e- Case Report
Dermoscopic Findings in Trichoblastoma
Dermatoscopia del tricoblastoma
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Design of a double rhomboidal flap. B, Incision of both flaps in the subcutaneous plane. C, Immediate postoperative appearance; it can be seen that the mucosal advancement was insufficient. D, Twenty-four months after surgery. Mild labial incompetence.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.M. Otero-Rivas, T. Alonso-Alonso, A. Pérez-Bustillo, M.Á. Rodríguez-Prieto" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M.M." "apellidos" => "Otero-Rivas" ] 1 => array:2 [ "nombre" => "T." "apellidos" => "Alonso-Alonso" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Pérez-Bustillo" ] 3 => array:2 [ "nombre" => "M.Á." 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García-Díez, L. Curto-Barredo, K. Weller, R.M. Pujol, M. Maurer, A.M. Giménez-Arnau" "autores" => array:6 [ 0 => array:2 [ "nombre" => "I." "apellidos" => "García-Díez" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Curto-Barredo" ] 2 => array:2 [ "nombre" => "K." "apellidos" => "Weller" ] 3 => array:2 [ "nombre" => "R.M." "apellidos" => "Pujol" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Maurer" ] 5 => array:2 [ "nombre" => "A.M." 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Pitarch, R. Botella-Estrada" "autores" => array:2 [ 0 => array:4 [ "nombre" => "G." "apellidos" => "Pitarch" "email" => array:1 [ 0 => "gerardpitarch@hotmail.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" => "R." "apellidos" => "Botella-Estrada" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital General Universitari de Castelló, Castelló de la Plana, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Universitario La Fe, Valencia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Dermatoscopia del tricoblastoma" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 634 "Ancho" => 976 "Tamanyo" => 62706 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Dermoscopy findings for case 2. Poorly branching crown vessels with white striae and milia pseudocysts.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">INTRODUCTION</span><p id="par0005" class="elsevierStylePara elsevierViewall">Trichoblastoma is a benign cutaneous neoplasm that can appear on any surface with hair follicles, mainly the scalp and face. It generally appears as a solitary nonulcerated flesh-colored nodule measuring 1-2<span class="elsevierStyleHsp" style=""></span>cm and may have superficial telangiectases. Clinically, the differential diagnosis is mainly with basal cell carcinoma.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Case Descriptions</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Case 1</span><p id="par0010" class="elsevierStylePara elsevierViewall">The patient was a 68-year-old man with a history of multiple basal cell carcinomas on the face. Routine examination revealed a whitish plaque measuring 9<span class="elsevierStyleHsp" style=""></span>mm on the left temple. It had well-defined margins and was poorly infiltrated. Contact polarized light dermoscopy (DermLite FOTO, 3Gen LLC) with ultrasound gel as the interface medium revealed very short and fine telangiectases distributed randomly throughout the lesion on a pearly background (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Histopathology revealed basal cell nests of various sizes with pilar differentiation in the dermis. There was no contact with the epidermis. The tumor stroma was abundant and contained densely packed fibrocytes (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Case 2</span><p id="par0020" class="elsevierStylePara elsevierViewall">The second patient was a 52-year-old woman who consulted with a 4-mm wheal on her chin that had first appeared 8 months previously. Dermoscopy revealed scarcely branching, radially distributed short vessels arranged in a crown pattern and crossing a ring-like structure with white striae and white spots similar to milia cysts (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Histopathology revealed basal cell tumor nests throughout the dermis, although there was no contact with the epidermis. The stroma was dense and contained a high number of fibroblasts (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>).</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Discussion</span><p id="par0030" class="elsevierStylePara elsevierViewall">Trichoblastoma is a benign cutaneous tumor that differentiates toward hair follicle germinative cells. Trichoepithelioma, desmoplastic trichoepithelioma, and cutaneous lymphadenoma (adamantinoid trichoblastoma) are histopathologic variants of trichoblastoma. Histology reveals follicular papillae and bulbs, as well as abundant stroma containing densely packed fibrocytes.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">1,2</span></a> In clinical and histopathological terms, the differential diagnosis of trichoblastoma is with nodular basal cell carcinoma.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Dermoscopy is very useful for the diagnosis of cutaneous tumors. In the cases reported here, the main dermoscopic structure observed was fine, short, and scarcely branching telangiectases. This structure has been observed in other basal cell skin tumors, such as trichoepithelioma, desmoplastic trichoepithelioma, fibroepithelioma of Pinkus, and, particularly, basal cell carcinoma, as well as in other cutaneous tumors (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">3,4</span></a> In a sample of 531 melanocytic and nonmelanocytic cutaneous tumors with a vascular pattern in dermoscopy, branching vessels were described in 82.1% of basal cell carcinomas, 16.7% of sebaceous hyperplasias, 3.2% of dermal or congenital melanocytic nevi, 2.4% of seborrheic keratoses, and 0.7% of melanomas.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">5</span></a> Even though branching telangiectases are a common finding in many cutaneous neoplasms, they are wider in caliber and tend to branch more in nodular basal cell carcinomas, unlike neoplasms included under the term trichoblastoma (trichoblastoma, “classic” trichoepithelioma, and desmoplastic trichoepithelioma), in that they are thin and scarcely branching.<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">6–8</span></a> Superficial basal cell carcinoma is also characterized by fine, short telangiectases, generally against a whitish-red background and with multiple small erosions; however, in clinical terms, they are not usually included in the differential diagnosis, since the lesions are flat and nonnodular, like trichoblastomas. The branches in sclerodermiform basal cell carcinoma tend to be finer and less disperse than the arborizing telangiectases that are typical of nodular or cystic basal cell carcinoma. Furthermore, in sclerodermiform basal cell carcinoma, the telangiectases are located on a whitish background with poorly defined margins, in contrast with the translucent, pink, and well-defined background of solid or cystic basal cell carcinoma.<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">9,10</span></a> Fibroepithelioma of Pinkus is generally considered a variant of basal cell carcinoma, although some authors feel that it fits better with the concept of “fenestrated” trichoblastoma, or a retiform variant of trichoblastoma, than with basal cell carcinoma.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">11</span></a> Fibroepithelioma of Pinkus is characterized by fine arborizing vessels that are thinner and less branching than the telangiectases of basal cell carcinoma. Whitish striae, the white septal lines corresponding to the intense fibrosis of fibroepithelioma of Pinkus, are very common. Also frequent are the punctiform vessels that are more typical of melanocytic lesions (which in the present case appear on the periphery of the lesion and are always associated with fine arborizing vessels) and milia cysts associated with seborrheic keratosis.<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">12,13</span></a> Angiohistiocytoma or intraepidermal poroma may have arborizing telangiectases, even leaf-like structures, that make them almost clinically and dermoscopically identical to basal cell carcinoma.<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">14</span></a> Arborizing vessels have also been observed in epidermal cysts, although in these cases, their cystic appearance, the central pore, and the homogeneous color provide clear clues for a correct diagnosis.<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">10</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">The trichoblastomas described here also had crown vessels, a pearly background, milia cysts, and brilliant white striae. Given that these dermoscopy findings have also been reported in other basal cell skin tumors, no single dermoscopic finding can be considered pathognomic of trichoblastoma.</p><p id="par0045" class="elsevierStylePara elsevierViewall">The white structures observed in the cases of trichoblastoma we report seem to reflect the dermatoscopic image of their densely fibrous stroma, as is the case in trichoepithelioma, fibroepithelioma of Pinkus, and sclerodermiform basal cell carcinoma. Compared with the brilliant white background of the “classic” trichoepitheliomas, the pearly or ivory-colored background could be characteristic of desmoplastic trichoepithelioma; however, this finding is difficult to differentiate using dermoscopy, and interobserver agreement has never been assessed.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">15</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="par0050" class="elsevierStylePara elsevierViewall">The dermoscopy findings in the 2 cases of trichoblastoma described here have been observed in other basal cell neoplasms, such as trichoepithelioma, desmoplastic trichoepithelioma, fibroepithelioma of Pinkus, and, more commonly, basal cell carcinoma. The only dermoscopy finding common to the 2 cases was the presence of fine, short, poorly branching telangiectases. Although this vascular pattern has been observed in various neoplasms that are clinically similar to trichoblastoma, it could prove useful for differentiating this neoplasm from nodular basal cell carcinoma.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Ethical Disclosures</span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Protection of Persons and Animals</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors declare that this research did not involve experiments performed on humans or animals.</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Confidentiality of Data</span><p id="par0060" class="elsevierStylePara elsevierViewall">The authors declare that they have followed their hospital's protocol on the publication of data concerning patients.</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Right to privacy and informed consent</span><p id="par0065" class="elsevierStylePara elsevierViewall">The authors declare that no private patient data are disclosed in this article.</p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Conflicts of Interest</span><p id="par0070" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres576340" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec592998" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres576339" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec592997" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "INTRODUCTION" ] 5 => array:3 [ "identificador" => "sec0010" "titulo" => "Case Descriptions" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0015" "titulo" => "Case 1" ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Case 2" ] ] ] 6 => array:2 [ "identificador" => "sec0025" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0030" "titulo" => "Conclusions" ] 8 => array:3 [ "identificador" => "sec0035" "titulo" => "Ethical Disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0040" "titulo" => "Protection of Persons and Animals" ] 1 => array:2 [ "identificador" => "sec0045" "titulo" => "Confidentiality of Data" ] 2 => array:2 [ "identificador" => "sec0050" "titulo" => "Right to privacy and informed consent" ] ] ] 9 => array:2 [ "identificador" => "sec0055" "titulo" => "Conflicts of Interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec592998" "palabras" => array:4 [ 0 => "Dermoscopy" 1 => "Trichoblastoma" 2 => "Trichoepithelioma" 3 => "Basal cell carcinoma" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec592997" "palabras" => array:4 [ 0 => "Dermatoscopia" 1 => "Tricoblastoma" 2 => "Tricoepitelioma" 3 => "Carcinoma basocelular" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Trichoblastoma is a benign cutaneous neoplasm that is clinically and histologically similar to basal cell carcinoma. We report the dermoscopic features seen in 2 cases of facial trichoblastoma. One case presented with very short, delicate, scarcely branching telangiectases against a pearly white background. In the second case, the veins were also short and scarcely branching, but they were arranged in a crown pattern, with white striae and milia-like cysts. Although dermoscopic evidence of fine, scarcely branching telangiectases is not specific to a diagnosis of trichoblastoma, these features may be useful for differentiating this neoplasm from nodular basal cell carcinoma.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">El tricoblastoma es una neoplasia cutánea benigna, con un aspecto clínico e histológico similar al carcinoma basocelular nodular. Comunicamos los hallazgos dermatoscópicos de 2 casos de tricoblastomas localizados en la cara. Un caso presentaba telangiectasias muy finas y cortas, poco ramificadas, sobre un fondo blanquecino perlado. El otro caso mostraba vasos cortos y poco ramificados dispuestos en corona, con estrías blancas y puntos similares a quistes de milium. Aunque las telangiectasias finas y poco ramificadas no son un criterio específico del tricoblastoma, pueden resultar útiles en el diagnóstico diferencial frente al carcinoma basocelular nodular.</p></span>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Pitarch G, Botella-Estrada R. Dermatoscopia del tricoblastoma. Actas Dermosifiliogr. 2015;106:e45–e48.</p>" ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 732 "Ancho" => 976 "Tamanyo" => 77665 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Dermoscopy findings for case 1. Short, fine, poorly branching telangiectases on a pearly background.</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" => 732 "Ancho" => 976 "Tamanyo" => 325367 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Basal cell nests in dense stroma in the dermis (hematoxylin-eosin, ×40).</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" => 634 "Ancho" => 976 "Tamanyo" => 62706 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Dermoscopy findings for case 2. Poorly branching crown vessels with white striae and milia pseudocysts.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 732 "Ancho" => 976 "Tamanyo" => 324600 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Nests of basal cells in dense stroma with a high fibroblast count (hematoxylin-eosin, ×40).</p>" ] ] 4 => 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"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tumor \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">Vascular Pattern \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">Other Dermoscopy Findings \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">Trichoblastoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Small, fine arborizing telangiectases, crown vessels \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Pearly background, milia cysts, white striae, ulceration, brown globules \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">Desmoplastic trichoepithelioma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Thin and small, or prominent, arborizing telangiectases \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Ivory-colored or pearly background, brilliant white areas, keratin cysts \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">“Classic” trichoepithelioma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Small, fine arborizing telangiectases \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Brilliant white background, milia cysts \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">Fibroepithelioma of Pinkus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Fine arborizing vessels, punctiform vessels \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">White striae, structureless gray-brown areas with blue-gray spots, milia cysts, ulcers, comedones, negative maple leaf or spoke-wheel areas \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">Basal cell carcinoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Arborizing telangiectases, fine and short superficial telangiectases \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Ulcers, small multiple erosions, maple leaf, spoke-wheel areas, concentric structures, rainbow pattern, semitranslucence, brilliant milky-red areas, brilliant white areas, white lines and striaePigmented lesions: blue-gray ovoid nests, multiple blue-gray globules or spots, multiple brown-black globules or spots, blue-white veil \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab940665.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Dermatoscopy Findings for Cutaneous Neoplasms With Branching Telangiectasis.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:15 [ 0 => array:3 [ "identificador" => "bib0080" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neoplasias anexiales cutáneas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.C. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 10 | 15 |
| 2024 October | 147 | 55 | 202 |
| 2024 September | 139 | 60 | 199 |
| 2024 August | 205 | 111 | 316 |
| 2024 July | 184 | 78 | 262 |
| 2024 June | 145 | 66 | 211 |
| 2024 May | 130 | 67 | 197 |
| 2024 April | 119 | 60 | 179 |
| 2024 March | 152 | 59 | 211 |
| 2024 February | 139 | 59 | 198 |
| 2024 January | 101 | 54 | 155 |
| 2023 December | 124 | 38 | 162 |
| 2023 November | 144 | 63 | 207 |
| 2023 October | 127 | 57 | 184 |
| 2023 September | 153 | 59 | 212 |
| 2023 August | 139 | 37 | 176 |
| 2023 July | 161 | 60 | 221 |
| 2023 June | 204 | 48 | 252 |
| 2023 May | 322 | 57 | 379 |
| 2023 April | 185 | 33 | 218 |
| 2023 March | 112 | 43 | 155 |
| 2023 February | 161 | 69 | 230 |
| 2023 January | 163 | 69 | 232 |
| 2022 December | 139 | 73 | 212 |
| 2022 November | 86 | 49 | 135 |
| 2022 October | 96 | 61 | 157 |
| 2022 September | 105 | 104 | 209 |
| 2022 August | 57 | 66 | 123 |
| 2022 July | 45 | 65 | 110 |
| 2022 June | 24 | 36 | 60 |
| 2022 May | 114 | 57 | 171 |
| 2022 April | 101 | 47 | 148 |
| 2022 March | 138 | 65 | 203 |
| 2022 February | 139 | 36 | 175 |
| 2022 January | 189 | 75 | 264 |
| 2021 December | 97 | 66 | 163 |
| 2021 November | 142 | 66 | 208 |
| 2021 October | 119 | 78 | 197 |
| 2021 September | 112 | 53 | 165 |
| 2021 August | 96 | 54 | 150 |
| 2021 July | 85 | 42 | 127 |
| 2021 June | 87 | 39 | 126 |
| 2021 May | 97 | 32 | 129 |
| 2021 April | 214 | 62 | 276 |
| 2021 March | 139 | 31 | 170 |
| 2021 February | 128 | 35 | 163 |
| 2021 January | 80 | 34 | 114 |
| 2020 December | 91 | 31 | 122 |
| 2020 November | 65 | 22 | 87 |
| 2020 October | 78 | 30 | 108 |
| 2020 September | 86 | 32 | 118 |
| 2020 August | 56 | 31 | 87 |
| 2020 July | 67 | 29 | 96 |
| 2020 June | 57 | 47 | 104 |
| 2020 May | 47 | 38 | 85 |
| 2020 April | 72 | 40 | 112 |
| 2020 March | 40 | 35 | 75 |
| 2020 February | 1 | 14 | 15 |
| 2020 January | 4 | 14 | 18 |
| 2019 December | 10 | 9 | 19 |
| 2019 November | 4 | 15 | 19 |
| 2019 October | 0 | 10 | 10 |
| 2019 September | 4 | 25 | 29 |
| 2019 August | 4 | 18 | 22 |
| 2019 July | 4 | 31 | 35 |
| 2019 June | 4 | 41 | 45 |
| 2019 May | 10 | 64 | 74 |
| 2019 April | 2 | 52 | 54 |
| 2019 March | 4 | 26 | 30 |
| 2019 February | 5 | 15 | 20 |
| 2019 January | 3 | 10 | 13 |
| 2018 December | 5 | 8 | 13 |
| 2018 November | 7 | 1 | 8 |
| 2018 October | 3 | 1 | 4 |
| 2018 September | 5 | 8 | 13 |
| 2018 August | 0 | 12 | 12 |
| 2018 July | 0 | 23 | 23 |
| 2018 June | 0 | 11 | 11 |
| 2018 May | 0 | 7 | 7 |
| 2018 April | 1 | 4 | 5 |
| 2018 March | 5 | 9 | 14 |
| 2018 February | 73 | 14 | 87 |
| 2018 January | 81 | 13 | 94 |
| 2017 December | 58 | 20 | 78 |
| 2017 November | 58 | 17 | 75 |
| 2017 October | 53 | 10 | 63 |
| 2017 September | 48 | 6 | 54 |
| 2017 August | 44 | 25 | 69 |
| 2017 July | 66 | 23 | 89 |
| 2017 June | 49 | 22 | 71 |
| 2017 May | 45 | 16 | 61 |
| 2017 April | 42 | 20 | 62 |
| 2017 March | 28 | 36 | 64 |
| 2017 February | 40 | 40 | 80 |
| 2017 January | 32 | 14 | 46 |
| 2016 December | 42 | 6 | 48 |
| 2016 November | 49 | 17 | 66 |
| 2016 October | 32 | 17 | 49 |
| 2016 September | 0 | 9 | 9 |
| 2016 August | 0 | 3 | 3 |
| 2016 July | 2 | 3 | 5 |
| 2016 June | 2 | 5 | 7 |
| 2016 May | 1 | 3 | 4 |
| 2016 February | 0 | 4 | 4 |
| 2016 January | 0 | 4 | 4 |
| 2015 November | 0 | 5 | 5 |
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