Original article
Severe Adult Atopic Dermatitis: Treatment With Mycophenolate Mofetil in 8 Patients
Tratamiento de la Dermatitis Atópica Grave del adulto con Mofetil Micofenolato en 8 Pacientes
I. Ballester
, J.F. Silvestre, M. Pérez-Crespo, A. Lucas
Corresponding author
ibalnor@coma.es
Correspondence: Nortes. Servicio de Dermatología. C/ Pintor Baeza, s/n. 03010 Alicante. Spain.
Correspondence: Nortes. Servicio de Dermatología. C/ Pintor Baeza, s/n. 03010 Alicante. Spain.
Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, Spain
Read
7934
Timeswas read the article
4198
Total PDF
3736
Total HTML
Share statistics
array:23 [ "pii" => "S1578219009705591" "issn" => "15782190" "doi" => "10.1016/S1578-2190(09)70559-1" "estado" => "S300" "fechaPublicacion" => "2009-12-01" "aid" => "70559" "copyright" => "Academia Española de Dermatología y Venereología and Elsevier España, S.L." "copyrightAnyo" => "2009" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2009;100:883-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3919 "formatos" => array:3 [ "EPUB" => 36 "HTML" => 1567 "PDF" => 2316 ] ] "itemSiguiente" => array:18 [ "pii" => "S1578219009705608" "issn" => "15782190" "doi" => "10.1016/S1578-2190(09)70560-8" "estado" => "S300" "fechaPublicacion" => "2009-12-01" "aid" => "70560" "copyright" => "Academia Española de Dermatología y Venereología and Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2009;100:888-94" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3322 "formatos" => array:3 [ "EPUB" => 38 "HTML" => 1679 "PDF" => 1605 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original articles</span>" "titulo" => "Erysipelas and Cellulitis: A Retrospective Study of 122 Cases" "tienePdf" => "en" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "888" "paginaFinal" => "894" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Erisipelas y Celulitis. Estudio Retrospectivo de 122 Casos" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Concheiro, M. Loureiro, D. González-Vilas, J. García-Gavín, D. Sánchez-Aguilar, J. Toribio" "autores" => array:6 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Concheiro" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Loureiro" ] 2 => array:2 [ "nombre" => "D." "apellidos" => "González-Vilas" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "García-Gavín" ] 4 => array:2 [ "nombre" => "D." "apellidos" => "Sánchez-Aguilar" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Toribio" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219009705608?idApp=UINPBA000044" "url" => "/15782190/0000010000000010/v1_201304241509/S1578219009705608/v1_201304241509/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S157821900970558X" "issn" => "15782190" "doi" => "10.1016/S1578-2190(09)70558-X" "estado" => "S300" "fechaPublicacion" => "2009-12-01" "aid" => "70558" "copyright" => "Academia Española de Dermatología y Venereología and Elsevier España, S.L." "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2009;100:875-82" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5127 "formatos" => array:3 [ "EPUB" => 35 "HTML" => 1357 "PDF" => 3735 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Practical dermatology</span>" "titulo" => "Key Diagnostic Features and Treatment of Subungual Glomus Tumor" "tienePdf" => "en" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "875" "paginaFinal" => "882" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Claves del Diagnóstico y Tratamiento del tumor Glómico Sublingual" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "E. Samaniego, A. Crespo, A. Sanz" "autores" => array:3 [ 0 => array:2 [ "nombre" => "E." "apellidos" => "Samaniego" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Crespo" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Sanz" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157821900970558X?idApp=UINPBA000044" "url" => "/15782190/0000010000000010/v1_201304241509/S157821900970558X/v1_201304241509/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Severe Adult Atopic Dermatitis: Treatment With Mycophenolate Mofetil in 8 Patients" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "883" "paginaFinal" => "887" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "I. Ballester, J.F. Silvestre, M. Pérez-Crespo, A. Lucas" "autores" => array:4 [ 0 => array:4 [ "nombre" => "I." "apellidos" => "Ballester" "email" => array:1 [ 0 => "ibalnor@coma.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "J.F." "apellidos" => "Silvestre" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Pérez-Crespo" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Lucas" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Dermatología, Hospital General Universitario de Alicante, Alicante, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondence: Nortes. Servicio de Dermatología. C/ Pintor Baeza, s/n. 03010 Alicante. Spain." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento de la Dermatitis Atópica Grave del adulto con Mofetil Micofenolato en 8 Pacientes" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaAceptado" => "2009-04-30" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec84631" "palabras" => array:3 [ 0 => "mycophenolate mofetil" 1 => "atopic dermatitis" 2 => "immunosuppressive agents" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec84632" "palabras" => array:3 [ 0 => "mofetil micofenolato" 1 => "dermatitis atópica" 2 => "agentes inmunosupresores" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p class="elsevierStyleSimplePara elsevierViewall">Atopic dermatitis (AD) includes severe forms that can be refractory to various systemic treatments. Mycophenolate mofetil (MMF) has been found to be useful in patients with severe forms of AD and to have fewer side effects than long-term treatment with oral corticosteroids or cyclosporine.</p> <span class="elsevierStyleSectionTitle">Objectives</span><p class="elsevierStyleSimplePara elsevierViewall">To evaluate the efficacy and adverse effects of MMF in patients seen in our skin allergy unit with severe adult AD refractory to other systemic treatments.</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">We performed a retrospective study of 8 patients with severe adult AD treated with MMF, analyzing the baseline characteristics, previous treatments used by the patients, and the outcome and adverse effects of treatment with MMF.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Five patients treated with MMF showed improvement in the fourth week of treatment. In addition, 5 of the 8 patients presented a clear, long-term improvement in their disease. Remission of AD occurred in 1 patient, making it possible to discontinue MMF; this patient remains stable with no relapses after 4 months without treatment. The other 4 patients continue on maintenance therapy. Three patients continued to have frequent acute outbreaks of AD despite treatment with MMF for 16 to 72 weeks. All patients tolerated the treatment and there were few adverse effects.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">MMF can be an effective option in selected patients with severe forms of atopic dermatitis. Although the response is not as rapid as with oral corticosteroids or cyclosporine, it can be used for maintenance treatment with good clinical control and few adverse effects.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p class="elsevierStyleSimplePara elsevierViewall">La dermatitis atópica (DA) incluye formas graves que pueden ser refractarias a varios tratamientos sistémicos. Mofetil micofenolato (MMF) ha demostrado ser útil en pacientes con formas graves de DA y produce menos efectos secundarios que el tratamiento a largo plazo con ciclosporina o corticosteroides orales.</p> <span class="elsevierStyleSectionTitle">Objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">Valorar la eficacia y los efectos adversos del MMF en pacientes con DA grave del adulto refractaria a otros tratamientos sistémicos en nuestra Unidad de Alergia Cutánea.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Realizamos un estudio retrospectivo de 8 pacientes con DA grave del adulto tratados con MMF. Analizamos las características basales y los tratamientos previos utilizados por los pacientes, así como los resultados y efectos secundarios obtenidos tras el empleo de MMF.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Cinco pacientes tratados con MMF presentaron mejoría en la cuarta semana de tratamiento. Además, en 5 de 8 pacientes se consiguió una clara mejoría de la DA a largo plazo. En uno de ellos se logró una remisión de la DA, lo que permitió la retirada de MMF y después de 4 meses sin tratamiento permanece estable y sin recaídas. Los cuatro restantes siguen con terapia de mantenimiento. Tres pacientes continuaron con brotes agudos frecuentes de DA a pesar de haber mantenido el tratamiento con MMF entre 16-72 semanas. Todos los pacientes toleraron el tratamiento con escasos efectos secundarios.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">MMF puede ser una opción eficaz en pacientes seleccionados con formas graves de DA. Aunque MMF no produce una respuesta tan rápida como la que se obtiene con ciclosporina o con corticoides orales, permite un tratamiento mantenido, con buen control clínico y escasos efectos secundarios.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:18 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Successful treatment of severe refractory atopic dermatitis with mycophenolate mofetil" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Grundmann-Kollmann" 1 => "H.C. Korting" 2 => "S. Behrens" 3 => "U. Leiter" 4 => "G. Krähn" 5 => "R. Kaufmann" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "1999" "volumen" => "141" "paginaInicial" => "175" "paginaFinal" => "176" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10417840" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Practical issues on interpretation of scoring atopic dermatitis: the SCORAD index, objective SCORAD and the three-item severity score" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Oranje" 1 => "E. Glazenburg" 2 => "A. Wolkerstorfer" 3 => "F.B. Waard-van der Spek" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2133.2007.08112.x" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2007" "volumen" => "157" "paginaInicial" => "645" "paginaFinal" => "648" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17714568" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mycophenolate mofetil is effective in the treatment of atopic dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M. Grundmann-Kollmann" 1 => "M. Podda" 2 => "F. Ochsendorf" 3 => "W.H. Boehncke" 4 => "R. Kaufmann" 5 => "T.M. Zollner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Dermatol" "fecha" => "2001" "volumen" => "137" "paginaInicial" => "870" "paginaFinal" => "873" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11453805" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib4" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mycophenolate mofetil therapy for moderate to severe atopic dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.L. Murray" 1 => "J.B. Cohen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2230.2006.02290.x" "Revista" => array:6 [ "tituloSerie" => "Clin Exp Dermatol" "fecha" => "2006" "volumen" => "32" "paginaInicial" => "23" "paginaFinal" => "37" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17059445" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib5" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mycophenolate mofetil for severe childhood atopic dermatitis: experience in 14 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Heller" 1 => "H.T. Shin" 2 => "S.J. Orlow" 3 => "J.V. Schaffer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2133.2007.07947.x" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2007" "volumen" => "157" "paginaInicial" => "127" "paginaFinal" => "132" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17489974" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib6" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of atopic dermatitis with mycophenolate mofetil" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E.R. Hansen" 1 => "S. Buus" 2 => "M. Deleuran" 3 => "K.E. Andersen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2000" "volumen" => "143" "paginaInicial" => "1324" "paginaFinal" => "1326" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11122047" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib7" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Double-blind, controlled, crossover study of cyclosporin in adults with severe refractory atopic dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.M. Sowden" 1 => "J. Berth-Jones" 2 => "J.S. Ross" 3 => "R.J. Motley" 4 => "R. Marks" 5 => "A.Y. Finlay" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "1991" "volumen" => "338" "paginaInicial" => "137" "paginaFinal" => "140" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1677063" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib8" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Azathioprine dosed by thiopurine methyltransferase activity for moderate-to-severe atopic eczema: a double-blind, randomised controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.J. Meggitt" 1 => "J.C. Gray" 2 => "N.J. Reynolds" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(06)68340-2" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2006" "volumen" => "367" "paginaInicial" => "839" "paginaFinal" => "846" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16530578" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib9" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Narrow-band ultraviolet B and broad-band ultraviolet A phototherapy in adult atopic eczema: a randomised controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "N.J. Reynolds" 1 => "V. Franklin" 2 => "J.C. Gray" 3 => "B.L. Diffey" 4 => "P.M. Farr" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(00)05114-X" "Revista" => array:6 [ "tituloSerie" => "Lancet" "fecha" => "2001" "volumen" => "357" "paginaInicial" => "2012" "paginaFinal" => "2016" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11438134" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib10" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The treatment of atopic dermatitis with systemic immunosuppressive agents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Akhavan" 1 => "D. Rudikoff" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Exp Dermatol" "fecha" => "2003" "volumen" => "21" "paginaInicial" => "225" "paginaFinal" => "240" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Staphylococcal septicaemia complicating treatment of atopic dermatitis with mycophenolate" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.C. Satchell" 1 => "R. Barnetson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2000" "volumen" => "143" "paginaInicial" => "198" "paginaFinal" => "233" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10886162" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib12" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Staphylococcus aureus in the lesions of atopic dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.J. Leyden" 1 => "R.R. Marples" 2 => "A.M. Kligman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "1974" "volumen" => "90" "paginaInicial" => "525" "paginaFinal" => "530" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4601016" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib13" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis and treatment of atopic dermatitis in children and adults: European Academy of Allergology and Clinical Immunology/American Academy of Allergy, Asthma and Immunology/PRACTALL Consensus Report" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.A. Akdis" 1 => "M. Akdis" 2 => "T. Bieber" 3 => "C. Bindslev-Jensen" 4 => "M. Boguniewicz" 5 => "P. Eigenmann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1398-9995.2006.01153.x" "Revista" => array:6 [ "tituloSerie" => "Allergy" "fecha" => "2006" "volumen" => "61" "paginaInicial" => "969" "paginaFinal" => "987" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16867052" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib14" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Communication About an Ongoing Safety Review of Cell-Cept (mycophenolate mofetil) and Myfortic (mycophenolate acid). US Food and Drug Administration: Center for Drug Evaluation and Research; 2008." ] ] ] 14 => array:3 [ "identificador" => "bib15" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Systemic treatment of severe atopic eczema: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Schmitt" 1 => "K. Schäkel" 2 => "N. Schmitt" 3 => "M. Meurer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2340/00015555-0207" "Revista" => array:6 [ "tituloSerie" => "Acta Derm Venereol" "fecha" => "2007" "volumen" => "87" "paginaInicial" => "100" "paginaFinal" => "111" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17340015" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib16" "etiqueta" => "16." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Emerging treatment of atopic dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.J. Hsu" 1 => "L.F. Wang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s12016-007-0043-6" "Revista" => array:6 [ "tituloSerie" => "Clin Rev Allergy Immunol" "fecha" => "2007" "volumen" => "33" "paginaInicial" => "199" "paginaFinal" => "203" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18163226" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib17" "etiqueta" => "17." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of atopic eczema with oral mycophenolate mofetil" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K. Neuber" 1 => "I. Schwartz" 2 => "G. Itschert" 3 => "A.T. Dieck" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2000" "volumen" => "143" "paginaInicial" => "385" "paginaFinal" => "391" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10951150" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib18" "etiqueta" => "18." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Successful long-term treatment of severe atopic dermatitis with mycophenolate mofetil" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Benez" 1 => "G. Fierlbeck" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2001" "volumen" => "144" "paginaInicial" => "638" "paginaFinal" => "639" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11260038" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010000000010/v1_201304241509/S1578219009705591/v1_201304241509/en/main.assets" "Apartado" => array:4 [ "identificador" => "6155" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010000000010/v1_201304241509/S1578219009705591/v1_201304241509/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219009705591?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 4 | 7 | 11 |
| 2024 October | 61 | 53 | 114 |
| 2024 September | 67 | 35 | 102 |
| 2024 August | 93 | 55 | 148 |
| 2024 July | 62 | 48 | 110 |
| 2024 June | 103 | 26 | 129 |
| 2024 May | 69 | 27 | 96 |
| 2024 April | 61 | 34 | 95 |
| 2024 March | 48 | 54 | 102 |
| 2024 February | 53 | 43 | 96 |
| 2024 January | 45 | 39 | 84 |
| 2023 December | 43 | 27 | 70 |
| 2023 November | 58 | 55 | 113 |
| 2023 October | 58 | 47 | 105 |
| 2023 September | 52 | 29 | 81 |
| 2023 August | 38 | 19 | 57 |
| 2023 July | 27 | 37 | 64 |
| 2023 June | 34 | 15 | 49 |
| 2023 May | 42 | 21 | 63 |
| 2023 April | 25 | 13 | 38 |
| 2023 March | 27 | 25 | 52 |
| 2023 February | 43 | 25 | 68 |
| 2023 January | 54 | 40 | 94 |
| 2022 December | 40 | 46 | 86 |
| 2022 November | 23 | 32 | 55 |
| 2022 October | 14 | 21 | 35 |
| 2022 September | 14 | 35 | 49 |
| 2022 August | 21 | 29 | 50 |
| 2022 July | 15 | 30 | 45 |
| 2022 June | 13 | 30 | 43 |
| 2022 May | 30 | 44 | 74 |
| 2022 April | 45 | 39 | 84 |
| 2022 March | 45 | 57 | 102 |
| 2022 February | 29 | 29 | 58 |
| 2022 January | 31 | 42 | 73 |
| 2021 December | 29 | 39 | 68 |
| 2021 November | 44 | 52 | 96 |
| 2021 October | 39 | 49 | 88 |
| 2021 September | 36 | 40 | 76 |
| 2021 August | 41 | 38 | 79 |
| 2021 July | 24 | 31 | 55 |
| 2021 June | 31 | 33 | 64 |
| 2021 May | 26 | 31 | 57 |
| 2021 April | 68 | 62 | 130 |
| 2021 March | 56 | 26 | 82 |
| 2021 February | 43 | 40 | 83 |
| 2021 January | 27 | 22 | 49 |
| 2020 December | 27 | 23 | 50 |
| 2020 November | 24 | 34 | 58 |
| 2020 October | 22 | 10 | 32 |
| 2020 September | 18 | 16 | 34 |
| 2020 August | 15 | 35 | 50 |
| 2020 July | 11 | 6 | 17 |
| 2020 June | 24 | 21 | 45 |
| 2020 May | 22 | 21 | 43 |
| 2020 April | 28 | 22 | 50 |
| 2020 March | 26 | 22 | 48 |
| 2020 February | 1 | 1 | 2 |
| 2020 January | 0 | 6 | 6 |
| 2019 December | 0 | 13 | 13 |
| 2019 November | 0 | 1 | 1 |
| 2019 September | 0 | 5 | 5 |
| 2019 August | 0 | 2 | 2 |
| 2019 July | 0 | 6 | 6 |
| 2019 June | 0 | 9 | 9 |
| 2019 May | 2 | 40 | 42 |
| 2019 April | 0 | 7 | 7 |
| 2019 March | 0 | 5 | 5 |
| 2019 February | 0 | 10 | 10 |
| 2019 January | 0 | 3 | 3 |
| 2018 December | 0 | 7 | 7 |
| 2018 September | 0 | 7 | 7 |
| 2018 August | 0 | 13 | 13 |
| 2018 July | 0 | 22 | 22 |
| 2018 June | 0 | 16 | 16 |
| 2018 May | 0 | 18 | 18 |
| 2018 April | 0 | 19 | 19 |
| 2018 March | 1 | 12 | 13 |
| 2018 February | 17 | 49 | 66 |
| 2018 January | 14 | 69 | 83 |
| 2017 December | 19 | 36 | 55 |
| 2017 November | 18 | 67 | 85 |
| 2017 October | 14 | 62 | 76 |
| 2017 September | 21 | 42 | 63 |
| 2017 August | 19 | 56 | 75 |
| 2017 July | 18 | 53 | 71 |
| 2017 June | 26 | 83 | 109 |
| 2017 May | 20 | 62 | 82 |
| 2017 April | 27 | 45 | 72 |
| 2017 March | 20 | 77 | 97 |
| 2017 February | 15 | 120 | 135 |
| 2017 January | 15 | 80 | 95 |
| 2016 December | 31 | 60 | 91 |
| 2016 November | 23 | 51 | 74 |
| 2016 October | 31 | 49 | 80 |
| 2016 September | 41 | 70 | 111 |
| 2016 August | 50 | 35 | 85 |
| 2016 July | 34 | 14 | 48 |
| 2016 June | 7 | 9 | 16 |
| 2016 May | 5 | 14 | 19 |
| 2016 April | 4 | 1 | 5 |
| 2016 March | 3 | 8 | 11 |
| 2016 February | 8 | 28 | 36 |
| 2016 January | 11 | 21 | 32 |
| 2015 December | 8 | 8 | 16 |
| 2015 November | 11 | 1 | 12 |
| 2015 October | 5 | 27 | 32 |
| 2015 September | 7 | 16 | 23 |
| 2015 August | 9 | 3 | 12 |
| 2015 July | 32 | 22 | 54 |
| 2015 June | 33 | 17 | 50 |
| 2015 May | 55 | 39 | 94 |
| 2015 April | 38 | 19 | 57 |
| 2015 March | 28 | 17 | 45 |
| 2015 February | 38 | 20 | 58 |
| 2015 January | 35 | 16 | 51 |
| 2014 December | 35 | 15 | 50 |
| 2014 November | 37 | 18 | 55 |
| 2014 October | 27 | 17 | 44 |
| 2014 September | 35 | 16 | 51 |
| 2014 August | 33 | 24 | 57 |
| 2014 July | 53 | 24 | 77 |
| 2014 June | 42 | 14 | 56 |
| 2014 May | 47 | 17 | 64 |
| 2014 April | 40 | 15 | 55 |
| 2014 March | 42 | 27 | 69 |
| 2014 February | 27 | 35 | 62 |
| 2014 January | 23 | 32 | 55 |
| 2013 December | 26 | 22 | 48 |
| 2013 November | 26 | 25 | 51 |
| 2013 October | 30 | 23 | 53 |
| 2013 September | 28 | 29 | 57 |
| 2013 August | 25 | 44 | 69 |
| 2013 July | 36 | 48 | 84 |
| 2013 June | 17 | 57 | 74 |
| 2013 May | 28 | 36 | 64 |
| 2013 April | 41 | 30 | 71 |
| 2013 March | 35 | 34 | 69 |
| 2013 February | 19 | 26 | 45 |
| 2013 January | 2 | 1 | 3 |
Show all
