array:24 [
  "pii" => "S1578219016302414"
  "issn" => "15782190"
  "doi" => "10.1016/j.adengl.2016.05.027"
  "estado" => "S300"
  "fechaPublicacion" => "2016-12-01"
  "aid" => "1457"
  "copyright" => "Elsevier España, S.L.U. and AEDV"
  "copyrightAnyo" => "2016"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "ssu"
  "cita" => "Actas Dermosifiliogr. 2016;107:816-22"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 1382
    "formatos" => array:3 [
      "EPUB" => 45
      "HTML" => 957
      "PDF" => 380
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0001731016301831"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2016.06.001"
      "estado" => "S300"
      "fechaPublicacion" => "2016-12-01"
      "aid" => "1457"
      "copyright" => "AEDV"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "ssu"
      "cita" => "Actas Dermosifiliogr. 2016;107:816-22"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 510
        "formatos" => array:3 [
          "EPUB" => 3
          "HTML" => 377
          "PDF" => 130
        ]
      ]
      "es" => array:14 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Revisi&#243;n</span>"
        "titulo" => "Afectaci&#243;n cut&#225;nea en las micosis profundas&#58; una revisi&#243;n de la literatura&#46; Parte 2&#46; Micosis sist&#233;micas"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:3 [
          0 => "es"
          1 => "es"
          2 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "816"
            "paginaFinal" => "822"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Cutaneous involvement in the deep mycoses&#58; A review&#46; Part II &#8212;Systemic mycoses"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 1
          "multimedia" => array:5 [
            "identificador" => "fig0030"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => false
            "mostrarDisplay" => true
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "fx1.jpeg"
                "Alto" => 888
                "Ancho" => 1333
                "Tamanyo" => 143314
              ]
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "J&#46;E&#46; Carrasco-Zuber, C&#46; Navarrete-Dechent, A&#46; Bonifaz, F&#46; Fich, V&#46; Vial-Letelier, D&#46; Berroeta-Mauriziano"
            "autores" => array:6 [
              0 => array:2 [
                "nombre" => "J&#46;E&#46;"
                "apellidos" => "Carrasco-Zuber"
              ]
              1 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Navarrete-Dechent"
              ]
              2 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Bonifaz"
              ]
              3 => array:2 [
                "nombre" => "F&#46;"
                "apellidos" => "Fich"
              ]
              4 => array:2 [
                "nombre" => "V&#46;"
                "apellidos" => "Vial-Letelier"
              ]
              5 => array:2 [
                "nombre" => "D&#46;"
                "apellidos" => "Berroeta-Mauriziano"
              ]
            ]
          ]
        ]
        "resumen" => array:1 [
          0 => array:3 [
            "titulo" => "Graphical abstract"
            "clase" => "graphical"
            "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><elsevierMultimedia ident="fig0030"></elsevierMultimedia></p></span>"
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1578219016302414"
          "doi" => "10.1016/j.adengl.2016.05.027"
          "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/S1578219016302414?idApp=UINPBA000044"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731016301831?idApp=UINPBA000044"
      "url" => "/00017310/0000010700000010/v1_201611260105/S0001731016301831/v1_201611260105/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1578219016302384"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2016.05.025"
    "estado" => "S300"
    "fechaPublicacion" => "2016-12-01"
    "aid" => "1445"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "ssu"
    "cita" => "Actas Dermosifiliogr. 2016;107:823-9"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1980
      "formatos" => array:3 [
        "EPUB" => 56
        "HTML" => 1634
        "PDF" => 290
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Advances in Dermatology</span>"
      "titulo" => "Kidney Disease and Psoriasis&#46; A New Comorbidity&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "823"
          "paginaFinal" => "829"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Enfermedad renal y psoriasis&#46; &#191;Una nueva comorbilidad&#63;"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "E&#46; Gonz&#225;lez-Parra, E&#46; Daud&#233;n, J&#46;M&#46; Carrascosa, A&#46; Olveira, R&#46; Botella, C&#46; Bonanad, R&#46; Rivera"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Gonz&#225;lez-Parra"
            ]
            1 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Daud&#233;n"
            ]
            2 => array:2 [
              "nombre" => "J&#46;M&#46;"
              "apellidos" => "Carrascosa"
            ]
            3 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Olveira"
            ]
            4 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Botella"
            ]
            5 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Bonanad"
            ]
            6 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Rivera"
            ]
            7 => array:1 [
              "colaborador" => "for the Systemic Inflammation in Psoriasis Working Group"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731016301715"
        "doi" => "10.1016/j.ad.2016.05.009"
        "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/S0001731016301715?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219016302384?idApp=UINPBA000044"
    "url" => "/15782190/0000010700000010/v1_201611260103/S1578219016302384/v1_201611260103/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1578219016302402"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2016.05.026"
    "estado" => "S300"
    "fechaPublicacion" => "2016-12-01"
    "aid" => "1456"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "ssu"
    "cita" => "Actas Dermosifiliogr. 2016;107:806-15"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1890
      "formatos" => array:3 [
        "EPUB" => 46
        "HTML" => 1398
        "PDF" => 446
      ]
    ]
    "en" => array:14 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Review</span>"
      "titulo" => "Cutaneous Involvement in the Deep Mycoses&#58; A Literature Review&#46; Part I&#8212;Subcutaneous Mycoses"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:3 [
        0 => "en"
        1 => "en"
        2 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "806"
          "paginaFinal" => "815"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Afectaci&#243;n cut&#225;nea en las micosis profundas&#58; una revisi&#243;n de la literatura&#46; Parte 1&#58; micosis subcut&#225;neas"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 1
        "multimedia" => array:5 [
          "identificador" => "fig0030"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => false
          "mostrarDisplay" => true
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "fx1.jpeg"
              "Alto" => 772
              "Ancho" => 1333
              "Tamanyo" => 98146
            ]
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46;E&#46; Carrasco-Zuber, C&#46; Navarrete-Dechent, A&#46; Bonifaz, F&#46; Fich, V&#46; Vial-Letelier, D&#46; Berroeta-Mauriziano"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "J&#46;E&#46;"
              "apellidos" => "Carrasco-Zuber"
            ]
            1 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Navarrete-Dechent"
            ]
            2 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Bonifaz"
            ]
            3 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "Fich"
            ]
            4 => array:2 [
              "nombre" => "V&#46;"
              "apellidos" => "Vial-Letelier"
            ]
            5 => array:2 [
              "nombre" => "D&#46;"
              "apellidos" => "Berroeta-Mauriziano"
            ]
          ]
        ]
      ]
      "resumen" => array:1 [
        0 => array:3 [
          "titulo" => "Graphical abstract"
          "clase" => "graphical"
          "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><elsevierMultimedia ident="fig0030"></elsevierMultimedia></p></span>"
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S000173101630182X"
        "doi" => "10.1016/j.ad.2016.05.017"
        "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/S000173101630182X?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219016302402?idApp=UINPBA000044"
    "url" => "/15782190/0000010700000010/v1_201611260103/S1578219016302402/v1_201611260103/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Review</span>"
    "titulo" => "Cutaneous involvement in the Deep Mycoses&#58; A Review&#46; Part II&#8212;Systemic Mycoses"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "816"
        "paginaFinal" => "822"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "J&#46;E&#46; Carrasco-Zuber, C&#46; Navarrete-Dechent, A&#46; Bonifaz, F&#46; Fich, V&#46; Vial-Letelier, D&#46; Berroeta-Mauriziano"
        "autores" => array:6 [
          0 => array:4 [
            "nombre" => "J&#46;E&#46;"
            "apellidos" => "Carrasco-Zuber"
            "email" => array:1 [
              0 => "juaneduardocarrasco&#64;gmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "C&#46;"
            "apellidos" => "Navarrete-Dechent"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Bonifaz"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "F&#46;"
            "apellidos" => "Fich"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "V&#46;"
            "apellidos" => "Vial-Letelier"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "D&#46;"
            "apellidos" => "Berroeta-Mauriziano"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Unidad de Dermatolog&#237;a&#44; Cl&#237;nica Alemana de Valdivia&#44; Valdivia&#44; Chile"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Departamento de Dermatolog&#237;a&#44; Escuela de Medicina&#44; Pontificia Universidad Cat&#243;lica de Chile&#44; Santiago&#44; Chile"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Departamento de Micolog&#237;a&#44; Hospital General de M&#233;xico&#44; Ciudad de M&#233;xico&#44; Mexico"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Afectaci&#243;n cut&#225;nea en las micosis profundas&#58; una revisi&#243;n de la literatura&#46; Parte II&#46; Micosis sist&#233;micas"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 1
      "multimedia" => array:5 [
        "identificador" => "fig0030"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 888
            "Ancho" => 1333
            "Tamanyo" => 143314
          ]
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The systemic mycoses are infections caused by fungi that enter the body through an internal organ or a deep focus&#44; such as the lungs&#44; the digestive tract&#44; or the paranasal sinuses&#46; Infections can spread through the blood&#44; causing disseminated disease with frequent skin involvement&#46; There are 2 types of systemic mycoses&#58; opportunistic mycoses &#40;systemic candidiasis&#44; aspergillosis&#44; and systemic mucormycosis&#41; and endemic respiratory infections &#40;histoplasmosis&#44; blastomycosis&#44; coccidioidomycosis&#44; paracoccidioidomycosis&#44; and cryptococcosis&#41;&#46; In practice&#44; however&#44; it is difficult to distinguish between the 2 types as they tend to affect predisposed patients&#46; Accordingly&#44; they are generally studied together&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">In the second part of this review&#44; we discuss the main deep mycoses that produce cutaneous manifestations during the course of disease&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Mucormycosis</span><p id="par0015" class="elsevierStylePara elsevierViewall">Mucormycosis affects the visceral organs in immunosuppressed patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> It is caused by mucoraceous Zygomycetes and can lead to rhinocerebral&#44; cutaneous&#44; or pulmonary manifestations&#44; or disseminated disease&#46; The most common presentation is rhinocerebral mucormycosis&#44; which involves the nasal sinuses and causes palatal ulcers and extensive necrotic lesions involving the brain and skin&#46; Most cases are associated with decompensated diabetes mellitus or neutropenic states &#40;leukemia&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Clinical Forms</span><p id="par0020" class="elsevierStylePara elsevierViewall">Mucormycosis typically follows an acute&#44; rapidly progressive course associated with high mortality&#46; Rhinocerebral manifestations are the most common clinical presentation&#44; followed by pulmonary&#44; intestinal&#44; and cutaneous manifestations and dissemination&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Primary cutaneous manifestations are extremely rare and occur mainly at venipuncture sites&#59; they are therefore seen most often on the extremities&#46; Lesions present as papules or nodules that progress to ulcers with a necrotic center and a foul-smelling or purulent exudate&#46; Locally&#44; primary infection can affect the deep tissues &#40;muscle and bone&#41; and is highly destructive&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Secondary cutaneous manifestations are much more common in rhinocerebral mucormycosis&#44; with 25&#37; of patients developing palatal ulcers and extremely painful eyelid sinuses &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Diagnosis</span><p id="par0025" class="elsevierStylePara elsevierViewall">Direct mycological examination of necrotic material&#44; sputum&#44; bronchopulmonary lavage fluid&#44; paranasal sinus aspirate&#44; and skin scrapings shows long branching thin-walled cenocytic &#40;nonseptate&#41; hyphae &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Microorganisms grow quickly on Sabouraud dextrose agar &#40;SDA&#41; and can be identified on the basis of reproduction structures or by molecular biology techniques&#59; the most widely used technique is polymerase chain reaction &#40;PCR&#41; analysis of internal transcribed spacer &#40;ITS&#41; regions of ribosomal DNA &#40;rDNA&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;4</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Treatment</span><p id="par0030" class="elsevierStylePara elsevierViewall">Treatment is multifactorial and includes control of predisposing factors &#40;ketoacidosis&#44; neutropenia&#44; etc&#46;&#41;&#44; systemic antifungals&#44; and aggressive surgical debridement&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Potassium iodide&#44; ketoconazole&#44; and fluconazole are used for subcutaneous lesions and can be combined with trimethoprim-sulfametoxazole&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The antifungal of choice is amphotericin B and it can be used in association with caspofungin or posaconazole&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Paracoccidioidomycosis</span><p id="par0035" class="elsevierStylePara elsevierViewall">Paracoccidioidomycosis is a chronic&#44; subacute&#44; or&#44; in rare cases&#44; acute mycosis caused by <span class="elsevierStyleItalic">Paracoccidioides brasiliensis</span> and <span class="elsevierStyleItalic">Paracoccidioides lutzii</span>&#46; It affects the skin and visceral organs&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> This potentially fatal systemic granulomatous disease is considered endemic in Mexico&#44; Argentina&#44; Guyana&#44; Brazil&#44; Venezuela&#44; and Colombia&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a><span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">brasiliensis</span> is a dimorphic fungus that grows as mycelia in vegetation and soil in humid regions&#46; It is not known whether human-to-human transmission occurs&#46; The fungus enters the body through the respiratory system&#46; Infections acquired through inhalation can remain latent for 1 or 2 decades and reactivation is dependent on immune status&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#8211;8</span></a></p><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Clinical Forms</span><p id="par0040" class="elsevierStylePara elsevierViewall">Primary infection tends to be asymptomatic and can resolve or leave a residual lesion &#40;scar&#41;&#46; Symptomatic disease is a result of the parasite-host relationship in which the virulence of each strain has an important role&#46; Chronic paracoccidioidomycosis&#44; which typically affects adults&#44; is the most common form of disease &#40;&#62;90&#37; of patients develop lung lesions and metastases in diverse organs&#41;&#46; There is also an acute juvenile form characterized by pulmonary and reticuloendothelial involvement&#44; with enlarged lymph nodes&#44; hepatosplenomegaly&#44; and bone involvement&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Patients may also develop lesions in the oropharyngeal mucosa&#44; mimicking chronic tonsillitis&#44; periodontal and laryngeal lesions&#44; and perioral ulcero-vegetative lesions&#46; There may also be nodular cutaneous lesions that can become necrotic or result in subcutaneous cold abscesses &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> There have been reports of extragenital lesions mimicking syphilis sores&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">The differential diagnosis should include mucocutaneous leishmaniasis&#44; Wegener granulomatosis&#44; syphilis&#44; lymphoma&#44; sporotrichosis&#44; and scrofuloderma&#44; among other entities&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Diagnosis</span><p id="par0050" class="elsevierStylePara elsevierViewall">A diagnosis can be made by direct visualization of multiple budding of yeast cells forming a structure similar to a ship&#39;s wheel &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41; in sputum samples&#44; skin scrapings&#44; or pus&#46; The microorganisms grow over a period of 15 to 20 days on SDA with or without antibiotics&#44; producing white filamentous colonies with visible mycelia&#46; PCR analysis of tissue or serum targeting ITS<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> or other regions<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> can also be used for diagnosis&#46; Skin biopsy shows a suppurative cutaneous granulomatous inflammation and pseudoepitheliomatous hyperplasia&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Treatment</span><p id="par0055" class="elsevierStylePara elsevierViewall">Treatment includes long-term administration of amphotericin<span class="elsevierStyleHsp" style=""></span>B&#44; systemic triazoles&#44; and sulfonamides&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Coccidioidomycosis</span><p id="par0060" class="elsevierStylePara elsevierViewall">Coccidioidomycosis is caused by 2 dimorphic fungi&#58; <span class="elsevierStyleItalic">Coccidioides immitis</span> and <span class="elsevierStyleItalic">Coccidioides</span> posadasii&#46; The reservoir of the fungi is dry soil with an alkaline pH&#46; Coccidioidomycosis affects both humans and animals and the infection is acquired by inhalation of <span class="elsevierStyleItalic">C</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">immitis</span> arthroconidia from soil in endemic regions &#40;United States&#44; Mexico&#44; Argentina&#44; Paraguay&#44; Colombia&#44; Venezuela&#44; and Brazil&#41;&#46; The incubation period is 1 to 4 weeks&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;11&#44;12</span></a></p><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Clinical Forms</span><p id="par0065" class="elsevierStylePara elsevierViewall">Pulmonary involvement is the predominant clinical form of coccidioidomycosis&#44; but the infection can also affect the skin&#44; larynx&#44; bones&#44; joints&#44; and meninges&#46; Skin lesions are diverse and can present as papules&#44; pustules&#44; plaques&#44; abscesses&#44; sinus tracts &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#44; ulcers&#44; diffuse macular rash&#44; erythema multiforme&#44; or erythema nodosum&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#44;12</span></a></p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The differential diagnosis should include tuberculosis&#44; paracoccidioidomycosis&#44; sporotrichosis&#44; histoplasmosis&#44; and even neoplasms&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Diagnosis</span><p id="par0075" class="elsevierStylePara elsevierViewall">Culture and direct mycological examination show double-membrane spherules containing spores &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; The fungi can be cultivated on SDA with or without antibiotics&#44; although the procedure is dangerous due to the high risk of infection&#46; Colonies will show hyaline arthroconidia separated from each other by a disjunctor cell following lysis&#46; Histology is useful as it can detect spherules with endospores &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41; Serology with specific immunoglobulin &#40;Ig&#41; M antibodies in acute infections is diagnostic only after 4 weeks&#46; Coccidioidin skin tests and complement levels are also important diagnostic aids&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#44;12</span></a> Finally&#44; coccidioidomycosis can be diagnosed by PCR analysis of the 28S region of rDNA&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Treatment</span><p id="par0080" class="elsevierStylePara elsevierViewall">Treatment consists of deoxycholate or liposomal amphotericin&#44; itraconazole&#44; or fluconazole for 6 to 12 months&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Histoplasmosis</span><p id="par0085" class="elsevierStylePara elsevierViewall">American histoplasmosis or Darling disease is a systemic mycosis that is caused by the dimorphic fungus <span class="elsevierStyleItalic">Histoplasma capsulatum</span> var&#46; <span class="elsevierStyleItalic">capsulatum</span><a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> and primarily affects the reticuloendothelial system&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">The lung is the most common site of primary infection&#46; The fungus may subsequently spread to various organs&#44; including the skin&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> Histoplasmosis is the most common pulmonary fungal infection and it occurs worldwide&#44; with cases reported in over 60 countries&#46; The pathogen is particularly prevalent in regions with tropical climates&#44; such as Central and South America&#44; Eastern United States&#44; and South Mexico&#46; It is found in soil&#44; decomposing organic matter&#44; and in the droppings of bats &#40;typically in caves&#41;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> and some birds such as chickens&#44; turkeys&#44; pigeons&#44; and geese&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Clinical Forms</span><p id="par0095" class="elsevierStylePara elsevierViewall">Ninety-five percent of people infected with histoplasmosis do not show clinical manifestations&#46; In the acute form of disease&#44; symptoms range from flu-like symptoms to more complex manifestations with radiological images showing disseminated calcifications and findings similar to those seen in tuberculosis&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> Acute forms can progress to chronic forms&#44; which preferentially affect men aged over 50 years&#46; Acute disease is characterized by cough and expectoration but it is difficult to isolate <span class="elsevierStyleItalic">H capsulatum</span> in sputum&#46; Mucosal involvement is highly characteristic in chronic disseminated forms&#44; and ulcerative granulomatous lesions are common on the oral mucosa&#44; tongue&#44; nasal septum&#44; and larynx&#46; Finally&#44; meningoencephalitis and focal osteolysis in the metaphysis of long bones may be observed in acute disseminated histoplasmosis&#44; which typically affects patients with AIDS&#46; Around 11&#37; of patients with AIDS develop skin manifestations&#44;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> which tend to be disseminated and include papular lesions on the face and the trunk &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41; and&#44; sometimes&#44; ulcerative lesions on the mucosa&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a></p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Diagnosis</span><p id="par0100" class="elsevierStylePara elsevierViewall">The fungus can be isolated in blood&#44; bone marrow&#44; cerebrospinal fluid&#44; bone marrow aspirate&#44; or biopsy specimens of infected tissues&#46; Specimens can be inoculated on SDA with or without antibiotics&#46; Identification is also possible using molecular biology techniques such as PCR analysis of fungal DNA &#40;ITS or 18S rDNA&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17&#44;18</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">Direct examination of Giemsa-stained specimens shows characteristic intracellular yeast forms surrounded by a halo simulating a capsule &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Treatment</span><p id="par0110" class="elsevierStylePara elsevierViewall">Treatment consists of itraconazole for 6 to 24<span class="elsevierStyleHsp" style=""></span>months or amphotericin<span class="elsevierStyleHsp" style=""></span>B&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a></p></span></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Cryptococcosis</span><p id="par0115" class="elsevierStylePara elsevierViewall">Cryptococcosis is a systemic mycosis caused by an encapsulated yeast of the genus <span class="elsevierStyleItalic">Cryptococcus</span>&#46; The 2 most common species are <span class="elsevierStyleItalic">Cryptococcus neoformans</span> and <span class="elsevierStyleItalic">Cryptococcus gatii</span>&#46; The lungs are the main route of entry for the pathogen&#46; Clinical manifestations range from asymptomatic lung colonization to systemic dissemination&#46; The main clinical manifestation is meningoencephalitis&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#44;20</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">C neoformans</span> is typically found in soil and in pigeon and bat droppings&#46; In urban areas&#44; it is disseminated through domestic dust from trees&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Clinical Forms</span><p id="par0125" class="elsevierStylePara elsevierViewall">Inhaled yeasts and spores reach the alveolar spaces&#46; Subsequent development of disease will depend on the phagocytic efficacy of the macrophages and the host&#39;s immune response&#46; Clinical forms involve the lungs&#44; the central nervous system &#40;CNS&#41;&#44; or the mucocutaneous structures&#44; and may also be disseminated&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> Lung involvement tends to be asymptomatic&#44; nonspecific&#44; or similar to acute tuberculosis&#46; CNS cryptococcosis is the most common clinical form and presents as chronic meningitis&#44; meningoencephalitis&#44; or cerebral cryptococcal granuloma&#46; The mucocutaneous form is the result of the spread of infection from other foci in patients with disseminated disease&#46; It presents as subcutaneous papules and nodules &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#41; on the face and neck&#44; primarily in patients with human immunodeficiency virus infection in the advanced AIDS stage&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">15&#44;20</span></a></p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">Diagnosis can be challenging given the wide range of possible lesions&#46; The most common alternative diagnoses contemplated in the literature are molluscum contagiosum and herpes infections&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">These multiple polymorphic lesions&#44; which are common in patients with diseases such as AIDS&#44; lymphoma&#44; sarcoidosis&#44; and diabetes and in transplant recipients&#8212;and may also be due to multiple microorganisms&#8212;require an exhaustive study&#46;</p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Diagnosis</span><p id="par0140" class="elsevierStylePara elsevierViewall">Cryptococcus yeasts are large encapsulated cells that are best observed under the microscope with India ink &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#41; or Mayer mucicarmine stains&#46; The microorganisms grow on SDA within 24 to 48<span class="elsevierStyleHsp" style=""></span>hours or after a week&#46; Serology is fast and specific&#46; Immunological identification is also possible and one particularly effective test &#40;with a sensitivity and specificity of &#62;80&#37;&#41; is the latex agglutination test&#44; which searches for the cryptococcal capsular antigen in serum&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> Detection is also possible using different PCR assays<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> or MALDI-ToF mass spectrometry&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> The advantage of the latter is that positive results are identified almost immediately &#40;10<span class="elsevierStyleHsp" style=""></span>minutes&#41; and correlate 100&#37; with DNA sequencing results&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">24&#8211;26</span></a></p></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Treatment</span><p id="par0145" class="elsevierStylePara elsevierViewall">Treatment is with deoxycholate or liposomal amphotericin B&#44; with or without fluorocytosine or fluconazole&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p></span></span><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conclusions</span><p id="par0150" class="elsevierStylePara elsevierViewall">We have reviewed the cutaneous manifestations of the systemic mycoses &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Recognition of these manifestations is important&#44; as these infections are associated with high mortality&#46; Dermatologists can play an important role in ensuring an accurate diagnosis by recognizing the clinical signs or ordering an appropriate test&#44; such as a skin biopsy&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0115" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Conflicts of Interest</span><p id="par0155" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:14 [
        0 => array:3 [
          "identificador" => "xres762916"
          "titulo" => "Graphical abstract"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0005"
            ]
          ]
        ]
        1 => array:3 [
          "identificador" => "xres762917"
          "titulo" => "Abstract"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0010"
            ]
          ]
        ]
        2 => array:2 [
          "identificador" => "xpalclavsec764391"
          "titulo" => "Keywords"
        ]
        3 => array:3 [
          "identificador" => "xres762918"
          "titulo" => "Resumen"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0015"
            ]
          ]
        ]
        4 => array:2 [
          "identificador" => "xpalclavsec764392"
          "titulo" => "Palabras clave"
        ]
        5 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        6 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Mucormycosis"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Clinical Forms"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Diagnosis"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Treatment"
            ]
          ]
        ]
        7 => array:3 [
          "identificador" => "sec0030"
          "titulo" => "Paracoccidioidomycosis"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Clinical Forms"
            ]
            1 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Diagnosis"
            ]
            2 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Treatment"
            ]
          ]
        ]
        8 => array:3 [
          "identificador" => "sec0050"
          "titulo" => "Coccidioidomycosis"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Clinical Forms"
            ]
            1 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "Diagnosis"
            ]
            2 => array:2 [
              "identificador" => "sec0065"
              "titulo" => "Treatment"
            ]
          ]
        ]
        9 => array:3 [
          "identificador" => "sec0070"
          "titulo" => "Histoplasmosis"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0075"
              "titulo" => "Clinical Forms"
            ]
            1 => array:2 [
              "identificador" => "sec0080"
              "titulo" => "Diagnosis"
            ]
            2 => array:2 [
              "identificador" => "sec0085"
              "titulo" => "Treatment"
            ]
          ]
        ]
        10 => array:3 [
          "identificador" => "sec0090"
          "titulo" => "Cryptococcosis"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0095"
              "titulo" => "Clinical Forms"
            ]
            1 => array:2 [
              "identificador" => "sec0100"
              "titulo" => "Diagnosis"
            ]
            2 => array:2 [
              "identificador" => "sec0105"
              "titulo" => "Treatment"
            ]
          ]
        ]
        11 => array:2 [
          "identificador" => "sec0110"
          "titulo" => "Conclusions"
        ]
        12 => array:2 [
          "identificador" => "sec0115"
          "titulo" => "Conflicts of Interest"
        ]
        13 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-01-07"
    "fechaAceptado" => "2016-05-29"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec764391"
          "palabras" => array:5 [
            0 => "Paracoccidioidomycosis"
            1 => "Coccidioidomycosis"
            2 => "Histoplasmosis"
            3 => "Mucormycosis"
            4 => "Cryptococcosis"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec764392"
          "palabras" => array:5 [
            0 => "Paracoccidioidomicosis"
            1 => "Coccidioidomicosis"
            2 => "Histoplasmosis"
            3 => "Mucormicosis"
            4 => "Criptococosis"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">In the second part of this review on the deep mycoses&#44; we describe the main systemic mycoses&#8212;paracoccidioidomycosis&#44; coccidioidomycosis&#44; histoplasmosis&#44; mucormycosis&#44; and cryptococcosis&#8212;and their cutaneous manifestations&#46; Skin lesions are only occasionally seen in deep systemic mycoses either directly&#44; when the skin is the route of entry for the fungus&#44; or indirectly&#44; when the infection has spread from a deeper focus&#46; These cutaneous signs are often the only clue to the presence of a potentially fatal infection&#46; As with the subcutaneous mycoses&#44; early diagnosis and treatment is important&#44; but in this case&#44; even more so&#46;</p></span>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0015" class="elsevierStyleSection elsevierViewall"><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En la segunda parte de este art&#237;culo se revisan las principales micosis sist&#233;micas y sus manifestaciones cut&#225;neas&#58; paracoccidioidomicosis&#44; coccidioidomicosis&#44; histoplasmosis&#44; mucormicosis y criptococosis&#46; Las micosis sist&#233;micas presentan lesiones en la piel solo en algunas ocasiones&#44; ya sea por afectaci&#243;n directa de ella como puerta de entrada o tras la diseminaci&#243;n de la infecci&#243;n a partir de un foco profundo&#46; Muchas veces estos signos cut&#225;neos ser&#225;n la &#250;nica pista para el diagn&#243;stico certero de patolog&#237;as potencialmente fatales&#46; Por lo mismo&#44; y con mucho mayor &#233;nfasis que las micosis tratadas en la primera parte&#44; es importante saber reconocer y tratar las micosis sist&#233;micas&#46;</p></span>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Carrasco-Zuber JE&#44; Navarrete-Dechent C&#44; Bonifaz A&#44; Fich F&#44; Vial-Letelier V&#44; Berroeta-Mauriziano D&#46; Afectaci&#243;n cut&#225;nea en las micosis profundas&#58; una revisi&#243;n de la literatura&#46; Parte II&#46; Micosis sist&#233;micas&#46; 2016&#59;107&#58;816&#8211;822&#46;</p>"
      ]
    ]
    "multimedia" => array:7 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 928
            "Ancho" => 1600
            "Tamanyo" => 263178
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Rhinocerebral-cutaneous mucormycosis in a patient with decompensated diabetes&#46; Cenocytic hyphae in biopsy sample &#40;Grocott&#44; original magnification &#215;40&#41; and direct examination of <span class="elsevierStyleItalic">Rhizopus arrhizus</span> &#40;lactophenol cotton blue&#44; original magnification &#215;10&#41;&#46; gr1&#46;</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" => 907
            "Ancho" => 1500
            "Tamanyo" => 256821
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Paracoccidioidomycosis&#46; Multiple budding of <span class="elsevierStyleItalic">Paracoccidioides brasiliensis</span> cells in biopsy sample &#40;Grocott&#44; original magnification &#215;40&#41;&#46;</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" => 990
            "Ancho" => 1500
            "Tamanyo" => 225798
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Disseminated coccidioidomycosis sinus&#46; Spherules in biopsy sample &#40;Periodic acid-Schiff&#44; original magnification &#215;10&#41; and <span class="elsevierStyleItalic">Coccidioides immitis</span> arthroconidia &#40;lactophenol cotton blue&#44; original magnification &#215;40&#41;&#46;</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" => 988
            "Ancho" => 1500
            "Tamanyo" => 196486
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Papular lesions in a patient with disseminated cutaneous histoplasmosis and AIDS&#46; Intracellular yeast forms in biopsy sample &#40;hematoxylin-eosin&#44; original magnification &#215;100&#41; and direct examination of needle-shaped <span class="elsevierStyleItalic">Histoplasma capsulatum</span> conidia &#40;lactophenol cotton blue&#44; original magnification &#215;40&#41;&#46;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "fig0025"
        "etiqueta" => "Figure 5"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr5.jpeg"
            "Alto" => 997
            "Ancho" => 1500
            "Tamanyo" => 276087
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Cutaneous ulcer associated with a neural infection in a patient with cryptococcosis and AIDS&#46; Encapsulated <span class="elsevierStyleItalic">Cryptococcus neoformans</span> yeasts &#40;India ink&#44; original magnification &#215;40&#41; and yeast forms in biopsy sample &#40;periodic acid-Schiff&#44; original magnification &#215;40&#41;&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; IgM&#44; immunoglobulin M&#59; PCR&#44; polymerase chain reaction&#46;</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="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mycosis&nbsp;\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">Causative Agent&nbsp;\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">Diagnosis&nbsp;\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">Treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Paracoccidioidomycosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Paracoccidioides brasiliensis</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Direct mycological examination and culture&#59; histology&#59; PCR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Long-term systemic antifungals&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Coccidioidomycosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Coccidioides immitis</span>&#47;<span class="elsevierStyleItalic">Coccidioides posadasii</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Direct mycological examination and culture&#59; histology&#59; specific IgM antibodies&#59; PCR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Long-term systemic antifungals&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Histoplasmosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Histoplasma capsulatum</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Histology&#59; detection of fungus in blood&#44; bone marrow&#44; and cerebrospinal fluid&#59; culture&#59; PCR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Systemic antifungals for 6-24 mo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cryptococcosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Cryptococcus neoformans</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Direct microscopic examination with India ink stains&#59; culture&#59; serology&#59; PCR&#59; mass spectrometry &#40;rapid and specific&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Amphotericin B with fluorocytosine&#59; fluconazole &#40;both for long periods depending on response to treatment&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1260344.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Summary of the Characteristics of the Systemic Mycoses&#46;</p>"
        ]
      ]
      6 => array:5 [
        "identificador" => "fig0030"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 888
            "Ancho" => 1333
            "Tamanyo" => 143314
          ]
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:26 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous zygomycosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Bonifaz"
                            1 => "D&#46; V&#225;zquez-Gonz&#225;lez"
                            2 => "A&#46; Tirado-S&#225;nchez"
                            3 => "R&#46;M&#46; Ponce-Olivera"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clindermatol.2011.09.013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Dermatol&#46;"
                        "fecha" => "2012"
                        "volumen" => "30"
                        "paginaInicial" => "413"
                        "paginaFinal" => "419"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22682190"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology and outcome of zygomycosis&#58; A review of 929 reported cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;M&#46; Roden"
                            1 => "T&#46;E&#46; Zaoutis"
                            2 => "W&#46;L&#46; Buchanan"
                            3 => "T&#46;A&#46; Knudsen"
                            4 => "T&#46;A&#46; Sarkisova"
                            5 => "R&#46;L&#46; Schaufele"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/432579"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis&#46;"
                        "fecha" => "2005"
                        "volumen" => "41"
                        "paginaInicial" => "634"
                        "paginaFinal" => "653"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16080086"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "quiz 621-622"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Opportunistic filamentous mycoses&#58; Aspergillosis&#44; mucormycosis&#44; phaeohyphomycosis and hyalohyphomycosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;M&#46; Perusqu&#237;a-Ortiz"
                            1 => "D&#46; V&#225;zquez-Gonz&#225;lez"
                            2 => "A&#46; Bonifaz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1610-0387.2012.07994.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dtsch Dermatol Ges&#46;"
                        "fecha" => "2012"
                        "volumen" => "10"
                        "paginaInicial" => "611"
                        "paginaFinal" => "621"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22925358"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mucormicosis rinosinusal en un paciente infectado por VIH"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Luc&#237;a Aguad"
                            1 => "B&#46; M&#46; de la Luz Quezada"
                            2 => "E&#46; Maritza Rahal"
                            3 => "U&#46; M&#46; P&#237;a Vallejos"
                            4 => "B&#46; Mariano Moreno"
                            5 => "A&#46; Jorge Castillo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Chil Infectol&#46;"
                        "fecha" => "2004"
                        "volumen" => "21"
                        "paginaInicial" => "345"
                        "paginaFinal" => "350"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "quiz 715"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endemic systemic mycoses&#58; Coccidioidomycosis&#44; histoplasmosis&#44; paracoccidioidomycosis and blastomycosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Bonifaz"
                            1 => "D&#46; V&#225;zquez-Gonz&#225;lez"
                            2 => "A&#46;M&#46; Perusqu&#237;a-Ortiz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1610-0387.2011.07731.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dtsch Dermatol Ges&#46;"
                        "fecha" => "2011"
                        "volumen" => "9"
                        "paginaInicial" => "705"
                        "paginaFinal" => "714"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21722309"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Paracoccidioidomycosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46;A&#46; Marques"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clindermatol.2012.01.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Dermatol&#46;"
                        "fecha" => "2012"
                        "volumen" => "30"
                        "paginaInicial" => "610"
                        "paginaFinal" => "615"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23068148"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Paracoccidioidomycosis simulating a soft tissue tumor"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46; Marques"
                            1 => "P&#46; Batalha"
                            2 => "J&#46; Britto"
                            3 => "C&#46; Moura"
                            4 => "R&#46; Camargo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/ijd.12271"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Dermatol&#46;"
                        "fecha" => "2014"
                        "volumen" => "53"
                        "paginaInicial" => "e319"
                        "paginaFinal" => "e320"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24261836"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Paracoccidioidomycosis of external genitalia&#58; Report of six new cases and review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46;A&#46; Marques"
                            1 => "L&#46;K&#46; Tangoda"
                            2 => "R&#46;M&#46; Camargo"
                            3 => "H&#46;O&#46; Stolf"
                            4 => "M&#46;E&#46; Marques"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "An Bras Dermatol&#46;"
                        "fecha" => "2012"
                        "volumen" => "87"
                        "paginaInicial" => "235"
                        "paginaFinal" => "240"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22570027"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Application of PCR in serum samples for diagnosis of paracoccidioidomycosis in the southern Bahia-Brazil"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Dias"
                            1 => "L&#46;F&#46; de Carvalho"
                            2 => "C&#46;C&#46; Romano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pntd.0001909"
                      "Revista" => array:5 [
                        "tituloSerie" => "PLoS Negl Trop Dis&#46;"
                        "fecha" => "2012"
                        "volumen" => "6"
                        "paginaInicial" => "e1909"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23209853"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Molecular diagnosis of endemic and invasive mycoses&#58; Advances and challenges"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "B&#46;L&#46; G&#243;mez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.riam.2013.09.009"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Iberoam Micol&#46;"
                        "fecha" => "2014"
                        "volumen" => "31"
                        "paginaInicial" => "35"
                        "paginaFinal" => "41"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24252827"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Extrapulmonary coccidioidomycosis&#58; case report and review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Aviles-Salas"
                            1 => "Y&#46; Quintero-Cuadra"
                            2 => "P&#46; Cornejo-Ju&#225;rez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "/S0716-10182007000500009"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Chilena Infectol&#46;"
                        "fecha" => "2007"
                        "volumen" => "24"
                        "paginaInicial" => "398"
                        "paginaFinal" => "401"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17989846"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Coccidioidomycosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "O&#46; Welsh"
                            1 => "L&#46; Vera-Cabrera"
                            2 => "A&#46; Rendon"
                            3 => "G&#46; Gonzalez"
                            4 => "A&#46; Bonifaz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clindermatol.2012.01.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Dermatol&#46;"
                        "fecha" => "2012"
                        "volumen" => "30"
                        "paginaInicial" => "573"
                        "paginaFinal" => "591"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23068145"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Molecular probes for diagnosis of fungal infections"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46;S&#46; Sandhu"
                            1 => "B&#46;C&#46; Kline"
                            2 => "L&#46; Stockman"
                            3 => "G&#46;D&#46; Roberts"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol&#46;"
                        "fecha" => "1995"
                        "volumen" => "33"
                        "paginaInicial" => "2913"
                        "paginaFinal" => "2919"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8576345"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Skin lesions in histoplasmosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46; Chang"
                            1 => "C&#46; Rodas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clindermatol.2012.01.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Dermatol&#46;"
                        "fecha" => "2012"
                        "volumen" => "30"
                        "paginaInicial" => "592"
                        "paginaFinal" => "598"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23068146"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermatologic manifestations associated with HIV&#47;AIDS"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46; Navarrete-Dechent"
                            1 => "R&#46; Ortega"
                            2 => "F&#46; Fich"
                            3 => "M&#46; Concha"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4067/S0716-10182015000100005"
                      "Revista" => array:7 [
                        "tituloSerie" => "Rev Chilena Infectol&#46;"
                        "fecha" => "2015"
                        "volumen" => "32"
                        "numero" => "Suppl 1"
                        "paginaInicial" => "S57"
                        "paginaFinal" => "S71"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25860154"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Histoplasmosis pulmonar&#58; presentaci&#243;n de un caso"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Perez"
                            1 => "H&#46; Bitar"
                            2 => "D&#46; Valenzuela"
                            3 => "D&#46; Rodriguez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Chil Enfermedades Respir&#46;"
                        "fecha" => "2012"
                        "volumen" => "28"
                        "paginaInicial" => "150"
                        "paginaFinal" => "152"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Histoplasmosis diagnosis using a polymerase chain reaction method&#46; Application on human samples in French Guiana&#44; South America"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46; Maubon"
                            1 => "S&#46; Simon"
                            2 => "C&#46; Aznar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.diagmicrobio.2007.03.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Diagn Microbiol Infect Dis&#46;"
                        "fecha" => "2007"
                        "volumen" => "58"
                        "paginaInicial" => "441"
                        "paginaFinal" => "444"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17509796"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The use of nested Polymerase Chain Reaction &#40;nested PCR&#41; for the early diagnosis of <span class="elsevierStyleItalic">Histoplasma capsulatum</span> infection in serum and whole blood of HIV-positive patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46;C&#46; Dantas"
                            1 => "R&#46;S&#46; Freitas"
                            2 => "A&#46;P&#46; Moreira"
                            3 => "M&#46;V&#46; Silva"
                            4 => "G&#46; Benard"
                            5 => "C&#46; Vasconcellos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "An Bras Dermatol&#46;"
                        "fecha" => "2013"
                        "volumen" => "88"
                        "paginaInicial" => "141"
                        "paginaFinal" => "143"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23539023"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cryptococcal meningitis and systemic lupus erythematosus&#58; a case report and review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46;G&#46; Tristano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "/S0716-10182010000200011"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Chilena Infectol&#46;"
                        "fecha" => "2010"
                        "volumen" => "27"
                        "paginaInicial" => "155"
                        "paginaFinal" => "159"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20556320"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cryptococcosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46; Negroni"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clindermatol.2012.01.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Dermatol&#46;"
                        "fecha" => "2012"
                        "volumen" => "30"
                        "paginaInicial" => "599"
                        "paginaFinal" => "609"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23068147"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of commercial kits for detection of cryptococcal antigen"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "D&#46;C&#46; Tanner"
                            1 => "M&#46;P&#46; Weinstein"
                            2 => "B&#46; Fedorciw"
                            3 => "K&#46;L&#46; Joho"
                            4 => "J&#46;J&#46; Thorpe"
                            5 => "L&#46; Reller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol&#46;"
                        "fecha" => "1994"
                        "volumen" => "32"
                        "paginaInicial" => "1680"
                        "paginaFinal" => "1684"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7929757"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Molecular diagnosis of cryptococcal meningitis in cerebrospinal fluid&#58; Comparison of primer sets for <span class="elsevierStyleItalic">Cryptococcus neoformans</span> and <span class="elsevierStyleItalic">Cryptococcus gattii</span> species complex"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;o&#46;A&#46; Martins"
                            1 => "K&#46;B&#46; Brighente"
                            2 => "T&#46;A&#46; Matos"
                            3 => "J&#46;E&#46; Vidal"
                            4 => "D&#46;D&#46; Hip&#243;lito"
                            5 => "V&#46;L&#46; Pereira-Chioccola"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.bjid.2014.09.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Braz J Infect Dis&#46;"
                        "fecha" => "2015"
                        "volumen" => "19"
                        "paginaInicial" => "62"
                        "paginaFinal" => "67"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25523072"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Advances in identification of clinical yeast isolates by use of matrix-assisted laser desorption ionization-time of flight mass spectrometry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "B&#46;W&#46; Buchan"
                            1 => "N&#46;A&#46; Ledeboer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/JCM.03105-12"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol&#46;"
                        "fecha" => "2013"
                        "volumen" => "51"
                        "paginaInicial" => "1359"
                        "paginaFinal" => "1366"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23426924"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Are the conventional commercial yeast identification methods still helpful in the era of new clinical microbiology diagnostics&#63; A meta-analysis of their accuracy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46; Posteraro"
                            1 => "L&#46; Efremov"
                            2 => "E&#46; Leoncini"
                            3 => "R&#46; Amore"
                            4 => "P&#46; Posteraro"
                            5 => "W&#46; Ricciardi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/JCM.00802-15"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol&#46;"
                        "fecha" => "2015"
                        "volumen" => "53"
                        "paginaInicial" => "2439"
                        "paginaFinal" => "2450"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25994160"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "MALDI-TOF MS enables the rapid identification of the major molecular types within the <span class="elsevierStyleItalic">Cryptococcus neoformans</span>&#47;<span class="elsevierStyleItalic">C&#46;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">gattii</span> species complex"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Firacative"
                            1 => "L&#46; Trilles"
                            2 => "W&#46; Meyer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0037566"
                      "Revista" => array:5 [
                        "tituloSerie" => "PLoS One&#46;"
                        "fecha" => "2012"
                        "volumen" => "7"
                        "paginaInicial" => "e37566"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22666368"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rapid identification of <span class="elsevierStyleItalic">Cryptococcus neoformans</span> and <span class="elsevierStyleItalic">Cryptococcus gattii</span> by matrix-assisted laser desorption ionization-time of flight mass spectrometry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46;R&#46; McTaggart"
                            1 => "E&#46; Lei"
                            2 => "S&#46;E&#46; Richardson"
                            3 => "L&#46; Hoang"
                            4 => "A&#46; Fothergill"
                            5 => "S&#46;X&#46; Zhang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/JCM.00651-11"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol&#46;"
                        "fecha" => "2011"
                        "volumen" => "49"
                        "paginaInicial" => "3050"
                        "paginaFinal" => "3053"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21653762"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000010700000010/v1_201611260103/S1578219016302414/v1_201611260103/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "6150"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Review"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010700000010/v1_201611260103/S1578219016302414/v1_201611260103/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219016302414?idApp=UINPBA000044"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Review
Cutaneous involvement in the Deep Mycoses: A Review. Part II—Systemic Mycoses
Afectación cutánea en las micosis profundas: una revisión de la literatura. Parte II. Micosis sistémicas
J.E. Carrasco-Zubera,
Corresponding author
juaneduardocarrasco@gmail.com

Corresponding author.
, C. Navarrete-Dechentb, A. Bonifazc, F. Fichb, V. Vial-Letelierb, D. Berroeta-Maurizianob
a Unidad de Dermatología, Clínica Alemana de Valdivia, Valdivia, Chile
b Departamento de Dermatología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
c Departamento de Micología, Hospital General de México, Ciudad de México, Mexico
Read
13274
Times
was read the article
3008
Total PDF
10266
Total HTML
Share statistics
 array:24 [
  "pii" => "S1578219016302414"
  "issn" => "15782190"
  "doi" => "10.1016/j.adengl.2016.05.027"
  "estado" => "S300"
  "fechaPublicacion" => "2016-12-01"
  "aid" => "1457"
  "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
  "copyrightAnyo" => "2016"
  "documento" => "article"
  "crossmark" => 1
  "subdocumento" => "ssu"
  "cita" => "Actas Dermosifiliogr. 2016;107:816-22"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 1382
    "formatos" => array:3 [
      "EPUB" => 45
      "HTML" => 957
      "PDF" => 380
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0001731016301831"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2016.06.001"
      "estado" => "S300"
      "fechaPublicacion" => "2016-12-01"
      "aid" => "1457"
      "copyright" => "AEDV"
      "documento" => "article"
      "crossmark" => 1
      "subdocumento" => "ssu"
      "cita" => "Actas Dermosifiliogr. 2016;107:816-22"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 510
        "formatos" => array:3 [
          "EPUB" => 3
          "HTML" => 377
          "PDF" => 130
        ]
      ]
      "es" => array:14 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Revisi&#243;n</span>"
        "titulo" => "Afectaci&#243;n cut&#225;nea en las micosis profundas&#58; una revisi&#243;n de la literatura&#46; Parte 2&#46; Micosis sist&#233;micas"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:3 [
          0 => "es"
          1 => "es"
          2 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "816"
            "paginaFinal" => "822"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Cutaneous involvement in the deep mycoses&#58; A review&#46; Part II &#8212;Systemic mycoses"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 1
          "multimedia" => array:5 [
            "identificador" => "fig0030"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => false
            "mostrarDisplay" => true
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "fx1.jpeg"
                "Alto" => 888
                "Ancho" => 1333
                "Tamanyo" => 143314
              ]
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "J&#46;E&#46; Carrasco-Zuber, C&#46; Navarrete-Dechent, A&#46; Bonifaz, F&#46; Fich, V&#46; Vial-Letelier, D&#46; Berroeta-Mauriziano"
            "autores" => array:6 [
              0 => array:2 [
                "nombre" => "J&#46;E&#46;"
                "apellidos" => "Carrasco-Zuber"
              ]
              1 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Navarrete-Dechent"
              ]
              2 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Bonifaz"
              ]
              3 => array:2 [
                "nombre" => "F&#46;"
                "apellidos" => "Fich"
              ]
              4 => array:2 [
                "nombre" => "V&#46;"
                "apellidos" => "Vial-Letelier"
              ]
              5 => array:2 [
                "nombre" => "D&#46;"
                "apellidos" => "Berroeta-Mauriziano"
              ]
            ]
          ]
        ]
        "resumen" => array:1 [
          0 => array:3 [
            "titulo" => "Graphical abstract"
            "clase" => "graphical"
            "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><elsevierMultimedia ident="fig0030"></elsevierMultimedia></p></span>"
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1578219016302414"
          "doi" => "10.1016/j.adengl.2016.05.027"
          "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/S1578219016302414?idApp=UINPBA000044"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731016301831?idApp=UINPBA000044"
      "url" => "/00017310/0000010700000010/v1_201611260105/S0001731016301831/v1_201611260105/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1578219016302384"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2016.05.025"
    "estado" => "S300"
    "fechaPublicacion" => "2016-12-01"
    "aid" => "1445"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "ssu"
    "cita" => "Actas Dermosifiliogr. 2016;107:823-9"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1980
      "formatos" => array:3 [
        "EPUB" => 56
        "HTML" => 1634
        "PDF" => 290
      ]
    ]
    "en" => array:12 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Advances in Dermatology</span>"
      "titulo" => "Kidney Disease and Psoriasis&#46; A New Comorbidity&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "823"
          "paginaFinal" => "829"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Enfermedad renal y psoriasis&#46; &#191;Una nueva comorbilidad&#63;"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "E&#46; Gonz&#225;lez-Parra, E&#46; Daud&#233;n, J&#46;M&#46; Carrascosa, A&#46; Olveira, R&#46; Botella, C&#46; Bonanad, R&#46; Rivera"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Gonz&#225;lez-Parra"
            ]
            1 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Daud&#233;n"
            ]
            2 => array:2 [
              "nombre" => "J&#46;M&#46;"
              "apellidos" => "Carrascosa"
            ]
            3 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Olveira"
            ]
            4 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Botella"
            ]
            5 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Bonanad"
            ]
            6 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Rivera"
            ]
            7 => array:1 [
              "colaborador" => "for the Systemic Inflammation in Psoriasis Working Group"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731016301715"
        "doi" => "10.1016/j.ad.2016.05.009"
        "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/S0001731016301715?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219016302384?idApp=UINPBA000044"
    "url" => "/15782190/0000010700000010/v1_201611260103/S1578219016302384/v1_201611260103/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1578219016302402"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2016.05.026"
    "estado" => "S300"
    "fechaPublicacion" => "2016-12-01"
    "aid" => "1456"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
    "documento" => "article"
    "crossmark" => 1
    "subdocumento" => "ssu"
    "cita" => "Actas Dermosifiliogr. 2016;107:806-15"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1890
      "formatos" => array:3 [
        "EPUB" => 46
        "HTML" => 1398
        "PDF" => 446
      ]
    ]
    "en" => array:14 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Review</span>"
      "titulo" => "Cutaneous Involvement in the Deep Mycoses&#58; A Literature Review&#46; Part I&#8212;Subcutaneous Mycoses"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:3 [
        0 => "en"
        1 => "en"
        2 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "806"
          "paginaFinal" => "815"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Afectaci&#243;n cut&#225;nea en las micosis profundas&#58; una revisi&#243;n de la literatura&#46; Parte 1&#58; micosis subcut&#225;neas"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 1
        "multimedia" => array:5 [
          "identificador" => "fig0030"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => false
          "mostrarDisplay" => true
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "fx1.jpeg"
              "Alto" => 772
              "Ancho" => 1333
              "Tamanyo" => 98146
            ]
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46;E&#46; Carrasco-Zuber, C&#46; Navarrete-Dechent, A&#46; Bonifaz, F&#46; Fich, V&#46; Vial-Letelier, D&#46; Berroeta-Mauriziano"
          "autores" => array:6 [
            0 => array:2 [
              "nombre" => "J&#46;E&#46;"
              "apellidos" => "Carrasco-Zuber"
            ]
            1 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Navarrete-Dechent"
            ]
            2 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Bonifaz"
            ]
            3 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "Fich"
            ]
            4 => array:2 [
              "nombre" => "V&#46;"
              "apellidos" => "Vial-Letelier"
            ]
            5 => array:2 [
              "nombre" => "D&#46;"
              "apellidos" => "Berroeta-Mauriziano"
            ]
          ]
        ]
      ]
      "resumen" => array:1 [
        0 => array:3 [
          "titulo" => "Graphical abstract"
          "clase" => "graphical"
          "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><elsevierMultimedia ident="fig0030"></elsevierMultimedia></p></span>"
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S000173101630182X"
        "doi" => "10.1016/j.ad.2016.05.017"
        "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/S000173101630182X?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219016302402?idApp=UINPBA000044"
    "url" => "/15782190/0000010700000010/v1_201611260103/S1578219016302402/v1_201611260103/en/main.assets"
  ]
  "en" => array:20 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Review</span>"
    "titulo" => "Cutaneous involvement in the Deep Mycoses&#58; A Review&#46; Part II&#8212;Systemic Mycoses"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "816"
        "paginaFinal" => "822"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "J&#46;E&#46; Carrasco-Zuber, C&#46; Navarrete-Dechent, A&#46; Bonifaz, F&#46; Fich, V&#46; Vial-Letelier, D&#46; Berroeta-Mauriziano"
        "autores" => array:6 [
          0 => array:4 [
            "nombre" => "J&#46;E&#46;"
            "apellidos" => "Carrasco-Zuber"
            "email" => array:1 [
              0 => "juaneduardocarrasco&#64;gmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "C&#46;"
            "apellidos" => "Navarrete-Dechent"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "A&#46;"
            "apellidos" => "Bonifaz"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "F&#46;"
            "apellidos" => "Fich"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "V&#46;"
            "apellidos" => "Vial-Letelier"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "D&#46;"
            "apellidos" => "Berroeta-Mauriziano"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Unidad de Dermatolog&#237;a&#44; Cl&#237;nica Alemana de Valdivia&#44; Valdivia&#44; Chile"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Departamento de Dermatolog&#237;a&#44; Escuela de Medicina&#44; Pontificia Universidad Cat&#243;lica de Chile&#44; Santiago&#44; Chile"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Departamento de Micolog&#237;a&#44; Hospital General de M&#233;xico&#44; Ciudad de M&#233;xico&#44; Mexico"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Afectaci&#243;n cut&#225;nea en las micosis profundas&#58; una revisi&#243;n de la literatura&#46; Parte II&#46; Micosis sist&#233;micas"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 1
      "multimedia" => array:5 [
        "identificador" => "fig0030"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 888
            "Ancho" => 1333
            "Tamanyo" => 143314
          ]
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The systemic mycoses are infections caused by fungi that enter the body through an internal organ or a deep focus&#44; such as the lungs&#44; the digestive tract&#44; or the paranasal sinuses&#46; Infections can spread through the blood&#44; causing disseminated disease with frequent skin involvement&#46; There are 2 types of systemic mycoses&#58; opportunistic mycoses &#40;systemic candidiasis&#44; aspergillosis&#44; and systemic mucormycosis&#41; and endemic respiratory infections &#40;histoplasmosis&#44; blastomycosis&#44; coccidioidomycosis&#44; paracoccidioidomycosis&#44; and cryptococcosis&#41;&#46; In practice&#44; however&#44; it is difficult to distinguish between the 2 types as they tend to affect predisposed patients&#46; Accordingly&#44; they are generally studied together&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">In the second part of this review&#44; we discuss the main deep mycoses that produce cutaneous manifestations during the course of disease&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Mucormycosis</span><p id="par0015" class="elsevierStylePara elsevierViewall">Mucormycosis affects the visceral organs in immunosuppressed patients&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a> It is caused by mucoraceous Zygomycetes and can lead to rhinocerebral&#44; cutaneous&#44; or pulmonary manifestations&#44; or disseminated disease&#46; The most common presentation is rhinocerebral mucormycosis&#44; which involves the nasal sinuses and causes palatal ulcers and extensive necrotic lesions involving the brain and skin&#46; Most cases are associated with decompensated diabetes mellitus or neutropenic states &#40;leukemia&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Clinical Forms</span><p id="par0020" class="elsevierStylePara elsevierViewall">Mucormycosis typically follows an acute&#44; rapidly progressive course associated with high mortality&#46; Rhinocerebral manifestations are the most common clinical presentation&#44; followed by pulmonary&#44; intestinal&#44; and cutaneous manifestations and dissemination&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Primary cutaneous manifestations are extremely rare and occur mainly at venipuncture sites&#59; they are therefore seen most often on the extremities&#46; Lesions present as papules or nodules that progress to ulcers with a necrotic center and a foul-smelling or purulent exudate&#46; Locally&#44; primary infection can affect the deep tissues &#40;muscle and bone&#41; and is highly destructive&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Secondary cutaneous manifestations are much more common in rhinocerebral mucormycosis&#44; with 25&#37; of patients developing palatal ulcers and extremely painful eyelid sinuses &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Diagnosis</span><p id="par0025" class="elsevierStylePara elsevierViewall">Direct mycological examination of necrotic material&#44; sputum&#44; bronchopulmonary lavage fluid&#44; paranasal sinus aspirate&#44; and skin scrapings shows long branching thin-walled cenocytic &#40;nonseptate&#41; hyphae &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Microorganisms grow quickly on Sabouraud dextrose agar &#40;SDA&#41; and can be identified on the basis of reproduction structures or by molecular biology techniques&#59; the most widely used technique is polymerase chain reaction &#40;PCR&#41; analysis of internal transcribed spacer &#40;ITS&#41; regions of ribosomal DNA &#40;rDNA&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;4</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Treatment</span><p id="par0030" class="elsevierStylePara elsevierViewall">Treatment is multifactorial and includes control of predisposing factors &#40;ketoacidosis&#44; neutropenia&#44; etc&#46;&#41;&#44; systemic antifungals&#44; and aggressive surgical debridement&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Potassium iodide&#44; ketoconazole&#44; and fluconazole are used for subcutaneous lesions and can be combined with trimethoprim-sulfametoxazole&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The antifungal of choice is amphotericin B and it can be used in association with caspofungin or posaconazole&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Paracoccidioidomycosis</span><p id="par0035" class="elsevierStylePara elsevierViewall">Paracoccidioidomycosis is a chronic&#44; subacute&#44; or&#44; in rare cases&#44; acute mycosis caused by <span class="elsevierStyleItalic">Paracoccidioides brasiliensis</span> and <span class="elsevierStyleItalic">Paracoccidioides lutzii</span>&#46; It affects the skin and visceral organs&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> This potentially fatal systemic granulomatous disease is considered endemic in Mexico&#44; Argentina&#44; Guyana&#44; Brazil&#44; Venezuela&#44; and Colombia&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a><span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">brasiliensis</span> is a dimorphic fungus that grows as mycelia in vegetation and soil in humid regions&#46; It is not known whether human-to-human transmission occurs&#46; The fungus enters the body through the respiratory system&#46; Infections acquired through inhalation can remain latent for 1 or 2 decades and reactivation is dependent on immune status&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#8211;8</span></a></p><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Clinical Forms</span><p id="par0040" class="elsevierStylePara elsevierViewall">Primary infection tends to be asymptomatic and can resolve or leave a residual lesion &#40;scar&#41;&#46; Symptomatic disease is a result of the parasite-host relationship in which the virulence of each strain has an important role&#46; Chronic paracoccidioidomycosis&#44; which typically affects adults&#44; is the most common form of disease &#40;&#62;90&#37; of patients develop lung lesions and metastases in diverse organs&#41;&#46; There is also an acute juvenile form characterized by pulmonary and reticuloendothelial involvement&#44; with enlarged lymph nodes&#44; hepatosplenomegaly&#44; and bone involvement&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Patients may also develop lesions in the oropharyngeal mucosa&#44; mimicking chronic tonsillitis&#44; periodontal and laryngeal lesions&#44; and perioral ulcero-vegetative lesions&#46; There may also be nodular cutaneous lesions that can become necrotic or result in subcutaneous cold abscesses &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> There have been reports of extragenital lesions mimicking syphilis sores&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">The differential diagnosis should include mucocutaneous leishmaniasis&#44; Wegener granulomatosis&#44; syphilis&#44; lymphoma&#44; sporotrichosis&#44; and scrofuloderma&#44; among other entities&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Diagnosis</span><p id="par0050" class="elsevierStylePara elsevierViewall">A diagnosis can be made by direct visualization of multiple budding of yeast cells forming a structure similar to a ship&#39;s wheel &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41; in sputum samples&#44; skin scrapings&#44; or pus&#46; The microorganisms grow over a period of 15 to 20 days on SDA with or without antibiotics&#44; producing white filamentous colonies with visible mycelia&#46; PCR analysis of tissue or serum targeting ITS<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> or other regions<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> can also be used for diagnosis&#46; Skin biopsy shows a suppurative cutaneous granulomatous inflammation and pseudoepitheliomatous hyperplasia&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Treatment</span><p id="par0055" class="elsevierStylePara elsevierViewall">Treatment includes long-term administration of amphotericin<span class="elsevierStyleHsp" style=""></span>B&#44; systemic triazoles&#44; and sulfonamides&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Coccidioidomycosis</span><p id="par0060" class="elsevierStylePara elsevierViewall">Coccidioidomycosis is caused by 2 dimorphic fungi&#58; <span class="elsevierStyleItalic">Coccidioides immitis</span> and <span class="elsevierStyleItalic">Coccidioides</span> posadasii&#46; The reservoir of the fungi is dry soil with an alkaline pH&#46; Coccidioidomycosis affects both humans and animals and the infection is acquired by inhalation of <span class="elsevierStyleItalic">C</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">immitis</span> arthroconidia from soil in endemic regions &#40;United States&#44; Mexico&#44; Argentina&#44; Paraguay&#44; Colombia&#44; Venezuela&#44; and Brazil&#41;&#46; The incubation period is 1 to 4 weeks&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;11&#44;12</span></a></p><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Clinical Forms</span><p id="par0065" class="elsevierStylePara elsevierViewall">Pulmonary involvement is the predominant clinical form of coccidioidomycosis&#44; but the infection can also affect the skin&#44; larynx&#44; bones&#44; joints&#44; and meninges&#46; Skin lesions are diverse and can present as papules&#44; pustules&#44; plaques&#44; abscesses&#44; sinus tracts &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#44; ulcers&#44; diffuse macular rash&#44; erythema multiforme&#44; or erythema nodosum&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#44;12</span></a></p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">The differential diagnosis should include tuberculosis&#44; paracoccidioidomycosis&#44; sporotrichosis&#44; histoplasmosis&#44; and even neoplasms&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Diagnosis</span><p id="par0075" class="elsevierStylePara elsevierViewall">Culture and direct mycological examination show double-membrane spherules containing spores &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; The fungi can be cultivated on SDA with or without antibiotics&#44; although the procedure is dangerous due to the high risk of infection&#46; Colonies will show hyaline arthroconidia separated from each other by a disjunctor cell following lysis&#46; Histology is useful as it can detect spherules with endospores &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41; Serology with specific immunoglobulin &#40;Ig&#41; M antibodies in acute infections is diagnostic only after 4 weeks&#46; Coccidioidin skin tests and complement levels are also important diagnostic aids&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">11&#44;12</span></a> Finally&#44; coccidioidomycosis can be diagnosed by PCR analysis of the 28S region of rDNA&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Treatment</span><p id="par0080" class="elsevierStylePara elsevierViewall">Treatment consists of deoxycholate or liposomal amphotericin&#44; itraconazole&#44; or fluconazole for 6 to 12 months&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p></span></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Histoplasmosis</span><p id="par0085" class="elsevierStylePara elsevierViewall">American histoplasmosis or Darling disease is a systemic mycosis that is caused by the dimorphic fungus <span class="elsevierStyleItalic">Histoplasma capsulatum</span> var&#46; <span class="elsevierStyleItalic">capsulatum</span><a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> and primarily affects the reticuloendothelial system&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">The lung is the most common site of primary infection&#46; The fungus may subsequently spread to various organs&#44; including the skin&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> Histoplasmosis is the most common pulmonary fungal infection and it occurs worldwide&#44; with cases reported in over 60 countries&#46; The pathogen is particularly prevalent in regions with tropical climates&#44; such as Central and South America&#44; Eastern United States&#44; and South Mexico&#46; It is found in soil&#44; decomposing organic matter&#44; and in the droppings of bats &#40;typically in caves&#41;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> and some birds such as chickens&#44; turkeys&#44; pigeons&#44; and geese&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Clinical Forms</span><p id="par0095" class="elsevierStylePara elsevierViewall">Ninety-five percent of people infected with histoplasmosis do not show clinical manifestations&#46; In the acute form of disease&#44; symptoms range from flu-like symptoms to more complex manifestations with radiological images showing disseminated calcifications and findings similar to those seen in tuberculosis&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> Acute forms can progress to chronic forms&#44; which preferentially affect men aged over 50 years&#46; Acute disease is characterized by cough and expectoration but it is difficult to isolate <span class="elsevierStyleItalic">H capsulatum</span> in sputum&#46; Mucosal involvement is highly characteristic in chronic disseminated forms&#44; and ulcerative granulomatous lesions are common on the oral mucosa&#44; tongue&#44; nasal septum&#44; and larynx&#46; Finally&#44; meningoencephalitis and focal osteolysis in the metaphysis of long bones may be observed in acute disseminated histoplasmosis&#44; which typically affects patients with AIDS&#46; Around 11&#37; of patients with AIDS develop skin manifestations&#44;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> which tend to be disseminated and include papular lesions on the face and the trunk &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41; and&#44; sometimes&#44; ulcerative lesions on the mucosa&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a></p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Diagnosis</span><p id="par0100" class="elsevierStylePara elsevierViewall">The fungus can be isolated in blood&#44; bone marrow&#44; cerebrospinal fluid&#44; bone marrow aspirate&#44; or biopsy specimens of infected tissues&#46; Specimens can be inoculated on SDA with or without antibiotics&#46; Identification is also possible using molecular biology techniques such as PCR analysis of fungal DNA &#40;ITS or 18S rDNA&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17&#44;18</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">Direct examination of Giemsa-stained specimens shows characteristic intracellular yeast forms surrounded by a halo simulating a capsule &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p></span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Treatment</span><p id="par0110" class="elsevierStylePara elsevierViewall">Treatment consists of itraconazole for 6 to 24<span class="elsevierStyleHsp" style=""></span>months or amphotericin<span class="elsevierStyleHsp" style=""></span>B&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a></p></span></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Cryptococcosis</span><p id="par0115" class="elsevierStylePara elsevierViewall">Cryptococcosis is a systemic mycosis caused by an encapsulated yeast of the genus <span class="elsevierStyleItalic">Cryptococcus</span>&#46; The 2 most common species are <span class="elsevierStyleItalic">Cryptococcus neoformans</span> and <span class="elsevierStyleItalic">Cryptococcus gatii</span>&#46; The lungs are the main route of entry for the pathogen&#46; Clinical manifestations range from asymptomatic lung colonization to systemic dissemination&#46; The main clinical manifestation is meningoencephalitis&#46;<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">19&#44;20</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">C neoformans</span> is typically found in soil and in pigeon and bat droppings&#46; In urban areas&#44; it is disseminated through domestic dust from trees&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Clinical Forms</span><p id="par0125" class="elsevierStylePara elsevierViewall">Inhaled yeasts and spores reach the alveolar spaces&#46; Subsequent development of disease will depend on the phagocytic efficacy of the macrophages and the host&#39;s immune response&#46; Clinical forms involve the lungs&#44; the central nervous system &#40;CNS&#41;&#44; or the mucocutaneous structures&#44; and may also be disseminated&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> Lung involvement tends to be asymptomatic&#44; nonspecific&#44; or similar to acute tuberculosis&#46; CNS cryptococcosis is the most common clinical form and presents as chronic meningitis&#44; meningoencephalitis&#44; or cerebral cryptococcal granuloma&#46; The mucocutaneous form is the result of the spread of infection from other foci in patients with disseminated disease&#46; It presents as subcutaneous papules and nodules &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#41; on the face and neck&#44; primarily in patients with human immunodeficiency virus infection in the advanced AIDS stage&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">15&#44;20</span></a></p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0130" class="elsevierStylePara elsevierViewall">Diagnosis can be challenging given the wide range of possible lesions&#46; The most common alternative diagnoses contemplated in the literature are molluscum contagiosum and herpes infections&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">These multiple polymorphic lesions&#44; which are common in patients with diseases such as AIDS&#44; lymphoma&#44; sarcoidosis&#44; and diabetes and in transplant recipients&#8212;and may also be due to multiple microorganisms&#8212;require an exhaustive study&#46;</p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Diagnosis</span><p id="par0140" class="elsevierStylePara elsevierViewall">Cryptococcus yeasts are large encapsulated cells that are best observed under the microscope with India ink &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a>&#41; or Mayer mucicarmine stains&#46; The microorganisms grow on SDA within 24 to 48<span class="elsevierStyleHsp" style=""></span>hours or after a week&#46; Serology is fast and specific&#46; Immunological identification is also possible and one particularly effective test &#40;with a sensitivity and specificity of &#62;80&#37;&#41; is the latex agglutination test&#44; which searches for the cryptococcal capsular antigen in serum&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a> Detection is also possible using different PCR assays<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> or MALDI-ToF mass spectrometry&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> The advantage of the latter is that positive results are identified almost immediately &#40;10<span class="elsevierStyleHsp" style=""></span>minutes&#41; and correlate 100&#37; with DNA sequencing results&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">24&#8211;26</span></a></p></span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Treatment</span><p id="par0145" class="elsevierStylePara elsevierViewall">Treatment is with deoxycholate or liposomal amphotericin B&#44; with or without fluorocytosine or fluconazole&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a></p></span></span><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Conclusions</span><p id="par0150" class="elsevierStylePara elsevierViewall">We have reviewed the cutaneous manifestations of the systemic mycoses &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; Recognition of these manifestations is important&#44; as these infections are associated with high mortality&#46; Dermatologists can play an important role in ensuring an accurate diagnosis by recognizing the clinical signs or ordering an appropriate test&#44; such as a skin biopsy&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0115" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Conflicts of Interest</span><p id="par0155" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:14 [
        0 => array:3 [
          "identificador" => "xres762916"
          "titulo" => "Graphical abstract"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0005"
            ]
          ]
        ]
        1 => array:3 [
          "identificador" => "xres762917"
          "titulo" => "Abstract"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0010"
            ]
          ]
        ]
        2 => array:2 [
          "identificador" => "xpalclavsec764391"
          "titulo" => "Keywords"
        ]
        3 => array:3 [
          "identificador" => "xres762918"
          "titulo" => "Resumen"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0015"
            ]
          ]
        ]
        4 => array:2 [
          "identificador" => "xpalclavsec764392"
          "titulo" => "Palabras clave"
        ]
        5 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        6 => array:3 [
          "identificador" => "sec0010"
          "titulo" => "Mucormycosis"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0015"
              "titulo" => "Clinical Forms"
            ]
            1 => array:2 [
              "identificador" => "sec0020"
              "titulo" => "Diagnosis"
            ]
            2 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Treatment"
            ]
          ]
        ]
        7 => array:3 [
          "identificador" => "sec0030"
          "titulo" => "Paracoccidioidomycosis"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Clinical Forms"
            ]
            1 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Diagnosis"
            ]
            2 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Treatment"
            ]
          ]
        ]
        8 => array:3 [
          "identificador" => "sec0050"
          "titulo" => "Coccidioidomycosis"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0055"
              "titulo" => "Clinical Forms"
            ]
            1 => array:2 [
              "identificador" => "sec0060"
              "titulo" => "Diagnosis"
            ]
            2 => array:2 [
              "identificador" => "sec0065"
              "titulo" => "Treatment"
            ]
          ]
        ]
        9 => array:3 [
          "identificador" => "sec0070"
          "titulo" => "Histoplasmosis"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0075"
              "titulo" => "Clinical Forms"
            ]
            1 => array:2 [
              "identificador" => "sec0080"
              "titulo" => "Diagnosis"
            ]
            2 => array:2 [
              "identificador" => "sec0085"
              "titulo" => "Treatment"
            ]
          ]
        ]
        10 => array:3 [
          "identificador" => "sec0090"
          "titulo" => "Cryptococcosis"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0095"
              "titulo" => "Clinical Forms"
            ]
            1 => array:2 [
              "identificador" => "sec0100"
              "titulo" => "Diagnosis"
            ]
            2 => array:2 [
              "identificador" => "sec0105"
              "titulo" => "Treatment"
            ]
          ]
        ]
        11 => array:2 [
          "identificador" => "sec0110"
          "titulo" => "Conclusions"
        ]
        12 => array:2 [
          "identificador" => "sec0115"
          "titulo" => "Conflicts of Interest"
        ]
        13 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2016-01-07"
    "fechaAceptado" => "2016-05-29"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec764391"
          "palabras" => array:5 [
            0 => "Paracoccidioidomycosis"
            1 => "Coccidioidomycosis"
            2 => "Histoplasmosis"
            3 => "Mucormycosis"
            4 => "Cryptococcosis"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec764392"
          "palabras" => array:5 [
            0 => "Paracoccidioidomicosis"
            1 => "Coccidioidomicosis"
            2 => "Histoplasmosis"
            3 => "Mucormicosis"
            4 => "Criptococosis"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">In the second part of this review on the deep mycoses&#44; we describe the main systemic mycoses&#8212;paracoccidioidomycosis&#44; coccidioidomycosis&#44; histoplasmosis&#44; mucormycosis&#44; and cryptococcosis&#8212;and their cutaneous manifestations&#46; Skin lesions are only occasionally seen in deep systemic mycoses either directly&#44; when the skin is the route of entry for the fungus&#44; or indirectly&#44; when the infection has spread from a deeper focus&#46; These cutaneous signs are often the only clue to the presence of a potentially fatal infection&#46; As with the subcutaneous mycoses&#44; early diagnosis and treatment is important&#44; but in this case&#44; even more so&#46;</p></span>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0015" class="elsevierStyleSection elsevierViewall"><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">En la segunda parte de este art&#237;culo se revisan las principales micosis sist&#233;micas y sus manifestaciones cut&#225;neas&#58; paracoccidioidomicosis&#44; coccidioidomicosis&#44; histoplasmosis&#44; mucormicosis y criptococosis&#46; Las micosis sist&#233;micas presentan lesiones en la piel solo en algunas ocasiones&#44; ya sea por afectaci&#243;n directa de ella como puerta de entrada o tras la diseminaci&#243;n de la infecci&#243;n a partir de un foco profundo&#46; Muchas veces estos signos cut&#225;neos ser&#225;n la &#250;nica pista para el diagn&#243;stico certero de patolog&#237;as potencialmente fatales&#46; Por lo mismo&#44; y con mucho mayor &#233;nfasis que las micosis tratadas en la primera parte&#44; es importante saber reconocer y tratar las micosis sist&#233;micas&#46;</p></span>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Carrasco-Zuber JE&#44; Navarrete-Dechent C&#44; Bonifaz A&#44; Fich F&#44; Vial-Letelier V&#44; Berroeta-Mauriziano D&#46; Afectaci&#243;n cut&#225;nea en las micosis profundas&#58; una revisi&#243;n de la literatura&#46; Parte II&#46; Micosis sist&#233;micas&#46; 2016&#59;107&#58;816&#8211;822&#46;</p>"
      ]
    ]
    "multimedia" => array:7 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 928
            "Ancho" => 1600
            "Tamanyo" => 263178
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Rhinocerebral-cutaneous mucormycosis in a patient with decompensated diabetes&#46; Cenocytic hyphae in biopsy sample &#40;Grocott&#44; original magnification &#215;40&#41; and direct examination of <span class="elsevierStyleItalic">Rhizopus arrhizus</span> &#40;lactophenol cotton blue&#44; original magnification &#215;10&#41;&#46; gr1&#46;</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" => 907
            "Ancho" => 1500
            "Tamanyo" => 256821
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Paracoccidioidomycosis&#46; Multiple budding of <span class="elsevierStyleItalic">Paracoccidioides brasiliensis</span> cells in biopsy sample &#40;Grocott&#44; original magnification &#215;40&#41;&#46;</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" => 990
            "Ancho" => 1500
            "Tamanyo" => 225798
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Disseminated coccidioidomycosis sinus&#46; Spherules in biopsy sample &#40;Periodic acid-Schiff&#44; original magnification &#215;10&#41; and <span class="elsevierStyleItalic">Coccidioides immitis</span> arthroconidia &#40;lactophenol cotton blue&#44; original magnification &#215;40&#41;&#46;</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" => 988
            "Ancho" => 1500
            "Tamanyo" => 196486
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Papular lesions in a patient with disseminated cutaneous histoplasmosis and AIDS&#46; Intracellular yeast forms in biopsy sample &#40;hematoxylin-eosin&#44; original magnification &#215;100&#41; and direct examination of needle-shaped <span class="elsevierStyleItalic">Histoplasma capsulatum</span> conidia &#40;lactophenol cotton blue&#44; original magnification &#215;40&#41;&#46;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "fig0025"
        "etiqueta" => "Figure 5"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr5.jpeg"
            "Alto" => 997
            "Ancho" => 1500
            "Tamanyo" => 276087
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Cutaneous ulcer associated with a neural infection in a patient with cryptococcosis and AIDS&#46; Encapsulated <span class="elsevierStyleItalic">Cryptococcus neoformans</span> yeasts &#40;India ink&#44; original magnification &#215;40&#41; and yeast forms in biopsy sample &#40;periodic acid-Schiff&#44; original magnification &#215;40&#41;&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; IgM&#44; immunoglobulin M&#59; PCR&#44; polymerase chain reaction&#46;</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="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mycosis&nbsp;\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">Causative Agent&nbsp;\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">Diagnosis&nbsp;\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">Treatment&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Paracoccidioidomycosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Paracoccidioides brasiliensis</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Direct mycological examination and culture&#59; histology&#59; PCR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Long-term systemic antifungals&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Coccidioidomycosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Coccidioides immitis</span>&#47;<span class="elsevierStyleItalic">Coccidioides posadasii</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Direct mycological examination and culture&#59; histology&#59; specific IgM antibodies&#59; PCR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Long-term systemic antifungals&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Histoplasmosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Histoplasma capsulatum</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Histology&#59; detection of fungus in blood&#44; bone marrow&#44; and cerebrospinal fluid&#59; culture&#59; PCR&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Systemic antifungals for 6-24 mo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Cryptococcosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top"><span class="elsevierStyleItalic">Cryptococcus neoformans</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Direct microscopic examination with India ink stains&#59; culture&#59; serology&#59; PCR&#59; mass spectrometry &#40;rapid and specific&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Amphotericin B with fluorocytosine&#59; fluconazole &#40;both for long periods depending on response to treatment&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab1260344.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Summary of the Characteristics of the Systemic Mycoses&#46;</p>"
        ]
      ]
      6 => array:5 [
        "identificador" => "fig0030"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => false
        "mostrarDisplay" => true
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "fx1.jpeg"
            "Alto" => 888
            "Ancho" => 1333
            "Tamanyo" => 143314
          ]
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:26 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous zygomycosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Bonifaz"
                            1 => "D&#46; V&#225;zquez-Gonz&#225;lez"
                            2 => "A&#46; Tirado-S&#225;nchez"
                            3 => "R&#46;M&#46; Ponce-Olivera"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clindermatol.2011.09.013"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Dermatol&#46;"
                        "fecha" => "2012"
                        "volumen" => "30"
                        "paginaInicial" => "413"
                        "paginaFinal" => "419"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22682190"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology and outcome of zygomycosis&#58; A review of 929 reported cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;M&#46; Roden"
                            1 => "T&#46;E&#46; Zaoutis"
                            2 => "W&#46;L&#46; Buchanan"
                            3 => "T&#46;A&#46; Knudsen"
                            4 => "T&#46;A&#46; Sarkisova"
                            5 => "R&#46;L&#46; Schaufele"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1086/432579"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Infect Dis&#46;"
                        "fecha" => "2005"
                        "volumen" => "41"
                        "paginaInicial" => "634"
                        "paginaFinal" => "653"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16080086"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "quiz 621-622"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Opportunistic filamentous mycoses&#58; Aspergillosis&#44; mucormycosis&#44; phaeohyphomycosis and hyalohyphomycosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;M&#46; Perusqu&#237;a-Ortiz"
                            1 => "D&#46; V&#225;zquez-Gonz&#225;lez"
                            2 => "A&#46; Bonifaz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1610-0387.2012.07994.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dtsch Dermatol Ges&#46;"
                        "fecha" => "2012"
                        "volumen" => "10"
                        "paginaInicial" => "611"
                        "paginaFinal" => "621"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22925358"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mucormicosis rinosinusal en un paciente infectado por VIH"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Luc&#237;a Aguad"
                            1 => "B&#46; M&#46; de la Luz Quezada"
                            2 => "E&#46; Maritza Rahal"
                            3 => "U&#46; M&#46; P&#237;a Vallejos"
                            4 => "B&#46; Mariano Moreno"
                            5 => "A&#46; Jorge Castillo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Chil Infectol&#46;"
                        "fecha" => "2004"
                        "volumen" => "21"
                        "paginaInicial" => "345"
                        "paginaFinal" => "350"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:3 [
                  "comentario" => "quiz 715"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Endemic systemic mycoses&#58; Coccidioidomycosis&#44; histoplasmosis&#44; paracoccidioidomycosis and blastomycosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Bonifaz"
                            1 => "D&#46; V&#225;zquez-Gonz&#225;lez"
                            2 => "A&#46;M&#46; Perusqu&#237;a-Ortiz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1610-0387.2011.07731.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dtsch Dermatol Ges&#46;"
                        "fecha" => "2011"
                        "volumen" => "9"
                        "paginaInicial" => "705"
                        "paginaFinal" => "714"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21722309"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Paracoccidioidomycosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "S&#46;A&#46; Marques"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clindermatol.2012.01.006"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Dermatol&#46;"
                        "fecha" => "2012"
                        "volumen" => "30"
                        "paginaInicial" => "610"
                        "paginaFinal" => "615"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23068148"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Paracoccidioidomycosis simulating a soft tissue tumor"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46; Marques"
                            1 => "P&#46; Batalha"
                            2 => "J&#46; Britto"
                            3 => "C&#46; Moura"
                            4 => "R&#46; Camargo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/ijd.12271"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Dermatol&#46;"
                        "fecha" => "2014"
                        "volumen" => "53"
                        "paginaInicial" => "e319"
                        "paginaFinal" => "e320"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24261836"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Paracoccidioidomycosis of external genitalia&#58; Report of six new cases and review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46;A&#46; Marques"
                            1 => "L&#46;K&#46; Tangoda"
                            2 => "R&#46;M&#46; Camargo"
                            3 => "H&#46;O&#46; Stolf"
                            4 => "M&#46;E&#46; Marques"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "An Bras Dermatol&#46;"
                        "fecha" => "2012"
                        "volumen" => "87"
                        "paginaInicial" => "235"
                        "paginaFinal" => "240"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22570027"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Application of PCR in serum samples for diagnosis of paracoccidioidomycosis in the southern Bahia-Brazil"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46; Dias"
                            1 => "L&#46;F&#46; de Carvalho"
                            2 => "C&#46;C&#46; Romano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pntd.0001909"
                      "Revista" => array:5 [
                        "tituloSerie" => "PLoS Negl Trop Dis&#46;"
                        "fecha" => "2012"
                        "volumen" => "6"
                        "paginaInicial" => "e1909"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23209853"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Molecular diagnosis of endemic and invasive mycoses&#58; Advances and challenges"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "B&#46;L&#46; G&#243;mez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.riam.2013.09.009"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Iberoam Micol&#46;"
                        "fecha" => "2014"
                        "volumen" => "31"
                        "paginaInicial" => "35"
                        "paginaFinal" => "41"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24252827"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Extrapulmonary coccidioidomycosis&#58; case report and review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Aviles-Salas"
                            1 => "Y&#46; Quintero-Cuadra"
                            2 => "P&#46; Cornejo-Ju&#225;rez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "/S0716-10182007000500009"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Chilena Infectol&#46;"
                        "fecha" => "2007"
                        "volumen" => "24"
                        "paginaInicial" => "398"
                        "paginaFinal" => "401"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17989846"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Coccidioidomycosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "O&#46; Welsh"
                            1 => "L&#46; Vera-Cabrera"
                            2 => "A&#46; Rendon"
                            3 => "G&#46; Gonzalez"
                            4 => "A&#46; Bonifaz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clindermatol.2012.01.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Dermatol&#46;"
                        "fecha" => "2012"
                        "volumen" => "30"
                        "paginaInicial" => "573"
                        "paginaFinal" => "591"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23068145"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Molecular probes for diagnosis of fungal infections"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46;S&#46; Sandhu"
                            1 => "B&#46;C&#46; Kline"
                            2 => "L&#46; Stockman"
                            3 => "G&#46;D&#46; Roberts"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol&#46;"
                        "fecha" => "1995"
                        "volumen" => "33"
                        "paginaInicial" => "2913"
                        "paginaFinal" => "2919"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8576345"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Skin lesions in histoplasmosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46; Chang"
                            1 => "C&#46; Rodas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clindermatol.2012.01.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Dermatol&#46;"
                        "fecha" => "2012"
                        "volumen" => "30"
                        "paginaInicial" => "592"
                        "paginaFinal" => "598"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23068146"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermatologic manifestations associated with HIV&#47;AIDS"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46; Navarrete-Dechent"
                            1 => "R&#46; Ortega"
                            2 => "F&#46; Fich"
                            3 => "M&#46; Concha"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.4067/S0716-10182015000100005"
                      "Revista" => array:7 [
                        "tituloSerie" => "Rev Chilena Infectol&#46;"
                        "fecha" => "2015"
                        "volumen" => "32"
                        "numero" => "Suppl 1"
                        "paginaInicial" => "S57"
                        "paginaFinal" => "S71"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25860154"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Histoplasmosis pulmonar&#58; presentaci&#243;n de un caso"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Perez"
                            1 => "H&#46; Bitar"
                            2 => "D&#46; Valenzuela"
                            3 => "D&#46; Rodriguez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Chil Enfermedades Respir&#46;"
                        "fecha" => "2012"
                        "volumen" => "28"
                        "paginaInicial" => "150"
                        "paginaFinal" => "152"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Histoplasmosis diagnosis using a polymerase chain reaction method&#46; Application on human samples in French Guiana&#44; South America"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "D&#46; Maubon"
                            1 => "S&#46; Simon"
                            2 => "C&#46; Aznar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.diagmicrobio.2007.03.008"
                      "Revista" => array:6 [
                        "tituloSerie" => "Diagn Microbiol Infect Dis&#46;"
                        "fecha" => "2007"
                        "volumen" => "58"
                        "paginaInicial" => "441"
                        "paginaFinal" => "444"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17509796"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The use of nested Polymerase Chain Reaction &#40;nested PCR&#41; for the early diagnosis of <span class="elsevierStyleItalic">Histoplasma capsulatum</span> infection in serum and whole blood of HIV-positive patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46;C&#46; Dantas"
                            1 => "R&#46;S&#46; Freitas"
                            2 => "A&#46;P&#46; Moreira"
                            3 => "M&#46;V&#46; Silva"
                            4 => "G&#46; Benard"
                            5 => "C&#46; Vasconcellos"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "An Bras Dermatol&#46;"
                        "fecha" => "2013"
                        "volumen" => "88"
                        "paginaInicial" => "141"
                        "paginaFinal" => "143"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23539023"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cryptococcal meningitis and systemic lupus erythematosus&#58; a case report and review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46;G&#46; Tristano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "/S0716-10182010000200011"
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Chilena Infectol&#46;"
                        "fecha" => "2010"
                        "volumen" => "27"
                        "paginaInicial" => "155"
                        "paginaFinal" => "159"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20556320"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cryptococcosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46; Negroni"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clindermatol.2012.01.005"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Dermatol&#46;"
                        "fecha" => "2012"
                        "volumen" => "30"
                        "paginaInicial" => "599"
                        "paginaFinal" => "609"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23068147"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Comparison of commercial kits for detection of cryptococcal antigen"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "D&#46;C&#46; Tanner"
                            1 => "M&#46;P&#46; Weinstein"
                            2 => "B&#46; Fedorciw"
                            3 => "K&#46;L&#46; Joho"
                            4 => "J&#46;J&#46; Thorpe"
                            5 => "L&#46; Reller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol&#46;"
                        "fecha" => "1994"
                        "volumen" => "32"
                        "paginaInicial" => "1680"
                        "paginaFinal" => "1684"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7929757"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Molecular diagnosis of cryptococcal meningitis in cerebrospinal fluid&#58; Comparison of primer sets for <span class="elsevierStyleItalic">Cryptococcus neoformans</span> and <span class="elsevierStyleItalic">Cryptococcus gattii</span> species complex"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;o&#46;A&#46; Martins"
                            1 => "K&#46;B&#46; Brighente"
                            2 => "T&#46;A&#46; Matos"
                            3 => "J&#46;E&#46; Vidal"
                            4 => "D&#46;D&#46; Hip&#243;lito"
                            5 => "V&#46;L&#46; Pereira-Chioccola"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.bjid.2014.09.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Braz J Infect Dis&#46;"
                        "fecha" => "2015"
                        "volumen" => "19"
                        "paginaInicial" => "62"
                        "paginaFinal" => "67"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25523072"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Advances in identification of clinical yeast isolates by use of matrix-assisted laser desorption ionization-time of flight mass spectrometry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "B&#46;W&#46; Buchan"
                            1 => "N&#46;A&#46; Ledeboer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/JCM.03105-12"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol&#46;"
                        "fecha" => "2013"
                        "volumen" => "51"
                        "paginaInicial" => "1359"
                        "paginaFinal" => "1366"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23426924"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Are the conventional commercial yeast identification methods still helpful in the era of new clinical microbiology diagnostics&#63; A meta-analysis of their accuracy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46; Posteraro"
                            1 => "L&#46; Efremov"
                            2 => "E&#46; Leoncini"
                            3 => "R&#46; Amore"
                            4 => "P&#46; Posteraro"
                            5 => "W&#46; Ricciardi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/JCM.00802-15"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol&#46;"
                        "fecha" => "2015"
                        "volumen" => "53"
                        "paginaInicial" => "2439"
                        "paginaFinal" => "2450"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25994160"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "MALDI-TOF MS enables the rapid identification of the major molecular types within the <span class="elsevierStyleItalic">Cryptococcus neoformans</span>&#47;<span class="elsevierStyleItalic">C&#46;</span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">gattii</span> species complex"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Firacative"
                            1 => "L&#46; Trilles"
                            2 => "W&#46; Meyer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1371/journal.pone.0037566"
                      "Revista" => array:5 [
                        "tituloSerie" => "PLoS One&#46;"
                        "fecha" => "2012"
                        "volumen" => "7"
                        "paginaInicial" => "e37566"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22666368"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rapid identification of <span class="elsevierStyleItalic">Cryptococcus neoformans</span> and <span class="elsevierStyleItalic">Cryptococcus gattii</span> by matrix-assisted laser desorption ionization-time of flight mass spectrometry"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "L&#46;R&#46; McTaggart"
                            1 => "E&#46; Lei"
                            2 => "S&#46;E&#46; Richardson"
                            3 => "L&#46; Hoang"
                            4 => "A&#46; Fothergill"
                            5 => "S&#46;X&#46; Zhang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1128/JCM.00651-11"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Microbiol&#46;"
                        "fecha" => "2011"
                        "volumen" => "49"
                        "paginaInicial" => "3050"
                        "paginaFinal" => "3053"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21653762"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000010700000010/v1_201611260103/S1578219016302414/v1_201611260103/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "6150"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Review"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010700000010/v1_201611260103/S1578219016302414/v1_201611260103/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219016302414?idApp=UINPBA000044"
]
Article information
ISSN: 15782190
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 29 11 40
2024 October 215 62 277
2024 September 210 36 246
2024 August 274 72 346
2024 July 243 37 280
2024 June 243 58 301
2024 May 212 60 272
2024 April 172 47 219
2024 March 215 50 265
2024 February 193 58 251
2024 January 136 43 179
2023 December 193 90 283
2023 November 176 49 225
2023 October 219 54 273
2023 September 174 38 212
2023 August 167 23 190
2023 July 179 46 225
2023 June 168 45 213
2023 May 196 33 229
2023 April 146 41 187
2023 March 181 45 226
2023 February 194 38 232
2023 January 199 44 243
2022 December 126 68 194
2022 November 71 51 122
2022 October 94 33 127
2022 September 101 55 156
2022 August 55 45 100
2022 July 59 51 110
2022 June 70 30 100
2022 May 217 44 261
2022 April 280 52 332
2022 March 280 54 334
2022 February 318 56 374
2022 January 329 61 390
2021 December 190 59 249
2021 November 221 77 298
2021 October 179 74 253
2021 September 144 46 190
2021 August 164 49 213
2021 July 121 33 154
2021 June 171 45 216
2021 May 197 68 265
2021 April 342 79 421
2021 March 182 48 230
2021 February 176 41 217
2021 January 110 36 146
2020 December 112 28 140
2020 November 102 32 134
2020 October 75 32 107
2020 September 82 33 115
2020 August 73 22 95
2020 July 86 33 119
2020 June 77 48 125
2020 May 62 22 84
2020 April 52 23 75
2020 March 55 20 75
2020 February 4 0 4
2020 January 4 0 4
2019 December 7 0 7
2019 November 4 0 4
2019 September 4 0 4
2019 August 4 0 4
2019 July 4 0 4
2019 June 4 0 4
2019 May 6 1 7
2019 April 2 3 5
2019 March 4 0 4
2019 February 7 0 7
2019 January 8 0 8
2018 December 9 0 9
2018 November 10 0 10
2018 October 14 0 14
2018 September 5 0 5
2018 March 0 1 1
2018 February 55 12 67
2018 January 91 29 120
2017 December 75 14 89
2017 November 61 12 73
2017 October 65 14 79
2017 September 49 9 58
2017 August 51 16 67
2017 July 45 9 54
2017 June 61 31 92
2017 May 49 21 70
2017 April 42 40 82
2017 March 50 31 81
2017 February 32 21 53
2017 January 36 27 63
2016 December 76 55 131
2016 November 21 34 55
Show all

Follow this link to access the full text of the article

Idiomas
Actas Dermo-Sifiliográficas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?