Case and Research Letters
Anogenital Granulomatosis
Granulomatosis anogenitales
M. Villar
, G. Petiti, A. Guerra, F. Vanaclocha
Corresponding author
Servicio de Dermatología, Hospital Universitario 12 de octubre, Madrid, Spain
Read
10291
Timeswas read the article
3036
Total PDF
7255
Total HTML
Share statistics
array:24 [ "pii" => "S1578219012000601" "issn" => "15782190" "doi" => "10.1016/j.adengl.2011.05.007" "estado" => "S300" "fechaPublicacion" => "2012-01-01" "aid" => "458" "copyright" => "Elsevier España, S.L. and AEDV" "copyrightAnyo" => "2011" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2012;103:76-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5013 "formatos" => array:3 [ "EPUB" => 50 "HTML" => 3841 "PDF" => 1122 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731011003334" "issn" => "00017310" "doi" => "10.1016/j.ad.2011.05.016" "estado" => "S300" "fechaPublicacion" => "2012-01-01" "aid" => "458" "copyright" => "Elsevier España, S.L. y AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2012;103:76-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 7945 "formatos" => array:3 [ "EPUB" => 2 "HTML" => 6390 "PDF" => 1553 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científico-clínica</span>" "titulo" => "Granulomatosis anogenitales" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "76" "paginaFinal" => "79" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Anogenital Granulomatosis" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2278 "Ancho" => 2167 "Tamanyo" => 1001665 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A) Presencia de un infiltrado linfocitario que ocupa la dermis reticular, en el cual se distinguen estructuras granulomatosas sin necrosis central (HE x1,25). B) Detalle de un granuloma constituido por células gigantes multinucleadas y epitelioides y rodeado por una corona linfocitaria (HE x40). C) Denso infiltrado linfocitario ocupando el corion (HE x4). D) A mayor detalle, se observan células epitelioides constituyendo granulomas no necrotizantes (HEx40).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Villar, G. Petiti, A. Guerra y F. Vanaclocha" "autores" => array:3 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Villar" ] 1 => array:2 [ "nombre" => "G." "apellidos" => "Petiti" ] 2 => array:2 [ "nombre" => "A. Guerra y F." "apellidos" => "Vanaclocha" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219012000601" "doi" => "10.1016/j.adengl.2011.05.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012000601?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731011003334?idApp=UINPBA000044" "url" => "/00017310/0000010300000001/v1_201304241349/S0001731011003334/v1_201304241349/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219012000522" "issn" => "15782190" "doi" => "10.1016/j.adengl.2011.01.006" "estado" => "S300" "fechaPublicacion" => "2012-01-01" "aid" => "459" "copyright" => "Elsevier España, S.L. and AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2012;103:79-81" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4792 "formatos" => array:3 [ "EPUB" => 38 "HTML" => 3714 "PDF" => 1040 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Atypical Calciphylaxis Secondary to Treatment With Acenocoumarol" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "79" "paginaFinal" => "81" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Calcifilaxia atípica secundaria al tratamiento con acenocumarol" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 749 "Ancho" => 499 "Tamanyo" => 59202 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Ulcer with necrotic eschar surrounded by a reticular purpuric plaque on the back of the left leg.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Álvarez-Pérez, E. Gutiérrez-González, D. Sánchez-Aguilar, J. Toribio" "autores" => array:4 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Álvarez-Pérez" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Gutiérrez-González" ] 2 => array:2 [ "nombre" => "D." "apellidos" => "Sánchez-Aguilar" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Toribio" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731011003346" "doi" => "10.1016/j.ad.2011.01.017" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731011003346?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012000522?idApp=UINPBA000044" "url" => "/15782190/0000010300000001/v1_201304241248/S1578219012000522/v1_201304241248/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219012000595" "issn" => "15782190" "doi" => "10.1016/j.adengl.2011.02.005" "estado" => "S300" "fechaPublicacion" => "2012-01-01" "aid" => "457" "copyright" => "Elsevier España, S.L. and AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2012;103:75-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4019 "formatos" => array:3 [ "EPUB" => 53 "HTML" => 3178 "PDF" => 788 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Halo Nevi Associated With Interferon Beta-1a Therapy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "75" "paginaFinal" => "76" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Halo nevi asociados al tratamiento con interferón beta-1a" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "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" => 709 "Ancho" => 948 "Tamanyo" => 59467 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Halo nevi on the back.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "E. Vera-Iglesias, M. García-Arpa, P. Sánchez-Caminero" "autores" => array:3 [ 0 => array:2 [ "nombre" => "E." "apellidos" => "Vera-Iglesias" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "García-Arpa" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Sánchez-Caminero" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731011003322" "doi" => "10.1016/j.ad.2011.02.018" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731011003322?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012000595?idApp=UINPBA000044" "url" => "/15782190/0000010300000001/v1_201304241248/S1578219012000595/v1_201304241248/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Anogenital Granulomatosis" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor:</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "76" "paginaFinal" => "79" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M. Villar, G. Petiti, A. Guerra, F. Vanaclocha" "autores" => array:4 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "Villar" "email" => array:1 [ 0 => "mariavb20@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "G." "apellidos" => "Petiti" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Guerra" ] 3 => array:2 [ "nombre" => "F." "apellidos" => "Vanaclocha" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Dermatología, Hospital Universitario 12 de octubre, Madrid, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Granulomatosis anogenitales" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1367 "Ancho" => 1301 "Tamanyo" => 535322 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A) Lymphocytic infiltrate occupying the reticular dermis, showing granulomatous structures without central necrosis (hematoxylin–eosin, original magnification ×12.5). (B) Detail of a granuloma composed of multinucleated giant cells and epithelioid cells and surrounded by lymphocytes (hematoxylin–eosin, original magnification ×400). (C) Dense lymphocytic infiltrate occupying a mucous membrane (hematoxylin–eosin, original magnification ×40). (D) At higher magnification, epithelioid cells are seen forming nonnecrotizing granulomas (hematoxylin–eosin, original magnification ×400).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Chronic recurrent granulomatous processes in the anogenital area present with ulcers, fissures, and lymphedema; histopathology reveals nonnecrotizing granulomatous inflammation. Crohn disease is the most common etiologic factor, but cases in which no underlying cause is evident have been grouped under the term anogenital granulomatosis.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The first case we report is that of a 52-year-old woman with excrescent lesions that had a pseudocondylomatous appearance and fissures in the gluteal cleft that had started 6 months earlier. The lesions were excised but she did not return until 5 years later, when she sought care for chronic recurrent vulvar and perineal lesions. She had ulcers, marked edema of the vulva, longitudinal fissures in the folds, and indurated plaques that were excrescent in the gluteal cleft (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Histopathology of both the vulvar and the perianal areas revealed a lymphocytic infiltrate in the reticular dermis with nonnecrotizing granulomas consisting of multinucleated giant cells (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A and B). Additional tests, including complete blood count, biochemistry, chest radiograph, and cultures yielded no findings, except for an elevated erythrocyte sedimentation rate (ESR) of 52<span class="elsevierStyleHsp" style=""></span>mm/h. A colonoscopy with colorectal biopsies ruled out inflammatory bowel disease. The patient was treated with topical corticosteroids, salicylates, and oral corticosteroids; the lesions responded fully to the last treatment but recurred when they were suspended. She was subsequently treated with adalimumab (40<span class="elsevierStyleHsp" style=""></span>mg/15<span class="elsevierStyleHsp" style=""></span>d) but showed no response after 4 months. Fifteen years after the initial episode the patient had not developed systemic symptoms.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The second case is that of a 51-year-old woman who presented with painful erosions and vulvar edema dating from 5 months earlier. For 6 years she had also had recurrent perianal suppurative plaques and fissures that had been diagnosed as hidradenitis suppurativa. Physical examination revealed the granulomatous appearance of the vulvar mucosa, erosions on the inside of the labia minora (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>), and longitudinal fissures in the gluteal cleft. Two vulvar biopsies revealed a dense lymphocytic infiltrate of epithelioid cells and multinucleated giant cells forming granulomas without central necrosis (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>C and D). Additional tests (complete blood count, biochemistry, cultures, and chest radiograph) were normal or negative, except for a slightly elevated ESR of 25<span class="elsevierStyleHsp" style=""></span>mm/h. Crohn disease was ruled out after colonoscopy with biopsies. The patient had no systemic symptoms during the 18 months of follow-up and responded partially to treatment with oral corticosteroids but showed no response to salicylates or to adalimumab (40<span class="elsevierStyleHsp" style=""></span>mg/15<span class="elsevierStyleHsp" style=""></span>d), which was therefore suspended after 3 months.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The differential diagnosis of chronic granulomatous diseases in the perineum includes extraintestinal Crohn disease, although this condition is unlikely in the absence of intestinal symptoms or perianal fistulas and with normal colonoscopy.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Other possible differential diagnoses are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. In view of the clinical presentation, the first diagnostic steps should be biopsy to obtain a specimen for histology (on the basis of special stains and cultures for fungi, bacteria, and mycobacteria). Additional tests useful to rule out underlying causes include complete blood count, biochemistry, iron profile, ESR, angiotensin-converting enzyme levels, serology for syphilis, and chest radiograph. Colonoscopy is recommended, even in the absence of digestive symptoms.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Chronic genital granulomatosis without direct communication with the gastrointestinal tract can be observed in metastatic Crohn disease. This condition is the least common cutaneous manifestation of Crohn disease and consists of skin lesions separated from the digestive tract by healthy skin. It usually affects women between the second and fourth decades of life and can appear anywhere, including on the genitals, although the lower limbs are the most frequent location.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Clinical manifestations in the genital region are similar to those observed in our patients.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Lesions are associated with involvement of the colon or rectum<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> but usually do not follow a course that runs parallel to the intestinal disease. Chronic genital granulomatosis is associated with long-standing intestinal Crohn disease in 80% of cases.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,6</span></a> When the granulomatous process presents first, intestinal involvement usually develops within 4 months to 2 years. The literature offers at least 5 cases<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> of cutaneous Crohn disease in the absence of previously recognized intestinal disease, which did not appear during follow-up either. Some authors nonetheless recommend reserving this diagnosis for cases in which intestinal involvement has been demonstrated.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Orofacial granulomatosis or cheilitis granulomatosa, considered a monosymptomatic form of Melkersson–Rosenthal syndrome, shares some of the clinical and histological features of the anogenital granulomatosis in our 2 cases. Cheilitis granulomatosa presents as persistent and recurrent labial swelling; nonnecrotizing granulomas are sometimes associated with ulceration and gingival hyperplasia or cobblestoning. Anogenital granulomatosis has been suggested to be the genital equivalent of cheilitis granulomatosa<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and although the co-occurrence of these 2 conditions in the same patient is rare, it has been reported.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> In 10%–48% of cases cheilitis granulomatosa and intestinal Crohn disease are associated.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The term anogenital granulomatosis<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> was introduced in 2003 to identify these chronic recurrent conditions with characteristic clinical and histopathologic features that may have different causes. This clinical entity is a unifying concept for others used in the literature (chronic hypertrophic vulvitis, vulvitis granulomatosa, chronic edema of the vulva, Melkersson–Rosenthal vulvitis and anoperineitis granulomatosa) and is especially useful for cases of unknown etiology and those highly suggestive of metastatic Crohn disease in the absence of established intestinal disease.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Therapeutic management of this condition is difficult and there is no set protocol to follow because of the lack of case series and randomized trials. Suggested treatments have obtained mixed and sometimes unsatisfactory results marked by frequent relapse after treatment is discontinued. The reported options include topical, intralesional, and oral corticosteroids,<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> salicylates, antibiotics<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> such as metronidazole<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,10</span></a> and ciprofloxacin,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and immunosuppressants such as azathioprine and ciclosporin.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,3</span></a> More recently, anti-tumor necrosis factor monoclonal antibodies such as infliximab and adalimumab have given good results.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">We have reported 2 cases of idiopathic anogenital granulomatosis in which possible underlying causes were ruled out and no associated systemic symptoms developed even after years of follow-up.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Villar M, Petiti G, Guerra A, Vanaclocha F. Granulomatosis anogenitales. Actas Dermosifiliogr. 2012;103:76–79.</p>" ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 830 "Ancho" => 1301 "Tamanyo" => 181332 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Vulva, showing numerous ulcers, fissures arranged longitudinally in the folds, and edema of the labia majora, labia minora, and clitoral hood. In the gluteal cleft, excrescent plaques with a pseudocondylomatous appearance and longitudinal cracks.</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" => 1367 "Ancho" => 1301 "Tamanyo" => 535322 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A) Lymphocytic infiltrate occupying the reticular dermis, showing granulomatous structures without central necrosis (hematoxylin–eosin, original magnification ×12.5). (B) Detail of a granuloma composed of multinucleated giant cells and epithelioid cells and surrounded by lymphocytes (hematoxylin–eosin, original magnification ×400). (C) Dense lymphocytic infiltrate occupying a mucous membrane (hematoxylin–eosin, original magnification ×40). (D) At higher magnification, epithelioid cells are seen forming nonnecrotizing granulomas (hematoxylin–eosin, original magnification ×400).</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" => 696 "Ancho" => 1301 "Tamanyo" => 166194 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Edematous vulvar mucosa, with a granulomatous appearance. Erosions on the inner surface of the labia minora.</p>" ] ] 3 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "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"><td 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" style="border-bottom: 2px solid black">Noninfectious Causes \t\t\t\t\t\t\n \t\t\t\t</td><td 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" style="border-bottom: 2px solid black">Infectious Causes \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><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">Crohn disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Tuberculosis \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">Sarcoidosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lymphogranuloma venereum \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">Foreign body granuloma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Granuloma inguinale \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">Hidradenitis suppurativa \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Syphilis \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">Behçet disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Leprosy \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">Pyoderma gangrenosum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Deep mycoses \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">Lymphoproliferative diseases \t\t\t\t\t\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"> \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">Melkersson–Rosenthal syndrome \t\t\t\t\t\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"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab181992.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Differential Diagnosis of Anogenital Granulomatosis.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ano-genital granulomatosis: the counterpart of oro-facial granulomatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.R. van der Scheur" 1 => "R.I. van der Waal" 2 => "I. van der Waal" 3 => "T.J. Stoof" 4 => "S.J. van Deventer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2003" "volumen" => "17" "paginaInicial" => "184" "paginaFinal" => "189" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12705748" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vulvitis granulomatosa and anoperineitis granulomatosa" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H. Hackel" 1 => "A.A. Hartmann" 2 => "G. Burg" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Dermatologica" "fecha" => "1991" "volumen" => "182" "paginaInicial" => "128" "paginaFinal" => "131" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2050234" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Metastatic Crohn's disease: a review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I. Palamaras" 1 => "J. El-Jabbour" 2 => "N. Pietropaolo" 3 => "P. Thomson" 4 => "S. Mann" 5 => "W. Robles" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1468-3083.2008.02741.x" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2008" "volumen" => "22" "paginaInicial" => "1033" "paginaFinal" => "1043" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18573158" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Enfermedad de Crohn metastásica: a propósito de un caso con afectación vulvar" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P. Gómez-Centeno" 1 => "L. Casas" 2 => "F. Valdés-Tascón" 3 => "C. Peteiro" 4 => "J. Toribio" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "1999" "volumen" => "90" "paginaInicial" => "100" "paginaFinal" => "103" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Linfedema vulvar: una manifestación infrecuente de la enfermedad de Crohn metastásica" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Bel Pla" 1 => "V. García-Patos Briones" 2 => "D. García Fernández" 3 => "G. Aparicio Español" 4 => "A. Castells Rodellas" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Gastroenterol Hepatol" "fecha" => "2001" "volumen" => "24" "paginaInicial" => "297" "paginaFinal" => "299" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11459566" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vulvar inflammation as the only clinical manifestation of Crohn disease in an 8-year-old girl" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Shannon" 1 => "S.L. Corbett" 2 => "C.M. Walsh" 3 => "R.F. Spitzer" 4 => "B.Y. Ngan" 5 => "S. Kives" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1542/peds.2009-1829" "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2010" "volumen" => "125" "paginaInicial" => "e1518" "paginaFinal" => "e1522" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20457677" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Granulomatous vulvitis, granulomatous cheilitis: a single diagnosis?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Thiriar" 1 => "E. Deroux" 2 => "N. Dourov" 3 => "L. Evrard" 4 => "M.O. Peny" 5 => "P. Simon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Dermatology" "fecha" => "1998" "volumen" => "196" "paginaInicial" => "455" "paginaFinal" => "458" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9669130" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Orofacial granulomatosis as the initial presentation of Crohn's disease in an adolescent" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T. Bogenrieder" 1 => "G. Rogler" 2 => "T. Vogt" 3 => "M. Landthaler" 4 => "W. Stolz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "68900" "Revista" => array:6 [ "tituloSerie" => "Dermatology" "fecha" => "2003" "volumen" => "206" "paginaInicial" => "273" "paginaFinal" => "278" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12673090" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Maladie de Crohn vulvaire: 3 observations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Fenniche" 1 => "M. Mokni" 2 => "S. Haouet" 3 => "A. Ben Osman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Dermatol Venereol" "fecha" => "1997" "volumen" => "124" "paginaInicial" => "629" "paginaFinal" => "632" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9739928" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anogenital granulomatosis treated with ciprofloxacin" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Roé" 1 => "M.A. Barnadas" 2 => "P. Bergua" 3 => "F. Sancho" 4 => "L. Matas" 5 => "R. Paredes" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1468-3083.2008.02710.x" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2009" "volumen" => "23" "paginaInicial" => "89" "paginaFinal" => "90" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18384555" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010300000001/v1_201304241248/S1578219012000601/v1_201304241248/en/main.assets" "Apartado" => array:4 [ "identificador" => "6157" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case and Research Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010300000001/v1_201304241248/S1578219012000601/v1_201304241248/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012000601?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 12 | 10 | 22 |
| 2024 October | 99 | 39 | 138 |
| 2024 September | 90 | 24 | 114 |
| 2024 August | 124 | 51 | 175 |
| 2024 July | 87 | 40 | 127 |
| 2024 June | 92 | 36 | 128 |
| 2024 May | 81 | 40 | 121 |
| 2024 April | 78 | 23 | 101 |
| 2024 March | 95 | 30 | 125 |
| 2024 February | 87 | 46 | 133 |
| 2024 January | 94 | 41 | 135 |
| 2023 December | 72 | 15 | 87 |
| 2023 November | 72 | 28 | 100 |
| 2023 October | 52 | 19 | 71 |
| 2023 September | 59 | 29 | 88 |
| 2023 August | 45 | 19 | 64 |
| 2023 July | 86 | 35 | 121 |
| 2023 June | 54 | 21 | 75 |
| 2023 May | 63 | 26 | 89 |
| 2023 April | 64 | 21 | 85 |
| 2023 March | 57 | 18 | 75 |
| 2023 February | 41 | 18 | 59 |
| 2023 January | 36 | 29 | 65 |
| 2022 December | 57 | 40 | 97 |
| 2022 November | 46 | 23 | 69 |
| 2022 October | 37 | 29 | 66 |
| 2022 September | 27 | 27 | 54 |
| 2022 August | 11 | 29 | 40 |
| 2022 July | 21 | 29 | 50 |
| 2022 June | 23 | 29 | 52 |
| 2022 May | 48 | 23 | 71 |
| 2022 April | 65 | 41 | 106 |
| 2022 March | 60 | 48 | 108 |
| 2022 February | 72 | 28 | 100 |
| 2022 January | 79 | 36 | 115 |
| 2021 December | 62 | 35 | 97 |
| 2021 November | 70 | 41 | 111 |
| 2021 October | 85 | 39 | 124 |
| 2021 September | 59 | 42 | 101 |
| 2021 August | 77 | 43 | 120 |
| 2021 July | 65 | 28 | 93 |
| 2021 June | 61 | 28 | 89 |
| 2021 May | 48 | 41 | 89 |
| 2021 April | 121 | 83 | 204 |
| 2021 March | 70 | 28 | 98 |
| 2021 February | 99 | 30 | 129 |
| 2021 January | 48 | 16 | 64 |
| 2020 December | 50 | 23 | 73 |
| 2020 November | 40 | 31 | 71 |
| 2020 October | 28 | 20 | 48 |
| 2020 September | 47 | 17 | 64 |
| 2020 August | 31 | 21 | 52 |
| 2020 July | 20 | 26 | 46 |
| 2020 June | 38 | 24 | 62 |
| 2020 May | 28 | 20 | 48 |
| 2020 April | 42 | 22 | 64 |
| 2020 March | 35 | 106 | 141 |
| 2020 February | 6 | 182 | 188 |
| 2020 January | 6 | 19 | 25 |
| 2019 December | 4 | 9 | 13 |
| 2019 November | 4 | 52 | 56 |
| 2019 October | 0 | 2 | 2 |
| 2019 September | 0 | 7 | 7 |
| 2019 August | 4 | 1 | 5 |
| 2019 July | 4 | 4 | 8 |
| 2019 June | 4 | 17 | 21 |
| 2019 May | 5 | 47 | 52 |
| 2019 April | 2 | 43 | 45 |
| 2019 March | 2 | 20 | 22 |
| 2019 February | 0 | 10 | 10 |
| 2019 January | 2 | 11 | 13 |
| 2018 December | 3 | 3 | 6 |
| 2018 October | 3 | 0 | 3 |
| 2018 September | 1 | 1 | 2 |
| 2018 August | 0 | 10 | 10 |
| 2018 July | 0 | 15 | 15 |
| 2018 June | 0 | 8 | 8 |
| 2018 May | 0 | 18 | 18 |
| 2018 April | 0 | 3 | 3 |
| 2018 March | 6 | 8 | 14 |
| 2018 February | 48 | 12 | 60 |
| 2018 January | 55 | 8 | 63 |
| 2017 December | 60 | 6 | 66 |
| 2017 November | 62 | 10 | 72 |
| 2017 October | 38 | 13 | 51 |
| 2017 September | 41 | 26 | 67 |
| 2017 August | 73 | 14 | 87 |
| 2017 July | 74 | 8 | 82 |
| 2017 June | 87 | 19 | 106 |
| 2017 May | 82 | 10 | 92 |
| 2017 April | 69 | 15 | 84 |
| 2017 March | 55 | 18 | 73 |
| 2017 February | 136 | 29 | 165 |
| 2017 January | 64 | 14 | 78 |
| 2016 December | 80 | 20 | 100 |
| 2016 November | 114 | 25 | 139 |
| 2016 October | 127 | 18 | 145 |
| 2016 September | 145 | 12 | 157 |
| 2016 August | 101 | 11 | 112 |
| 2016 July | 70 | 7 | 77 |
| 2016 June | 11 | 15 | 26 |
| 2016 May | 4 | 8 | 12 |
| 2016 April | 9 | 1 | 10 |
| 2016 March | 7 | 1 | 8 |
| 2016 February | 11 | 4 | 15 |
| 2016 January | 9 | 3 | 12 |
| 2015 December | 9 | 1 | 10 |
| 2015 November | 14 | 7 | 21 |
| 2015 October | 16 | 2 | 18 |
| 2015 September | 15 | 1 | 16 |
| 2015 August | 20 | 5 | 25 |
| 2015 July | 94 | 12 | 106 |
| 2015 June | 86 | 8 | 94 |
| 2015 May | 110 | 12 | 122 |
| 2015 April | 110 | 12 | 122 |
| 2015 March | 99 | 11 | 110 |
| 2015 February | 71 | 8 | 79 |
| 2015 January | 83 | 15 | 98 |
| 2014 December | 111 | 17 | 128 |
| 2014 November | 79 | 8 | 87 |
| 2014 October | 104 | 22 | 126 |
| 2014 September | 84 | 11 | 95 |
| 2014 August | 78 | 22 | 100 |
| 2014 July | 87 | 15 | 102 |
| 2014 June | 109 | 11 | 120 |
| 2014 May | 119 | 15 | 134 |
| 2014 April | 91 | 13 | 104 |
| 2014 March | 94 | 19 | 113 |
| 2014 February | 73 | 23 | 96 |
| 2014 January | 80 | 24 | 104 |
| 2013 December | 35 | 7 | 42 |
| 2013 November | 22 | 12 | 34 |
| 2013 October | 17 | 5 | 22 |
| 2013 September | 13 | 6 | 19 |
| 2013 August | 11 | 11 | 22 |
| 2013 July | 11 | 7 | 18 |
| 2013 June | 19 | 20 | 39 |
| 2013 May | 15 | 9 | 24 |
| 2013 April | 15 | 14 | 29 |
| 2013 March | 16 | 7 | 23 |
| 2013 February | 68 | 9 | 77 |
| 2013 January | 60 | 6 | 66 |
| 2012 December | 18 | 3 | 21 |
| 2012 November | 1 | 0 | 1 |
| 2012 October | 0 | 2 | 2 |
| 2012 September | 0 | 3 | 3 |
Show all
