Case reports
Chronic Graft-Versus-Host Disease Presenting as Bullous Lesions
Lesiones Ampollosas Como Forma de Presentación de una Enfermedad de Injerto Contra Huésped Crónica
J. del Pozoa,
, J. García-Silvaa, M.T. Yebra-Pimentelb
Corresponding author
del_pozo@canalejo.org
Correspondence: Servicio de Dermatología, CHU Juan Canalejo, Xubias de Arriba, s/n, 15006 La Coruña, Spain.
Correspondence: Servicio de Dermatología, CHU Juan Canalejo, Xubias de Arriba, s/n, 15006 La Coruña, Spain.
Read
6610
Timeswas read the article
3376
Total PDF
3234
Total HTML
Share statistics
array:23 [ "pii" => "S157821900870369X" "issn" => "15782190" "doi" => "10.1016/S1578-2190(08)70369-X" "estado" => "S300" "fechaPublicacion" => "2008-12-01" "aid" => "70369" "copyright" => "Academia Española de Dermatología y Venereología and Elsevier España, S.L." "copyrightAnyo" => "2008" "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Actas Dermosifiliogr. 2008;99:803-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3017 "formatos" => array:3 [ "EPUB" => 41 "HTML" => 1619 "PDF" => 1357 ] ] "itemSiguiente" => array:18 [ "pii" => "S1578219008703706" "issn" => "15782190" "doi" => "10.1016/S1578-2190(08)70370-6" "estado" => "S300" "fechaPublicacion" => "2008-12-01" "aid" => "70370" "copyright" => "Academia Española de Dermatología y Venereología and Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "sco" "cita" => "Actas Dermosifiliogr. 2008;99:808-11" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4757 "formatos" => array:3 [ "EPUB" => 43 "HTML" => 1938 "PDF" => 2776 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case reports</span>" "titulo" => "Patient With Generalized Guttate Morphea and Lichen Sclerosus et Atrophicus" "tienePdf" => "en" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "808" "paginaFinal" => "811" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Coexistencia de Morfea en Gotas Generalizada y Liquen Escleroatrófico: A Propósito de un Caso" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "B. Blaya, J. Gardeazabal, Z. Martínez de Lagrán, J.L. Díaz-Pérez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "B." "apellidos" => "Blaya" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Gardeazabal" ] 2 => array:2 [ "nombre" => "Z." "apellidos" => "Martínez de Lagrán" ] 3 => array:2 [ "nombre" => "J.L." "apellidos" => "Díaz-Pérez" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219008703706?idApp=UINPBA000044" "url" => "/15782190/0000009900000010/v1_201304241444/S1578219008703706/v1_201304241444/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S1578219008703688" "issn" => "15782190" "doi" => "10.1016/S1578-2190(08)70368-8" "estado" => "S300" "fechaPublicacion" => "2008-12-01" "aid" => "70368" "copyright" => "Academia Española de Dermatología y Venereología and Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2008;99:795-802" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2072 "formatos" => array:3 [ "EPUB" => 36 "HTML" => 1280 "PDF" => 756 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original articles</span>" "titulo" => "An Economic Analysis of Presurgical Teledermatology in Patients with Nonmelanoma Skin Cancer" "tienePdf" => "en" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "795" "paginaFinal" => "802" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Teledermatología Prequirúrgica en Pacientes con Cáncer Cutáneo no Melanoma. Evaluación Económica" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L. Ferrándiz, D. Moreno-Ramírez, A. Ruiz-de-Casas, A. Nieto-García, P. Moreno-Álvarez, R. Galdeano, F.M. Camacho" "autores" => array:7 [ 0 => array:2 [ "nombre" => "L." "apellidos" => "Ferrándiz" ] 1 => array:2 [ "nombre" => "D." "apellidos" => "Moreno-Ramírez" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Ruiz-de-Casas" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Nieto-García" ] 4 => array:2 [ "nombre" => "P." "apellidos" => "Moreno-Álvarez" ] 5 => array:2 [ "nombre" => "R." "apellidos" => "Galdeano" ] 6 => array:2 [ "nombre" => "F.M." "apellidos" => "Camacho" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219008703688?idApp=UINPBA000044" "url" => "/15782190/0000009900000010/v1_201304241444/S1578219008703688/v1_201304241444/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case reports</span>" "titulo" => "Chronic Graft-Versus-Host Disease Presenting as Bullous Lesions" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "803" "paginaFinal" => "807" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. del Pozo, J. García-Silva, M.T. Yebra-Pimentel" "autores" => array:3 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "del Pozo" "email" => array:1 [ 0 => "del_pozo@canalejo.org" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "J." "apellidos" => "García-Silva" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 2 => array:3 [ "nombre" => "M.T." "apellidos" => "Yebra-Pimentel" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Complejo Hospitalario Universitario Juan Canalejo, La Coruña, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Complejo Hospitalario Universitario Juan Canalejo, La Coruña, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondence: Servicio de Dermatología, CHU Juan Canalejo, Xubias de Arriba, s/n, 15006 La Coruña, Spain." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Lesiones Ampollosas Como Forma de Presentación de una Enfermedad de Injerto Contra Huésped Crónica" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaAceptado" => "2007-12-12" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec84336" "palabras" => array:2 [ 0 => "chronic graft-vs-host disease" 1 => "bullous lesions" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec84335" "palabras" => array:2 [ 0 => "enfermedad injerto contra huésped crónica" 1 => "lesiones ampollosas" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">Graft-vs-host disease is still the leading cause of morbidity and mortality in patients undergoing bone marrow transplantation. It is important to start treatment early to reduce the severity and consequences of this complication. Cutaneous lesions are often the presenting compliant of graft-vs-host disease and presage visceral involvement.</p><p class="elsevierStyleSimplePara elsevierViewall">We present the case of a 45-year-old woman with multiple myeloma who underwent autologous and subsequently allogeneic bone marrow transplantation with hematopoietic precursors. She developed bullous lesions with fluid elimination on the abdomen and legs. Biopsy findings were compatible with graft-vs-host disease and immunosuppressive therapy was increased. She subsequently presented oral lichenoid lesions and sicca syndrome. The bullous lesions progressed to painful ulcers that healed leaving highly sclerodermatous skin with substantial hyperpigmentation.</p><p class="elsevierStyleSimplePara elsevierViewall">Bullous lesions are a rare form of presentation of chronic graft-vs-host disease. In such cases, the diagnosis may not be suspected initially, particularly when the lesions are isolated and internal organs are not involved.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p class="elsevierStyleSimplePara elsevierViewall">La enfermedad de injerto contra huésped (EICH) continúa siendo la primera causa de morbilidad y mortalidad en los enfermos con trasplante de médula ósea, de modo que un tratamiento precoz es importante para reducir la gravedad y las consecuencias de esta complicación.</p><p class="elsevierStyleSimplePara elsevierViewall">Las lesiones cutáneas son en muchas ocasiones la forma de presentación de una EICH y anuncian la afectación visceral.</p><p class="elsevierStyleSimplePara elsevierViewall">Presentamos el caso de una paciente de 45 años con mieloma múltiple a la que se realizó primero un trasplante autólogo y posteriormente un trasplante alogénico de médula ósea con precursores hematopoyéticos. Desarrolló lesiones ampollosas con eliminación de líquido en el abdomen y los miembros inferiores. Se realizó una biopsia que fue compatible con una EICH y se aumentó el tratamiento inmunodepresor. La paciente posteriormente presentó lesiones liquenoides orales, síndrome seco y las lesiones ampollosas que evolucionaron a úlceras dolorosas, que cicatrizaron con un intenso aspecto esclerodermiforme e importante hiperpigmentación.</p><p class="elsevierStyleSimplePara elsevierViewall">Las lesiones ampollosas son una forma de presentación excepcional en la EICH crónica, y en estos casos la sospecha inicial del diagnóstico puede ser difícil, sobre todo cuando se presentan de forma aislada sin afectación de órganos internos.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:21 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Predictors of death from chronic graft-versus-host disease after bone marrow transplantation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.R. Wingard" 1 => "S. Piantadosi" 2 => "G.B. Vogelsang" 3 => "E.R. Farmer" 4 => "D.A. Jabs" 5 => "S. Levin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "1989" "volumen" => "74" "paginaInicial" => "1428" "paginaFinal" => "1435" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2670000" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Enfermedad injerto contra huésped cutánea: estudio clínico e histopatológico" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Aragües-Montañés" 1 => "J. Fraga-Fernández" 2 => "J.M. Fernández-Herrera" 3 => "A. García-Díez" 4 => "R. Arranz-Saez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "1987" "volumen" => "78" "paginaInicial" => "7" "paginaFinal" => "11" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "High incidence of chronic graft versus host disease after allogeneic peripheral blood progenitor cell transplantation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Urbano-Ispizua" 1 => "J. García Conde" 2 => "S. Brunet" 3 => "F. Hernández" 4 => "G. Sanz" 5 => "J. Petit" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Haematologica" "fecha" => "1997" "volumen" => "82" "paginaInicial" => "683" "paginaFinal" => "689" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9499667" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparison of chronic graft-versus-host disease after transplantation of peripheral blood stem cells versus bone marrow in allogeneic recipients: long-term follow-up of a randomised trial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.E.D. Flowers" 1 => "P.M. Parker" 2 => "L.J. Johnston" 3 => "A.V.B. Matos" 4 => "B. Storer" 5 => "W.I. Bensinger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1182/blood-2002-01-0011" "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "2002" "volumen" => "100" "paginaInicial" => "415" "paginaFinal" => "419" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12091330" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chronic graft-versus-host disease after allogeneic blood stem cell transplantation: long-term results of a randomised study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Mothy" 1 => "M. Kuentz" 2 => "M. Michallet" 3 => "J.H. Bourhis" 4 => "N. Milpied" 5 => "L. Sutton" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1182/blood.V100.9.3128" "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "2002" "volumen" => "100" "paginaInicial" => "3128" "paginaFinal" => "3134" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12384409" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Performance of a new clinical grading system for chronic graft-versus-host disease: a multicenter study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Akpek" 1 => "S.J. Lee" 2 => "M.E. Flowers" 3 => "S.Z. Pavletic" 4 => "M. Arora" 5 => "S. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Blood" "fecha" => "2003" "volumen" => "102" "paginaInicial" => "902" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Macroscopic and microscopic mucinosis in chronic sclerodermoid graft-versus-host disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Ameen" 1 => "R. Russell-Jones" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2000" "volumen" => "142" "paginaInicial" => "529" "paginaFinal" => "532" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10735965" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sclerodermatous graft-versus-host disease limited to an area of the measles exanthem" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Fenyk" 1 => "C.M. Smith" 2 => "O.I. Warkentin" 3 => "W. Krivit" 4 => "R.W. Goltz" 5 => "J.E. Neely" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "1978" "volumen" => "1" "paginaInicial" => "472" "paginaFinal" => "473" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2893892" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Histochemical and ultrastructural study of diffuse melanoderma after bone marrow transplantation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Aractingi" 1 => "A. Janin" 2 => "A. Devergie" 3 => "M. Bourges" 4 => "G. Socié" 5 => "E. Gluckman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Br J Dermatol" "fecha" => "1996" "volumen" => "134" "paginaInicial" => "325" "paginaFinal" => "331" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8746350" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1474442207701783" "estado" => "S300" "issn" => "14744422" ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Total leucoderma: a rare manifestation of cutaneous chronic graft-versus host disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Nagler" 1 => "M.A. Goldenhersh" 2 => "F. Levi-Schaffer" 3 => "J.C. Bystryns" 4 => "S.N. Klaus" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "1996" "volumen" => "134" "paginaInicial" => "780" "paginaFinal" => "783" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8733392" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Melanocyte-lymphocyte interaction in human graft-versus host disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.L. Claudy" 1 => "D. Schmitt" 2 => "F. Freycon" 3 => "S. Boucheron" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Cutan Pathol" "fecha" => "1983" "volumen" => "10" "paginaInicial" => "305" "paginaFinal" => "311" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6630663" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pityriasis rosea-like eruption after bone marrow transplantation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "L.J. Spelman" 1 => "I.M. Robertson" 2 => "G.M. Strutton" 3 => "D. Weedon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "1994" "volumen" => "31" "paginaInicial" => "348" "paginaFinal" => "351" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8034803" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acquired ichthyosis associated with chronic graft-versus-host disease following allogeneic peripheral blood stem cell transplantation in a patient with chronic myelogenous leukaemia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I. Dilek" 1 => "T. Demirer" 2 => "C. Ustun" 3 => "M. Arat" 4 => "H. Koc" 5 => "M. Beksac" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/sj.bmt.1701240" "Revista" => array:6 [ "tituloSerie" => "Bone Marrow Transplant" "fecha" => "1998" "volumen" => "21" "paginaInicial" => "1159" "paginaFinal" => "1161" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9645582" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Graft versus-host disease limited to area of irradiated skin" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F.E. Zwaan" 1 => "J. Jansen" 2 => "E.M. Noordijk" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "1980" "volumen" => "1" "paginaInicial" => "1081" "paginaFinal" => "1082" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2566033" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Eruptive angiomatous lesions associated with graft-versus-host disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Adamski" 1 => "F. Le Gall" 2 => "L. Cartron" 3 => "C. Dauriac" 4 => "G. Lancien" 5 => "J. Wechsler" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2003" "volumen" => "149" "paginaInicial" => "667" "paginaFinal" => "668" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14511016" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Exhuberant granulation tissue associated with chronic graft versus host disease after transplantation of peripheral blood progenitor cells" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.A. Barnadas" 1 => "S. Brunet" 2 => "A. Sureda" 3 => "R. López" 4 => "R. Curell" 5 => "J. Sierra" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "1999" "volumen" => "41" "paginaInicial" => "876" "paginaFinal" => "879" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10534676" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bullous sclerodermalike changes in chronic graft-vs-host disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.R. Hymes" 1 => "E.R. Farmer" 2 => "W.H. Burns" 3 => "W.L. Morison" 4 => "P.J. Tutschka" 5 => "L.L. Walters" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Dermatol" "fecha" => "1985" "volumen" => "121" "paginaInicial" => "1189" "paginaFinal" => "1192" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3899019" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bullous scleroderma-like changes in chronic graft-versus-host disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.C. Moreno" 1 => "F. Valverde" 2 => "F. Martínez" 3 => "A. Vélez" 4 => "A. Torres" 5 => "J. Fanego" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2003" "volumen" => "17" "paginaInicial" => "200" "paginaFinal" => "203" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12705752" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib19" "etiqueta" => "19." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Erupción ampollosa generalizada tipo NET y enfermedad injerto contra huésped en un enfermo trasplantado con médula ósea alógena" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "V. Villanueva" 1 => "E. Hernández" 2 => "R. Mataix" 3 => "C. Díaz-Cascajo" 4 => "J. Bastida" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "1998" "volumen" => "89" "paginaInicial" => "405" "paginaFinal" => "408" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib20" "etiqueta" => "20." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sclerodermatous graft-versus-host disease. Clinical and pathological study of 17 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P.F. Peñas" 1 => "M. Jones-Caballero" 2 => "M. Aragües" 3 => "J. Fernández-Herrera" 4 => "J. Fraga" 5 => "A. García-Díez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Dermatol" "fecha" => "2002" "volumen" => "138" "paginaInicial" => "924" "paginaFinal" => "934" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12071820" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib21" "etiqueta" => "21." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "UVA-1 therapy for sclerodermoid graft-versus-host disease of the skin" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H. Ständer" 1 => "M. Schiller" 2 => "T. Schwarz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2002" "volumen" => "46" "paginaInicial" => "799" "paginaFinal" => "800" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12004332" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000009900000010/v1_201304241444/S157821900870369X/v1_201304241444/en/main.assets" "Apartado" => array:4 [ "identificador" => "6183" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case Reports" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000009900000010/v1_201304241444/S157821900870369X/v1_201304241444/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157821900870369X?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 7 | 7 | 14 |
| 2024 October | 52 | 42 | 94 |
| 2024 September | 42 | 32 | 74 |
| 2024 August | 80 | 63 | 143 |
| 2024 July | 45 | 80 | 125 |
| 2024 June | 54 | 79 | 133 |
| 2024 May | 44 | 35 | 79 |
| 2024 April | 48 | 35 | 83 |
| 2024 March | 53 | 45 | 98 |
| 2024 February | 40 | 40 | 80 |
| 2024 January | 40 | 44 | 84 |
| 2023 December | 46 | 50 | 96 |
| 2023 November | 46 | 43 | 89 |
| 2023 October | 39 | 30 | 69 |
| 2023 September | 36 | 22 | 58 |
| 2023 August | 26 | 16 | 42 |
| 2023 July | 26 | 62 | 88 |
| 2023 June | 35 | 25 | 60 |
| 2023 May | 30 | 27 | 57 |
| 2023 April | 19 | 37 | 56 |
| 2023 March | 21 | 31 | 52 |
| 2023 February | 22 | 32 | 54 |
| 2023 January | 17 | 42 | 59 |
| 2022 December | 26 | 42 | 68 |
| 2022 November | 15 | 25 | 40 |
| 2022 October | 14 | 18 | 32 |
| 2022 September | 13 | 51 | 64 |
| 2022 August | 20 | 38 | 58 |
| 2022 July | 14 | 22 | 36 |
| 2022 June | 20 | 33 | 53 |
| 2022 May | 19 | 38 | 57 |
| 2022 April | 30 | 46 | 76 |
| 2022 March | 28 | 62 | 90 |
| 2022 February | 12 | 21 | 33 |
| 2022 January | 24 | 55 | 79 |
| 2021 December | 14 | 42 | 56 |
| 2021 November | 17 | 50 | 67 |
| 2021 October | 24 | 45 | 69 |
| 2021 September | 24 | 48 | 72 |
| 2021 August | 12 | 30 | 42 |
| 2021 July | 19 | 29 | 48 |
| 2021 June | 22 | 34 | 56 |
| 2021 May | 18 | 35 | 53 |
| 2021 April | 47 | 59 | 106 |
| 2021 March | 46 | 28 | 74 |
| 2021 February | 31 | 21 | 52 |
| 2021 January | 28 | 26 | 54 |
| 2020 December | 23 | 11 | 34 |
| 2020 November | 20 | 21 | 41 |
| 2020 October | 23 | 20 | 43 |
| 2020 September | 26 | 14 | 40 |
| 2020 August | 21 | 23 | 44 |
| 2020 July | 27 | 11 | 38 |
| 2020 June | 9 | 24 | 33 |
| 2020 May | 26 | 27 | 53 |
| 2020 April | 21 | 20 | 41 |
| 2020 March | 13 | 27 | 40 |
| 2020 February | 1 | 9 | 10 |
| 2020 January | 0 | 14 | 14 |
| 2019 December | 0 | 8 | 8 |
| 2019 November | 0 | 7 | 7 |
| 2019 October | 0 | 4 | 4 |
| 2019 September | 0 | 7 | 7 |
| 2019 August | 0 | 2 | 2 |
| 2019 July | 0 | 8 | 8 |
| 2019 June | 0 | 3 | 3 |
| 2019 May | 0 | 47 | 47 |
| 2019 April | 0 | 24 | 24 |
| 2019 March | 0 | 7 | 7 |
| 2019 February | 0 | 5 | 5 |
| 2019 January | 0 | 1 | 1 |
| 2018 December | 0 | 5 | 5 |
| 2018 November | 0 | 3 | 3 |
| 2018 September | 0 | 3 | 3 |
| 2018 August | 0 | 6 | 6 |
| 2018 July | 0 | 4 | 4 |
| 2018 June | 0 | 4 | 4 |
| 2018 May | 0 | 6 | 6 |
| 2018 April | 0 | 12 | 12 |
| 2018 March | 0 | 1 | 1 |
| 2018 February | 7 | 7 | 14 |
| 2018 January | 10 | 9 | 19 |
| 2017 December | 14 | 14 | 28 |
| 2017 November | 15 | 11 | 26 |
| 2017 October | 7 | 12 | 19 |
| 2017 September | 14 | 9 | 23 |
| 2017 August | 18 | 11 | 29 |
| 2017 July | 32 | 10 | 42 |
| 2017 June | 28 | 20 | 48 |
| 2017 May | 24 | 11 | 35 |
| 2017 April | 26 | 17 | 43 |
| 2017 March | 30 | 13 | 43 |
| 2017 February | 13 | 18 | 31 |
| 2017 January | 9 | 19 | 28 |
| 2016 December | 24 | 13 | 37 |
| 2016 November | 22 | 22 | 44 |
| 2016 October | 24 | 14 | 38 |
| 2016 September | 33 | 16 | 49 |
| 2016 August | 32 | 6 | 38 |
| 2016 July | 20 | 2 | 22 |
| 2016 June | 9 | 10 | 19 |
| 2016 May | 7 | 4 | 11 |
| 2016 April | 8 | 11 | 19 |
| 2016 March | 2 | 17 | 19 |
| 2016 February | 9 | 19 | 28 |
| 2016 January | 6 | 19 | 25 |
| 2015 December | 9 | 13 | 22 |
| 2015 November | 11 | 23 | 34 |
| 2015 October | 8 | 29 | 37 |
| 2015 September | 5 | 14 | 19 |
| 2015 August | 11 | 13 | 24 |
| 2015 July | 29 | 38 | 67 |
| 2015 June | 33 | 26 | 59 |
| 2015 May | 53 | 37 | 90 |
| 2015 April | 42 | 26 | 68 |
| 2015 March | 46 | 18 | 64 |
| 2015 February | 24 | 16 | 40 |
| 2015 January | 25 | 11 | 36 |
| 2014 December | 29 | 10 | 39 |
| 2014 November | 33 | 13 | 46 |
| 2014 October | 31 | 20 | 51 |
| 2014 September | 42 | 24 | 66 |
| 2014 August | 42 | 19 | 61 |
| 2014 July | 36 | 27 | 63 |
| 2014 June | 50 | 17 | 67 |
| 2014 May | 40 | 23 | 63 |
| 2014 April | 50 | 13 | 63 |
| 2014 March | 71 | 23 | 94 |
| 2014 February | 35 | 26 | 61 |
| 2014 January | 46 | 16 | 62 |
| 2013 December | 44 | 19 | 63 |
| 2013 November | 33 | 27 | 60 |
| 2013 October | 34 | 40 | 74 |
| 2013 September | 33 | 24 | 57 |
| 2013 August | 28 | 34 | 62 |
| 2013 July | 48 | 34 | 82 |
| 2013 June | 35 | 42 | 77 |
| 2013 May | 27 | 39 | 66 |
| 2013 April | 18 | 38 | 56 |
| 2013 March | 27 | 25 | 52 |
| 2013 February | 32 | 15 | 47 |
| 2013 January | 16 | 5 | 21 |
Show all
