatment from the beginning may be considered&#46;<a class="elsevierStyleCrossRefs" href="#bib0820"><span class="elsevierStyleSup">67&#44;69</span></a> &#40;level of evidence 5&#44; grade of recommendation D&#41;&#46;</p></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Drug resistance</span><p id="par0230" class="elsevierStylePara elsevierViewall">In recent years&#44; therapeutic failures have been described with all scabicides&#46;<a class="elsevierStyleCrossRefs" href="#bib0500"><span class="elsevierStyleSup">3&#44;70&#8211;72</span></a> Contributing factors may include drug resistance generation&#44;<a class="elsevierStyleCrossRef" href="#bib0850"><span class="elsevierStyleSup">73</span></a> inadequate cutaneous bioavailability of the drug&#44;<a class="elsevierStyleCrossRef" href="#bib0855"><span class="elsevierStyleSup">74</span></a> incorrect treatment compliance&#44; and reinfection due to insufficient contact control&#46;<a class="elsevierStyleCrossRefs" href="#bib0520"><span class="elsevierStyleSup">7&#44;75</span></a> Poor control of fomites does not seem to be a plausible cause&#44; given the low frequency of this source of contagion and the demonstrated efficacy in community campaigns that do not involve environmental mite elimination&#46;<a class="elsevierStyleCrossRefs" href="#bib0865"><span class="elsevierStyleSup">76&#44;77</span></a></p><p id="par0235" class="elsevierStylePara elsevierViewall">In vitro tolerance of the mite to permethrin and ivermectin has increased since they started being used for scabies&#46;<a class="elsevierStyleCrossRefs" href="#bib0840"><span class="elsevierStyleSup">71&#44;78&#44;79</span></a> In addition&#44; mutations related to permethrin resistance have been identified&#46; However&#44; the few available clinical studies still report high efficacy rates&#46;<a class="elsevierStyleCrossRefs" href="#bib0885"><span class="elsevierStyleSup">80&#44;81</span></a></p><p id="par0240" class="elsevierStylePara elsevierViewall">It is difficult to prove the cause of failures for several reasons&#58; there is no experimental culture medium for the mite&#44; and in vitro studies lack standardization&#59; confirmation of correct treatment compliance is not always possible&#44; and&#44; eventually&#44; the higher the prevalence the more difficult it becomes to access to all individuals who need treatment as direct contacts&#46;</p><p id="par0245" class="elsevierStylePara elsevierViewall">In case of therapeutic failure&#44; due to absence of cure criteria 4 weeks into treatment&#44; the complete regimen should be repeated&#46; After confirming compliance with all necessary measures&#8212;personal&#44; contacts&#44; and environmental&#8212;the health care worker must decide whether to repeat the previous regimen&#44; extend the skin contact time with the topical scabicide&#44; increase the number of cycles of oral or topical treatment&#44; prescribe the association of permethrin and ivermectin&#44; or recommend an alternative treatment&#44; among those currently considered second-line therapies&#46; This decision should take into account the preferences and possible contraindications of the affected individual and his&#47;her contacts &#40;<a class="elsevierStyleCrossRef" href="#fig0015">figure 3</a>&#41;&#46;</p></span><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Post-mite elimination treatment &#40;persistent symptoms&#41;</span><p id="par0250" class="elsevierStylePara elsevierViewall">After mite elimination&#44; skin lesions&#44; itching&#44; and bacterial complications may persist for 2 to 4 weeks&#46;</p><p id="par0255" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Itching&#58;</span> oral antihistamines can alleviate it &#40;level of evidence 5&#44; grade of recommendation D&#41;&#46; The topical application of medium-potency corticosteroids and tacrolimus has proven effective in reducing itching &#40;level of evidence 1b&#44; grade of recommendation A&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0900"><span class="elsevierStyleSup">83</span></a> Before starting the application&#44; the absence of bacterial superinfection and parasitological cure should be confirmed to avoid masking infection and persistent scabies&#46;</p><p id="par0260" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Skin lesions&#58;</span> after parasitological cure&#44; topical corticosteroids can help resolve the inflammatory process &#40;level of evidence 5&#44; grade of recommendation D&#41;&#46;</p><p id="par0265" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Bacterial infections&#58;</span> they should be treated with topical or oral antibiotics based on their severity and&#44; eventually&#44; they should be antibiogram-guided &#40;level of evidence 2c&#44; grade of recommendation B&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0905"><span class="elsevierStyleSup">84</span></a></p></span><span id="sec0115" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Management of direct contacts</span><p id="par0270" class="elsevierStylePara elsevierViewall">In cases of classical scabies&#44; all close primary contacts of the affected individual from 1 to 2 months before the onset of symptoms&#44; should be treated&#44; regardless of the presence of symptoms&#44; including sexual partners and individuals who share a bed or have close household or institutional contact &#40;schools&#44; shelters&#44; nursing homes&#44; etc&#46;&#41;&#46;</p><p id="par0275" class="elsevierStylePara elsevierViewall">For secondary contacts&#8212;those who have had close contact with a primary contact of a case&#8212;follow-up is advised&#46;</p><p id="par0280" class="elsevierStylePara elsevierViewall">The sexual partners in the 2 months prior to symptom onset should be examined and treated &#40;level of evidence 5&#44; grade of recommendation D&#41;&#46; Close contact should be avoided until the affected individual and his&#47;her partners have been treated &#40;level of evidence 5&#44; grade of recommendation D&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0535"><span class="elsevierStyleSup">10&#44;11</span></a></p><p id="par0285" class="elsevierStylePara elsevierViewall">In cases of hyperinfestation&#44; all primary contacts should be treated&#44; even if they have not been in intimate or prolonged contact&#46; Secondary contacts should also be monitored&#44; and treatment should be considered&#46;<a class="elsevierStyleCrossRefs" href="#bib0545"><span class="elsevierStyleSup">12&#44;62&#44;81</span></a></p></span><span id="sec0120" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Environmental mite elimination</span><p id="par0290" class="elsevierStylePara elsevierViewall">For classical scabies&#44; there is no evidence that fomite treatment is helpful&#46;<a class="elsevierStyleCrossRef" href="#bib0675"><span class="elsevierStyleSup">38</span></a> However&#44; based on studies that found mites in the environment&#44; <a class="elsevierStyleCrossRef" href="#bib0675"><span class="elsevierStyleSup">38</span></a> most clinical practice guidelines recommend eliminating mites on fomites that have come into contact with the affected individual&#39;s skin &#40;level of evidence 5&#44; grade of recommendation D&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0535"><span class="elsevierStyleSup">10</span></a></p><p id="par0295" class="elsevierStylePara elsevierViewall">Mites can be completely eliminated by exposing clothes to 50<span class="elsevierStyleHsp" style=""></span>&#176;C temperatures for 10<span class="elsevierStyleHsp" style=""></span>minutes &#40;in washing machine&#44; tumble dryer or water&#41;&#44; keeping them in sealed bags for 3 &#40;moderate ambient temperature and humidity&#41; to 8 days &#40;high ambient humidity and low temperatures&#41;&#44; or keeping them in the freezer at -10<span class="elsevierStyleHsp" style=""></span>&#176;C for 5<span class="elsevierStyleHsp" style=""></span>hours&#46;<a class="elsevierStyleCrossRef" href="#bib0970"><span class="elsevierStyleSup">97</span></a> Surfaces should be cleaned with soap&#44; water&#44; and a vacuum cleaner&#46;<a class="elsevierStyleCrossRef" href="#bib0570"><span class="elsevierStyleSup">17</span></a></p><p id="par0300" class="elsevierStylePara elsevierViewall">To avoid reinfections&#44; these measures should be implemented the same day as the treatment for affected individuals and contacts&#46;</p><p id="par0305" class="elsevierStylePara elsevierViewall">For crusted scabies&#44; where patients harbor a very high number of mites&#44; all guidelines recommend rigorous environmental decontamination&#46;</p></span></span><span id="sec0125" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Outbreak control <span class="elsevierStyleBold">&#40;</span><a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a> and <a class="elsevierStyleCrossRef" href="#sec0160">supplementary data&#46; Annexes 4 and 5</a><span class="elsevierStyleBold">&#41;</span></span><p id="par0310" class="elsevierStylePara elsevierViewall">In the event of an institutional outbreak of scabies&#44; the following measures should be implemented&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#8226;</span><p id="par0315" class="elsevierStylePara elsevierViewall">Notify the administration and those responsible for prevention and occupational health at the center&#44; as well as residents&#44; their families&#44; and the centers the residents may have recently been transferred to&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#8226;</span><p id="par0320" class="elsevierStylePara elsevierViewall">Provide basic training on the disease to workers&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#8226;</span><p id="par0325" class="elsevierStylePara elsevierViewall">Daily evaluation of symptoms and signs in residents&#44; workers&#44; and new admissions while the outbreak persists&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#8226;</span><p id="par0330" class="elsevierStylePara elsevierViewall">Treatment of those meeting scabies diagnostic criteria&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">&#8226;</span><p id="par0335" class="elsevierStylePara elsevierViewall">Offer preventive treatment to workers&#44; visiting family members&#44; and asymptomatic residents living in the affected area of the institution&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">&#8226;</span><p id="par0340" class="elsevierStylePara elsevierViewall">Temporary work disability for affected workers for as long as they exhibit signs of active infestation and&#44; at least&#44; 24<span class="elsevierStyleHsp" style=""></span>hours after the first dose of treatment&#46;</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">&#8226;</span><p id="par0345" class="elsevierStylePara elsevierViewall">Contact isolation measures for affected residents&#46;</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">&#8226;</span><p id="par0350" class="elsevierStylePara elsevierViewall">Implementation of measures for environmental mite elimination&#46;</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">&#8226;</span><p id="par0355" class="elsevierStylePara elsevierViewall">Detailed notification of the situation to regional health authorities&#46;</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">&#8226;</span><p id="par0360" class="elsevierStylePara elsevierViewall">These same measures should be implemented to deal with cases of crusted scabies&#44; and all close primary contacts should be treated as well&#46; Secondary contacts and individuals in contact with the affected individual&#39;s fomites&#44; such as laundry personnel&#44; should be evaluated and offered curative or preventive treatment&#46;<a class="elsevierStyleCrossRefs" href="#bib0560"><span class="elsevierStyleSup">15&#44;17&#44;19&#44;62</span></a></p></li></ul></p></span></span><span id="sec0130" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0150">Pubic lice</span><p id="par0365" class="elsevierStylePara elsevierViewall">Pubic lice&#44; also known as &#8220;crab louse&#8221;&#44; are caused by the ectoparasite <span class="elsevierStyleItalic">Pthirus pubis</span>&#46; They are visible to the naked eye and smaller than head lice&#46; They infest pubic hair and&#44; to a lesser extent&#44; body hair&#44; eyebrows&#44; eyelashes and armpits&#46;</p></span><span id="sec0135" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0155">Transmission and epidemiology</span><p id="par0370" class="elsevierStylePara elsevierViewall">Pubic lice are primarily transmitted through sexual contact&#44; but depending on the site of infestation&#44; they can also spread through non-sexual contact among close household contacts&#46; Transmission via fomites is much less likely&#44; as the lice cannot survive for 24<span class="elsevierStyleHsp" style=""></span>hours without feeding from the host&#39;s blood&#46;</p><p id="par0375" class="elsevierStylePara elsevierViewall">The eggs are deposited&#44; attached to the hair&#44; close to the skin&#46; After hatching&#44; typically a week after being laid&#44; the empty eggshell may remain attached to the hair&#46; Nymphs reach maturity and become capable of contagion within 2 weeks&#46;<a class="elsevierStyleCrossRef" href="#bib0955"><span class="elsevierStyleSup">94</span></a></p><p id="par0380" class="elsevierStylePara elsevierViewall">Currently&#44; there are no current prevalence studies in the adult population&#46; Various studies&#44; albeit not recent&#44; evaluate cases seen in STI clinics with prevalence rates close to 2&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0960"><span class="elsevierStyleSup">95</span></a></p><p id="par0385" class="elsevierStylePara elsevierViewall">The incidence of pubic lice is increasing in disadvantaged communities with overcrowded conditions and decreasing in populations where pubic hair removal is a common practice&#46; Affected individuals are more likely than the general population to have other concurrent STIs&#46;<a class="elsevierStyleCrossRefs" href="#bib0525"><span class="elsevierStyleSup">8&#44;9</span></a></p></span><span id="sec0140" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0160">Clinical presentation&#44; treatment&#44; and control</span><p id="par0390" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#tbl0030">Table 6</a> summarizes the clinical characteristics and recommended treatment and control measures&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia></span><span id="sec0145" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0165">Funding</span><p id="par0395" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0150" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0170">Conflicts of interest</span><p id="par0400" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:15 [
        0 => array:3 [
          "identificador" => "xres2138811"
          "titulo" => "Abstract"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0005"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1815942"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres2138810"
          "titulo" => "Resumen"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0010"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1815943"
          "titulo" => "Palabras clave"
        ]
        4 => array:3 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
          "secciones" => array:1 [
            0 => array:2 [
              "identificador" => "sec0010"
              "titulo" => "Justification"
            ]
          ]
        ]
        5 => array:3 [
          "identificador" => "sec0015"
          "titulo" => "Methods"
          "secciones" => array:1 [
            0 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "External review"
            ]
          ]
        ]
        6 => array:3 [
          "identificador" => "sec0025"
          "titulo" => "Scabies"
          "secciones" => array:9 [
            0 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "What is scabies&#63;"
            ]
            1 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Etiology"
            ]
            2 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Transmission"
            ]
            3 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Pathophysiology"
            ]
            4 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Epidemiology"
            ]
            5 => array:3 [
              "identificador" => "sec0055"
              "titulo" => "Clinical presentation"
              "secciones" => array:2 [
                0 => array:2 [
                  "identificador" => "sec0060"
                  "titulo" => "Clinical forms"
                ]
                1 => array:2 [
                  "identificador" => "sec0065"
                  "titulo" => "Complications"
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "sec0070"
              "titulo" => "Diagnosis"
              "secciones" => array:3 [
                0 => array:2 [
                  "identificador" => "sec0075"
                  "titulo" => "Diagnostic criteria"
                ]
                1 => array:2 [
                  "identificador" => "sec0080"
                  "titulo" => "Situation diagnosis"
                ]
                2 => array:2 [
                  "identificador" => "sec0085"
                  "titulo" => "Cure diagnosis"
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "sec0090"
              "titulo" => "Treatment"
              "secciones" => array:6 [
                0 => array:2 [
                  "identificador" => "sec0095"
                  "titulo" => "Drugs in the pipeline&#44; or still not available in Spain"
                ]
                1 => array:2 [
                  "identificador" => "sec0100"
                  "titulo" => "Combined therapies"
                ]
                2 => array:2 [
                  "identificador" => "sec0105"
                  "titulo" => "Drug resistance"
                ]
                3 => array:2 [
                  "identificador" => "sec0110"
                  "titulo" => "Post-mite elimination treatment &#40;persistent symptoms&#41;"
                ]
                4 => array:2 [
                  "identificador" => "sec0115"
                  "titulo" => "Management of direct contacts"
                ]
                5 => array:2 [
                  "identificador" => "sec0120"
                  "titulo" => "Environmental mite elimination"
                ]
              ]
            ]
            8 => array:2 [
              "identificador" => "sec0125"
              "titulo" => "Outbreak control &#40;Figure 2 and supplementary data&#46; Annexes 4 and 5&#41;"
            ]
          ]
        ]
        7 => array:2 [
          "identificador" => "sec0130"
          "titulo" => "Pubic lice"
        ]
        8 => array:2 [
          "identificador" => "sec0135"
          "titulo" => "Transmission and epidemiology"
        ]
        9 => array:2 [
          "identificador" => "sec0140"
          "titulo" => "Clinical presentation&#44; treatment&#44; and control"
        ]
        10 => array:2 [
          "identificador" => "sec0145"
          "titulo" => "Funding"
        ]
        11 => array:2 [
          "identificador" => "sec0150"
          "titulo" => "Conflicts of interest"
        ]
        12 => array:2 [
          "identificador" => "xack742183"
          "titulo" => "Acknowledgments"
        ]
        13 => array:1 [
          "titulo" => "<span class="elsevierStyleSectionTitle" id="sect1190">Further Reading</span>"
        ]
        14 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2023-10-31"
    "fechaAceptado" => "2023-11-21"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1815942"
          "palabras" => array:5 [
            0 => "Scabies"
            1 => "Pediculosis pubis"
            2 => "Crab louse"
            3 => "Sexually transmitted infections"
            4 => "STI"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1815943"
          "palabras" => array:6 [
            0 => "Escabiosis"
            1 => "Sarna"
            2 => "Pediculosis p&#250;bica"
            3 => "Ladillas"
            4 => "Infecciones de transmisi&#243;n sexual"
            5 => "ITS"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Sexually transmitted infections are communicable diseases where the pathogen is transmitted through sexual contact&#46; The Sexually Transmitted Infections Working Group of the Spanish Academy of Dermatology and Venereology &#40;AEDV&#41; is engaged in the drafting of documents to guide dermatologists and health care personnel who treat Spanish patients with these infections&#46; This document analyzes the epidemiological&#44; clinical&#44; therapeutic&#44; and control characteristics of 2 sexually transmitted parasitosis&#58; scabies due to <span class="elsevierStyleItalic">Sarcoptes scabiei</span> var&#46; <span class="elsevierStyleItalic">hominis</span>&#44; and pubic pediculosis due to <span class="elsevierStyleItalic">Phthirus pubis</span>&#46; Both parasitoses share a sort of mixed spread through sexual and community transmission regardless of the route through which the infection was initially acquired&#46; This specific feature creates particularities in the management and control of the infestation&#46;</p></span>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Las enfermedades transmisibles en las que el pat&#243;geno se transmite por contacto sexual se denominan infecciones de transmisi&#243;n sexual&#46; La Academia Espa&#241;ola de Dermatolog&#237;a &#40;AEDV&#41;&#44; a trav&#233;s de su grupo de trabajo de infecciones de transmisi&#243;n sexual&#44; se ha propuesto elaborar documentos de recomendaciones&#44; destinados a la orientaci&#243;n de los dermat&#243;logos y del personal sanitario que atiende en Espa&#241;a a personas afectadas de estas infecciones&#46; El presente documento analiza las caracter&#237;sticas epidemiol&#243;gicas&#44; cl&#237;nicas&#44; terap&#233;uticas y de control de 2 parasitosis consideradas de transmisi&#243;n sexual&#58; la escabiosis&#44; causada por <span class="elsevierStyleItalic">Sarcoptes scabiei</span> var<span class="elsevierStyleItalic">&#46; hominis</span>&#44; y la pediculosis p&#250;bica&#44; causada por el <span class="elsevierStyleItalic">Pthirus pubis</span>&#46; Ambas parasitosis tienen en com&#250;n que pueden diseminarse de forma mixta&#44; por v&#237;a sexual y comunitaria&#44; independientemente del modo de adquisici&#243;n de la infestaci&#243;n&#46; Esta peculiaridad genera particularidades en el control de la infestaci&#243;n&#46;</p></span>"
      ]
    ]
    "apendice" => array:1 [
      0 => array:1 [
        "seccion" => array:1 [
          0 => array:4 [
            "apendice" => "<p id="par0420" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia><elsevierMultimedia ident="upi1010"></elsevierMultimedia><elsevierMultimedia ident="upi2010"></elsevierMultimedia><elsevierMultimedia ident="upi3010"></elsevierMultimedia><elsevierMultimedia ident="upi4010"></elsevierMultimedia><elsevierMultimedia ident="upi5010"></elsevierMultimedia><elsevierMultimedia ident="upi6010"></elsevierMultimedia><elsevierMultimedia ident="upi7010"></elsevierMultimedia></p>"
            "etiqueta" => "Appendix A"
            "titulo" => "Supplementary data"
            "identificador" => "sec0165"
          ]
        ]
      ]
    ]
    "multimedia" => array:75 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 2299
            "Ancho" => 2409
            "Tamanyo" => 720785
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Clinical and microscopic images of scabies&#59; a&#41; classical form in a young adult with skin type 3 exhibiting the characteristic burrows &#40;arrows&#41; and papules &#40;arrowheads&#41; evident at typical locations on the hand&#59; b&#41; crusted or Norwegian form &#40;hyperinfestation&#41; in an elderly bedridden woman with skin type 2&#44; nail abnormalities&#44; and discreet crusted lesions on her pinky finger&#44; posing a challenge for diagnosis&#59; c&#41; genital nodules and erosions &#40;arrow&#41; and burrow &#40;arrowhead&#41; in a young man with skin type 5&#59; d&#41; infantile acropustulosis&#44; pustules on the sole of a 3-month-old baby with skin type 6&#59; e&#41; atypical form with disseminated eczematous lesions &#40;abdomen shown&#41; in a middle-aged woman with skin type 3&#59; f&#41; classic impetiginized form&#44; pustules in typical scabies location on the hand of an 8-year-old girl with skin type 6&#59; g&#41; blistering atypical form&#44; with blisters on the side of the hand &#40;arrow&#41; and a burrow on the thumb &#40;arrowhead&#41; in a young woman with skin type 3&#59; h&#41; image of the burrow obtained using a manual dermatoscope&#46; At one end&#44; the dark triangle consistent with the anterior section of the mite can be seen &#40;arrowhead&#41;&#46; The sinuous linear path starting here ends in a triangular image &#40;arrows&#41;&#46; These structures make up the &#8220;delta wing sign&#8221;&#59; i&#41; image of the mite &#40;arrow&#41; and its eggs &#40;arrowheads&#41; obtained through optical microscopy of scraping of one of the burrows&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 4058
            "Ancho" => 3343
            "Tamanyo" => 692873
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Diagnostic algorithm of scabies&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 4215
            "Ancho" => 2760
            "Tamanyo" => 852323
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Therapeutic algorithm of scabies&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" 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">Frequency&#47;Characteristics&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">Pruritus&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">Preferred location&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">Lesions&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">Classic scabies&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Common form&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">- Intense- Nocturnal predominance&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">- Interdigital spaces- Wrists- Axillae- Waist- Feet- Buttocks- Thighs &#40;inner surface&#41;- Areola &#40;females&#41;- Genitals &#40;more common in males&#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">- Burrows- Papules- Erosions- Vesicles- Pustules- Eczema&#47;lichenification- Nodules &#40;common in genitals&#41;- Blisters &#40;<a class="elsevierStyleCrossRef" href="#fig0005">figure 1</a>g&#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">Infantile acropustulosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Common form in children &#60; 1 year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">- Often manifests as restlessness or crying- Scratching may be absent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">- Palms- Soles- Disseminated&#44; including face and head&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">- Vesiculopustules &#40;<a class="elsevierStyleCrossRef" href="#fig0005">figure 1</a>d&#41;- Nodules- Very prominent burrows&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">Crusted scabies &#40;formerly known as &#8220;Norwegian&#8221; scabies&#41; &#40;hyperinfestation&#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">- Very rare- Immunocompromised&#44; elderly&#44; malnourished- Large number of viable mites &#40;high contagiousness&#41;- Increased risk of complications&#44; such as severe infections&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">- Mild or absent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">- Broad cutaneous surfaces- Unusual locations in the classic form &#40;palms&#44; soles&#44; head&#44; face&#44; and nails&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">figure 1</a>b&#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">- Scaling- Crusts- Hyperkeratosis- Erythroderma- Thickening or irregularities in nails- Rarely&#44; burrows&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">Atypical scabies&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">- Rare- Atypical signs and symptoms&#44; which complicates diagnosis- Mimics known dermatoses &#40;<a class="elsevierStyleCrossRef" href="#sec0160">supplementary data&#46; Annex 1</a>&#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">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Variable&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">- Variable &#40;<a class="elsevierStyleCrossRef" href="#fig0005">figure 1</a>e&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3525822.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Clinical forms of scabies&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">IACS&#44; International Alliance for the Control of Scabies&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><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"><span class="elsevierStyleBold">Confirmed scabies</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Visualization of&#44; at least&#44; one of the following&#58;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>- A1&#58; mite&#44; eggs&#44; or feces on optical microscopy of skin samples&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>- A2&#58; mite&#44; eggs&#44; or feces using high-resolution imaging modalities&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>- A3&#58; mite on dermoscopy&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="elsevierStyleBold">Clinical scabies</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Presence of&#44; at least&#44; one of the following&#58;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>- B1&#58; burrows&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>- B2&#58; typical lesions in male genital region&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>- B3&#58; typical lesions with typical distribution and 2 clinical history criteria &#40;H&#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="elsevierStyleBold">Suspected scabies</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Presence of one of the following&#58;</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>- C1&#58; typical lesions with typical distribution and 1 element of clinical history &#40;H&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>- C2&#58; atypical lesions or atypical distribution and 2 elements of clinical history &#40;H&#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="elsevierStyleBold">Elements of clinical history</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>- H1&#58; itching&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>- H2&#58; contact with an infected individual&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3525821.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The IACS criteria&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall"><elsevierMultimedia ident="2024050306485865457"></elsevierMultimedia>&#44; yes&#59; <elsevierMultimedia ident="2024050306485865458"></elsevierMultimedia>&#44; no&#59; &#8593;&#44; high&#59; &#8593;&#8593;&#44; very high&#59; &#8593;&#8593;&#8593;&#44; extremely high&#59; &#8595;&#44; low&#59; &#8595;&#8595;&#44; too low&#59; &#177;&#44; medium&#46;</p><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Green color&#58; positive data&#59; red color&#58; difficulty&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Technique&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">Facilitates viewing the burrow&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">Allows visualization of the mite&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">Non-invasive technique&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">In vivo visualization of the mite&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">Accessibility&#47;availability&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">Price&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">Learning difficulty&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">Transillumination&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Light source applied to the palmar surface of the interdigital fold&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="202405030648586541"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="202405030648586542"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="202405030648586543"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="202405030648586544"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="202405030648586545"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="202405030648586546"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="202405030648586547"></elsevierMultimedia>&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">Ink stain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Apply ink to the burrow and clean the excess&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="202405030648586548"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="202405030648586549"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865410"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865411"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865412"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865413"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865414"></elsevierMultimedia>&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">UV light&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Illuminate with LED 365 nm<a class="elsevierStyleCrossRefs" href="#bib0790"><span class="elsevierStyleSup">61&#44;68</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865415"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865416"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865417"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865418"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865419"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865420"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865421"></elsevierMultimedia>&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">Dermatoscope&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Manual device with 10x magnification and illumination&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865422"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865423"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865424"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865425"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865426"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865427"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865428"></elsevierMultimedia>&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">Videodermatoscope&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Devices of different complexity and magnifications&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865429"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865430"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865431"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865432"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865433"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865434"></elsevierMultimedia><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865435"></elsevierMultimedia>&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">Confocal microscopy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Microscopy with high-resolution visualization of the superficial layers of the skin&#46; Resolution similar to histopathologyy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865436"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865437"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865438"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865439"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865440"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865441"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865442"></elsevierMultimedia>&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">Optical coherence tomography&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Uses light sources &#40;interferometry&#41;&#44; obtaining non-invasive high-resolution imaging of the superficial structures of skin and mite&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865443"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865444"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865445"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865446"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865447"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865448"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865449"></elsevierMultimedia>&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">Optical microscopy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Visualization under optical microscope of samples obtained with adhesive tape &#40;adhesive tape test&#41;&#44; scraping &#40;M&#252;ller test&#41;&#44; or biopsy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865450"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865451"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865452"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865453"></elsevierMultimedia>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865454"></elsevierMultimedia><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865455"></elsevierMultimedia><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><elsevierMultimedia ident="2024050306485865456"></elsevierMultimedia><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&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">Serological and molecular tests&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Detection of mite targets enabling simple and rapid point-of-care diagnosis&nbsp;\t\t\t\t\t\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><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Currently not available&nbsp;\t\t\t\t\t\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><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>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3525818.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Differing for the different techniques available&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Diagnostic aid and confirmation techniques&#46;</p>"
        ]
      ]
      6 => array:8 [
        "identificador" => "tbl0020"
        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at4"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Application areas&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">Observations&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"><span class="elsevierStyleItalic">Head and face&#58;</span> avoiding periocular and perioral area&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Only in children younger than 1 year and crusted forms&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">Body&#58;</span> cover from mandibular arch and retroauricular folds to tips of toes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">In all cases&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">Areas of special attention&#58;</span> careful application in skin folds and periungual areas and less accessible areas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">In all cases&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="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Application method1&#46; Trim nails before application&#46;2&#46; Remove crusts&#44; as much as possible&#44; before application&#44; in crusted or hyperkeratotic forms&#46;3&#46; Apply to an unclothed person&#46;4&#46; Assistance from another person to make sure application covers the entire recommended skin area&#46;5&#46; When the helper does not need treatment because he&#47;she is not a close contact and does not suffer from scabies&#44; he&#47;she should wear gloves and contact protection measures&#46;6&#46; Reapply the product on areas that were washed during the recommended drug contact time such as hands&#44; diaper area&#46;&#46;&#46;7&#46; Rinse off the product in the shower after the recommended contact time has gone by&#46;8&#46; All affected individuals and contacts in the household must undergo scabicide treatment &#40;it does not need to be the same drug&#41; within a 24-hour window to prevent reinfections&#46;</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3525817.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Mode of application of topical scabicides&#46;</p>"
        ]
      ]
      7 => array:8 [
        "identificador" => "tbl0025"
        "etiqueta" => "Table 5"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at5"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:3 [
          "leyenda" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">E&#44; level of evidence&#59; FDA&#44; Food and Drug Administration&#59; R&#44; degree of recommendation&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Active ingredient&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">Commercial brands&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">Mechanism of action&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">Ovicidal activity&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">Therapeutic formulation&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">Dosage&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">Efficacy and recommendation&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">Adverse events&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">Pediatric use&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">Use in pregnancy and lactation&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">Price<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">&#8224;</span></a>&#44; <a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">&#8224;&#8224;</span></a>&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">Permethrin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Perme-cure creamSarcop cream&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">PyrethroidNeurotoxicBlocks Na&#43; channels&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Doubtful&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\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&#37; cream&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Topical applicationRepeat within 7 to 14 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">First choice in adults &#40;E1a&#44; RA&#41; Equal efficacy to ivermectin &#40;E1a&#44; RA&#41;<a class="elsevierStyleCrossRefs" href="#bib0535"><span class="elsevierStyleSup">10&#44;85&#44;86</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">High safety profile Dermatitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">First choice &#62; 2 months &#40;E1a&#44; RA&#41;<a class="elsevierStyleCrossRef" href="#bib0535"><span class="elsevierStyleSup">10</span></a>&#40;safety not established for &#60; 2 months&#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">First choice &#40;2b&#44; RB&#41;<a class="elsevierStyleCrossRef" href="#bib0920"><span class="elsevierStyleSup">87</span></a> FDA pregnancy category B&#46; Non-teratogenic in animal models&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70 g&#58; &#8364;17&#46;02&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">Oral ivermectin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IvergalenIvercare Ivermectin Teva&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Macrocyclic lactone NeurotoxicBlocks Cl- channels&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Oral route 200<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;kg<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Single doseRepeat within 7 to 14 daysIngest with fatty food<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">First choice in adults &#40;E1a&#44; RA&#41;<a class="elsevierStyleCrossRefs" href="#bib0535"><span class="elsevierStyleSup">10&#44;67</span></a>Equal efficacy to permethrin &#40;E1a&#44; RA&#41;More suitable for population-wide treatments<a class="elsevierStyleCrossRefs" href="#bib0865"><span class="elsevierStyleSup">76&#44;77</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Very rare&#58;Neurotoxicity&#44; hepatotoxicity&#44; nephrotoxicity&#44; toxic epidermal necrolysis&#44; and Steven-Johnson syndrome&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">First choice for &#62; 15kgIll-advised in &#60; 15<span class="elsevierStyleHsp" style=""></span>kg &#40;safety not established&#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">Ill-advised in pregnancy &#40;safety not established&#41; FDA Pregnancy category CTeratogenic in rats&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\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<span class="elsevierStyleHsp" style=""></span>mg &#215; 8 tabs&#58; &#8364;34&#46;96&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">Topical ivermectin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Available in magistral formulation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Macrocyclic lactone NeurotoxicBlocks Cl- channels&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#37; lotion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Topical applicationRepeat within 7 to 14 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Similar efficacy to topical permethrin &#40;E1b&#44; RA&#41;<a class="elsevierStyleCrossRef" href="#bib0820"><span class="elsevierStyleSup">67</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">High safety profile67Dermatitis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ill-advised &#40;safety not established&#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">Ill-advised &#40;safety not established&#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">100 mL&#58; &#8364;50 &#40;approx&#46;&#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">Sulfur&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Available in magistral formulation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Keratolytic and scabicidal action&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Yes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vaseline&#44; emulsion&#44; or 10&#37; and 5&#37; lotion &#40;in patients younger than 1 year&#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">Topical application for 3 consecutive daysRepeat cycle after 7 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Contradictory efficacy data<a class="elsevierStyleCrossRefs" href="#bib0915"><span class="elsevierStyleSup">86&#44;88&#44;89</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DermatitisAsteatotic eczema&#46; Common mild adverse eventsNo serious adverse events described&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">First choice in infants &#60; 2 months &#40;E5&#44; RD&#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">Recommended &#40;E5&#44; RD&#41;<a class="elsevierStyleCrossRef" href="#bib0545"><span class="elsevierStyleSup">12</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">200 g&#47;mL&#58; &#8364;50 &#40;approx&#46;&#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">Benzyl benzoate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Available in magistral formulation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Unknown&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Unknown&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Emulsion or lotion for 1 to 12 years&#58; 5&#37; to10&#37;&#62;12 years&#58; 10&#37; to 25&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Topical application for 3 consecutive daysRepeat cycle after 7 days&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Comparable efficacy to oral ivermectin &#40;E1b&#44; RA&#41;<a class="elsevierStyleCrossRefs" href="#bib0920"><span class="elsevierStyleSup">87&#44;90</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Intense dermatitis&#44; conjunctivitis<a class="elsevierStyleCrossRefs" href="#bib0555"><span class="elsevierStyleSup">14&#44;86</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ill-advised in patients &#60; 1 year<a class="elsevierStyleCrossRef" href="#bib0940"><span class="elsevierStyleSup">91</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Recommended in pregnancy &#40;E2b&#44; RB&#41;<a class="elsevierStyleCrossRef" href="#bib0945"><span class="elsevierStyleSup">92</span></a> Ill-advised in lactation &#40;E4&#44; RC&#41;<a class="elsevierStyleCrossRefs" href="#bib0535"><span class="elsevierStyleSup">10&#44;93</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">200 mL&#58; &#8364;70 &#40;approx&#46;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3525819.png"
              ]
            ]
          ]
          "notaPie" => array:4 [
            0 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Dosage table by weight in <a class="elsevierStyleCrossRef" href="#sec0160">Annex 3</a>&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Recommended to enhance absorption&#44; unlike fasting intake&#44; indicated for other diseases in the technical sheet&#46;10</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "&#8224;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Price for the recommended regimen for an adult of average build&#46; In topical preparations&#44; calculated based on 35<span class="elsevierStyleHsp" style=""></span>g per application&#46; Figures from the Spanish Ministry of Health for drugs included in the pharmaceutical provision of the National Health System consulted in September 2023&#46;<a class="elsevierStyleCrossRef" href="#bib0630"><span class="elsevierStyleSup">29</span></a></p>"
            ]
            3 => array:3 [
              "identificador" => "tblfn0025"
              "etiqueta" => "&#8224;&#8224;"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0025">Approximate price calculated based on current documents on billing of magistral formulation from various Health Departments across various Spanish Autonomous Communities&#46;</p> <p class="elsevierStyleNotepara" id="npar0030">Green color&#58; first choice&#59; red color&#58; ill-advised&#44;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Scabicides available in Spain&#46;</p>"
        ]
      ]
      8 => array:8 [
        "identificador" => "tbl0030"
        "etiqueta" => "Table 6"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at6"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0130" class="elsevierStyleSimplePara elsevierViewall">E&#44; level of evidence&#59; R&#44; grade of recommendation&#46;</p>"
          "tablatextoimagen" => array:3 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Clinical signs</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">Diagnosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Visualization of the parasite or its eggs &#40;naked eye&#44; magnifying glass&#44; or dermatoscope&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Symptom&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Itching&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">Dermatological signs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">- Bluish spots &#40;violaceous macules &#60; 1<span class="elsevierStyleHsp" style=""></span>cm on the skin where the parasite fed from&#41;- Erythematous papules- Ochre spots &#40;parasite feces on the host&#39;s skin&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3525820.png"
              ]
            ]
            1 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">General guidelines&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">Give oral and written information on the disease&#44; its treatment&#44; and control measures &#40;E4&#44; RC&#41;&#46;&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">Investigate concomitant STIs &#40;E2b&#44; RB&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0955"><span class="elsevierStyleSup">94&#44;95</span></a>&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">Apply treatment to the affected hairy areas &#40;pubis and other affected areas such as perianal&#44; axillae&#44; trunk&#44; eyebrows&#44; eyelashes&#44; beard&#44; and mustache&#41;&#46;&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">Use creams or lotions&#44; preferably over shampoos&#46;&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">Repeat the treatment within 3 to 7 days &#40;E2b&#44; RB&#41;&#46;&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">Remove nits with hands or a fine-toothed comb&#46;&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">Decontaminate fomites &#40;personal clothing&#44; bedding&#44; and towels&#41; by washing in a hot water cycle followed by drying or sealing them in a bag for 72<span class="elsevierStyleHsp" style=""></span>hours&#46;&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">Review sexual partners from the previous 3 months and treat affected individuals and their sexual partners from the previous month &#40;E4&#44; RC&#41;&#46;&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">Avoid sharing clothing and bodily contact until the case and sexual partners have completed treatment&#46;&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  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Perform clinical surveillance 1 week after treatment &#40;E2b&#44; RB&#41;&#46;&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">Criterion for cure&#58; absence of lice and&#47;or viable eggs 1 week after completing treatment&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3525815.png"
              ]
            ]
            2 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="4" align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Therapeutic measures</th></tr><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Recommendation&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">Drug&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">Indication&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">Application method&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">First-line therapy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\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&#37; permethrin &#40;scalp cream or lotion&#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">Indicated in all ages and in pregnant or breastfeeding women&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Apply to damp area&#44; rinse off in 10<span class="elsevierStyleHsp" style=""></span>minutes &#40;E1b&#44; RA&#41;<a class="elsevierStyleCrossRef" href="#bib0530"><span class="elsevierStyleSup">9</span></a>&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">Second-line therapy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Oral ivermectin 250<span class="elsevierStyleHsp" style=""></span>&#956;g&#47;kg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Not recommended in pregnancy and children under 15 kg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ingest with fatty food&#46;Repeat dose within 7 to14 days &#40;E5&#44; RD&#41;<a class="elsevierStyleCrossRef" href="#bib0965"><span class="elsevierStyleSup">96</span></a>&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Topical 1&#37; ivermectin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Safety not studied in pregnant women or children&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Topical application&#46; No established regimen for this indication &#40;E5&#44; RD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#37; benzyl benzoate lotion&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Not recommended for children younger than 1 year-old&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Topical application&#46; No established regimen for this indication &#40;E5&#44; RD&#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">Not included in guidelines&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dimethicone&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No studies on pubic lice&#46;Effective in head lice and safe in pregnancy&#44; breastfeeding&#44; and childrenIt is not a pesticide&#59; it works by suffocation&#46; No risk of resistance&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Topical application&#46; Regimen not described for this indication&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Shaving&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Efficient&#44; cost-effective&#44; and safeEliminates infestation by removing the lice&#39;s natural habitat&#46;May be poorly accepted depending on location &#40;eyelashes&#46;&#46;&#46;&#41;&#44; extent of infestation&#44; and individual preferences&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Removal of the portion of hair that emerges from the skin &#40;it is not necessary to remove it from the root&#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">Treatment on eyelashes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Smooth petroleum jelly or ophthalmic ointment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No contraindicationsIt acts by suffocation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Apply thick layer&#44; in occlusive dressing &#40;covered&#41;&#44; twice daily for 10 days &#40;E5&#44; RD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Oral ivermectin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Not recommended in pregnancy and children under 15 kg&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Same regimen and evidence&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  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#37; permethrin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Safe&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Apply with eyes closed&#44; remove in 10<span class="elsevierStyleHsp" style=""></span>minutes &#40;E5&#44; RD&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Mechanical removal of lice&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SafeIt may be necessary to trim some eyelashes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Removal with tweezers&#44; visualization with slit lamp&#46;More difficult for nits than hatched lice&#46; Often requires subsequent treatment with petroleum jelly or ointment&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">Not currently available in Spain for human use&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\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&#46;5&#37; malathion lotion&nbsp;\t\t\t\t\t\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><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" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pyrethrins with topical piperonyl butoxide &#40;E1b&#44; RA&#41;<a class="elsevierStyleCrossRef" href="#bib0540"><span class="elsevierStyleSup">11</span></a>&nbsp;\t\t\t\t\t\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><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" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;2&#37; phenothrin lotion &#40;E1b&#44; RA&#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><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" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;5&#37; to 1&#37; carbaryl &#40;E5&#44; RD&#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><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" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lindane&nbsp;\t\t\t\t\t\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><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>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3525816.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0125" class="elsevierStyleSimplePara elsevierViewall">Pubic lice infestation&#46; Diagnosis and control&#46;</p>"
        ]
      ]
      9 => array:5 [
        "identificador" => "upi0005"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:2 [
          "fichero" => "mmc1.pdf"
          "ficheroTamanyo" => 118764
        ]
      ]
      10 => array:5 [
        "identificador" => "upi1010"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:2 [
          "fichero" => "mmc2.pdf"
          "ficheroTamanyo" => 370806
        ]
      ]
      11 => array:5 [
        "identificador" => "upi2010"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:2 [
          "fichero" => "mmc3.pdf"
          "ficheroTamanyo" => 118583
        ]
      ]
      12 => array:5 [
        "identificador" => "upi3010"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:2 [
          "fichero" => "mmc4.pdf"
          "ficheroTamanyo" => 196472
        ]
      ]
      13 => array:5 [
        "identificador" => "upi4010"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:2 [
          "fichero" => "mmc5.pdf"
          "ficheroTamanyo" => 117861
        ]
      ]
      14 => array:5 [
        "identificador" => "upi5010"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:2 [
          "fichero" => "mmc6.pdf"
          "ficheroTamanyo" => 115965
        ]
      ]
      15 => array:5 [
        "identificador" => "upi6010"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:3 [
          "fichero" => "mmc7.mp4"
          "ficheroTamanyo" => 1988582
          "Video" => array:2 [
            "mp4" => array:5 [
              "fichero" => "mmc7.m4v"
              "poster" => "mmc7.jpg"
              "tiempo" => 0
              "alto" => 0
              "ancho" => 0
            ]
            "flv" => array:5 [
              "fichero" => "mmc7.flv"
              "poster" => "mmc7.jpg"
              "tiempo" => 0
              "alto" => 0
              "ancho" => 0
            ]
          ]
        ]
      ]
      16 => array:5 [
        "identificador" => "upi7010"
        "tipo" => "MULTIMEDIAECOMPONENTE"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "Ecomponente" => array:2 [
          "fichero" => "mmc8.pdf"
          "ficheroTamanyo" => 152198
        ]
      ]
      17 => array:5 [
        "identificador" => "202405030648586541"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      18 => array:5 [
        "identificador" => "202405030648586542"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx2.jpeg"
            "Alto" => 27
            "Ancho" => 30
            "Tamanyo" => 1083
          ]
        ]
      ]
      19 => array:5 [
        "identificador" => "202405030648586543"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      20 => array:5 [
        "identificador" => "202405030648586544"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx2.jpeg"
            "Alto" => 27
            "Ancho" => 30
            "Tamanyo" => 1083
          ]
        ]
      ]
      21 => array:5 [
        "identificador" => "202405030648586545"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx3.jpeg"
            "Alto" => 28
            "Ancho" => 54
            "Tamanyo" => 1075
          ]
        ]
      ]
      22 => array:5 [
        "identificador" => "202405030648586546"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx4.jpeg"
            "Alto" => 28
            "Ancho" => 25
            "Tamanyo" => 676
          ]
        ]
      ]
      23 => array:5 [
        "identificador" => "202405030648586547"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx4.jpeg"
            "Alto" => 28
            "Ancho" => 25
            "Tamanyo" => 676
          ]
        ]
      ]
      24 => array:5 [
        "identificador" => "202405030648586548"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      25 => array:5 [
        "identificador" => "202405030648586549"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx2.jpeg"
            "Alto" => 27
            "Ancho" => 30
            "Tamanyo" => 1083
          ]
        ]
      ]
      26 => array:5 [
        "identificador" => "2024050306485865410"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      27 => array:5 [
        "identificador" => "2024050306485865411"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx2.jpeg"
            "Alto" => 27
            "Ancho" => 30
            "Tamanyo" => 1083
          ]
        ]
      ]
      28 => array:5 [
        "identificador" => "2024050306485865412"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx3.jpeg"
            "Alto" => 28
            "Ancho" => 54
            "Tamanyo" => 1075
          ]
        ]
      ]
      29 => array:5 [
        "identificador" => "2024050306485865413"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx4.jpeg"
            "Alto" => 28
            "Ancho" => 25
            "Tamanyo" => 676
          ]
        ]
      ]
      30 => array:5 [
        "identificador" => "2024050306485865414"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx4.jpeg"
            "Alto" => 28
            "Ancho" => 25
            "Tamanyo" => 676
          ]
        ]
      ]
      31 => array:5 [
        "identificador" => "2024050306485865415"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      32 => array:5 [
        "identificador" => "2024050306485865416"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx2.jpeg"
            "Alto" => 27
            "Ancho" => 30
            "Tamanyo" => 1083
          ]
        ]
      ]
      33 => array:5 [
        "identificador" => "2024050306485865417"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      34 => array:5 [
        "identificador" => "2024050306485865418"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx2.jpeg"
            "Alto" => 27
            "Ancho" => 30
            "Tamanyo" => 1083
          ]
        ]
      ]
      35 => array:5 [
        "identificador" => "2024050306485865419"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx5.jpeg"
            "Alto" => 28
            "Ancho" => 38
            "Tamanyo" => 895
          ]
        ]
      ]
      36 => array:5 [
        "identificador" => "2024050306485865420"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx4.jpeg"
            "Alto" => 28
            "Ancho" => 25
            "Tamanyo" => 676
          ]
        ]
      ]
      37 => array:5 [
        "identificador" => "2024050306485865421"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx4.jpeg"
            "Alto" => 28
            "Ancho" => 25
            "Tamanyo" => 676
          ]
        ]
      ]
      38 => array:5 [
        "identificador" => "2024050306485865422"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      39 => array:5 [
        "identificador" => "2024050306485865423"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      40 => array:5 [
        "identificador" => "2024050306485865424"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      41 => array:5 [
        "identificador" => "2024050306485865425"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx2.jpeg"
            "Alto" => 27
            "Ancho" => 30
            "Tamanyo" => 1083
          ]
        ]
      ]
      42 => array:5 [
        "identificador" => "2024050306485865426"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx5.jpeg"
            "Alto" => 28
            "Ancho" => 38
            "Tamanyo" => 895
          ]
        ]
      ]
      43 => array:5 [
        "identificador" => "2024050306485865427"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx5.jpeg"
            "Alto" => 28
            "Ancho" => 38
            "Tamanyo" => 895
          ]
        ]
      ]
      44 => array:5 [
        "identificador" => "2024050306485865428"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx5.jpeg"
            "Alto" => 28
            "Ancho" => 38
            "Tamanyo" => 895
          ]
        ]
      ]
      45 => array:5 [
        "identificador" => "2024050306485865429"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      46 => array:5 [
        "identificador" => "2024050306485865430"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      47 => array:5 [
        "identificador" => "2024050306485865431"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      48 => array:5 [
        "identificador" => "2024050306485865432"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      49 => array:5 [
        "identificador" => "2024050306485865433"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx6.jpeg"
            "Alto" => 27
            "Ancho" => 25
            "Tamanyo" => 752
          ]
        ]
      ]
      50 => array:5 [
        "identificador" => "2024050306485865434"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx8.jpeg"
            "Alto" => 28
            "Ancho" => 53
            "Tamanyo" => 1261
          ]
        ]
      ]
      51 => array:5 [
        "identificador" => "2024050306485865435"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx5.jpeg"
            "Alto" => 28
            "Ancho" => 38
            "Tamanyo" => 895
          ]
        ]
      ]
      52 => array:5 [
        "identificador" => "2024050306485865436"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx2.jpeg"
            "Alto" => 27
            "Ancho" => 30
            "Tamanyo" => 1083
          ]
        ]
      ]
      53 => array:5 [
        "identificador" => "2024050306485865437"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      54 => array:5 [
        "identificador" => "2024050306485865438"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      55 => array:5 [
        "identificador" => "2024050306485865439"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      56 => array:5 [
        "identificador" => "2024050306485865440"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx7.jpeg"
            "Alto" => 28
            "Ancho" => 54
            "Tamanyo" => 1289
          ]
        ]
      ]
      57 => array:5 [
        "identificador" => "2024050306485865441"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx9.jpeg"
            "Alto" => 28
            "Ancho" => 82
            "Tamanyo" => 1700
          ]
        ]
      ]
      58 => array:5 [
        "identificador" => "2024050306485865442"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx9.jpeg"
            "Alto" => 28
            "Ancho" => 82
            "Tamanyo" => 1700
          ]
        ]
      ]
      59 => array:5 [
        "identificador" => "2024050306485865443"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx2.jpeg"
            "Alto" => 27
            "Ancho" => 30
            "Tamanyo" => 1083
          ]
        ]
      ]
      60 => array:5 [
        "identificador" => "2024050306485865444"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      61 => array:5 [
        "identificador" => "2024050306485865445"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      62 => array:5 [
        "identificador" => "2024050306485865446"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      63 => array:5 [
        "identificador" => "2024050306485865447"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx7.jpeg"
            "Alto" => 28
            "Ancho" => 54
            "Tamanyo" => 1289
          ]
        ]
      ]
      64 => array:5 [
        "identificador" => "2024050306485865448"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx9.jpeg"
            "Alto" => 28
            "Ancho" => 82
            "Tamanyo" => 1700
          ]
        ]
      ]
      65 => array:5 [
        "identificador" => "2024050306485865449"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx9.jpeg"
            "Alto" => 28
            "Ancho" => 82
            "Tamanyo" => 1700
          ]
        ]
      ]
      66 => array:5 [
        "identificador" => "2024050306485865450"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx2.jpeg"
            "Alto" => 27
            "Ancho" => 30
            "Tamanyo" => 1083
          ]
        ]
      ]
      67 => array:5 [
        "identificador" => "2024050306485865451"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      68 => array:5 [
        "identificador" => "2024050306485865452"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx2.jpeg"
            "Alto" => 27
            "Ancho" => 30
            "Tamanyo" => 1083
          ]
        ]
      ]
      69 => array:5 [
        "identificador" => "2024050306485865453"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx2.jpeg"
            "Alto" => 27
            "Ancho" => 30
            "Tamanyo" => 1083
          ]
        ]
      ]
      70 => array:5 [
        "identificador" => "2024050306485865454"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx5.jpeg"
            "Alto" => 28
            "Ancho" => 38
            "Tamanyo" => 895
          ]
        ]
      ]
      71 => array:5 [
        "identificador" => "2024050306485865455"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx5.jpeg"
            "Alto" => 28
            "Ancho" => 38
            "Tamanyo" => 895
          ]
        ]
      ]
      72 => array:5 [
        "identificador" => "2024050306485865456"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx10.jpeg"
            "Alto" => 28
            "Ancho" => 24
            "Tamanyo" => 732
          ]
        ]
      ]
      73 => array:5 [
        "identificador" => "2024050306485865457"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 38
            "Ancho" => 40
            "Tamanyo" => 888
          ]
        ]
      ]
      74 => array:5 [
        "identificador" => "2024050306485865458"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx2.jpeg"
            "Alto" => 27
            "Ancho" => 30
            "Tamanyo" => 1083
          ]
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:96 [
            0 => array:3 [
              "identificador" => "bib0490"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Scabies in Spain&#63; A comprehensive epidemiological picture"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0258780"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0495"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Scabies epidemiology in health care centers for refugees and asylum seekers in Greece"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pntd.0010153"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0500"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Is Scabies becoming less sensitive to permethrin therapy&#63;"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jdv.17339"
                      "Revista" => array:3 [ …3]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0505"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Scabies outbreak during home confinement due to the SARS-CoV-2 pandemic"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jdv.16879"
                      "Revista" => array:3 [ …3]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0510"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "FR - Epidemia de sarna en el contexto de la pandemia de COVID-19"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ad.2020.11.028"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0515"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalencia y caracter&#237;sticas cl&#237;nicas de pacientes diagnosticados de escabiosis durante la pandemia producida por el coronavirus de tipo 2 causante del s&#237;ndrome respiratorio agudo &#40;SARS-CoV-2&#41; en un hospital de tercer nivel&#46; Un estudio descriptivo"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ad.2022.05.017"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0520"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Galv&#225;n Casas C&#44; Ruiz Villaverde C&#44; Prados Carmona &#193;&#44; Fern&#225;ndez Camporro A&#44; Angulo Men&#233;ndez AG&#44; &#193;lvarez-Buylla Puente MC&#44; et al&#46; Caracter&#237;sticas cl&#237;nicas y epidemiol&#243;gicas de pacientes diagnosticados de escabiosis en Espa&#241;a&#58; oportunidades de mejora&#46; Estudio transversal multic&#233;ntrico CLINI-AEDV&#46; Actas Dermosifiliogr&#44; <a target="_blank" href="https://doi.org/10.1016/j.ad.2023.08.006">https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1016&#47;j&#46;ad&#46;2023&#46;08&#46;006</a>&#46;"
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0525"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Phthirus pubis as a Predictor for Chlamydia Infections in Adolescents"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/00007435-200206000-00004"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0530"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "European guideline for the management of pediculosis pubis"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jdv.14420"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0535"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "European guideline for the management of scabies"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jdv.14351"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0540"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "2015 European guidelines for the management of partners of persons with sexually transmitted infections"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jdv.13181"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0545"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guideline for the diagnosis and treatment of scabies in Japan &#40;third edition&#41;&#58; Executive Committee of Guideline for the Diagnosis and Treatment of Scabies"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/1346-8138.13896"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0550"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "S1 guidelines on the diagnosis and treatment of scabies - Short version"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/ddg.13130"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0555"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [ …2]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0560"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Prevention CC for DC and&#46; CDC - Scabies - Resources for Health Professionals - Institutional Settings&#46; Published April 19&#44; 2019&#46; Accessed August 27&#44; 2023&#46; &#91;accessed 29 Aug 2023&#93;&#46; Available from&#58; <a target="_blank" href="https://www.cdc.gov/parasites/scabies/health_professionals/institutions.html">https&#58;&#47;&#47;www&#46;cdc&#46;gov&#47;parasites&#47;scabies&#47;health&#95;professionals&#47;institutions&#46;html</a>"
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0565"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sexually Transmitted Infections Treatment Guidelines"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [ …2]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0570"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Subdirecci&#243; General de Vigil&#224;ncia i Resposta a Emerg&#232;ncies&#44; de Salut P&#250;blica"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [ …2]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0575"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [ …2]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0580"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Consejer&#237;a de Salud &#8211; Direcci&#243;n General de Salud P&#250;blica y Adicciones&#46; Servicio de Epidemiolog&#237;a&#46; Gobierno de Murcia&#46; Protocolo de actuaci&#243;n frente a escabiosis&#46; Published online March 2022&#46; &#91;accessed 22 Aug 2023&#93;&#46; Available from&#58; <a target="_blank" href="https://www.murciasalud.es/recursos/ficheros/499065-Protocolo_escabiosis_DEF_2022.pdf#:~:text=El%20paciente%20diagnosticado%20de%20sarna%20deber%C3%A1%20realizar%20el%20siguiente%20tratamiento%3A%26text=Se%20recomienda%20ducharse%2060%20minutos,u%C3%B1as%20de%20manos%20y%20pies.%26text=producto%20mediante%20una%20ducha%20de,deber%C3%A1%20estar%20desinfectada%20y%20limpia">https&#58;&#47;&#47;www&#46;murciasalud&#46;es&#47;recursos&#47;ficheros&#47;499065-Protocolo&#95;escabiosis&#95;DEF&#95;2022&#46;pdf&#35;&#58;&#8764;&#58;text&#61;El&#37;20paciente&#37;20diagnosticado&#37;20de&#37;20sarna&#37;20deber&#37;C3&#37;A1&#37;20realizar&#37;20el&#37;20siguiente&#37;20tratamiento&#37;3A&#38;text&#61;Se&#37;20recomienda&#37;20ducharse&#37;2060&#37;20minutos&#44;u&#37;C3&#37;B1as&#37;20de&#37;20manos&#37;20y&#37;20pies&#46;&#38;text&#61;producto&#37;20mediante&#37;20una&#37;20ducha&#37;20de&#44;deber&#37;C3&#37;A1&#37;20estar&#37;20desinfectada&#37;20y&#37;20limpia</a>"
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0585"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Departamento de Salud del Gobierno Vasco&#46; Tratamiento de la sarna&#46; Published online 2022&#46; &#91;accessed 22 Aug 2023&#93;&#46; Available from&#58; <a target="_blank" href="https://www.euskadi.eus/contenidos/informacion/cevime_infac_2022/es_def/adjuntos/INFAC_Vol_30_3_SARNA.pdf">https&#58;&#47;&#47;www&#46;euskadi&#46;eus&#47;contenidos&#47;informacion&#47;cevime&#95;infac&#95;2022&#47;es&#95;def&#47;adjuntos&#47;INFAC&#95;Vol&#95;30&#95;3&#95;SARNA&#46;pdf</a>"
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0590"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Xunta de Galicia&#46; Protocolo de actuaci&#243;n ante a sarna humana en instituci&#243;ns con coidadores&#46; Published online November 2017&#46; &#91;accessed 22 Aug 2023&#93;&#46; Available from&#58; <a target="_blank" href="https://www.sergas.es/Saude-publica/Documents/1312/Protocolo_sarna_2017.pdf">https&#58;&#47;&#47;www&#46;sergas&#46;es&#47;Saude-publica&#47;Documents&#47;1312&#47;Protocolo&#95;sarna&#95;2017&#46;pdf</a>"
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0595"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Servicio de Vigilancia Epidemiol&#243;gica de Andaluc&#237;a&#46; Protocolo de intervenci&#243;n ante alerta por infestacion por ectoparasitos Version 2&#46; Documento no publicado&#46;"
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0600"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Drake Monfort M&#44; Abraira Meriel C&#44; Naharro Fernandez C&#44; Lopez Sundh AE&#44; Gonz&#225;lez L&#243;pez MA&#46; Protocolo diagn&#243;stico terape&#250;tico de escabiosis Servicio de Dermatolog&#237;a Hospital Universitario Marqu&#233;s de Valdecilla&#46; Diciembre 2021&#46; Documento no publicado&#46;"
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0605"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Departamento de Salud Gobierno Vasco&#46; Unidad de vigilancia epidemiol&#243;gica&#46; Protocolo de actuaci&#243;n ante casos de escabiosis&#46; 8 abril 2022&#46; Documento no publicado&#46;&#46;"
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0610"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Red de Vigilancia Epidemiol&#243;gica de la Comunidad de Madrid&#46; Protocolo de actuaci&#243;n frente a la escabiosis&#46; <a target="_blank" href="https://www.comunidad.madrid/sites/default/files/doc/sanidad/epid/protocolo_escabiosis_octubre2022.pdf">https&#58;&#47;&#47;www&#46;comunidad&#46;madrid&#47;sites&#47;default&#47;files&#47;doc&#47;sanidad&#47;epid&#47;protocolo&#95;escabiosis&#95;octubre2022&#46;pdf</a>"
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0615"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Gerencia de Atenci&#243;n Primaria&#46; Tratamiento y medidas higienicas de la escabiosis&#46; &#91;accessed 22 Aug 2023&#93;&#46; Available from&#58; <a target="_blank" href="https://www.ibsalut.es/apmallorca/es/profesionales/publicaciones/consejos-de-salud/seguridad-y-prevencion-del-riesgo/2209-sarna-tratamiento-y-medidas-higienicas">https&#58;&#47;&#47;www&#46;ibsalut&#46;es&#47;apmallorca&#47;es&#47;profesionales&#47;publicaciones&#47;consejos-de-salud&#47;seguridad-y-prevencion-del-riesgo&#47;2209-sarna-tratamiento-y-medidas-higienicas</a>"
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0620"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Direcci&#243;n General de Salud P&#250;blica&#46; Protocolo escabiosis o sarna&#46; Published online July 2023&#46; &#91;accessed 22 Aug 2023&#93;&#46; Available from&#58; <a target="_blank" href="https://www.riojasalud.es/files/content/salud-publica-consumo/epidemiologia/alertas/sarna/Protocolo_La_Rioja_Sarna.pdf">https&#58;&#47;&#47;www&#46;riojasalud&#46;es&#47;files&#47;content&#47;salud-publica-consumo&#47;epidemiologia&#47;alertas&#47;sarna&#47;Protocolo&#95;La&#95;Rioja&#95;Sarna&#46;pdf</a>"
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0625"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "OCEBM Levels of Evidence Working Group&#46; The Oxford Levels of Evidence&#46; Published online March 2009&#46; &#91;accessed 28 Aug 2023&#93;&#46; Available from&#58; <a target="_blank" href="https://www.cebm.ox.ac.uk/resources/levels-of-evidence/oxford-centre-for-evidence-based-medicine-levels-of-evidence-march-2009">https&#58;&#47;&#47;www&#46;cebm&#46;ox&#46;ac&#46;uk&#47;resources&#47;levels-of-evidence&#47;oxford-centre-for-evidence-based-medicine-levels-of-evidence-march-2009</a>"
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0630"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Ministerio de Sanidad - Profesionales de la Salud &#8211; Nomenclator &#91;accessed 27 Aug 2023&#93;&#46; Available from&#58; <a target="_blank" href="https://www.sanidad.gob.es/profesionales/nomenclator.do">https&#58;&#47;&#47;www&#46;sanidad&#46;gob&#46;es&#47;profesionales&#47;nomenclator&#46;do</a>"
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0635"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A review of Sarcoptes scabiei&#58; Past&#44; present and future"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s13071-017-2234-1"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0640"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Scabies and Pruritus&#46; A Historical Review"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jamadermatol.2018.0147"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0645"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0065-308X(04)57005-7"
                      "Libro" => array:4 [ …4]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0650"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The effects of climate factors on scabies&#46; A 14-year population-based study in Taiwan"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1051/parasite/2016065"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0655"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Scabies&#58; A Review of Diagnosis and Management Based on Mite Biology"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1542/pir.33.1.e1"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0660"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Survival and infestivity of Sarcoptes scabiei var&#46; canis and var&#46; hominis"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0190-9622(84)70151-4"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0665"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of scabies"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1097/QCO.0b013e32835eb851"
                      "Revista" => array:6 [ …6]
                    ]
                    1 => array:2 [
                      "doi" => "10.1097/QCO.0b013e32835eb851"
                      "WWW" => array:1 [ …1]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0670"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A systematic review of scabies transmission models and data to evaluate the cost-effectiveness of scabies interventions"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pntd.0007182"
                      "Revista" => array:5 [ …5]
                    ]
                    1 => array:2 [
                      "doi" => "10.1371/journal.pntd.0007182"
                      "WWW" => array:1 [ …1]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0675"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Transmission of Scabies"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:1 [
                      "Revista" => array:6 [ …6]
                    ]
                    1 => array:1 [
                      "WWW" => array:1 [ …1]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0680"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The development of symptoms&#44; parasitic infection and immunity in human scabies"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1017/S 0031182000021612"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0685"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Large Nosocomial Outbreak Associated with a Norwegian Scabies Index Case Undergoing TNF-&#945; Inhibitor Treatment&#58; Management and Control"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:2 [
                    0 => array:2 [
                      "doi" => "10.1017/ice.2015.188"
                      "Revista" => array:6 [ …6]
                    ]
                    1 => array:2 [
                      "doi" => "10.1017/ice.2015.188"
                      "WWW" => array:1 [ …1]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib0690"
              "etiqueta" => "41"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A framework for scabies control"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pntd.0009661"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib0695"
              "etiqueta" => "42"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Molecular survey of knockdown resistance to pyrethroids in human scabies mites"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/1469-0691.12334"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib0700"
              "etiqueta" => "43"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Zoonotic Episodes of Scabies&#58; A Global Overview"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/pathogens11020213"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            43 => array:3 [
              "identificador" => "bib0705"
              "etiqueta" => "44"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Canine Scabies in Humans&#58; A Case Report and Review of the Literature"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000327378"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            44 => array:3 [
              "identificador" => "bib0710"
              "etiqueta" => "45"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Scabies and pediculosis"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(99)09458-1"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            45 => array:3 [
              "identificador" => "bib0715"
              "etiqueta" => "46"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The public health control of scabies&#58; Priorities for research and action"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(19)31136-5"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            46 => array:3 [
              "identificador" => "bib0720"
              "etiqueta" => "47"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "WHO&#46; Scabies&#46; Published online May 31&#44; 2023&#46; &#91;accessed 12 Oct 2023&#93;&#46; Available from&#58; <a target="_blank" href="https://www.who.int/news-room/fact-sheets/detail/scabies">https&#58;&#47;&#47;www&#46;who&#46;int&#47;news-room&#47;fact-sheets&#47;detail&#47;scabies</a>"
                ]
              ]
            ]
            47 => array:3 [
              "identificador" => "bib0725"
              "etiqueta" => "48"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "World Health Organization&#46; Ending the Neglect to Attain the Sustainable Development Goals&#58; A Sustainability Framework for Action against Neglected Tropical Diseases 2021-2030&#46; World Health Organization&#59; 2021&#46; &#91;accessed 29 Aug 2023&#93;&#46; Available from&#58; <a target="_blank" href="https://apps.who.int/iris/handle/10665/338886">https&#58;&#47;&#47;apps&#46;who&#46;int&#47;iris&#47;handle&#47;10665&#47;338886</a>"
                ]
              ]
            ]
            48 => array:3 [
              "identificador" => "bib0730"
              "etiqueta" => "49"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A biological model of scabies infection dynamics and treatment informs mass drug administration strategies to increase the likelihood of elimination"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.mbs.2018.08.007"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            49 => array:3 [
              "identificador" => "bib0735"
              "etiqueta" => "50"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Scabies in residential care homes&#58; Modelling&#44; inference and interventions for well-connected population sub-units"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pcbi.1006046"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            50 => array:3 [
              "identificador" => "bib0740"
              "etiqueta" => "51"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Scabies in Cox&#39;s Bazar"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(23)01731-2"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            51 => array:3 [
              "identificador" => "bib0745"
              "etiqueta" => "52"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Escabiosis en Espa&#241;a&#58; tendencias del inter&#233;s p&#250;blico y consumo de ectoparasiticidas"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ad.2022.11.018"
                      "Revista" => array:2 [ …2]
                    ]
                  ]
                ]
              ]
            ]
            52 => array:3 [
              "identificador" => "bib0750"
              "etiqueta" => "53"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estimating the global burden of scabies&#58; What else do we need&#63;"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/bjd.19170"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            53 => array:3 [
              "identificador" => "bib0755"
              "etiqueta" => "54"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prescriptions for scabies are rapidly increasing in Spain&#58; An ecological study with national prescription data&#44; 2008-2021"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jdv.18599"
                      "Revista" => array:3 [ …3]
                    ]
                  ]
                ]
              ]
            ]
            54 => array:3 [
              "identificador" => "bib0760"
              "etiqueta" => "55"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ectoparasites&#58; Scabies"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2019.05.109"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            55 => array:3 [
              "identificador" => "bib0765"
              "etiqueta" => "56"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Norwegian scabies in HIV&#47;AIDS"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/08998280.2022.2028705"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            56 => array:3 [
              "identificador" => "bib0770"
              "etiqueta" => "57"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Crusted Scabies&#44; a Neglected Tropical Disease&#58; Case Series and Literature Review"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3390/idr14030051"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            57 => array:3 [
              "identificador" => "bib0775"
              "etiqueta" => "58"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Community perspectives on scabies&#44; impetigo and mass drug administration in Fiji&#58; A qualitative study"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pntd.0008825"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            58 => array:3 [
              "identificador" => "bib0780"
              "etiqueta" => "59"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The 2020 International Alliance for the Control of Scabies Consensus Criteria for the Diagnosis of Scabies"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/bjd.18943"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            59 => array:3 [
              "identificador" => "bib0785"
              "etiqueta" => "60"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermoscopy of crusted scabies&#58; Revisiting the new and old signs"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4103/idoj.idoj_263_22"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            60 => array:3 [
              "identificador" => "bib0790"
              "etiqueta" => "61"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Scabies&#58; Advances in Noninvasive Diagnosis"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pntd.0004691"
                      "Revista" => array:4 [ …4]
                    ]
                  ]
                ]
              ]
            ]
            61 => array:3 [
              "identificador" => "bib0795"
              "etiqueta" => "62"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:1 [
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:2 [ …2]
                    ]
                  ]
                ]
              ]
            ]
            62 => array:3 [
              "identificador" => "bib0800"
              "etiqueta" => "63"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Scabies&#58; Epidemiology&#44; diagnosis&#44; and treatment"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3238/arztebl.m2021.0296"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            63 => array:3 [
              "identificador" => "bib0805"
              "etiqueta" => "64"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prospects for Moxidectin as a New Oral Treatment for Human Scabies"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pntd.0004389"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            64 => array:3 [
              "identificador" => "bib0810"
              "etiqueta" => "65"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Antiparasitic Moxidectin&#58; Safety Tolerability&#44; and Pharmacokinetics in Humans"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1177/0091270003257456"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            65 => array:3 [
              "identificador" => "bib0815"
              "etiqueta" => "66"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Properties&#44; toxicity and current applications of the biolarvicide spinosad"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/10937404.2019.1689878"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            66 => array:3 [
              "identificador" => "bib0820"
              "etiqueta" => "67"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy and safety of antiscabietic agents&#58; A systematic review and network meta-analysis of randomized controlled trials"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2019.01.004"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            67 => array:3 [
              "identificador" => "bib0825"
              "etiqueta" => "68"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Communicable Disease Section&#46; Scabies control guidelines&#46; Published online October 2015&#46; &#91;accessed 12 Oct 2023&#93;&#46; Available from&#58; <a target="_blank" href="https://www.health.vic.gov.au/infectious-diseases/scabies-control-guidelines">https&#58;&#47;&#47;www&#46;health&#46;vic&#46;gov&#46;au&#47;infectious-diseases&#47;scabies-control-guidelines</a>"
                ]
              ]
            ]
            68 => array:3 [
              "identificador" => "bib0830"
              "etiqueta" => "69"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Combined ivermectin and topical therapy significantly reduces treatment time in aged scabietic patients"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/1346-8138.12070"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            69 => array:3 [
              "identificador" => "bib0835"
              "etiqueta" => "70"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Longitudinal evidence of increasing in vitro tolerance of scabies mites to ivermectin in scabies-endemic communities"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archdermatol.2009.125"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            70 => array:3 [
              "identificador" => "bib0840"
              "etiqueta" => "71"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "First documentation of in vivo and in vitro ivermectin resistance in <span class="elsevierStyleItalic">Sarcoptes scabiei</span>"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/421776"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            71 => array:3 [
              "identificador" => "bib0845"
              "etiqueta" => "72"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Effect of Insecticide Synergists on the Response of Scabies Mites to Pyrethroid Acaricides"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pntd.0000354"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            72 => array:3 [
              "identificador" => "bib0850"
              "etiqueta" => "73"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Detection of a knockdown mutation in the voltage-sensitive sodium channel associated with permethrin tolerance in <span class="elsevierStyleItalic">Sarcoptes scabiei</span> var&#46; <span class="elsevierStyleItalic">hominis</span> mites"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jdv.19288"
                      "Revista" => array:5 [ …5]
                    ]
                  ]
                ]
              ]
            ]
            73 => array:3 [
              "identificador" => "bib0855"
              "etiqueta" => "74"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Permethrin Steal Effect by Unmasked Corneocytic Keratin in Topical Therapy of Scabies"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000529401"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            74 => array:3 [
              "identificador" => "bib0860"
              "etiqueta" => "75"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Application errors associated with topical treatment of scabies&#58; An observational study"
                      "autores" => array:1 [ …1]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/ddg.14122"
                      "Revista" => array:6 [ …6]
                    ]
                  ]
                ]
              ]
            ]
            75 => array:3 [
              "identificador" => "bib0865"
              "etiqueta" => "76"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:2 [ …2]
                  ]
                ]
              ]
            ]
            76 => array:3 [
              "identificador" => "bib0870"
              "etiqueta" => "77"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:2 [ …2]
                  ]
                ]
              ]
            ]
            77 => array:3 [
              "identificador" => "bib0875"
              "etiqueta" => "78"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:2 [ …2]
                  ]
                ]
              ]
            ]
            78 => array:3 [
              "identificador" => "bib0880"
              "etiqueta" => "79"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:2 [ …2]
                  ]
                ]
              ]
            ]
            79 => array:3 [
              "identificador" => "bib0885"
              "etiqueta" => "80"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:2 [ …2]
                  ]
                ]
              ]
            ]
            80 => array:3 [
              "identificador" => "bib0890"
              "etiqueta" => "81"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:2 [ …2]
                  ]
                ]
              ]
            ]
            81 => array:3 [
              "identificador" => "bib0900"
              "etiqueta" => "83"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:2 [ …2]
                  ]
                ]
              ]
            ]
            82 => array:3 [
              "identificador" => "bib0905"
              "etiqueta" => "84"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:2 [ …2]
                  ]
                ]
              ]
            ]
            83 => array:3 [
              "identificador" => "bib0910"
              "etiqueta" => "85"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:2 [ …2]
                  ]
                ]
              ]
            ]
            84 => array:3 [
              "identificador" => "bib0915"
              "etiqueta" => "86"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:2 [ …2]
                  ]
                ]
              ]
            ]
            85 => array:3 [
              "identificador" => "bib0920"
              "etiqueta" => "87"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:2 [ …2]
                  ]
                ]
              ]
            ]
            86 => array:3 [
              "identificador" => "bib0925"
              "etiqueta" => "88"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:2 [ …2]
                  ]
                ]
              ]
            ]
            87 => array:3 [
              "identificador" => "bib0930"
              "etiqueta" => "89"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:1 [ …1]
                  ]
                ]
              ]
            ]
            88 => array:3 [
              "identificador" => "bib0935"
              "etiqueta" => "90"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:2 [ …2]
                  ]
                ]
              ]
            ]
            89 => array:3 [
              "identificador" => "bib0940"
              "etiqueta" => "91"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:2 [ …2]
                  ]
                ]
              ]
            ]
            90 => array:3 [
              "identificador" => "bib0945"
              "etiqueta" => "92"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:2 [ …2]
                  ]
                ]
              ]
            ]
            91 => array:3 [
              "identificador" => "bib0950"
              "etiqueta" => "93"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:2 [ …2]
                  ]
                ]
              ]
            ]
            92 => array:3 [
              "identificador" => "bib0955"
              "etiqueta" => "94"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:2 [ …2]
                  ]
                ]
              ]
            ]
            93 => array:3 [
              "identificador" => "bib0960"
              "etiqueta" => "95"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:2 [ …2]
                  ]
                ]
              ]
            ]
            94 => array:3 [
              "identificador" => "bib0965"
              "etiqueta" => "96"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:2 [ …2]
                  ]
                ]
              ]
            ]
            95 => array:3 [
              "identificador" => "bib0970"
              "etiqueta" => "97"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [ …2]
                  ]
                  "host" => array:1 [
                    0 => array:2 [ …2]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "lecturaRecomendada" => array:1 [
      0 => array:3 [
        "vista" => "all"
        "titulo" => "<span class="elsevierStyleSectionTitle" id="sect1190">Further Reading</span>"
        "seccion" => array:1 [
          0 => array:2 [
            "vista" => "all"
            "bibliografiaReferencia" => array:1 [
              0 => array:3 [
                "identificador" => "bibe0010"
                "etiqueta" => "82"
                "referencia" => array:1 [
                  0 => array:2 [
                    "contribucion" => array:1 [ …1]
                    "host" => array:1 [ …1]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack742183"
        "titulo" => "Acknowledgments"
        "texto" => "<p id="par0410" class="elsevierStylePara elsevierViewall">We wish to thank Dr&#46; Mar&#237;a Rebollo Polo &#40;WHO&#41; and Dr&#46; Ana Garc&#237;a de Mingo &#40;IACS&#41;&#44; for their external review of this study and their recommendations&#46; Also&#44; we wish to thank Dr&#46; Gerard Carot&#44; medical writer&#44; for his critical review of the manuscript&#44; Pedro Galv&#225;n Lamet for designing the patient information sheet &#40;<a class="elsevierStyleCrossRef" href="#sec0160">supplementary data&#46; Annex 2</a>&#41;&#44; and Jorge Bravo Galv&#225;n for producing the video &#40;<a class="elsevierStyleCrossRef" href="#sec0160">supplementary data&#46; Annex 6</a>&#41;&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/00017310/0000011500000005/v1_202405030647/S0001731024002047/v1_202405030647/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "6238"
    "tipo" => "SECCION"
    "es" => array:2 [
      "titulo" => "Documento de consenso"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "es"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/00017310/0000011500000005/v1_202405030647/S0001731024002047/v1_202405030647/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731024002047?idApp=UINPBA000044"
]