Original Article
Mycosis Fungoides: Experience in a Pediatric Hospital
Micosis fungoide. Experiencia en un hospital pediátrico
A.B. Cervinia, A.N. Torres-Huamania,
, C. Sanchez-La-Rosab, L. Galluzzoc, V. Solernouc, J. Digiorged, P. Rubiod
Corresponding author
a Servicio de Dermatología, Hospital de Pediatría Dr. Garrahan, Buenos Aires, Argentina
b Servicio de Hemato-Oncología, Hospital de Pediatría Dr. Garrahan, Buenos Aires, Argentina
c Servicio de Anatomía Patológica, Hospital de Pediatría Dr. Garrahan, Buenos Aires, Argentina
d Servicio de Biología Molecular, Hospital de Pediatría Dr. Garrahan, Buenos Aires, Argentina
Read
9280
Timeswas read the article
2654
Total PDF
6626
Total HTML
Share statistics
array:24 [ "pii" => "S1578219017301555" "issn" => "15782190" "doi" => "10.1016/j.adengl.2017.05.013" "estado" => "S300" "fechaPublicacion" => "2017-07-01" "aid" => "1609" "copyright" => "Elsevier España, S.L.U. and AEDV" "copyrightAnyo" => "2017" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2017;108:564-70" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 572 "formatos" => array:3 [ "EPUB" => 32 "HTML" => 407 "PDF" => 133 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731017300650" "issn" => "00017310" "doi" => "10.1016/j.ad.2017.01.008" "estado" => "S300" "fechaPublicacion" => "2017-07-01" "aid" => "1609" "copyright" => "AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2017;108:564-70" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 344 "formatos" => array:3 [ "EPUB" => 4 "HTML" => 244 "PDF" => 96 ] ] "es" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Micosis fungoide. Experiencia en un hospital pediátrico" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:3 [ 0 => "es" 1 => "es" 2 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "564" "paginaFinal" => "570" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Mycosis Fungoides: Experience in a Pediatric Hospital" ] ] "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" => "fig0035" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 971 "Ancho" => 1333 "Tamanyo" => 86126 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A.B. Cervini, A.N. Torres-Huamani, C. Sanchez-La-Rosa, L. Galluzzo, V. Solernou, J. Digiorge, P. Rubio" "autores" => array:7 [ 0 => array:2 [ "nombre" => "A.B." "apellidos" => "Cervini" ] 1 => array:2 [ "nombre" => "A.N." "apellidos" => "Torres-Huamani" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Sanchez-La-Rosa" ] 3 => array:2 [ "nombre" => "L." "apellidos" => "Galluzzo" ] 4 => array:2 [ "nombre" => "V." "apellidos" => "Solernou" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Digiorge" ] 6 => array:2 [ "nombre" => "P." "apellidos" => "Rubio" ] ] ] ] "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="fig0035"></elsevierMultimedia></p></span>" ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219017301555" "doi" => "10.1016/j.adengl.2017.05.013" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017301555?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731017300650?idApp=UINPBA000044" "url" => "/00017310/0000010800000006/v3_201707250313/S0001731017300650/v3_201707250313/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219017301543" "issn" => "15782190" "doi" => "10.1016/j.adengl.2017.05.012" "estado" => "S300" "fechaPublicacion" => "2017-07-01" "aid" => "1614" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2017;108:571-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 730 "formatos" => array:3 [ "EPUB" => 37 "HTML" => 564 "PDF" => 129 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Pediatric Allergic Contact Dermatitis: Clinical and Epidemiological Study in a Tertiary Hospital" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "571" "paginaFinal" => "578" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Dermatitis alérgica de contacto pediátrica. Estudio clínico-epidemiológico en un hospital terciario" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1685 "Ancho" => 2343 "Tamanyo" => 187507 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Allergen series applied.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.M. Ortiz Salvador, A. Esteve Martínez, D. Subiabre Ferrer, A.M. Victoria Martínez, J. de la Cuadra Oyanguren, V. Zaragoza Ninet" "autores" => array:6 [ 0 => array:2 [ "nombre" => "J.M." "apellidos" => "Ortiz Salvador" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Esteve Martínez" ] 2 => array:2 [ "nombre" => "D." "apellidos" => "Subiabre Ferrer" ] 3 => array:2 [ "nombre" => "A.M." "apellidos" => "Victoria Martínez" ] 4 => array:2 [ "nombre" => "J." "apellidos" => "de la Cuadra Oyanguren" ] 5 => array:2 [ "nombre" => "V." "apellidos" => "Zaragoza Ninet" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731017300704" "doi" => "10.1016/j.ad.2016.12.018" "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/S0001731017300704?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017301543?idApp=UINPBA000044" "url" => "/15782190/0000010800000006/v1_201706300050/S1578219017301543/v1_201706300050/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219017302068" "issn" => "15782190" "doi" => "10.1016/j.adengl.2017.02.026" "estado" => "S300" "fechaPublicacion" => "2017-07-01" "aid" => "1625" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2017;108:550-63" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 610 "formatos" => array:3 [ "EPUB" => 36 "HTML" => 410 "PDF" => 164 ] ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Comparison of ixekizumab with etanercept or placebo in moderate-to-severe psoriasis: Subgroup analysis of Latin American patients in the phase 3 randomized UNCOVER-3 study" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:3 [ 0 => "en" 1 => "en" 2 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "550" "paginaFinal" => "563" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Comparación de ixekizumab y etanercept o placebo en la psoriasis de moderada a grave: análisis del subgrupo de pacientes latinoamericanos de la fase 3 del estudio aleatorizado UNCOVER-3" ] ] "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" => "fig0015" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 694 "Ancho" => 1333 "Tamanyo" => 123520 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "F. Valenzuela, C. de la Cruz Fernandez, R.L. Galimberti, S. Gürbüz, M. McKean-Matthews, L. Goncalves, R. Romiti" "autores" => array:7 [ 0 => array:2 [ "nombre" => "F." "apellidos" => "Valenzuela" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "de la Cruz Fernandez" ] 2 => array:2 [ "nombre" => "R.L." "apellidos" => "Galimberti" ] 3 => array:2 [ "nombre" => "S." "apellidos" => "Gürbüz" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "McKean-Matthews" ] 5 => array:2 [ "nombre" => "L." "apellidos" => "Goncalves" ] 6 => array:2 [ "nombre" => "R." "apellidos" => "Romiti" ] ] ] ] "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="fig0015"></elsevierMultimedia></p></span>" ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0001731017300911" "doi" => "10.1016/j.ad.2017.02.005" "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/S0001731017300911?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017302068?idApp=UINPBA000044" "url" => "/15782190/0000010800000006/v1_201706300050/S1578219017302068/v1_201706300050/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Mycosis Fungoides: Experience in a Pediatric Hospital" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "564" "paginaFinal" => "570" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A.B. Cervini, A.N. Torres-Huamani, C. Sanchez-La-Rosa, L. Galluzzo, V. Solernou, J. Digiorge, P. Rubio" "autores" => array:7 [ 0 => array:3 [ "nombre" => "A.B." "apellidos" => "Cervini" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:4 [ "nombre" => "A.N." "apellidos" => "Torres-Huamani" "email" => array:1 [ 0 => "torresnat@yahoo.com.ar" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 2 => array:3 [ "nombre" => "C." "apellidos" => "Sanchez-La-Rosa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "L." "apellidos" => "Galluzzo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "V." "apellidos" => "Solernou" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 5 => array:3 [ "nombre" => "J." "apellidos" => "Digiorge" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] 6 => array:3 [ "nombre" => "P." "apellidos" => "Rubio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital de Pediatría Dr. Garrahan, Buenos Aires, Argentina" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Hemato-Oncología, Hospital de Pediatría Dr. Garrahan, Buenos Aires, Argentina" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital de Pediatría Dr. Garrahan, Buenos Aires, Argentina" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Servicio de Biología Molecular, Hospital de Pediatría Dr. Garrahan, Buenos Aires, Argentina" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Micosis fungoide. Experiencia en un hospital pediátrico" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figure 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 991 "Ancho" => 975 "Tamanyo" => 142437 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Patient #1. Achromic macules, plaques, and ulcerated tumor.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Mycosis fungoides (MF) is the most common primary T-cell cutaneous lymphoma and it mainly affects adults in the fifth decade of life.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a> Clinically, it has 3 classic stages (macule, plaque, and tumor) that can overlap. Patients typically have exclusive cutaneous involvement that follows an indolent course for years or even decades. Characteristic histopathologic findings include an epidermotropic tumor infiltrate and proliferation of atypical T cells with a cerebriform appearance.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Primary cutaneous lymphomas are rare in childhood. MF is also rare, but, as with adults, it is the most common type of primary cutaneous lymphoma in this population.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">2</span></a> The first descriptions of MF in children date back to 1984.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">3</span></a> Several cases have been reported since and the most common clinical presentation in most cases has been hypopigmented MF.<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">2,4–11</span></a> Histopathologic findings are similar to those seen in adults, but immunohistochemical studies show a predominant CD8<span class="elsevierStyleSup">+</span> T-cell infiltrate, which would correlate with the hypopigmented clinical lesions.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The aim of this study was to describe the epidemiological, clinical, histopathologic, and immunophenotypic characteristics of MF in pediatric patients and report on T-cell receptor (TCR) gene rearrangement test results, treatments, and disease course.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Patients and Methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">We conducted a retrospective, observational, descriptive, cross-sectional study of patients with a clinical and histopathologic diagnosis of MF seen at Hospital de Pediatría S.A.M.<span class="elsevierStyleSmallCaps">I</span>.C. «Prof. Dr. Juan P. Garrahan» in Buenos Aires, Argentina between August 1988 and July 2004. This hospital is a referral hospital for children in our country and Latin America. The following variables were analyzed: sex, age, initial diagnosis, time from onset to diagnosis, clinical manifestations, location, stage at diagnosis, histopathologic findings, immunophenotype, TCR gene rearrangement, treatments received, disease course, and follow-up duration. We reviewed clinical charts and pathology reports and applied the diagnostic criteria of the World Health Organization/European Organisation for Research and Treatment of Cancer (2005)<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">1</span></a> and the staging criteria of the International Society for Cutaneous Lymphomas/European Organisation for Research and Treatment of Cancer (2007).<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">12</span></a></p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Results</span><p id="par0025" class="elsevierStylePara elsevierViewall">Fourteen patients with clinical and histologic features of MF were included in the study. The male to female ratio was 1:1.33. Mean age at diagnosis was 11.23 years (range, 8-15 years) and mean time from onset to diagnosis was 3 years and 6 months (range, 4 months to 7 years). Information on demographic, clinical, histopathologic, and immunohistochemical characteristics, TCR gene rearrangement, disease stage, treatments, disease course, follow-up, and disease-free months is summarized in <a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1 and 2</a>.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">MF was the initial diagnosis in just 8 patients (57%). The initial diagnoses in the other 6 patients were pityriasis lichenoides chronica (2 patients), lymphomatoid papulosis (1 patient), hypopigmented pityriasis versicolor (1 patient), vitiligo (1 patient), and atopic dermatitis (1 patient) (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><p id="par0035" class="elsevierStylePara elsevierViewall">All patients had hypopigmented macules (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a>). Six patients (42.8%) developed concomitant or subsequent classic MF lesions. These took the form of macules (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>) in 2 patients, plaques (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>) in 6, and a tumor (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>) in 1. One patient (#9) had clinical manifestations of pityriasis lichenoides chronica but a histopathologic diagnosis of MF.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Two patients (#11 and #12) with a clinical and histopathologic diagnosis of pityriasis lichenoides chronica developed MF after a period of 7 years, and another (#5) experienced progression of lymphomatoid papulosis to MF after a period of 5 years.</p><p id="par0045" class="elsevierStylePara elsevierViewall">All the patients had histopathologic findings consistent with MF (epidermotropic atypical lymphocytic infiltrate) and half of them had Pautrier microabscesses (<a class="elsevierStyleCrossRef" href="#fig0030">Fig. 6</a>). One of these (patient #8) had a folliculotropic histopathologic variant, but there was no correlation with clinical findings. In the immunohistochemical studies, 7 patients (50%) had a CD8<span class="elsevierStyleSup">+</span><span class="elsevierStyleHsp" style=""></span>CD4<span class="elsevierStyleSup">–</span> immunophenotype, 5 had a CD8<span class="elsevierStyleSup">+</span> CD4<span class="elsevierStyleSup">+</span> immunophenotype, and just 2 had a CD8<span class="elsevierStyleSup">–</span> CD4<span class="elsevierStyleSup">+</span> immunophenotype (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><elsevierMultimedia ident="fig0030"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">TCR gene rearrangement tests were performed in just 6 patients. The results were positive in patient #1 (Vb22 CD4, variable region of beta chain), patient #4 (gamma), and patient #14 (beta) and negative in patients #3, #8, and #9. The studies were performed using skin samples in all cases. Blood samples were also tested in 1 patient, and the result was positive for TCR delta (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><p id="par0055" class="elsevierStylePara elsevierViewall">At the time of MF diagnosis, 11 patients (78.5%) had stage IB disease, 2 had stage IA disease, and 1 had stage IVA2 disease (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). The patient with stage IV disease had extracutaneous involvement of the axillary and inguinal lymph nodes.</p><p id="par0060" class="elsevierStylePara elsevierViewall">Lactate dehydrogenase (LDH) levels and eosinophil counts were available for 11 of the 14 patients. None had elevated LDH levels and just 1 (#4) had hypereosinophilia (><span class="elsevierStyleHsp" style=""></span>700/mm<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">3</span></a>). Although this patient had chronic bronchitis episodes, it is noteworthy that he did not have hypereosinophilia during his time free of MF.</p><p id="par0065" class="elsevierStylePara elsevierViewall">The treatments reported are summarized in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>, and it is important to note that some treatments were administered concurrently or sequentially in different patients. The initial treatment of choice was phototherapy in 12 patients (85.7%) due to the extension of their lesions. Six received psoralen plus UV-A (PUVA) therapy, 2 received narrowband UV-B therapy, and 3 received these treatments consecutively. Finally, 1 patient was treated with UV-A1 phototherapy.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Additional concomitant and/or consecutive treatments in 9 patients were high-potency topical corticosteroids (clobetasol) (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>6), topical bexarotene (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2), and a combination of oral retinoids (acitretin), psoralens, and heliotherapy (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1). The patient with stage IV disease was treated with CHOP chemotherapy (cyclophosphamide 750<span class="elsevierStyleHsp" style=""></span>mg/m<span class="elsevierStyleSup">2</span>/d, doxorubicin 50<span class="elsevierStyleHsp" style=""></span>mg/m<span class="elsevierStyleSup">2</span>/d, intravenous vincristine 1.4<span class="elsevierStyleHsp" style=""></span>mg/m<span class="elsevierStyleSup">2</span>/d, and methylprednisone 60<span class="elsevierStyleHsp" style=""></span>mg/m<span class="elsevierStyleSup">2</span>/d for 5 days) and with electron beam radiotherapy.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Eight patients are currently receiving treatment, 4 are free of disease, 1 (patient #1) was referred to an adult hospital after a disease-free period of 4 years, and another (#2) was lost to follow up.</p><p id="par0080" class="elsevierStylePara elsevierViewall">Four of the 14 patients (#1, #3, #4, and #5) had at least 1 recurrence, 3 experienced extension of cutaneous involvement, and 1 showed partial response with persistence of MF. There were no deaths over a median follow-up period of 3 years (range, 2 months to 9 years). The median disease-free period was 3 months (range, 1-48 months). These wide ranges can be explained by the fact that 9 of 14 patients were added to the series in the last 18 months. Six of them had been followed for less than 1 year and most were on their first treatment, preventing us from evaluating overall treatment effectiveness.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discussion</span><p id="par0085" class="elsevierStylePara elsevierViewall">Children account for between 5% and 16% of all MF patients, although rates vary greatly from study to study.<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">6–9,11,13</span></a> The incidence of MF before the age of 20 years is approximately 0.05 cases per 100 000 inhabitants per year<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a> and MF is the most common primary cutaneous T-cell lymphoma in children. Although a predilection for the male sex has been reported,<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">13,14</span></a> there was a slight female predominance in our series. The mean age at diagnosis (11.23 years) and the mean time from onset to diagnosis (3 years and 6 months) are similar to those reported in other publications.<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">4,6–10,13,15</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">MF is difficult to diagnosis on purely clinical grounds in children due to the rarity of the disease in this population, the low index of suspicion among physicians, and the broad differential diagnosis.<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">4,9</span></a> This diagnostic difficulty is reflected in our study by the time it took to establish a diagnosis (3 years and 6 months) and the low level of clinical suspicion at the first visit, where just 57% of children were diagnosed with MF.</p><p id="par0095" class="elsevierStylePara elsevierViewall">Hypopigmented MF is the most common clinical variant of MF in children, and is particularly frequent in patients with Fitzpatrick skin types <span class="elsevierStyleSmallCaps">iii</span> or <span class="elsevierStyleSmallCaps">iv</span>.<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">4,5,7,8,10,11,13,16,17</span></a> Forty percent of our patients had hypopigmented lesions coexisting with classic MF lesions, supporting previous reports.<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">6,8,10</span></a> It should be highlighted that 1 patient in our series had a clinical diagnosis of pityriasis lichenoides chronica but histopathologic findings consistent with MF. Another 2 patients, one with a diagnosis of pityriasis lichenoides chronica and the other with a diagnosis of lymphomatoid papulosis developed MF after several years. These situations have been described infrequently in the literature.</p><p id="par0100" class="elsevierStylePara elsevierViewall">Classic MF typically has a CD3<span class="elsevierStyleSup">+</span>, CD4, CD5<span class="elsevierStyleSup">+</span>, and CD8<span class="elsevierStyleSup">−</span> immunophenotype, with loss of CD7 expression. CD8<span class="elsevierStyleSup">+</span> predominance is common in hypopigmented MF<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">5,7,9</span></a> and was observed in 12 of our patients. It should be noted that 5 patients (35%) had a CD4<span class="elsevierStyleSup">+</span> and CD8<span class="elsevierStyleSup">+</span> immunophenotype, which is a rare variant.<a class="elsevierStyleCrossRefs" href="#bib0190"><span class="elsevierStyleSup">18,19</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">It is difficult to assess treatment response in our series due to the retrospective nature of our study and the fact that a majority of the children are still undergoing treatment. Sixty-four percent of patients were included in the last 18 months and almost half have been monitored for less than a year.</p><p id="par0110" class="elsevierStylePara elsevierViewall">Treatments for MF vary according to disease stage. Because most patients have generalized cutaneous lesions, without systemic involvement, the treatment of choice is phototherapy. Topical corticosteroids are used in cases of localized disease. Phototherapy was also the treatment of choice in most of our patients. PUVA was more effective than narrowband UV-B therapy, and no adverse effects have been observed to date. Young patients with MF, however, require multiple treatments over a lifetime due to the high recurrence rates. Accordingly, prolonged maintenance phototherapy is recommended to prevent early relapse.<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">5,13,14,17</span></a> However, while these treatment regimens prolong periods of remission, they can result in high cumulative doses of UV-A and long-term monitoring is therefore necessary due to the risk of early carcinogenesis.<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">16</span></a> Over half of the patients in our series were treated with high-potency topical corticosteroids and/or topical bexarotene. Response was moderate or short-lasting.</p><p id="par0115" class="elsevierStylePara elsevierViewall">Coinciding with reports in the literature,<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">2,4,6,8–11,13,15,16</span></a> all but 1 patient in our series had stage IA or IB disease; 78% had stage IB disease, which has an excellent prognosis and a life expectancy comparable to that of the general population.<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">1,20</span></a> Most of the patients progressed very favorably. There were no deaths and only 20% experienced disease progression. Progression, however, was marked by an extension in cutaneous involvement and none of the patients developed systemic disease. The only patient with skin tumors and lymph node involvement was free of disease after 7 years’ follow-up. Other series of childhood MF have reported similar progression-free results.<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">5,13,15</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">Our study has limitations inherent to its retrospective design. We used empirical definitions to assess treatment response as there are no standardized criteria for the pediatric population as such, these definitions mainly depend on the assest of the attending specialist. Another limitation is the short follow-up period, as this made it difficult to draw conclusions on long-term outcomes, although the literature reports low rates of disease progression and excellent survival.<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">5,9,11,13,14</span></a> Nonetheless, in a study of patients under 30 years old with MF who were followed for 10 years Ai et al.<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a> detected an increased risk of a second cancer (standard incidence ratio of 3.49), in particular lymphoma and melanoma. Overall survival, however, was between 88.9% and 94.3% and the differences were not statistically significant</p><p id="par0125" class="elsevierStylePara elsevierViewall">In conclusion, MF is uncommon in children and difficult to diagnose due to the broad differential diagnosis. The hypopigmented variant is the most common form of MF in this age group. Although MF in childhood has a good prognosis, it has high recurrence rates and therefore requires long-term follow-up. Monitoring of children with MF over time will provide more insights into disease course and progression, long-term treatment effects, and onset of second cancers.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Ethical Disclosures</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Protection of humans and animals</span><p id="par0130" class="elsevierStylePara elsevierViewall">The authors declare that no tests were carried out in humans or animals for the purpose of this study.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Confidentiality of data</span><p id="par0135" class="elsevierStylePara elsevierViewall">The authors declare that they have followed their hospital's protocol on the publication of data concerning patients.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Right to privacy and informed consent</span><p id="par0140" class="elsevierStylePara elsevierViewall">The authors declare that no private patient data appear in this article.</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflicts of Interest</span><p id="par0145" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres858587" "titulo" => "Abstract" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objectives" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Material and methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec852708" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres858586" "titulo" => "Resumen" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivos" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Material y método" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec852707" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Patients and Methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:3 [ "identificador" => "sec0025" "titulo" => "Ethical Disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0030" "titulo" => "Protection of humans and animals" ] 1 => array:2 [ "identificador" => "sec0035" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0040" "titulo" => "Right to privacy and informed consent" ] ] ] 9 => array:2 [ "identificador" => "sec0045" "titulo" => "Conflicts of Interest" ] 10 => array:2 [ "identificador" => "xack287830" "titulo" => "Acknowledgments" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec852708" "palabras" => array:4 [ 0 => "Mycosis fungoides" 1 => "Children" 2 => "Lymphoma" 3 => "Primary cutaneous" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec852707" "palabras" => array:3 [ 0 => "Micosis fungoide" 1 => "Niños" 2 => "Linfoma cutáneo primario" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Mycosis fungoides (MF), the most common primary cutaneous T-cell lymphoma, is unusual in children.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objectives</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We aimed to describe the epidemiologic, clinical, histopathologic, and immunophenotypic characteristics of MF as well as treatments and course of disease in a pediatric case series.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Material and methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Data for all patients admitted to our pediatric hospital (Hospital Dr. J. P. Garrahan) in Argentina with a clinical and histopathologic diagnosis of MF between August 1988 and July 2014 were included.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A total of 14 patients were diagnosed with MF. The ratio of boys to girls was 1:1.33. The mean age at diagnosis was 11.23 years (range, 8–15 years). The mean time between onset and diagnosis was 3.5 years (range, 4 months–7 years). All patients had hypopigmented MF and 42% also presented the features of classic MF. Seven (50%) had the CD8<span class="elsevierStyleSup">+</span> immunophenotype exclusively. Seventy-eight percent were in stage IB at presentation. Phototherapy was the treatment of choice. Four patients relapsed at least once and skin lesions progressed in 3 patients. All patients improved.</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">MF is unusual in children. The hypopigmented form is the most common. Diagnosis is delayed because the condition is similar to other hypopigmented diseases seen more often in childhood. Although prognosis is good, the rate of recurrence is high, so long-term follow-up is necessary.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Objectives" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Material and methods" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Results" ] 4 => array:2 [ "identificador" => "abst0025" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Introducción</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">La micosis fungoide (MF) es el linfoma cutáneo primario de células T más frecuente. Su aparición en la infancia es excepcional.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objetivos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Describir las características epidemiológicas, clínicas, histopatológicas e inmunofenotípicas de los pacientes con MF. Describir los tratamientos utilizados y la evolución.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Material y método</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron todos los pacientes admitidos en el Hospital de Pediatría Dr. J. P. Garrahan (Argentina) en el período comprendido entre agosto de 1988 y julio de 2014 con diagnóstico clínico e histopatológico de MF.</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Se diagnosticaron 14 pacientes con MF. La distribución por sexo fue M/F: 1:1,33. La edad media al diagnóstico fue de 11,23 años (rango: 8 a 15 años). El tiempo promedio de evolución hasta el momento del diagnóstico fue de 3 años y 6 meses (rango: 4 meses a 7 años). Todos los pacientes presentaron la forma clínica hipopigmentada y en el 42% se asoció la forma clásica. El 50% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>7) exhibió un inmunofenotipo CD8 positivo de forma exclusiva. El 78% presentó estadio IB. La fototerapia fue el tratamiento de elección. Cuatro pacientes tuvieron por lo menos una recaída y 3 demostraron progresión de su enfermedad a nivel cutáneo. La evolución fue favorable en todos los casos.</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">La MF es una entidad infrecuente en la infancia, siendo la forma hipopigmentada la más frecuente. Su diagnóstico es tardío debido a la similitud con otras enfermedades hipopigmentadas frecuentes en la niñez. A pesar de tener un buen pronóstico, presenta alta tasa de recidivas y requiere un seguimiento a largo plazo.</p></span>" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "abst0030" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0035" "titulo" => "Objetivos" ] 2 => array:2 [ "identificador" => "abst0040" "titulo" => "Material y método" ] 3 => array:2 [ "identificador" => "abst0045" "titulo" => "Resultados" ] 4 => array:2 [ "identificador" => "abst0050" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as: Cervini AB, Torres-Huamani AN, Sanchez-La-Rosa C, Galluzzo L, Solernou V, Digiorge J, et al. Micosis fungoide. Experiencia en un hospital pediátrico. Actas Dermosifiliogr. 2017;108:564–570.</p>" ] ] "multimedia" => array:8 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1134 "Ancho" => 850 "Tamanyo" => 125774 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Patient #10. Hypopigmented macules.</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" => 711 "Ancho" => 975 "Tamanyo" => 94728 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Patient #5. Hypopigmented macules.</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" => 904 "Ancho" => 975 "Tamanyo" => 137106 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Patient #4. Classic macules.</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" => 1099 "Ancho" => 850 "Tamanyo" => 196340 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Patient #1. Achromic macules, plaques, and ulcerated tumor.</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" => 991 "Ancho" => 975 "Tamanyo" => 142437 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Patient #1. Achromic macules, plaques, and ulcerated tumor.</p>" ] ] 5 => array:7 [ "identificador" => "fig0030" "etiqueta" => "Figure 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 660 "Ancho" => 975 "Tamanyo" => 193687 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Epidermotropic atypical lymphocytes and Pautrier microabscess (hematoxylin-eosin, original magnification ×20).</p>" ] ] 6 => 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="spar0090" class="elsevierStyleSimplePara elsevierViewall">Abbreviations: CMF, classic mycosis fungoides; F, female; HMF, hypopigmented mycosis fungoides; M, male; TOD, time from onset to diagnosis.</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">Patient \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">Sex/Age, y \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">TOD, y \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">Clinical Manifestations \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">Location \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">Initial Clinical Diagnosis \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">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F/10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Plaques and tumors<br>HMF and CMF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Disseminated \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF \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">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F/13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Plaques<br>HMF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Trunk<br>Upper extremities \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Atopic dermatitis \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">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M/13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">HMF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Trunk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF \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">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F/12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Plaques<br>HMF and CMF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Abdomen<br>Lower extremities \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF \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">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F/9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">HMF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Trunk and extremities \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Lymphomatoid papulosis \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">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F/14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">HMF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Trunk<br>Abdomen \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Pityriasis versicolor with achromic lesions \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">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F/11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">HMF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Upper extremities \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF \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">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M/13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">HMF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Extremities \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Vitiligo \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">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">W/8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Plaques<br>HMF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Abdomen<br>Extremities \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Pityriasis lichenoides \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">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F/10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Plaques<br>HMF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Trunk<br>Extremities \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF \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">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M/10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Plaques<br>HMF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Trunk<br>Extremities \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF \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">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M/8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">HMF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Disseminated \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Pityriasis lichenoides \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">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">F/15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">HMF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Disseminated \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF \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">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">M/13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">HMF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Disseminated \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1450851.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Clinical Data.</p>" ] ] 7 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Abbreviations: CHOP,cyclophosphamide, doxorubicin, vincristine, and prednisone; CS, corticosteroids; HT, heliotherapy; DF, disease-free; IHC, immunohistochemical; MF, micosis fungoides; ND, not done; QT, chemotherapy; TCR, T-cell receptor gene rearrangement.</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">Patient \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">HP and IHC Diagnosis \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">TCR \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">TNM/Stage<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \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 \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">Disease Course \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">Follow-up \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">DF Period \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">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF<br>CD4<span class="elsevierStyleSup">−</span> CD8<span class="elsevierStyleSup">+</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">+ Vb22 (94%)<br>CD4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">T3 N3 M0/IVA2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">CHOP QT and electron beam radiotherapy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">DF and recurrence (n=1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">7.51 y \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 y \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">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF<br>CD4<span class="elsevierStyleSup">−</span> CD8<span class="elsevierStyleSup">+</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">T2b N0 M0/IB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Lost to follow-up \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 mo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF<br>CD4<span class="elsevierStyleSup">−</span> CD8<span class="elsevierStyleSup">+</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">- \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">T2b N0 M0/IB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PUVA<br>UV-B<br>Topical CS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">DF after recurrence (n = 1) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.5 y \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6 mo \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">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF<br>CD4<span class="elsevierStyleSup">+</span> CD8<span class="elsevierStyleSup">-</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">+ gamma (skin) and delta (blood) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">T2b N0 M0/IB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PUVA<br>Topical bexarotene \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Under treatment after recurrence (n=1) and progression \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 y \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF<br>CD4<span class="elsevierStyleSup">+</span> CD8<span class="elsevierStyleSup">+</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND<br> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">T2a N0 M0/IB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PUVA<br>UV-B<br>Topical bexarotene \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Under treatment after recurrence (n=2) and progression \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 y \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF<br>CD4<span class="elsevierStyleSup">+</span> CD8<span class="elsevierStyleSup">-</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">T2a N0 M0/IB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PUVA<br>Topical CS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Under treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">9 mo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF<br>CD4<span class="elsevierStyleSup">+</span> CD8<span class="elsevierStyleSup">+</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">T1a N0 M0/IA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PUVA<br>Topical CS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">DF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 mo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 mo \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">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF<br>Folliclular<br>CD4<span class="elsevierStyleSup">−</span> CD8<span class="elsevierStyleSup">+</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">- \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">T1a N0 M0/IA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">UV-B<br>Topical CS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">DF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13 mo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 mo \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">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF<br>CD4<span class="elsevierStyleSup">−</span> CD8<span class="elsevierStyleSup">+</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">- \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">T2a N0 M0/IB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">UV-B<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>psoralen<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>retinoids + HT<br>Topical CS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Progression<br>Under treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13 mo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF<br>CD4<span class="elsevierStyleSup">−</span> CD8<span class="elsevierStyleSup">+</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">T2a N0 M0/IB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">UV-B<br>PUVA<br>Topical CS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">DF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12 mo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 mo \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">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF<br>CD4<span class="elsevierStyleSup">−</span> CD8<span class="elsevierStyleSup">+</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">T2a N0 M0/IB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PUVA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Under treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 mo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF<br>CD4<span class="elsevierStyleSup">+</span> CD8<span class="elsevierStyleSup">+</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">T2a N0 M0/IB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">UV-A-1<br>Topical CS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Under treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 mo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF<br>CD4<span class="elsevierStyleSup">−</span> CD8<span class="elsevierStyleSup">+</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">T2a N0 M0/IB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PUVA<br>Topical CS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Under treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 mo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MF<br>CD4<span class="elsevierStyleSup">−</span> CD8<span class="elsevierStyleSup">+</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">+ beta \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">T2a N0 M0/IB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PUVA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Under treatment \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 mo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">– \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1450850.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">According to the 2007 staging and classification recommendations of the International Society for Cutaneous Lymphomas and the European Organisation for Research and Treatment of Cancer.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Clinical Findings, Treatment, and Disease Course.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:20 [ 0 => array:3 [ "identificador" => "bib0105" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "WHO-EORTC classification for cutaneous lymphomas" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Willemze" 1 => "E.S. Jaffe" 2 => "G. Burg" 3 => "L. Cerroni" 4 => "E. Berti" 5 => "S.H. Swerdlow" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1182/blood-2004-09-3502" "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "2005" "volumen" => "105" "paginaInicial" => "3768" "paginaFinal" => "3785" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15692063" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0110" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The spectrum of cutaneous lymphomas in patients less than 20 years of age" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Fink-Puches" 1 => "A. Chott" 2 => "M. Ardigó" 3 => "I. Simonitsch" 4 => "G. Ferrara" 5 => "H. Kerl" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.0736-8046.2004.21500.x" "Revista" => array:6 [ "tituloSerie" => "Pediatr Dermatol" "fecha" => "2004" "volumen" => "21" "paginaInicial" => "525" "paginaFinal" => "533" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15461755" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0115" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary cutaneous T-cell lymphoma in a child" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.S. Paller" 1 => "N.B. Esterly" 2 => "E.S. Baum" 3 => "F. Gonzalez-Crussi" 4 => "W.A. Caro" 5 => "D. Variakojis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pediatr Dermatol" "fecha" => "1984" "volumen" => "2" "paginaInicial" => "131" "paginaFinal" => "135" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6334849" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0120" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pediatric mycosis fungoides in Singapore: A series of 46 children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Y.K. Heng" 1 => "M.J. Koh" 2 => "Y.C. Giam" 3 => "M.B. Tang" 4 => "W.S. Chong" 5 => "S.H. Tan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/pde.12352" "Revista" => array:6 [ "tituloSerie" => "Pediatr Dermatol" "fecha" => "2014" "volumen" => "31" "paginaInicial" => "477" "paginaFinal" => "482" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24890628" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0125" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hypopigmented mycosis fungoides in childhood and adolescence: A long-term retrospective study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Castano" 1 => "S. Glick" 2 => "L. Wolgast" 3 => "R. Naeem" 4 => "J. Sunkara" 5 => "D. Elston" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Cutan Pathol" "fecha" => "2013" "volumen" => "40" "paginaInicial" => "924" "paginaFinal" => "934" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0130" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Childhood mycosis fungoides: A report of 20 cases from Turkey" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K.D. Yazganoglu" 1 => "Z. Topkarci" 2 => "N. Buyukbabani" 3 => "C. Baykal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1468-3083.2011.04383.x" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2013" "volumen" => "27" "paginaInicial" => "295" "paginaFinal" => "300" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22176010" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0135" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mycosis fungoides in children and adolescents: A report of six cases with predominantly hypopigmentation, along with a literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F.A. Rizzo" 1 => "E.G. Vilar" 2 => "L. Pantaleão" 3 => "E.C. Fonseca" 4 => "P.F. Magrin" 5 => "M. Henrique-Xavier" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Dermatol Online J" "fecha" => "2012" "volumen" => "18" "paginaInicial" => "5" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23286795" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0140" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mycosis fungoides in Arab children and adolescents: A report of 36 patients from Kuwait" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Nanda" 1 => "Q.A. AlSaleh" 2 => "H. Al-Ajmi" 3 => "H. Al-Sabah" 4 => "M. Elkashlan" 5 => "S. Al-Shemmari" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1525-1470.2010.01129.x" "Revista" => array:6 [ "tituloSerie" => "Pediatr Dermatol" "fecha" => "2010" "volumen" => "27" "paginaInicial" => "607" "paginaFinal" => "613" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21138468" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0145" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outcome in 34 patients with juvenile-onset mycosis fungoides: A clinical, immunophenotypic, and molecular study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E.M. Wain" 1 => "G.E. Orchard" 2 => "S.J. Whittaker" 3 => "M. Spittle" 4 => "M.F. Sc" 5 => "R. Russell-Jones" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/cncr.11780" "Revista" => array:6 [ "tituloSerie" => "Cancer" "fecha" => "2003" "volumen" => "98" "paginaInicial" => "2282" "paginaFinal" => "2290" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14601100" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0150" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Juvenile mycosis fungoides diagnosed before 18 years of age" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D. Ben-Amitai" 1 => "D. Michael" 2 => "M. Feinmesser" 3 => "E. Hodak" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Derm Venereol" "fecha" => "2003" "volumen" => "83" "paginaInicial" => "451" "paginaFinal" => "456" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14690342" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0155" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mycosis fungoides in patients under 20 years of age: Report of 7 cases, review of the literature and study of the clinical course" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P. Quaglino" 1 => "A. Zaccagna" 2 => "A. Verrone" 3 => "F. Dardano" 4 => "M.G. Bernengo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "18196" "Revista" => array:6 [ "tituloSerie" => "Dermatology" "fecha" => "1999" "volumen" => "199" "paginaInicial" => "8" "paginaFinal" => "14" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10449950" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0160" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Revisions to the staging and classification of mycosis fungoides and Sezary syndrome: A proposal of the International Society for Cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Olsen" 1 => "E. Vonderheid" 2 => "N. Pimpinelli" 3 => "R. Willemze" 4 => "Y. Kim" 5 => "R. Knobler" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1182/blood-2007-03-055749" "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "2007" "volumen" => "110" "paginaInicial" => "1713" "paginaFinal" => "1722" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17540844" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0165" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Profile and outcome of childhood mycosis fungoides in Singapore" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E. Tan" 1 => "Y.K. Tay" 2 => "Y.C. Giam" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pediatr Dermatol" "fecha" => "2000" "volumen" => "17" "paginaInicial" => "352" "paginaFinal" => "356" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11085660" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0170" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Outcomes after diagnosis of mycosis fungoides and Sézary syndrome before 30 years of age: A population-based study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W.Z. Ai" 1 => "T.H. Keegan" 2 => "D.J. Press" 3 => "J. Yang" 4 => "L.B. Pincus" 5 => "Y.H. Kim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamadermatol.2013.7747" "Revista" => array:6 [ "tituloSerie" => "JAMA Dermatol" "fecha" => "2014" "volumen" => "150" "paginaInicial" => "709" "paginaFinal" => "715" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24718769" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0175" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinicopathological features and T-cell receptor gene rearrangement findings of mycosis fungoides in patients younger than age 20 years" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.T. Kim" 1 => "H.J. Sim" 2 => "Y.S. Jeon" 3 => "J.W. Lee" 4 => "H.J. Roh" 5 => "S.Y. Choi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1346-8138.2009.00665.x" "Revista" => array:6 [ "tituloSerie" => "J Dermatol" "fecha" => "2009" "volumen" => "36" "paginaInicial" => "392" "paginaFinal" => "402" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19583687" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0180" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Childhood mycosis fungoides: Experience of 28 patients and response to phototherapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P.M. Laws" 1 => "N.H. Shear" 2 => "E. Pope" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/pde.12338" "Revista" => array:6 [ "tituloSerie" => "Pediatr Dermatol" "fecha" => "2014" "volumen" => "31" "paginaInicial" => "459" "paginaFinal" => "464" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24916067" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0185" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Narrow-band ultraviolet B phototherapy for mycosis fungoides in children" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.J. Koh" 1 => "W.S. Chong" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ced.12364" "Revista" => array:6 [ "tituloSerie" => "Clin Exp Dermatol" "fecha" => "2014" "volumen" => "39" "paginaInicial" => "474" "paginaFinal" => "478" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24825139" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0190" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "CD4/CD8 dual-positive mycosis fungoides: a previously unrecognized variant" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C.F. Knapp" 1 => "R. Mathew" 2 => "J.L. Messina" 3 => "M.H. Lien" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/DAD.0b013e31823e25bb" "Revista" => array:6 [ "tituloSerie" => "Am J Dermatopathol" "fecha" => "2012" "volumen" => "34" "paginaInicial" => "e37" "paginaFinal" => "e39" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22356917" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0195" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Double-positive CD4/CD8 mycosis fungoides: A rarely reported immunohistochemical profile" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Tournier" 1 => "C. Laurent" 2 => "M. Thomas" 3 => "N. Meyer" 4 => "R. Viraben" 5 => "P. Brousset" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/cup.12248" "Revista" => array:6 [ "tituloSerie" => "J Cutan Pathol" "fecha" => "2014" "volumen" => "41" "paginaInicial" => "58" "paginaFinal" => "62" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24134789" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0200" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "1-99.28" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Skin malignancies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.M. Pierini" 1 => "A.B. Cervini" 2 => "M. Bocián" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "editores" => "J.HarperA.OranjeN.Prose" "edicion" => "3<span class="elsevierStyleHsp" style=""></span>th ed" "serieVolumen" => "99" "serieTitulo" => "Textbook of pediatric dermatology" "serieFecha" => "2011" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack287830" "titulo" => "Acknowledgments" "texto" => "<p id="par0150" class="elsevierStylePara elsevierViewall">Dr Guillermo Chantada and Centro Médico PSORIAHUE.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010800000006/v1_201706300050/S1578219017301555/v1_201706300050/en/main.assets" "Apartado" => array:4 [ "identificador" => "6256" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original article" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010800000006/v1_201706300050/S1578219017301555/v1_201706300050/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017301555?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 12 | 24 | 36 |
| 2024 October | 102 | 82 | 184 |
| 2024 September | 115 | 25 | 140 |
| 2024 August | 138 | 81 | 219 |
| 2024 July | 106 | 90 | 196 |
| 2024 June | 101 | 56 | 157 |
| 2024 May | 99 | 47 | 146 |
| 2024 April | 96 | 24 | 120 |
| 2024 March | 130 | 53 | 183 |
| 2024 February | 132 | 35 | 167 |
| 2024 January | 172 | 37 | 209 |
| 2023 December | 97 | 25 | 122 |
| 2023 November | 124 | 28 | 152 |
| 2023 October | 119 | 25 | 144 |
| 2023 September | 77 | 38 | 115 |
| 2023 August | 74 | 17 | 91 |
| 2023 July | 86 | 29 | 115 |
| 2023 June | 107 | 23 | 130 |
| 2023 May | 89 | 32 | 121 |
| 2023 April | 97 | 20 | 117 |
| 2023 March | 89 | 22 | 111 |
| 2023 February | 90 | 29 | 119 |
| 2023 January | 66 | 40 | 106 |
| 2022 December | 108 | 53 | 161 |
| 2022 November | 49 | 29 | 78 |
| 2022 October | 74 | 26 | 100 |
| 2022 September | 64 | 40 | 104 |
| 2022 August | 68 | 41 | 109 |
| 2022 July | 46 | 46 | 92 |
| 2022 June | 74 | 35 | 109 |
| 2022 May | 109 | 47 | 156 |
| 2022 April | 130 | 62 | 192 |
| 2022 March | 104 | 63 | 167 |
| 2022 February | 96 | 39 | 135 |
| 2022 January | 138 | 61 | 199 |
| 2021 December | 78 | 61 | 139 |
| 2021 November | 123 | 53 | 176 |
| 2021 October | 132 | 69 | 201 |
| 2021 September | 104 | 61 | 165 |
| 2021 August | 127 | 55 | 182 |
| 2021 July | 80 | 44 | 124 |
| 2021 June | 100 | 46 | 146 |
| 2021 May | 131 | 75 | 206 |
| 2021 April | 296 | 108 | 404 |
| 2021 March | 272 | 60 | 332 |
| 2021 February | 185 | 65 | 250 |
| 2021 January | 131 | 58 | 189 |
| 2020 December | 109 | 39 | 148 |
| 2020 November | 101 | 54 | 155 |
| 2020 October | 80 | 29 | 109 |
| 2020 September | 300 | 39 | 339 |
| 2020 August | 103 | 32 | 135 |
| 2020 July | 93 | 32 | 125 |
| 2020 June | 100 | 49 | 149 |
| 2020 May | 71 | 30 | 101 |
| 2020 April | 76 | 21 | 97 |
| 2020 March | 45 | 17 | 62 |
| 2020 February | 5 | 0 | 5 |
| 2020 January | 4 | 0 | 4 |
| 2019 December | 4 | 0 | 4 |
| 2019 November | 3 | 0 | 3 |
| 2019 September | 4 | 0 | 4 |
| 2019 August | 4 | 0 | 4 |
| 2019 July | 6 | 0 | 6 |
| 2019 June | 5 | 0 | 5 |
| 2019 May | 4 | 0 | 4 |
| 2019 April | 6 | 0 | 6 |
| 2019 February | 4 | 0 | 4 |
| 2018 December | 6 | 0 | 6 |
| 2018 November | 2 | 0 | 2 |
| 2018 October | 3 | 0 | 3 |
| 2018 September | 4 | 0 | 4 |
| 2018 May | 1 | 0 | 1 |
| 2018 February | 16 | 5 | 21 |
| 2018 January | 50 | 12 | 62 |
| 2017 December | 45 | 9 | 54 |
| 2017 November | 48 | 8 | 56 |
| 2017 October | 29 | 10 | 39 |
| 2017 September | 50 | 9 | 59 |
| 2017 August | 41 | 28 | 69 |
| 2017 July | 53 | 32 | 85 |
| 2017 June | 14 | 20 | 34 |
Show all
