Case and Research Letter
Granulomatous Variant of Pigmented Purpura
Variante granulomatosa de púrpura pigmentada
Department of Dermatology, Shirakawa Kosei General Hospital, and Fukushima Medical University, Fukushima, Japan
Read
4563
Timeswas read the article
1598
Total PDF
2965
Total HTML
Share statistics
array:23 [ "pii" => "S1578219015003492" "issn" => "15782190" "doi" => "10.1016/j.adengl.2015.04.021" "estado" => "S300" "fechaPublicacion" => "2016-01-01" "aid" => "1237" "copyright" => "Elsevier España, S.L.U. and AEDV" "copyrightAnyo" => "2015" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2016;107:91-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 425 "formatos" => array:3 [ "EPUB" => 41 "HTML" => 286 "PDF" => 98 ] ] "Traduccion" => array:1 [ "en" => array:19 [ "pii" => "S0001731015003415" "issn" => "00017310" "doi" => "10.1016/j.ad.2015.04.019" "estado" => "S300" "fechaPublicacion" => "2016-01-01" "aid" => "1237" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2016;107:91-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 600 "formatos" => array:3 [ "EPUB" => 41 "HTML" => 235 "PDF" => 324 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>" "titulo" => "Granulomatous Variant of Pigmented Purpura" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "91" "paginaFinal" => "92" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Variante granulomatosa de púrpura pigmentada" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 964 "Ancho" => 1300 "Tamanyo" => 196035 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Clinical features of purpuric lesions on the right and left shin. (B) Close-up view.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "H. Hakenoshita, T. Yamamoto" "autores" => array:2 [ 0 => array:2 [ "nombre" => "H." "apellidos" => "Hakenoshita" ] 1 => array:2 [ "nombre" => "T." "apellidos" => "Yamamoto" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219015003492" "doi" => "10.1016/j.adengl.2015.04.021" "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/S1578219015003492?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731015003415?idApp=UINPBA000044" "url" => "/00017310/0000010700000001/v1_201512300105/S0001731015003415/v1_201512300105/en/main.assets" ] ] "itemAnterior" => array:19 [ "pii" => "S1578219015003480" "issn" => "15782190" "doi" => "10.1016/j.adengl.2015.05.023" "estado" => "S300" "fechaPublicacion" => "2016-01-01" "aid" => "1236" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2016;107:88-90" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 621 "formatos" => array:3 [ "EPUB" => 43 "HTML" => 425 "PDF" => 153 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>" "titulo" => "Intradermal Lipoblastoma-Like Tumor of the Lip in an Adult Woman" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "88" "paginaFinal" => "90" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Lipoblastoma intradérmico tumor tipo en el labio de una mujer adulta" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "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" => 1415 "Ancho" => 1050 "Tamanyo" => 364001 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Multivacuolated and univacuolated lipoblasts constitute most of the dermal fat tissue. Mature adipocytes are scant (hematoxylin and eosin, original magnification ×200).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.F. Val-Bernal, S. Hermana, R. Sánchez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "J.F." "apellidos" => "Val-Bernal" ] 1 => array:2 [ "nombre" => "S." "apellidos" => "Hermana" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Sánchez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0001731015003403" "doi" => "10.1016/j.ad.2015.05.013" "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/S0001731015003403?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219015003480?idApp=UINPBA000044" "url" => "/15782190/0000010700000001/v2_201704190205/S1578219015003480/v2_201704190205/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>" "titulo" => "Granulomatous Variant of Pigmented Purpura" "tieneTextoCompleto" => true "saludo" => "Dear Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "91" "paginaFinal" => "92" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "H. Hakenoshita, T. Yamamoto" "autores" => array:2 [ 0 => array:2 [ "nombre" => "H." "apellidos" => "Hakenoshita" ] 1 => array:4 [ "nombre" => "T." "apellidos" => "Yamamoto" "email" => array:1 [ 0 => "toyamade@fmu.ac.jp" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Department of Dermatology, Shirakawa Kosei General Hospital, and Fukushima Medical University, Fukushima, Japan" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Variante granulomatosa de púrpura pigmentada" ] ] "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" => 964 "Ancho" => 1300 "Tamanyo" => 196035 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Clinical features of purpuric lesions on the right and left shin. (B) Close-up view.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report the case of an elderly man with a granulomatous variant of chronic pigmented purpura who presented with papular lesions on the lower legs.</p><p id="par0010" class="elsevierStylePara elsevierViewall">A 78-year-old Japanese man complained of asymptomatic eruptions of 2 years’ duration on his lower legs. He had no history of systemic granulomatous disease and had not taken any drugs. Physical examination showed a number of purpuric papular lesions on both shins (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and B). The lesions were tiny, ranging from the size of a pinhead to 5<span class="elsevierStyleHsp" style=""></span>mm, and were both isolated and arranged in clusters. Laboratory data, which included blood cell counts, biochemical liver and renal function tests, and lipid, cholesterol, and triglyceride levels were normal. Histologic examination revealed extravasation of red blood cells, hemosiderin deposition, and dense inflammatory cell infiltration in the upper dermis (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A). The infiltrate was composed of mononuclear cells, histiocytes, and giant cells (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>B), and immunohistochemistry revealed a number of CD3<span class="elsevierStyleSup">+</span> T cells, with a predominance of CD4<span class="elsevierStyleSup">+</span> cells. There were also CD8<span class="elsevierStyleSup">+</span> T cells scattered among the granulomatous lesions (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>C–E) and abundant CD68<span class="elsevierStyleSup">+</span> cells at the periphery of the cellular infiltrates (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>F). Vasculitis was not observed. Special stains for microorganisms were all negative. The purpuric lesions were resistant to treatment with topical corticosteroids.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Several cases of granulomatous pigmented purpura have been described since the entity was first reported by Saito and Matsuoka.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> Most of the cases have involved Asian people, but there have been few reports from Japan.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> Although the clinical features described in the original report included lichen aureus-like brown coalesced hemorrhagic papules on the dorsum of the feet,<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> additional features such as macules, papules, plaques, and pigmentation have been reported. Apart from the typical clinical features of chronic pigmented purpura, our patient also had a number of papular lesions on both shins, similarly to a previously reported case.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> The age of the patients with granulomatous pigmented purpura described in the literature ranges from 22 to 78 years old (present case), with disease duration varying from 2 months to 20 years. In addition to the lower extremities, there have also been rare reports of lesions on the wrists,<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> forearms, and lower back.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">In our case, histologic features showed dense cellular infiltrates composed of lymphocytes and histiocytes in the upper dermis. CD4<span class="elsevierStyleSup">+</span> cells were predominant among the CD3<span class="elsevierStyleSup">+</span> T cells, C, and CD68<span class="elsevierStyleSup">+</span> histiocytes surrounded the cellular infiltrates in the upper dermis. What triggered the granulomatous reaction is not clear, but the long-term chronic course may have had a role. Hyperlipidemia has been reported in several cases,<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> and other studies have suggested that lipid microdroplets may induce an inflammatory reaction of the microvasculature.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> Drugs have also been suggested as possible triggers and have been implicated as causative factors of pigmented purpura. In addition, there have been reports of an association with antinuclear antibody and rheumatoid factor positivity, and regulatory T cells were attributed a possible role in the induction of granulomatous changes in pigmented purpura in a patient with Sjögren syndrome.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> In our case, associations with systemic autoimmune diseases, hyperlipidemia, and drug intake were all ruled out. Further studies are necessary to investigate the triggering events and etiology of granulomatous reactions in pigmented purpura.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 964 "Ancho" => 1300 "Tamanyo" => 196035 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Clinical features of purpuric lesions on the right and left shin. (B) Close-up view.</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" => 1439 "Ancho" => 1950 "Tamanyo" => 559753 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A) Histological features showing focal dense cellular infiltrates in the upper dermis. (B) Higher magnification showed lymphohistiocytic infiltration with giant cells. The immunohistochemistry study revealed a number of CD3<span class="elsevierStyleSup">+</span> (C), CD4<span class="elsevierStyleSup">+</span> (D), CD8<span class="elsevierStyleSup">+</span> (E), and CD68<span class="elsevierStyleSup">+</span> (F) cells.</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" => "Granulomatous pigmented purpuric dermatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Saito" 1 => "Y. Matsuoka" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Dermatol" "fecha" => "1996" "volumen" => "23" "paginaInicial" => "551" "paginaFinal" => "555" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8854588" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Granulomatous pigmented purpuric dermatitis associated with primary Sjögren's syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C. Wakusawa" 1 => "T. Fujimura" 2 => "T. Haga" 3 => "S. Aiba" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2340/00015555-1380" "Revista" => array:7 [ "tituloSerie" => "Acta Derm Venereol" "fecha" => "2013" "volumen" => "93" "paginaInicial" => "95" "paginaFinal" => "96" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22717995" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109712042398" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Granulomatous pigmented purpura: an unusual histological variant" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.J.J. Kerns" 1 => "B.D. Mallatt" 2 => "H.N. Shamma" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/DAD.0b013e31817e23c9" "Revista" => array:6 [ "tituloSerie" => "Am J Dermatopathol" "fecha" => "2009" "volumen" => "31" "paginaInicial" => "77" "paginaFinal" => "80" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19155731" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0050" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Granulomatous variant of chronic pigmented purpuric dermatoses: report of four new cases and an association with hyperlipidaemia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "W.L. Lin" 1 => "T.T. Kuo" 2 => "P.Y. Shih" 3 => "W.C. Lin" 4 => "W.R. Wong" 5 => "H.S. Hong" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2230.2007.02462.x" "Revista" => array:6 [ "tituloSerie" => "Clin Exp Dermatol" "fecha" => "2007" "volumen" => "32" "paginaInicial" => "513" "paginaFinal" => "515" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17535280" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Granulomatous pigmented purpura: report of a case and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Kaplan" 1 => "S. Burgin" 2 => "A. Sepehr" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1600-0560.2011.01744.x" "Revista" => array:6 [ "tituloSerie" => "J Cutan Pathol" "fecha" => "2011" "volumen" => "38" "paginaInicial" => "984" "paginaFinal" => "989" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21752054" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Persistent pigmented purpuric dermatitis: granulomatous variant" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E.K. MacQuarrie" 1 => "S. Pasternak" 2 => "M. Torok" 3 => "S. Veerassamy" 4 => "N.M.G. Walsh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1600-0560.2011.01793.x" "Revista" => array:7 [ "tituloSerie" => "J Cutan Pathol" "fecha" => "2011" "volumen" => "38" "paginaInicial" => "979" "paginaFinal" => "983" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21899591" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0735109712010698" "estado" => "S300" "issn" => "07351097" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010700000001/v2_201704190205/S1578219015003492/v2_201704190205/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/15782190/0000010700000001/v2_201704190205/S1578219015003492/v2_201704190205/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219015003492?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 15 | 7 | 22 |
| 2024 October | 79 | 38 | 117 |
| 2024 September | 60 | 28 | 88 |
| 2024 August | 84 | 48 | 132 |
| 2024 July | 67 | 41 | 108 |
| 2024 June | 71 | 27 | 98 |
| 2024 May | 61 | 37 | 98 |
| 2024 April | 66 | 31 | 97 |
| 2024 March | 78 | 33 | 111 |
| 2024 February | 58 | 35 | 93 |
| 2024 January | 48 | 32 | 80 |
| 2023 December | 47 | 18 | 65 |
| 2023 November | 58 | 23 | 81 |
| 2023 October | 45 | 17 | 62 |
| 2023 September | 48 | 33 | 81 |
| 2023 August | 34 | 10 | 44 |
| 2023 July | 51 | 25 | 76 |
| 2023 June | 49 | 24 | 73 |
| 2023 May | 48 | 23 | 71 |
| 2023 April | 45 | 15 | 60 |
| 2023 March | 51 | 25 | 76 |
| 2023 February | 38 | 20 | 58 |
| 2023 January | 40 | 22 | 62 |
| 2022 December | 59 | 42 | 101 |
| 2022 November | 26 | 22 | 48 |
| 2022 October | 19 | 16 | 35 |
| 2022 September | 22 | 34 | 56 |
| 2022 August | 30 | 28 | 58 |
| 2022 July | 21 | 30 | 51 |
| 2022 June | 26 | 29 | 55 |
| 2022 May | 30 | 18 | 48 |
| 2022 April | 44 | 34 | 78 |
| 2022 March | 42 | 51 | 93 |
| 2022 February | 45 | 28 | 73 |
| 2022 January | 35 | 39 | 74 |
| 2021 December | 28 | 32 | 60 |
| 2021 November | 40 | 39 | 79 |
| 2021 October | 43 | 47 | 90 |
| 2021 September | 29 | 33 | 62 |
| 2021 August | 37 | 19 | 56 |
| 2021 July | 31 | 29 | 60 |
| 2021 June | 31 | 15 | 46 |
| 2021 May | 38 | 33 | 71 |
| 2021 April | 87 | 31 | 118 |
| 2021 March | 82 | 27 | 109 |
| 2021 February | 113 | 22 | 135 |
| 2021 January | 56 | 16 | 72 |
| 2020 December | 52 | 17 | 69 |
| 2020 November | 59 | 19 | 78 |
| 2020 October | 50 | 5 | 55 |
| 2020 September | 51 | 15 | 66 |
| 2020 August | 47 | 15 | 62 |
| 2020 July | 48 | 19 | 67 |
| 2020 June | 43 | 33 | 76 |
| 2020 May | 26 | 20 | 46 |
| 2020 April | 29 | 13 | 42 |
| 2020 March | 14 | 18 | 32 |
| 2020 February | 6 | 0 | 6 |
| 2020 January | 4 | 1 | 5 |
| 2019 December | 4 | 1 | 5 |
| 2019 November | 4 | 1 | 5 |
| 2019 October | 0 | 2 | 2 |
| 2019 August | 6 | 0 | 6 |
| 2019 July | 4 | 0 | 4 |
| 2019 June | 4 | 0 | 4 |
| 2019 May | 6 | 1 | 7 |
| 2019 April | 2 | 0 | 2 |
| 2019 March | 2 | 3 | 5 |
| 2019 January | 2 | 0 | 2 |
| 2018 October | 3 | 0 | 3 |
| 2018 September | 5 | 0 | 5 |
| 2018 March | 1 | 1 | 2 |
| 2018 February | 14 | 1 | 15 |
| 2018 January | 26 | 5 | 31 |
| 2017 December | 24 | 7 | 31 |
| 2017 November | 12 | 3 | 15 |
| 2017 October | 13 | 4 | 17 |
| 2017 September | 8 | 1 | 9 |
| 2017 August | 21 | 6 | 27 |
| 2017 July | 18 | 9 | 27 |
| 2017 June | 18 | 5 | 23 |
| 2017 May | 14 | 3 | 17 |
| 2017 April | 15 | 6 | 21 |
| 2017 March | 5 | 7 | 12 |
| 2017 February | 9 | 6 | 15 |
| 2017 January | 8 | 6 | 14 |
| 2016 December | 10 | 3 | 13 |
| 2016 November | 15 | 0 | 15 |
| 2016 October | 8 | 13 | 21 |
| 2016 April | 0 | 1 | 1 |
| 2016 January | 0 | 2 | 2 |
Show all
