Case and Research Letters
Erythema Multiforme Contact Dermatitis After Accidental Exposure to Acrylate-based Printing Inks
Eritema multiforme de contacto tras exposición accidental a acrilatos en tintas de impresión
S. Córdoba
, N. Puente, A. Calderón, J.M. Borbujo
Corresponding author
Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Madrid, Spain
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Córdoba, N. Puente, A. Calderón, J.M. Borbujo" "autores" => array:4 [ 0 => array:4 [ "nombre" => "S." "apellidos" => "Córdoba" "email" => array:1 [ 0 => "scordoba.hflr@salud.madrid.org" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "N." "apellidos" => "Puente" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Calderón" ] 3 => array:2 [ "nombre" => "J.M." "apellidos" => "Borbujo" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Eritema multiforme de contacto tras exposición accidental a acrilatos en tintas de impresión" ] ] "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" => 472 "Ancho" => 1300 "Tamanyo" => 114379 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A and B, Similar lesions on both thighs and the trunk (areas not exposed to direct contact with ink).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Acrylates are well recognized as allergens. People working in the graphic arts field are exposed to acrylate-based printing inks and are therefore at high risk for occupational allergic contact dermatitis to acrylates.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> The most commonly used acrylic monomers in the printing process are 2-hydroxyethyl acrylate, 2-hydroxypropyl acrylate, 2-hydroxypropyl methacrylate, 2-hydroxyethyl methacrylate, and 2-ethyl acrylate.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We present the case of a 26-year-old printing worker whose forearms came into contact with waste ink that spilled from a container. He was not exposed to sunlight or UV light and washed the affected area after the spill. Three days later, he began to experience intense pruritus, and vesicles began to appear on the wrists and forearms. The intensity of the lesions increased during the following days, with the appearance of multiple targetoid erythematous-edematous macules in the neighboring areas of the forearms and arms (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) and on the face, trunk, and extremities at some distance from the ink splashes (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The patient had no history of skin disease, infection, or ingestion of medication during the previous months.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Analysis of a biopsy specimen revealed vacuolar degeneration of the basement membrane, necrotic keratinocytes in the epidermis, exocytosis, and a predominantly perivascular, lymphocytic inflammatory dermal infiltrate with no spongiosis.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The suspected diagnosis was erythema multiforme contact dermatitis. Oral prednisone was prescribed, and the lesions improved gradually until they had completely resolved 2 weeks later leaving only scaling. A few hours after returning to work, he experienced a new outbreak, albeit of lesser intensity. The patient remains asymptomatic 7 months after being moved from his job.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Patch tests were performed using the standard series of the Spanish Contact Dermatitis and Skin Allergy Research Group (GEIDAC) and the Marti Tor meth(acrylate) series. Positive reactions were recorded for 2-hydroxyethyl methacrylate 1% petrolatum (pet), 2-hydroxyethyl acrylate 0.1% pet, 2-hydroxypropyl methacrylate 2% pet, ethyl acrylate 0.1% pet, and tetrahydrofurfuryl methacrylate 2% pet. No further positive reactions were recorded (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Although we did not have access to the ink that caused the initial reaction (SR238, Sartomer), the technical specifications of the product showed that it contained hexamethylene diacrylate. Therefore, diagnosis was confirmed as erythema multiforme contact dermatitis, probably caused by sensitization to hexamethylene diacrylate, with cross-reaction to other acrylates.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Erythema multiforme contact dermatitis is an uncommon condition that is caused by contact with vegetable allergens, metals, tropical woods, cosmetics, and chemicals.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> It is the most common noneczematous clinical presentation of allergic contact dermatitis. The initial lesions are eczematous in appearance and are found in the area of direct contact with the allergen. During the following days, targetoid, erythematous-vesicular, or urticarial lesions appear on the periphery of and at a distance from the area of the original contact. Histopathology findings are nonspecific. Spongiosis and exocytosis are common findings, although vacuolar degeneration of the basement membrane or epidermal necrolysis is more unusual.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Acrylate-induced allergic contact dermatitis usually manifests as eczematous dermatitis on the hands or fingertip dermatitis in patients who handle acrylates in the workplace.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">4–6</span></a> To date, only 1 case of acrylate-induced erythema multiforme contact dermatitis has been reported. The patient developed large blisters with skin detachment indicative of progress to toxic epidermal necrolysis.</p><p id="par0040" class="elsevierStylePara elsevierViewall">We present a case of acrylate-induced allergic contact dermatitis after accidental workplace exposure to printing ink. The case is interesting because of the curious nature of the presentation. We wish to highlight the importance of protective measures in industries where workers are required to handle acrylates. Workers should be aware that they are handling potent sensitizers that can lead to occupational disability.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of Interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as: Córdoba S, Puente N, Calderón A, Borbujo JM. Eritema multiforme de contacto tras exposición accidental a acrilatos en tintas de impresión. Actas Dermosifiliogr. 2015;106:684–685.</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" => 631 "Ancho" => 975 "Tamanyo" => 102884 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Targetoid erythematous macules on the forearm.</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" => 472 "Ancho" => 1300 "Tamanyo" => 114379 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A and B, Similar lesions on both thighs and the trunk (areas not exposed to direct contact with ink).</p>" ] ] 2 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Abbreviation: Pet, petrolatum.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">48 h \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">96 h \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleItalic">GEIDAC</span><a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a><span class="elsevierStyleItalic">standard series</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">− \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">− \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">MartiTor (meth)acrylate series \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2-hydroxyethyl methacrylate 1% pet \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">− \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">+ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2-hydroxyethyl acrylate 0.1% pet \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">++ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">++ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>2-hydroxypropyl methacrylate 2% pet \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">+ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">++ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Bisphenol A methacrylate 2% pet \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">− \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">− \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Butyl acrylate 0.1% pet \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">− \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">− \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ethylene glycol dimethacrylate 2% pet \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Methyl methacrylate 2% pet \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">− \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">− \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Triethylene glycol dimethacrylate 2% pet \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">− \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">− \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ethyl acrylate 0.1% pet \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">+ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">++ \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ethyl cyanoacrylate 10% pet \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">− \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">− \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Ethyl methacrylate 2% pet \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">− \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">− \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Tetrahydrofurfuryl methacrylate 2% pet \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">+ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">+ \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab908837.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Spanish Contact Dermatitis and Skin Allergy Research Group.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara 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Rycroft" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "titulo" => "Textbook of contact dermat." "paginaInicial" => "343" "paginaFinal" => "400" "edicion" => "2nd edn." "serieFecha" => "1999" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "1,6-hexanediol diacrylate: A rapid and potent sensitizer in the printing industry" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "V.A. Morgan" 1 => "J.M. Fewings" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Australas J Dermatol" "fecha" => "2000" "volumen" => "41" "paginaInicial" => "190" "paginaFinal" => "192" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10954995" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Toxic epidermal necrolysis following allergic contact dermatitis caused by occupational exposure to ultraviolet-cured inks" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T. Ido" 1 => "T. Kiyohara" 2 => "H. Takahashi" 3 => "Y. Yamaguchi" 4 => "D. Tani" 5 => "M. 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Alegre" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2008" "volumen" => "99" "paginaInicial" => "788" "paginaFinal" => "794" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19091218" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010600000008/v1_201510011018/S1578219015002048/v1_201510011018/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/15782190/0000010600000008/v1_201510011018/S1578219015002048/v1_201510011018/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219015002048?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 8 | 9 | 17 |
| 2024 October | 121 | 51 | 172 |
| 2024 September | 101 | 34 | 135 |
| 2024 August | 220 | 62 | 282 |
| 2024 July | 202 | 38 | 240 |
| 2024 June | 132 | 44 | 176 |
| 2024 May | 82 | 37 | 119 |
| 2024 April | 81 | 25 | 106 |
| 2024 March | 85 | 32 | 117 |
| 2024 February | 72 | 33 | 105 |
| 2024 January | 67 | 28 | 95 |
| 2023 December | 59 | 31 | 90 |
| 2023 November | 94 | 41 | 135 |
| 2023 October | 59 | 22 | 81 |
| 2023 September | 77 | 42 | 119 |
| 2023 August | 77 | 18 | 95 |
| 2023 July | 103 | 38 | 141 |
| 2023 June | 86 | 24 | 110 |
| 2023 May | 109 | 37 | 146 |
| 2023 April | 60 | 22 | 82 |
| 2023 March | 65 | 29 | 94 |
| 2023 February | 52 | 26 | 78 |
| 2023 January | 57 | 21 | 78 |
| 2022 December | 74 | 57 | 131 |
| 2022 November | 58 | 39 | 97 |
| 2022 October | 54 | 18 | 72 |
| 2022 September | 53 | 44 | 97 |
| 2022 August | 39 | 38 | 77 |
| 2022 July | 62 | 49 | 111 |
| 2022 June | 48 | 44 | 92 |
| 2022 May | 92 | 65 | 157 |
| 2022 April | 84 | 50 | 134 |
| 2022 March | 82 | 49 | 131 |
| 2022 February | 84 | 24 | 108 |
| 2022 January | 92 | 33 | 125 |
| 2021 December | 71 | 34 | 105 |
| 2021 November | 51 | 48 | 99 |
| 2021 October | 68 | 49 | 117 |
| 2021 September | 56 | 28 | 84 |
| 2021 August | 58 | 40 | 98 |
| 2021 July | 58 | 34 | 92 |
| 2021 June | 66 | 38 | 104 |
| 2021 May | 33 | 25 | 58 |
| 2021 April | 64 | 93 | 157 |
| 2021 March | 75 | 34 | 109 |
| 2021 February | 70 | 22 | 92 |
| 2021 January | 65 | 32 | 97 |
| 2020 December | 35 | 24 | 59 |
| 2020 November | 34 | 19 | 53 |
| 2020 October | 31 | 17 | 48 |
| 2020 September | 37 | 18 | 55 |
| 2020 August | 34 | 20 | 54 |
| 2020 July | 34 | 16 | 50 |
| 2020 June | 46 | 26 | 72 |
| 2020 May | 26 | 12 | 38 |
| 2020 April | 38 | 18 | 56 |
| 2020 March | 27 | 14 | 41 |
| 2020 February | 3 | 4 | 7 |
| 2019 December | 4 | 2 | 6 |
| 2019 October | 0 | 2 | 2 |
| 2019 September | 4 | 0 | 4 |
| 2019 August | 0 | 1 | 1 |
| 2019 July | 0 | 2 | 2 |
| 2019 June | 0 | 1 | 1 |
| 2019 May | 3 | 15 | 18 |
| 2019 April | 0 | 1 | 1 |
| 2019 March | 2 | 3 | 5 |
| 2019 February | 1 | 0 | 1 |
| 2019 January | 2 | 0 | 2 |
| 2018 December | 3 | 0 | 3 |
| 2018 October | 6 | 0 | 6 |
| 2018 September | 3 | 0 | 3 |
| 2018 April | 0 | 1 | 1 |
| 2018 March | 4 | 0 | 4 |
| 2018 February | 28 | 5 | 33 |
| 2018 January | 22 | 2 | 24 |
| 2017 December | 33 | 11 | 44 |
| 2017 November | 17 | 5 | 22 |
| 2017 October | 19 | 5 | 24 |
| 2017 September | 17 | 4 | 21 |
| 2017 August | 25 | 7 | 32 |
| 2017 July | 18 | 14 | 32 |
| 2017 June | 26 | 11 | 37 |
| 2017 May | 20 | 11 | 31 |
| 2017 April | 24 | 11 | 35 |
| 2017 March | 8 | 6 | 14 |
| 2017 February | 16 | 11 | 27 |
| 2017 January | 13 | 5 | 18 |
| 2016 December | 20 | 11 | 31 |
| 2016 November | 33 | 23 | 56 |
| 2016 October | 14 | 18 | 32 |
| 2016 September | 0 | 16 | 16 |
| 2016 August | 0 | 1 | 1 |
| 2016 July | 1 | 2 | 3 |
| 2016 June | 4 | 2 | 6 |
| 2016 May | 0 | 10 | 10 |
| 2016 April | 0 | 5 | 5 |
| 2016 March | 0 | 8 | 8 |
| 2016 February | 0 | 1 | 1 |
| 2015 November | 0 | 1 | 1 |
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