Case for Diagnosis
Pink Papules Arranged Linearly
Pápulas rosadas de distribución lineal
Read
5011
Timeswas read the article
1895
Total PDF
3116
Total HTML
Share statistics
array:24 [ "pii" => "S1578219015002553" "issn" => "15782190" "doi" => "10.1016/j.adengl.2015.09.020" "estado" => "S300" "fechaPublicacion" => "2015-11-01" "aid" => "1172" "copyright" => "Elsevier España, S.L.U. and AEDV" "copyrightAnyo" => "2014" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2015;106:755-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 913 "formatos" => array:3 [ "EPUB" => 44 "HTML" => 510 "PDF" => 359 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731015002021" "issn" => "00017310" "doi" => "10.1016/j.ad.2014.12.025" "estado" => "S300" "fechaPublicacion" => "2015-11-01" "aid" => "1172" "copyright" => "Elsevier España, S.L.U. y AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2015;106:755-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 655 "formatos" => array:3 [ "EPUB" => 4 "HTML" => 447 "PDF" => 204 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Casos para el diagnóstico</span>" "titulo" => "Pápulas rosadas de distribución lineal" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "755" "paginaFinal" => "756" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Pink Papules Arranged Linearly" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 676 "Ancho" => 500 "Tamanyo" => 92973 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Pápulas de agrupación lineal en axila derecha.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L. Campos-Muñoz, R. Ramírez-Mora, E. López-Bran" "autores" => array:3 [ 0 => array:2 [ "nombre" => "L." "apellidos" => "Campos-Muñoz" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Ramírez-Mora" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "López-Bran" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219015002553" "doi" => "10.1016/j.adengl.2015.09.020" "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/S1578219015002553?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731015002021?idApp=UINPBA000044" "url" => "/00017310/0000010600000009/v1_201511040159/S0001731015002021/v1_201511040159/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219015002590" "issn" => "15782190" "doi" => "10.1016/j.adengl.2015.09.024" "estado" => "S300" "fechaPublicacion" => "2015-11-01" "aid" => "1104" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Actas Dermosifiliogr. 2015;106:757-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1688 "formatos" => array:3 [ "EPUB" => 47 "HTML" => 721 "PDF" => 920 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Resident's Forum</span>" "titulo" => "Frontal Fibrosing Alopecia: An Update on Epidemiology and Treatment" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "757" "paginaFinal" => "758" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "FR – Alopecia frontal fibrosante: novedades epidemiológicas y terapéuticas" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Martínez-Pérez, M. Churruca-Grijelmo" "autores" => array:2 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Martínez-Pérez" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Churruca-Grijelmo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S000173101400516X" "doi" => "10.1016/j.ad.2014.12.002" "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/S000173101400516X?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219015002590?idApp=UINPBA000044" "url" => "/15782190/0000010600000009/v1_201511040157/S1578219015002590/v1_201511040157/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219015002565" "issn" => "15782190" "doi" => "10.1016/j.adengl.2015.09.021" "estado" => "S300" "fechaPublicacion" => "2015-11-01" "aid" => "1167" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2015;106:753-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 922 "formatos" => array:3 [ "EPUB" => 43 "HTML" => 634 "PDF" => 245 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case for Diagnosis</span>" "titulo" => "Scaly Erythematous Patches in a Patient With Down Syndrome" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "753" "paginaFinal" => "754" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Placas eritematodescamativas en paciente con síndrome de Down" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 550 "Ancho" => 735 "Tamanyo" => 107391 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "E. Hernández-Ruiz, A. García-Herrera, J. Ferrando" "autores" => array:3 [ 0 => array:2 [ "nombre" => "E." "apellidos" => "Hernández-Ruiz" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "García-Herrera" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Ferrando" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731015001970" "doi" => "10.1016/j.ad.2014.12.024" "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/S0001731015001970?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219015002565?idApp=UINPBA000044" "url" => "/15782190/0000010600000009/v1_201511040157/S1578219015002565/v1_201511040157/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case for Diagnosis</span>" "titulo" => "Pink Papules Arranged Linearly" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "755" "paginaFinal" => "756" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "L. Campos-Muñoz, R. Ramírez-Mora, E. López-Bran" "autores" => array:3 [ 0 => array:4 [ "nombre" => "L." "apellidos" => "Campos-Muñoz" "email" => array:1 [ 0 => "luciacampos78@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" => "Ramírez-Mora" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "E." "apellidos" => "López-Bran" "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 Clínico San Carlos, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Clínico San Carlos, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Pápulas rosadas de distribución lineal" ] ] "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" => 376 "Ancho" => 500 "Tamanyo" => 88862 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">CD1a, original magnification × 100.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Medical History</span><p id="par0005" class="elsevierStylePara elsevierViewall">An 8-year-old girl with no relevant past history presented with asymptomatic lesions on the right axilla that had remained stable since they first appeared 2 years earlier. The patient was asymptomatic.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Physical Examination</span><p id="par0010" class="elsevierStylePara elsevierViewall">Physical examination revealed several pink and brown papules arranged linearly on the floor of the right axilla (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Histopathology</span><p id="par0015" class="elsevierStylePara elsevierViewall">Histopathologic findings showed a dense dermal infiltrate composed of eosinophils, lymphocytes, and cells with abundant cytoplasm and reniform nuclei (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>), which were positive for S-100 and CD1a (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Additional Tests</span><p id="par0020" class="elsevierStylePara elsevierViewall">The following tests were carried out: complete blood count, biochemistry profile, skeletal survey, chest radiograph, abdominal ultrasound, and full physical examination. All results were normal.</p><p id="par0025" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">What Is Your Diagnosis?</span></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Diagnosis</span><p id="par0030" class="elsevierStylePara elsevierViewall">Unifocal Langerhans cell histiocytosis (LCH) of the skin (cutaneous eosinophilic granuloma).</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Clinical Course and Treatment</span><p id="par0035" class="elsevierStylePara elsevierViewall">The lesion was surgically excised and the patient has been followed up for 18 months with no local or systemic recurrence.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0040" class="elsevierStylePara elsevierViewall">LCH is characterized by an infiltrate of cells with Langerhans cell phenotype and can affect various organs, including the skin, mucosas, lymph nodes, liver, spleen, bone, digestive tract, thymus, and pituitary gland.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> According to some studies, skin lesions are present in up to 50% of patients in the initial stages of LCH and can therefore be decisive in establishing a diagnosis; however, because clinical presentation varies so widely, LCH is often not suspected.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">LCH has traditionally been classified as follows: eosinophilic granuloma (single-site disease), Hand-Schüller-Christian disease (chronic, progressive, multifocal disease), and Letterer-Siwe disease (acute, diffuse disease with a poor prognosis). In recent years, however, the Histiocyte Society has recommended classifying LCH by site and extent, as follows: type 1, unifocal; type 2, multifocal without involvement of the liver, spleen, lungs, or bone marrow; type 3, multifocal with involvement of the liver, spleen, lungs, and/or bone marrow, or age less than 2 years.</p><p id="par0050" class="elsevierStylePara elsevierViewall">The typical, classical LCH skin lesions are described as small, purpuric, infiltrated papules with a crusted or scaly surface on the scalp, face, flexures, genital region, and trunk. However, it should be noted that a wide variety of skin lesions of various morphologies can be found in LCH,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> including the following: blisters; vesicles; pustules; single or multiple papules that can be skin-colored, pink, xanthomatous, or purpuric; tumors; nail dystrophy;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> and mucosal ulcerations.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> As a result, the differential diagnosis is very extensive and includes Darier disease, cutaneous candidiasis, non-Langerhans cell histiocytosis, intertrigo, vasculitis, urticaria pigmentosa, sarcoidosis, mycosis fungoides, impetigo, folliculitis, herpes simplex, and chickenpox.</p><p id="par0055" class="elsevierStylePara elsevierViewall">LCH is diagnosed histologically. Skin lesions, because of their accessibility, are often the key to diagnosis. Histologic examination reveals an infiltrate of histiocytoid cells with reniform nuclei that express CD1a and S-100. Intracytoplasmic Birbeck granules are visible with electron microscopy. In the case of our patient, the late presentation of a supposed epidermal nevus at age 8 years prompted us to order the histologic study, which led us to the correct diagnosis.</p><p id="par0060" class="elsevierStylePara elsevierViewall">Unifocal forms of LCH are usually found on bone, most frequently the cranium and long bones. Unifocal manifestation on the skin—as in the reported case—is rare. These localized cases can be treated with nitrogen mustard, psoralen–UV-A therapy, surgery, intralesional corticosteroids, radiation therapy, or thalidomide.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Prognosis is determined by the number of organs involved and will be worse if the liver, lungs, or bone marrow are affected. Localized cutaneous forms of LCH have a good prognosis and rarely progress to multisystem disease.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:8 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Medical History" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Physical Examination" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Histopathology" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Additional Tests" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Diagnosis" ] 5 => array:2 [ "identificador" => "sec0030" "titulo" => "Clinical Course and Treatment" ] 6 => array:2 [ "identificador" => "sec0035" "titulo" => "Discussion" ] 7 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Campos-Muñoz L, Ramírez-Mora R, López-Bran E. Pápulas rosadas de distribución lineal. Actas Dermosifiliogr. 2015;106:755–756.</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" => 676 "Ancho" => 500 "Tamanyo" => 89192 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Papules arranged linearly in the right axilla.</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" => 763 "Ancho" => 500 "Tamanyo" => 199564 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, Hematoxylin-eosin, original magnification × 40. B, Hematoxylin-eosin, original magnification × 200.</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" => 376 "Ancho" => 500 "Tamanyo" => 88862 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">CD1a, original magnification × 100.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Langerhans cell histiocytosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Valdivielso" 1 => "C. Bueno" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2005" "volumen" => "96" "paginaInicial" => "275" "paginaFinal" => "284" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16476387" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0140673608614506" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical spectrum of cutaneous Langerhans’ cell histiocytosis mimicking various diseases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K. Querings" 1 => "H. Starz" 2 => "B. Balda" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2340/00015555-0003" "Revista" => array:6 [ "tituloSerie" => "Acta Derm Venereol" "fecha" => "2006" "volumen" => "86" "paginaInicial" => "39" "paginaFinal" => "43" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16585988" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Manifestations cutanées des histiocytoses langerhansiennes de l’enfant" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Rybojad" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0929-693X(08)71820-7" "Revista" => array:6 [ "tituloSerie" => "Arch Pediatr" "fecha" => "2008" "volumen" => "15" "paginaInicial" => "523" "paginaFinal" => "525" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18582659" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0050" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nail changes in Langerhans cell histiocytosis: A possible marker of multisystem disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Mataix" 1 => "I. Betlloch" 2 => "A. Lucas-Costa" 3 => "M. Pérez-Crespo" 4 => "C. Moscardó-Guilleme" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1525-1470.2008.00645.x" "Revista" => array:6 [ "tituloSerie" => "Pediatr Dermatol" "fecha" => "2008" "volumen" => "25" "paginaInicial" => "247" "paginaFinal" => "251" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18429791" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Eosinophilic granuloma of the skin: Response to intralesional corticosteroid injection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Myers" 1 => "C.R. Shea" 2 => "T. Krausz" 3 => "V. Petronic-Rosic" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Drugs Dermatol" "fecha" => "2007" "volumen" => "6" "paginaInicial" => "329" "paginaFinal" => "332" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17373196" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The natural history of skin-limited Langerhans cell histiocytosis: A single institution experience" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.J. Ehrhardt" 1 => "S.R. Humphrey" 2 => "M.E. Kelly" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MPH.0000000000000248" "Revista" => array:6 [ "tituloSerie" => "J Pediatr Hematol Oncol" "fecha" => "2014" "volumen" => "36" "paginaInicial" => "613" "paginaFinal" => "616" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25171449" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010600000009/v1_201511040157/S1578219015002553/v1_201511040157/en/main.assets" "Apartado" => array:4 [ "identificador" => "6171" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Cases for Diagnosis" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010600000009/v1_201511040157/S1578219015002553/v1_201511040157/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219015002553?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 5 | 10 | 15 |
| 2024 October | 70 | 31 | 101 |
| 2024 September | 98 | 26 | 124 |
| 2024 August | 102 | 76 | 178 |
| 2024 July | 82 | 37 | 119 |
| 2024 June | 94 | 32 | 126 |
| 2024 May | 72 | 29 | 101 |
| 2024 April | 74 | 22 | 96 |
| 2024 March | 81 | 27 | 108 |
| 2024 February | 70 | 34 | 104 |
| 2024 January | 71 | 35 | 106 |
| 2023 December | 74 | 18 | 92 |
| 2023 November | 66 | 27 | 93 |
| 2023 October | 79 | 29 | 108 |
| 2023 September | 78 | 29 | 107 |
| 2023 August | 54 | 13 | 67 |
| 2023 July | 53 | 31 | 84 |
| 2023 June | 53 | 26 | 79 |
| 2023 May | 52 | 18 | 70 |
| 2023 April | 49 | 14 | 63 |
| 2023 March | 68 | 28 | 96 |
| 2023 February | 61 | 21 | 82 |
| 2023 January | 32 | 36 | 68 |
| 2022 December | 52 | 44 | 96 |
| 2022 November | 37 | 26 | 63 |
| 2022 October | 31 | 27 | 58 |
| 2022 September | 28 | 36 | 64 |
| 2022 August | 30 | 33 | 63 |
| 2022 July | 30 | 39 | 69 |
| 2022 June | 34 | 35 | 69 |
| 2022 May | 34 | 35 | 69 |
| 2022 April | 31 | 25 | 56 |
| 2022 March | 41 | 39 | 80 |
| 2022 February | 27 | 22 | 49 |
| 2022 January | 30 | 28 | 58 |
| 2021 December | 25 | 30 | 55 |
| 2021 November | 30 | 45 | 75 |
| 2021 October | 29 | 40 | 69 |
| 2021 September | 21 | 36 | 57 |
| 2021 August | 18 | 18 | 36 |
| 2021 July | 24 | 22 | 46 |
| 2021 June | 19 | 25 | 44 |
| 2021 May | 25 | 14 | 39 |
| 2021 April | 45 | 54 | 99 |
| 2021 March | 51 | 21 | 72 |
| 2021 February | 73 | 26 | 99 |
| 2021 January | 31 | 15 | 46 |
| 2020 December | 23 | 12 | 35 |
| 2020 November | 29 | 20 | 49 |
| 2020 October | 21 | 18 | 39 |
| 2020 September | 30 | 17 | 47 |
| 2020 August | 30 | 11 | 41 |
| 2020 July | 30 | 12 | 42 |
| 2020 June | 27 | 18 | 45 |
| 2020 May | 17 | 12 | 29 |
| 2020 April | 30 | 18 | 48 |
| 2020 March | 32 | 14 | 46 |
| 2020 February | 7 | 0 | 7 |
| 2020 January | 4 | 2 | 6 |
| 2019 December | 9 | 3 | 12 |
| 2019 November | 4 | 10 | 14 |
| 2019 October | 0 | 5 | 5 |
| 2019 September | 8 | 10 | 18 |
| 2019 August | 1 | 8 | 9 |
| 2019 July | 5 | 13 | 18 |
| 2019 June | 6 | 20 | 26 |
| 2019 May | 5 | 21 | 26 |
| 2019 April | 2 | 22 | 24 |
| 2019 March | 2 | 12 | 14 |
| 2019 February | 3 | 4 | 7 |
| 2019 January | 3 | 4 | 7 |
| 2018 December | 4 | 5 | 9 |
| 2018 November | 1 | 8 | 9 |
| 2018 October | 5 | 0 | 5 |
| 2018 September | 6 | 0 | 6 |
| 2018 April | 0 | 2 | 2 |
| 2018 February | 21 | 2 | 23 |
| 2018 January | 19 | 7 | 26 |
| 2017 December | 35 | 13 | 48 |
| 2017 November | 18 | 6 | 24 |
| 2017 October | 30 | 4 | 34 |
| 2017 September | 16 | 3 | 19 |
| 2017 August | 39 | 13 | 52 |
| 2017 July | 29 | 10 | 39 |
| 2017 June | 37 | 7 | 44 |
| 2017 May | 31 | 7 | 38 |
| 2017 April | 26 | 7 | 33 |
| 2017 March | 21 | 62 | 83 |
| 2017 February | 19 | 4 | 23 |
| 2017 January | 19 | 4 | 23 |
| 2016 December | 23 | 17 | 40 |
| 2016 November | 23 | 21 | 44 |
| 2016 October | 27 | 11 | 38 |
| 2016 September | 0 | 1 | 1 |
| 2016 July | 0 | 1 | 1 |
| 2016 June | 1 | 1 | 2 |
| 2016 May | 4 | 1 | 5 |
| 2016 April | 0 | 1 | 1 |
| 2016 February | 0 | 1 | 1 |
| 2016 January | 0 | 2 | 2 |
| 2015 November | 0 | 4 | 4 |
Show all
