Case and Research Letters
Verruciform Xanthoma Associated with Reactivation of Epstein-Barr Virus
Xantoma verruciforme asociado a reactivación de virus de Epstein-Barr
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Maldonado-Cid, L. Noguera-Morel, M.J. Beato-Merino, R. de Lucas-Laguna" "autores" => array:4 [ 0 => array:4 [ "nombre" => "P." "apellidos" => "Maldonado-Cid" "email" => array:1 [ 0 => "pmaldonadocid@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "L." "apellidos" => "Noguera-Morel" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "M.J." "apellidos" => "Beato-Merino" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "R." "apellidos" => "de Lucas-Laguna" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Universitario La Paz, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Universitario La Paz, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Xantoma verruciforme asociado a reactivación de virus de Epstein-Barr" ] ] "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" => 682 "Ancho" => 900 "Tamanyo" => 102671 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Whitish sessile lesion with a verrucous surface on the left lateral border of the tongue.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Verruciform xanthoma is a rare benign tumor first described by Shafer<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> in 1971. It usually arises on the oral mucosa.</p><p id="par0010" class="elsevierStylePara elsevierViewall">An 11-year-old boy was referred to our outpatient clinic for evaluation of a lesion that had been present on the tongue for 6 weeks and was slightly tender on palpation. The child had been diagnosed with acute myeloblastic leukemia 4 years earlier and had received 2 allogeneic bone marrow transplants, the first 3 months after the diagnosis and the second 3 years later. At the time we saw the patient, he was in complete remission, with full chimera of the transplant, and he had never presented signs of graft-versus-host disease (GVHD). He had not received immunosuppressant treatment for the previous 7 months.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Physical examination revealed an elevated, oval-shaped, sessile tumor with a long axis of about 2<span class="elsevierStyleHsp" style=""></span>cm. The tumor was located on the left lateral surface of the tongue and had a whitish, verrucous surface that was not ulcerated (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Two months before the lesion appeared, asymptomatic reactivation of Epstein-Barr virus (EBV) infection had been detected, evidenced by an increase in the viral load on serial measurements performed as part of the routine follow-up of the patient's hematologic disease.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Biopsy showed verrucous acanthosis with hyperkeratosis and isolated plaques of parakeratosis, and there were numerous foamy histiocytes in the dermal papillae (<a class="elsevierStyleCrossRefs" href="#fig0010">Figs. 2 and 3</a>). The lesion was diagnosed as verrucous xanthoma.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">The tumor was completely excised and there were no signs of recurrence during 2 months of follow-up.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Verrucous xanthoma usually presents clinically as a slow-growing asymptomatic lesion with a yellowish, reddish, or gray color, a rough surface with a granular or papillomatous appearance, a sessile or pedunculated base, and it can measure up to 2<span class="elsevierStyleHsp" style=""></span>cm in diameter.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a> The most common site is the oral mucosa,<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> although it can also arise on the genitalia<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,5</span></a> or, more rarely, on other sites of the skin. Approximately 70% of such tumors arising on the oral mucosa are located on the masticatory mucosa, followed by the hard palate and the tongue, as in our case.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> There have also been isolated cases of multifocal involvement of the skin and mucosas.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">With regard to the epidemiology of the tumor, it can occur at any age, though there is a slightly higher prevalence in middle age (40-60 years).<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Under 50 years of age, the incidence is slightly higher in men whereas, in the population over 50 years, these tumors are slightly more common in women; overall, the frequency is practically the same in men and women.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The clinical differential diagnosis should include condyloma acuminatum, common warts, and squamous cell carcinoma (including the verrucous form).<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> In our case, in view of the recent reactivation of EVB infection, we also considered the possibility of lymphoma.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Histology of verrucous xanthoma reveals a hyperkeratotic squamous epithelium with focal parakeratosis and no cellular atypia; foam cells are observed between elongated epithelial crests.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,6</span></a> These cells present a granular cytoplasm and the nucleus is typically eccentric. Immunohistochemistry of these cells is intensely positive for CD68 and negative for S-100.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3</span></a> Three histopathological patterns have been described: verrucous, papillary, and flat. The verrucous pattern is the most common.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The pathological differential diagnosis includes the common wart, lichen simplex chronicus, and eruptive xanthoma.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> There have been no previous reports of an association between this tumor and infection with EBV. However, there have been descriptions of patients in whom this lesion has arisen on previous mucosal or cutaneous lesions, such as oral lichen planus or mucosal GVHD.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Our patient did not have GVHD affecting the mucosa or any other previous lesions of the oral mucosa.</p><p id="par0060" class="elsevierStylePara elsevierViewall">The etiology and pathogenesis of verrucous xanthoma is not fully understood. It has been suggested that it may be an inflammatory reaction secondary to recurrent trauma, as the lesions mainly arise on areas subject to friction,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> or that the accumulation of foam cells in the dermis is the primary trigger, though no association with disorders of lipid metabolism has been found in the majority of the cases.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> No pathogenic role of the papillomavirus has been demonstrated.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Given the known association between EBV and the induction of other lesions of the oral mucosa, such as oral hairy leukoplakia, in immunosuppressed patients, we considered the possibility that the appearance of this lesion could have been related to reactivation of this virus in our patient.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> However, no pathogenic relationship between EBV and verrucous xanthoma has been described to date, and this could therefore be an incidental finding in our case.</p><p id="par0065" class="elsevierStylePara elsevierViewall">The treatment of choice is surgical excision of the lesion and recurrence is extremely rare.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">In summary, we have presented the case of a patient with a lingual tumor having the typical clinical and histopathological features of verrucous xanthoma. The patient presented recent reactivation of EBV infection, an association not previously described in the literature and which could therefore be a casual finding.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Maldonado-Cid P, et al. Xantoma verruciforme asociado a reactivación de virus de Epstein-Barr. Actas Dermosifiliogr 2013;104:445–6.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 682 "Ancho" => 900 "Tamanyo" => 102671 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Whitish sessile lesion with a verrucous surface on the left lateral border of the tongue.</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" => 641 "Ancho" => 900 "Tamanyo" => 196407 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Papillomatous acanthosis with hyperkeratosis and foci of parakeratosis (hematoxylin-eosin, original magnification x2).</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" => 1206 "Ancho" => 900 "Tamanyo" => 442733 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Dermal papillae with numerous foamy histiocytes. Neutrophils are present in the foci of parakeratosis (hematoxylin-eosin, original magnification x20).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Verruciform xanthoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "W.G. Shafer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Oral Surg Oral Med Oral Pathol" "fecha" => "1971" "volumen" => "31" "paginaInicial" => "784" "paginaFinal" => "789" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5280461" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Verruciform xanthoma of the oral mucosa. Report of four cases and a review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P.T. Oliveira" 1 => "R.G. Jaeger" 2 => "L.A. Cabral" 3 => "Y.R. Carvalho" 4 => "A.L. Costa" 5 => "M.M. Jaeger" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Oral Oncol" "fecha" => "2001" "volumen" => "37" "paginaInicial" => "326" "paginaFinal" => "331" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11287290" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Verruciform xanthoma--biological profile of 282 oral lesions based on a literature survey with nine new cases from Japan" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "H.P. Philipsen" 1 => "P.A. Reichart" 2 => "T. Takata" 3 => "I. Ogawa" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Oral Oncol" "fecha" => "2003" "volumen" => "39" "paginaInicial" => "325" "paginaFinal" => "336" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12676251" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Verruciform xanthoma of the scrotum in a renal transplant patient" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Kanitakis" 1 => "S. Euvrard" 2 => "A.C. Butnaru" 3 => "A. Claudy" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2004" "volumen" => "150" "paginaInicial" => "161" "paginaFinal" => "163" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14746641" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vulvar verruciform xanthoma: ten cases associated with lichen sclerosus, lichen planus, or other conditions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Fite" 1 => "F. Plantier" 2 => "N. Dupin" 3 => "M.F. Avril" 4 => "M. Moyal-Barracco" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archdermatol.2011.113" "Revista" => array:6 [ "tituloSerie" => "Arch Dermatol" "fecha" => "2011" "volumen" => "147" "paginaInicial" => "1087" "paginaFinal" => "1092" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21576553" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Disseminated verruciform xanthoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Sopena" 1 => "R. Gamo" 2 => "L. Iglesias" 3 => "J.L. Rodriguez-Peralto" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2133.2004.06164.x" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2004" "volumen" => "151" "paginaInicial" => "717" "paginaFinal" => "719" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15377372" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mucocutaneous manifestations of Epstein-Barr virus infection" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Mendoza" 1 => "M. Diamantis" 2 => "A. Arora" 3 => "B. Bartlett" 4 => "A. Gewirtzman" 5 => "A.M. Tremaine" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Clin Dermatol" "fecha" => "2008" "volumen" => "9" "paginaInicial" => "295" "paginaFinal" => "305" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18717604" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A persistent lower lip lesion. Verruciform xanthoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T.M. Colonna" 1 => "K.P. Fair" 2 => "J.W. Patterson" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Dermatol" "fecha" => "2000" "volumen" => "136" "paginaInicial" => "665" "paginaFinal" => "666" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10815863" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Verruciform xanthoma in an adolescent: a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.A. Frankel" 1 => "H.E. Rhodes" 2 => "E.D. Euscher" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/LGT.0b013e31822fcadd" "Revista" => array:6 [ "tituloSerie" => "J Low Genit Tract Dis" "fecha" => "2012" "volumen" => "16" "paginaInicial" => "70" "paginaFinal" => "74" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22126832" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010400000005/v1_201307051101/S1578219013001029/v1_201307051101/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/15782190/0000010400000005/v1_201307051101/S1578219013001029/v1_201307051101/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219013001029?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 8 | 10 | 18 |
| 2024 October | 81 | 45 | 126 |
| 2024 September | 88 | 28 | 116 |
| 2024 August | 122 | 103 | 225 |
| 2024 July | 97 | 48 | 145 |
| 2024 June | 121 | 56 | 177 |
| 2024 May | 83 | 57 | 140 |
| 2024 April | 83 | 44 | 127 |
| 2024 March | 71 | 38 | 109 |
| 2024 February | 72 | 45 | 117 |
| 2024 January | 65 | 38 | 103 |
| 2023 December | 68 | 33 | 101 |
| 2023 November | 76 | 61 | 137 |
| 2023 October | 97 | 44 | 141 |
| 2023 September | 71 | 47 | 118 |
| 2023 August | 51 | 29 | 80 |
| 2023 July | 82 | 46 | 128 |
| 2023 June | 57 | 24 | 81 |
| 2023 May | 77 | 36 | 113 |
| 2023 April | 66 | 25 | 91 |
| 2023 March | 68 | 24 | 92 |
| 2023 February | 70 | 19 | 89 |
| 2023 January | 52 | 40 | 92 |
| 2022 December | 68 | 34 | 102 |
| 2022 November | 32 | 43 | 75 |
| 2022 October | 28 | 30 | 58 |
| 2022 September | 20 | 59 | 79 |
| 2022 August | 22 | 51 | 73 |
| 2022 July | 24 | 49 | 73 |
| 2022 June | 37 | 36 | 73 |
| 2022 May | 53 | 42 | 95 |
| 2022 April | 67 | 44 | 111 |
| 2022 March | 81 | 76 | 157 |
| 2022 February | 42 | 35 | 77 |
| 2022 January | 49 | 69 | 118 |
| 2021 December | 28 | 55 | 83 |
| 2021 November | 52 | 70 | 122 |
| 2021 October | 64 | 66 | 130 |
| 2021 September | 38 | 42 | 80 |
| 2021 August | 72 | 42 | 114 |
| 2021 July | 50 | 49 | 99 |
| 2021 June | 29 | 39 | 68 |
| 2021 May | 45 | 40 | 85 |
| 2021 April | 60 | 67 | 127 |
| 2021 March | 57 | 29 | 86 |
| 2021 February | 65 | 35 | 100 |
| 2021 January | 45 | 18 | 63 |
| 2020 December | 35 | 18 | 53 |
| 2020 November | 30 | 27 | 57 |
| 2020 October | 35 | 9 | 44 |
| 2020 September | 33 | 11 | 44 |
| 2020 August | 26 | 17 | 43 |
| 2020 July | 27 | 17 | 44 |
| 2020 June | 36 | 22 | 58 |
| 2020 May | 26 | 24 | 50 |
| 2020 April | 35 | 29 | 64 |
| 2020 March | 24 | 20 | 44 |
| 2020 February | 5 | 2 | 7 |
| 2020 January | 4 | 10 | 14 |
| 2019 December | 8 | 5 | 13 |
| 2019 November | 4 | 8 | 12 |
| 2019 October | 0 | 3 | 3 |
| 2019 September | 8 | 3 | 11 |
| 2019 August | 4 | 3 | 7 |
| 2019 July | 4 | 4 | 8 |
| 2019 June | 6 | 16 | 22 |
| 2019 May | 5 | 47 | 52 |
| 2019 April | 2 | 10 | 12 |
| 2019 March | 2 | 9 | 11 |
| 2019 February | 2 | 3 | 5 |
| 2019 January | 2 | 1 | 3 |
| 2018 December | 0 | 7 | 7 |
| 2018 November | 1 | 3 | 4 |
| 2018 October | 3 | 0 | 3 |
| 2018 March | 2 | 1 | 3 |
| 2018 February | 40 | 3 | 43 |
| 2018 January | 62 | 3 | 65 |
| 2017 December | 48 | 10 | 58 |
| 2017 November | 46 | 2 | 48 |
| 2017 October | 52 | 3 | 55 |
| 2017 September | 49 | 6 | 55 |
| 2017 August | 76 | 5 | 81 |
| 2017 July | 63 | 11 | 74 |
| 2017 June | 78 | 8 | 86 |
| 2017 May | 89 | 2 | 91 |
| 2017 April | 69 | 8 | 77 |
| 2017 March | 61 | 9 | 70 |
| 2017 February | 53 | 3 | 56 |
| 2017 January | 40 | 7 | 47 |
| 2016 December | 52 | 7 | 59 |
| 2016 November | 77 | 7 | 84 |
| 2016 October | 76 | 10 | 86 |
| 2016 September | 117 | 13 | 130 |
| 2016 August | 68 | 10 | 78 |
| 2016 July | 37 | 4 | 41 |
| 2016 June | 7 | 9 | 16 |
| 2016 May | 7 | 4 | 11 |
| 2016 April | 4 | 12 | 16 |
| 2016 March | 3 | 8 | 11 |
| 2016 February | 5 | 8 | 13 |
| 2016 January | 9 | 10 | 19 |
| 2015 December | 7 | 6 | 13 |
| 2015 November | 21 | 11 | 32 |
| 2015 October | 21 | 11 | 32 |
| 2015 September | 17 | 7 | 24 |
| 2015 August | 8 | 4 | 12 |
| 2015 July | 108 | 16 | 124 |
| 2015 June | 78 | 24 | 102 |
| 2015 May | 50 | 14 | 64 |
| 2015 April | 43 | 9 | 52 |
| 2015 March | 31 | 3 | 34 |
| 2015 February | 36 | 10 | 46 |
| 2015 January | 45 | 6 | 51 |
| 2014 December | 40 | 7 | 47 |
| 2014 November | 33 | 9 | 42 |
| 2014 October | 39 | 17 | 56 |
| 2014 September | 22 | 14 | 36 |
| 2014 August | 38 | 11 | 49 |
| 2014 July | 43 | 8 | 51 |
| 2014 June | 40 | 8 | 48 |
| 2014 May | 35 | 15 | 50 |
| 2014 April | 33 | 6 | 39 |
| 2014 March | 41 | 11 | 52 |
| 2014 February | 41 | 8 | 49 |
| 2014 January | 41 | 6 | 47 |
| 2013 December | 41 | 16 | 57 |
| 2013 November | 18 | 9 | 27 |
| 2013 October | 19 | 3 | 22 |
| 2013 September | 34 | 4 | 38 |
| 2013 August | 19 | 4 | 23 |
| 2013 July | 8 | 2 | 10 |
| 2013 June | 2 | 1 | 3 |
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