array:24 [
  "pii" => "S1578219017303402"
  "issn" => "15782190"
  "doi" => "10.1016/j.adengl.2017.10.022"
  "estado" => "S300"
  "fechaPublicacion" => "2017-12-01"
  "aid" => "1720"
  "copyright" => "Elsevier España, S.L.U. and AEDV"
  "copyrightAnyo" => "2017"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Actas Dermosifiliogr. 2017;108:956-8"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 384
    "formatos" => array:3 [
      "EPUB" => 20
      "HTML" => 299
      "PDF" => 65
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0001731017303113"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2017.03.015"
      "estado" => "S300"
      "fechaPublicacion" => "2017-12-01"
      "aid" => "1720"
      "copyright" => "AEDV"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Actas Dermosifiliogr. 2017;108:956-8"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 268
        "formatos" => array:2 [
          "HTML" => 206
          "PDF" => 62
        ]
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fico-cl&#237;nica</span>"
        "titulo" => "S&#237;ndrome de Schnitzler con respuesta a anakinra en monoterapia&#58; 7 a&#241;os de seguimiento"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "956"
            "paginaFinal" => "958"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Schnitzler Syndrome With Response to Anakinra Monotherapy&#58; 7 Years of Follow-up"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1106
                "Ancho" => 2450
                "Tamanyo" => 364935
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">a y b&#58; <span class="elsevierStyleItalic">rash</span> urticariforme de p&#225;pulas y placas rosadas&#44; edematosas&#44; no descamativas&#44; de evoluci&#243;n fugaz&#44; en el tronco y las extremidades&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Y&#46; Hidalgo-Garc&#237;a, E&#46; Garc&#237;a-Fern&#225;ndez, L&#46; Palacio-Aller, P&#46; Gonzalvo"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "Y&#46;"
                "apellidos" => "Hidalgo-Garc&#237;a"
              ]
              1 => array:2 [
                "nombre" => "E&#46;"
                "apellidos" => "Garc&#237;a-Fern&#225;ndez"
              ]
              2 => array:2 [
                "nombre" => "L&#46;"
                "apellidos" => "Palacio-Aller"
              ]
              3 => array:2 [
                "nombre" => "P&#46;"
                "apellidos" => "Gonzalvo"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1578219017303402"
          "doi" => "10.1016/j.adengl.2017.10.022"
          "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/S1578219017303402?idApp=UINPBA000044"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731017303113?idApp=UINPBA000044"
      "url" => "/00017310/0000010800000010/v1_201711300829/S0001731017303113/v1_201711300829/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1578219017303384"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2017.10.020"
    "estado" => "S300"
    "fechaPublicacion" => "2017-12-01"
    "aid" => "1719"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2017;108:958-9"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 520
      "formatos" => array:3 [
        "EPUB" => 18
        "HTML" => 415
        "PDF" => 87
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
      "titulo" => "Intense Local Reaction at the Sites of Injection of Lipolytic Mesotherapy"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "958"
          "paginaFinal" => "959"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Reacci&#243;n Local Intensa en Zonas de Inyecci&#243;n de Mesoterapia Lipol&#237;tica"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 2250
              "Ancho" => 1500
              "Tamanyo" => 493292
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Confluent&#44; erythematous edematous plaques with vesicles at the sites of injection of mesotherapy on the thigh&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "S&#46; C&#243;rdoba, E&#46; Rojas, A&#46; Garrido-R&#237;os, J&#46; Borbujo"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "C&#243;rdoba"
            ]
            1 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Rojas"
            ]
            2 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Garrido-R&#237;os"
            ]
            3 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Borbujo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731017303101"
        "doi" => "10.1016/j.ad.2017.02.027"
        "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/S0001731017303101?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017303384?idApp=UINPBA000044"
    "url" => "/15782190/0000010800000010/v1_201711300824/S1578219017303384/v1_201711300824/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1578219017303165"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2017.10.013"
    "estado" => "S300"
    "fechaPublicacion" => "2017-12-01"
    "aid" => "1721"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2017;108:954-5"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 482
      "formatos" => array:3 [
        "EPUB" => 17
        "HTML" => 391
        "PDF" => 74
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
      "titulo" => "Acquired Port-Wine Stain &#40;Fegeler Syndrome&#41;&#58; A Report of 3 Cases"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "954"
          "paginaFinal" => "955"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Malformaci&#243;n capilar adquirida &#40;s&#237;ndrome de Fegeler&#41;&#58; 3 casos"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1586
              "Ancho" => 3417
              "Tamanyo" => 449888
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A&#44; Patient<span class="elsevierStyleHsp" style=""></span>1&#46; A reddish macule affecting the first and second branches of the trigeminal nerve &#40;dotted line&#41;&#44; with a more violaceous color in the periocular region &#40;arrow&#41;&#46; B&#44; Patient<span class="elsevierStyleHsp" style=""></span>2&#46; Patchy pink macules &#40;dotted line&#41;&#46; C&#44; More intense appearance of the lesions in B after the patient performed physical exercise&#46; D&#44; Patient<span class="elsevierStyleHsp" style=""></span>3&#46; Single macule of reddish color &#40;dotted line&#41;&#46; E&#44; More intense appearance of the lesion in D after the patient performed physical exercise&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46;F&#46; Mill&#225;n-Cayetano, J&#46; del Boz, P&#46; Garc&#237;a-Montero, M&#46; de Troya-Mart&#237;n"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "J&#46;F&#46;"
              "apellidos" => "Mill&#225;n-Cayetano"
            ]
            1 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "del Boz"
            ]
            2 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Garc&#237;a-Montero"
            ]
            3 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "de Troya-Mart&#237;n"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731017303125"
        "doi" => "10.1016/j.ad.2017.02.028"
        "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/S0001731017303125?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017303165?idApp=UINPBA000044"
    "url" => "/15782190/0000010800000010/v1_201711300824/S1578219017303165/v1_201711300824/en/main.assets"
  ]
  "en" => array:16 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
    "titulo" => "Schnitzler Syndrome With Response to Anakinra Monotherapy&#58; 7 Years of Follow-up"
    "tieneTextoCompleto" => true
    "saludo" => "<span class="elsevierStyleItalic">To the Editor&#58;</span>"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "956"
        "paginaFinal" => "958"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Y&#46; Hidalgo-Garc&#237;a, E&#46; Garc&#237;a-Fern&#225;ndez, L&#46; Palacio-Aller, P&#46; Gonzalvo"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "Y&#46;"
            "apellidos" => "Hidalgo-Garc&#237;a"
            "email" => array:1 [
              0 => "yhidalgog&#64;yahoo&#46;es"
            ]
            "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" => "E&#46;"
            "apellidos" => "Garc&#237;a-Fern&#225;ndez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "L&#46;"
            "apellidos" => "Palacio-Aller"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "P&#46;"
            "apellidos" => "Gonzalvo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:4 [
          0 => array:3 [
            "entidad" => "Servicio de Dermatolog&#237;a&#44; Hospital Central de Asturias&#44; Oviedo&#44; Espa&#241;a"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Reumatolog&#237;a&#44; Hospital de Cabue&#241;es&#44; Gij&#243;n&#44; Espa&#241;a"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Servicio de Dermatolog&#237;a&#44; Hospital de Cabue&#241;es&#44; Gij&#243;n&#44; Espa&#241;a"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Servicio de Anatom&#237;a Patol&#243;gica&#44; Hospital de Cabue&#241;es&#44; Gij&#243;n&#44; Espa&#241;a"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "S&#237;ndrome de Schnitzler con respuesta a anakinra en monoterapia&#58; 7 a&#241;os de seguimiento"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1106
            "Ancho" => 2450
            "Tamanyo" => 360514
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A and B&#44; Urticarial rash of fleeting pink edematous papules and plaques on the trunk and limbs&#44; with no desquamation&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Schnitzler syndrome is a rare entity&#44; with around 250 cases reported to date&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> It is characterized by the presence of an urticarial rash associated with a monoclonal gammopathy&#44; together with recurrent episodes of fever&#44; joint pain&#44; generalized bone pain&#44; lymphadenopathy&#44; hepatosplenomegaly&#44; and bone changes&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;3</span></a> Although its etiology and pathogenesis remain unknown&#44; an excellent response to interleukin &#40;IL&#41;<span class="elsevierStyleHsp" style=""></span>1 inhibitors has been observed&#44; and absence of a response should lead us to reconsider the diagnosis&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A 63-year-old woman with no family history of interest and who reported undiagnosed bone and joint pain since 2001&#44; was seen in 2007 for an 18-month history of fleeting&#44; slightly pruritic skin lesions on her trunk and limbs&#44; with no fever or other associated systemic symptoms&#46; She had not identified any etiological or pathogenic agents&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">There were no relevant findings on examination and she presented a good general state of health&#46; Dermographism was negative&#46; No goiter&#44; palpable peripheral lymph nodes&#44; or hepatosplenomegaly were detected&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Complete blood count&#44; erythrocyte sedimentation rate&#44; general biochemistry including electrolytes&#44; liver and kidney function tests&#44; antinuclear antibodies&#44; complement &#40;C3 and C4&#41;&#44; thyrotropin&#44; protein electrophoresis&#44; immunoglobulin &#40;Ig&#41; levels &#40;IgG&#44; IgA&#44; IgM&#44; IgE&#41;&#44; and tumor markers were normal or negative&#46; No abnormal findings were detected on plain chest x-ray or abdominopelvic ultrasound&#46; C-reactive protein was 87&#46;5&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">With a diagnosis of chronic idiopathic urticaria&#44; treatment was started with oral antihistamines with a poor response&#46; In January 2009&#44; the patient developed recurrent spikes of fever that lasted 2 to 3 days and were associated with intense generalized bone pain and the appearance on her trunk and limbs of well-defined&#44; edematous pink lesions that resolved in less than 24<span class="elsevierStyleHsp" style=""></span>hours leaving no residual lesion &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#44; A and<span class="elsevierStyleHsp" style=""></span>B&#41;&#46; Skin biopsy revealed a superficial and deep perivascular infiltrate formed of neutrophils&#44; affecting the interstitium &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>A&#41;&#44; with leukocytoclasia without vasculitis &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>B&#41;&#46; In addition&#44; a focal neutrophilic infiltrate was observed around the eccrine glands&#44; both at the level of the epidermis and around the dermal duct&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Blood tests revealed neutrophil leukocytosis and elevation of the acute phase reactants&#46; Antinuclear antibodies&#44; C3&#44; C4&#44; ferritin&#44; rheumatoid factor&#44; serology for hepatitis B and C viruses&#44; and cryoglobulins remained normal or negative&#46; In September 2009&#44; a monoclonal IgM-&#954; band of 2&#46;61 was detected &#40;upper limit of normal&#44; 2&#46;30&#41;&#44; enabling us to make a diagnosis of Schnitzler syndrome&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Sequential treatment was started with colchicine&#44; 100<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#44; oral prednisone&#44; 0&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;d&#44; dapsone&#44; 50<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#44; and methotrexate&#44; 15<span class="elsevierStyleHsp" style=""></span>mg&#47;wk&#44; with no improvement&#46; In 2010&#44; the patient commenced treatment with subcutaneous anakinra&#44; 100<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#44; leading to complete resolution of all her symptoms&#44; including the nonspecific bone pain&#44; within a week of starting treatment&#46; The acute phase reactants normalized and no complications have arisen&#46; At the time of writing&#44; the monoclonal IgM-&#954; band persisted at levels between 2&#46;40 and 2&#46;85&#46; Attempts to withdraw anakinra have led to immediate recurrence of the patient&#39;s symptoms&#44; and she is currently asymptomatic on subcutaneous anakinra at a dose of 100<span class="elsevierStyleHsp" style=""></span>mg every 48<span class="elsevierStyleHsp" style=""></span>hours&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The first case of Schnitzler syndrome was reported in 1972 by Liliana Schnitzler&#46; It is now considered the paradigm of acquired or late-onset autoinflammatory diseases&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> The diagnostic criteria were proposed by Lipsker et al&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> in 2001 and are still used with minor modifications made at the expert meeting in Strasbourg in 2012&#46; It is a diagnosis of exclusion&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The presence of an urticarial rash is an obligate criterion for the diagnosis of Schnitzler syndrome&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> Histologically&#44; the syndrome is included in the group of neutrophilic urticarial dermatoses&#44; and leukocytoclasia is a constant finding&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6&#44;7</span></a> Involvement of the eccrine ducts by the neutrophils&#44; as found in our patient&#44; has been reported as an epiphenomenon&#44; and the presence of an intraepidermal neutrophilic infiltrate has recently been proposed as a marker of the neutrophilic dermatoses&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6&#44;8</span></a> Vasculitis is observed in 20&#37; of cases&#44;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> but this is questioned by some authors<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> who have critically reviewed biopsies and a number of literature reports and have found no clear evidence of vasculitis&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The other major diagnostic criterion is the presence of a monoclonal IgM-&#954; band&#44; observed in 90&#37; of cases&#44;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> although an IgG variant has also been described&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> The minor diagnostic criteria include fever&#44; joint pain and arthritis&#44; bone pain&#44; palpable lymphadenopathy&#44; hepatosplenomegaly&#44; elevation of the erythrocyte sedimentation rate&#44; leukocytosis&#44; and x-ray changes&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;3</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The two main complications reported during the course of the disease are AA amyloidosis and lymphoproliferative disorders&#46; These develop in approximately 10&#37; of patients&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Although the etiology and pathogenesis of Schnitzler syndrome remain unknown&#44; the rapid response of the majority of patients to anakinra&#44; an IL-1 receptor inhibitor&#44; and more recently to canakinumab&#44; an IL-1&#946; inhibitor&#44; would suggest a pivotal role for this interleukin in the etiology and pathogenesis of the disease and a relationship with cryopyrine-associated periodic syndromes&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">8&#44;9</span></a> A mutation in the <span class="elsevierStyleItalic">NLRP3</span> gene has been detected in some cases&#59; that study was not performed in our patient&#46; Although patient follow-up of up to 35 years has been reported&#44; the relatively recent introduction of anakinra to the treatment of this disease means we cannot yet determine if it will reduce the frequency of blood dyscrasias&#44; although a reduction in the frequency of amyloidosis is assumed&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3&#44;10</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">We consider it important to report this case to draw attention to diagnostic difficulty of this syndrome and the need to follow-up atypical presentations&#44; given the progressive appearance of symptoms and of alterations in the blood tests&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0070" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflicts of Interest"
        ]
        1 => array:1 [
          "titulo" => "R&#233;f&#233;rences"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Hidalgo-Garc&#237;a Y&#44; Garc&#237;a-Fern&#225;ndez E&#44; Palacio-Aller L&#44; Gonzalvo P&#46; S&#237;ndrome de Schnitzler con respuesta a anakinra en monoterapia&#58; 7 a&#241;os de seguimiento&#46; Actas Dermosifiliogr&#46; 2017&#59;108&#58;956&#8211;958&#46;</p>"
      ]
    ]
    "multimedia" => array:2 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1106
            "Ancho" => 2450
            "Tamanyo" => 360514
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A and B&#44; Urticarial rash of fleeting pink edematous papules and plaques on the trunk and limbs&#44; with no desquamation&#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" => 1244
            "Ancho" => 3367
            "Tamanyo" => 1330440
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A&#44; Superficial and deep perivascular inflammatory infiltrate with involvement of the interstitium&#46; Hematoxylin and eosin &#40;H&#38;E&#41;&#44; original magnification<span class="elsevierStyleHsp" style=""></span>&#215;20&#46; B&#44; Predominantly neutrophilic infiltrate with leukocytoclasia without vasculitis&#46; H&#38;E&#44; original magnification<span class="elsevierStyleHsp" style=""></span>&#215;40&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "R&#233;f&#233;rences"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Schnitzler&#39;s syndrome&#58; Diagnosis&#44; treatment and follow-up"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Simon"
                            1 => "B&#46; Asli"
                            2 => "M&#46; Braun-Falco"
                            3 => "H&#46; de Koning"
                            4 => "J&#46;P&#46; Ferrand"
                            5 => "C&#46; Grattan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/all.12129"
                      "Revista" => array:6 [
                        "tituloSerie" => "Allergy"
                        "fecha" => "2013"
                        "volumen" => "68"
                        "paginaInicial" => "562"
                        "paginaFinal" => "568"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23480774"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Schnitzler syndrome&#58; Four new cases and review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "D&#46; Lipsker"
                            1 => "Y&#46; Veran"
                            2 => "F&#46; Grunenberger"
                            3 => "B&#46; Cribier"
                            4 => "E&#46; Heid"
                            5 => "E&#46; Grosshans"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Medicine"
                        "fecha" => "2001"
                        "volumen" => "80"
                        "paginaInicial" => "37"
                        "paginaFinal" => "44"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11204501"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Schnitzler syndrome&#58; Beyond the case reports&#58; Review and follow-up of 94 patients with an emphasis on prognosis and treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46;D&#46; De Koning"
                            1 => "E&#46;J&#46; Bodar"
                            2 => "J&#46;W&#46; van der Meer"
                            3 => "A&#46; Simon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.semarthrit.2007.04.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Semin Arthritis Rheum"
                        "fecha" => "2007"
                        "volumen" => "37"
                        "paginaInicial" => "137"
                        "paginaFinal" => "148"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17586002"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Schnitzler syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46; Lipsker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1750-1172-5-38"
                      "Revista" => array:5 [
                        "tituloSerie" => "Orphanet J Rare Dis"
                        "fecha" => "2010"
                        "volumen" => "5"
                        "paginaInicial" => "38"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21143856"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Schnitzler syndrome&#58; Validation and applicability of diagnostic criteria in real-life patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Gusdorf"
                            1 => "B&#46; Asli"
                            2 => "S&#46; Barbarot"
                            3 => "A&#46; N&#233;el"
                            4 => "A&#46; Masseau"
                            5 => "X&#46; Pu&#233;chal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/all.13035"
                      "Revista" => array:6 [
                        "tituloSerie" => "Allergy"
                        "fecha" => "2017"
                        "volumen" => "72"
                        "paginaInicial" => "177"
                        "paginaFinal" => "182"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27564982"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neutrophilic urticarial dermatosis&#46; A variant of neutrophilic urticaria strongly associated with systemic disease report of 9 new cases and review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Kieffer"
                            1 => "B&#46; Cribier"
                            2 => "D&#46; Lipsker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MD.0b013e3181943f5e"
                      "Revista" => array:6 [
                        "tituloSerie" => "Medicine"
                        "fecha" => "2009"
                        "volumen" => "88"
                        "paginaInicial" => "23"
                        "paginaFinal" => "31"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19352297"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neutrophilic epitheliotropism is a histopathological clue to neutrophilic urticarial dermatosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;M&#46; Broekaert"
                            1 => "A&#46; B&#246;er-Auer"
                            2 => "K&#46; Kerl"
                            3 => "I&#46; Herrgott"
                            4 => "X&#46; Schulz"
                            5 => "G&#46; Bonsmann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/DAD.0000000000000390"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Dermatopathol"
                        "fecha" => "2016"
                        "volumen" => "38"
                        "paginaInicial" => "39"
                        "paginaFinal" => "49"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26317390"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy and safety of canakinumab in Schnitzler&#39;s syndrome&#58; A multi-center&#44; randomized placebo-controlled study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Krause"
                            1 => "A&#46; Tsianakas"
                            2 => "N&#46; Wagner"
                            3 => "J&#46; Fischer"
                            4 => "K&#46; Weller"
                            5 => "M&#46; Metz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaci.2016.07.041"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "2017"
                        "volumen" => "139"
                        "paginaInicial" => "1311"
                        "paginaFinal" => "1320"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27658762"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of interleukin-1&#946; in the pathophysiology of Schnitzler syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46;D&#46; De Koning"
                            1 => "J&#46; Schalkwijk"
                            2 => "M&#46; Stoffels"
                            3 => "J&#46; Jongekrijg"
                            4 => "J&#46;F&#46; Jacobs"
                            5 => "E&#46; Verwiel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s13075-015-0696-0"
                      "Revista" => array:5 [
                        "tituloSerie" => "Arthritis Res Ther"
                        "fecha" => "2015"
                        "volumen" => "17"
                        "paginaInicial" => "187"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26198339"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term effectiveness and safety of interleukin-1 receptor antagonist &#40;anakinra&#41; in Schnitzler&#39;s syndrome&#58; A French multicentre study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; N&#233;el"
                            1 => "B&#46; Henry"
                            2 => "S&#46; Barbarot"
                            3 => "A&#46; Massaveu"
                            4 => "F&#46; Perrin"
                            5 => "C&#46; Bernier"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Autoinmun Rev"
                        "fecha" => "2014"
                        "volumen" => "13"
                        "paginaInicial" => "1035"
                        "paginaFinal" => "1041"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000010800000010/v1_201711300824/S1578219017303402/v1_201711300824/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "6157"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Case and Research Letters"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010800000010/v1_201711300824/S1578219017303402/v1_201711300824/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017303402?idApp=UINPBA000044"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Case and Research Letters
Schnitzler Syndrome With Response to Anakinra Monotherapy: 7 Years of Follow-up
Síndrome de Schnitzler con respuesta a anakinra en monoterapia: 7 años de seguimiento
Y. Hidalgo-Garcíaa,
Corresponding author
yhidalgog@yahoo.es

Corresponding author.
, E. García-Fernándezb, L. Palacio-Allerc, P. Gonzalvod
a Servicio de Dermatología, Hospital Central de Asturias, Oviedo, España
b Servicio de Reumatología, Hospital de Cabueñes, Gijón, España
c Servicio de Dermatología, Hospital de Cabueñes, Gijón, España
d Servicio de Anatomía Patológica, Hospital de Cabueñes, Gijón, España
Read
5765
Times
was read the article
1991
Total PDF
3774
Total HTML
Share statistics
 array:24 [
  "pii" => "S1578219017303402"
  "issn" => "15782190"
  "doi" => "10.1016/j.adengl.2017.10.022"
  "estado" => "S300"
  "fechaPublicacion" => "2017-12-01"
  "aid" => "1720"
  "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
  "copyrightAnyo" => "2017"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Actas Dermosifiliogr. 2017;108:956-8"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 384
    "formatos" => array:3 [
      "EPUB" => 20
      "HTML" => 299
      "PDF" => 65
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0001731017303113"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2017.03.015"
      "estado" => "S300"
      "fechaPublicacion" => "2017-12-01"
      "aid" => "1720"
      "copyright" => "AEDV"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Actas Dermosifiliogr. 2017;108:956-8"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 268
        "formatos" => array:2 [
          "HTML" => 206
          "PDF" => 62
        ]
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fico-cl&#237;nica</span>"
        "titulo" => "S&#237;ndrome de Schnitzler con respuesta a anakinra en monoterapia&#58; 7 a&#241;os de seguimiento"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "956"
            "paginaFinal" => "958"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Schnitzler Syndrome With Response to Anakinra Monotherapy&#58; 7 Years of Follow-up"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1106
                "Ancho" => 2450
                "Tamanyo" => 364935
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">a y b&#58; <span class="elsevierStyleItalic">rash</span> urticariforme de p&#225;pulas y placas rosadas&#44; edematosas&#44; no descamativas&#44; de evoluci&#243;n fugaz&#44; en el tronco y las extremidades&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Y&#46; Hidalgo-Garc&#237;a, E&#46; Garc&#237;a-Fern&#225;ndez, L&#46; Palacio-Aller, P&#46; Gonzalvo"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "Y&#46;"
                "apellidos" => "Hidalgo-Garc&#237;a"
              ]
              1 => array:2 [
                "nombre" => "E&#46;"
                "apellidos" => "Garc&#237;a-Fern&#225;ndez"
              ]
              2 => array:2 [
                "nombre" => "L&#46;"
                "apellidos" => "Palacio-Aller"
              ]
              3 => array:2 [
                "nombre" => "P&#46;"
                "apellidos" => "Gonzalvo"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1578219017303402"
          "doi" => "10.1016/j.adengl.2017.10.022"
          "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/S1578219017303402?idApp=UINPBA000044"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731017303113?idApp=UINPBA000044"
      "url" => "/00017310/0000010800000010/v1_201711300829/S0001731017303113/v1_201711300829/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1578219017303384"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2017.10.020"
    "estado" => "S300"
    "fechaPublicacion" => "2017-12-01"
    "aid" => "1719"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2017;108:958-9"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 520
      "formatos" => array:3 [
        "EPUB" => 18
        "HTML" => 415
        "PDF" => 87
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
      "titulo" => "Intense Local Reaction at the Sites of Injection of Lipolytic Mesotherapy"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "958"
          "paginaFinal" => "959"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Reacci&#243;n Local Intensa en Zonas de Inyecci&#243;n de Mesoterapia Lipol&#237;tica"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figure 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 2250
              "Ancho" => 1500
              "Tamanyo" => 493292
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Confluent&#44; erythematous edematous plaques with vesicles at the sites of injection of mesotherapy on the thigh&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "S&#46; C&#243;rdoba, E&#46; Rojas, A&#46; Garrido-R&#237;os, J&#46; Borbujo"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "C&#243;rdoba"
            ]
            1 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Rojas"
            ]
            2 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Garrido-R&#237;os"
            ]
            3 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Borbujo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731017303101"
        "doi" => "10.1016/j.ad.2017.02.027"
        "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/S0001731017303101?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017303384?idApp=UINPBA000044"
    "url" => "/15782190/0000010800000010/v1_201711300824/S1578219017303384/v1_201711300824/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1578219017303165"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2017.10.013"
    "estado" => "S300"
    "fechaPublicacion" => "2017-12-01"
    "aid" => "1721"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2017;108:954-5"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 482
      "formatos" => array:3 [
        "EPUB" => 17
        "HTML" => 391
        "PDF" => 74
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
      "titulo" => "Acquired Port-Wine Stain &#40;Fegeler Syndrome&#41;&#58; A Report of 3 Cases"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "954"
          "paginaFinal" => "955"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Malformaci&#243;n capilar adquirida &#40;s&#237;ndrome de Fegeler&#41;&#58; 3 casos"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1586
              "Ancho" => 3417
              "Tamanyo" => 449888
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A&#44; Patient<span class="elsevierStyleHsp" style=""></span>1&#46; A reddish macule affecting the first and second branches of the trigeminal nerve &#40;dotted line&#41;&#44; with a more violaceous color in the periocular region &#40;arrow&#41;&#46; B&#44; Patient<span class="elsevierStyleHsp" style=""></span>2&#46; Patchy pink macules &#40;dotted line&#41;&#46; C&#44; More intense appearance of the lesions in B after the patient performed physical exercise&#46; D&#44; Patient<span class="elsevierStyleHsp" style=""></span>3&#46; Single macule of reddish color &#40;dotted line&#41;&#46; E&#44; More intense appearance of the lesion in D after the patient performed physical exercise&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "J&#46;F&#46; Mill&#225;n-Cayetano, J&#46; del Boz, P&#46; Garc&#237;a-Montero, M&#46; de Troya-Mart&#237;n"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "J&#46;F&#46;"
              "apellidos" => "Mill&#225;n-Cayetano"
            ]
            1 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "del Boz"
            ]
            2 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Garc&#237;a-Montero"
            ]
            3 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "de Troya-Mart&#237;n"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731017303125"
        "doi" => "10.1016/j.ad.2017.02.028"
        "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/S0001731017303125?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017303165?idApp=UINPBA000044"
    "url" => "/15782190/0000010800000010/v1_201711300824/S1578219017303165/v1_201711300824/en/main.assets"
  ]
  "en" => array:16 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
    "titulo" => "Schnitzler Syndrome With Response to Anakinra Monotherapy&#58; 7 Years of Follow-up"
    "tieneTextoCompleto" => true
    "saludo" => "<span class="elsevierStyleItalic">To the Editor&#58;</span>"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "956"
        "paginaFinal" => "958"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Y&#46; Hidalgo-Garc&#237;a, E&#46; Garc&#237;a-Fern&#225;ndez, L&#46; Palacio-Aller, P&#46; Gonzalvo"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "Y&#46;"
            "apellidos" => "Hidalgo-Garc&#237;a"
            "email" => array:1 [
              0 => "yhidalgog&#64;yahoo&#46;es"
            ]
            "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" => "E&#46;"
            "apellidos" => "Garc&#237;a-Fern&#225;ndez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "L&#46;"
            "apellidos" => "Palacio-Aller"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "P&#46;"
            "apellidos" => "Gonzalvo"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:4 [
          0 => array:3 [
            "entidad" => "Servicio de Dermatolog&#237;a&#44; Hospital Central de Asturias&#44; Oviedo&#44; Espa&#241;a"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Reumatolog&#237;a&#44; Hospital de Cabue&#241;es&#44; Gij&#243;n&#44; Espa&#241;a"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Servicio de Dermatolog&#237;a&#44; Hospital de Cabue&#241;es&#44; Gij&#243;n&#44; Espa&#241;a"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Servicio de Anatom&#237;a Patol&#243;gica&#44; Hospital de Cabue&#241;es&#44; Gij&#243;n&#44; Espa&#241;a"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "S&#237;ndrome de Schnitzler con respuesta a anakinra en monoterapia&#58; 7 a&#241;os de seguimiento"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1106
            "Ancho" => 2450
            "Tamanyo" => 360514
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A and B&#44; Urticarial rash of fleeting pink edematous papules and plaques on the trunk and limbs&#44; with no desquamation&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Schnitzler syndrome is a rare entity&#44; with around 250 cases reported to date&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> It is characterized by the presence of an urticarial rash associated with a monoclonal gammopathy&#44; together with recurrent episodes of fever&#44; joint pain&#44; generalized bone pain&#44; lymphadenopathy&#44; hepatosplenomegaly&#44; and bone changes&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;3</span></a> Although its etiology and pathogenesis remain unknown&#44; an excellent response to interleukin &#40;IL&#41;<span class="elsevierStyleHsp" style=""></span>1 inhibitors has been observed&#44; and absence of a response should lead us to reconsider the diagnosis&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">A 63-year-old woman with no family history of interest and who reported undiagnosed bone and joint pain since 2001&#44; was seen in 2007 for an 18-month history of fleeting&#44; slightly pruritic skin lesions on her trunk and limbs&#44; with no fever or other associated systemic symptoms&#46; She had not identified any etiological or pathogenic agents&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">There were no relevant findings on examination and she presented a good general state of health&#46; Dermographism was negative&#46; No goiter&#44; palpable peripheral lymph nodes&#44; or hepatosplenomegaly were detected&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Complete blood count&#44; erythrocyte sedimentation rate&#44; general biochemistry including electrolytes&#44; liver and kidney function tests&#44; antinuclear antibodies&#44; complement &#40;C3 and C4&#41;&#44; thyrotropin&#44; protein electrophoresis&#44; immunoglobulin &#40;Ig&#41; levels &#40;IgG&#44; IgA&#44; IgM&#44; IgE&#41;&#44; and tumor markers were normal or negative&#46; No abnormal findings were detected on plain chest x-ray or abdominopelvic ultrasound&#46; C-reactive protein was 87&#46;5&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">With a diagnosis of chronic idiopathic urticaria&#44; treatment was started with oral antihistamines with a poor response&#46; In January 2009&#44; the patient developed recurrent spikes of fever that lasted 2 to 3 days and were associated with intense generalized bone pain and the appearance on her trunk and limbs of well-defined&#44; edematous pink lesions that resolved in less than 24<span class="elsevierStyleHsp" style=""></span>hours leaving no residual lesion &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#44; A and<span class="elsevierStyleHsp" style=""></span>B&#41;&#46; Skin biopsy revealed a superficial and deep perivascular infiltrate formed of neutrophils&#44; affecting the interstitium &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>A&#41;&#44; with leukocytoclasia without vasculitis &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>B&#41;&#46; In addition&#44; a focal neutrophilic infiltrate was observed around the eccrine glands&#44; both at the level of the epidermis and around the dermal duct&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Blood tests revealed neutrophil leukocytosis and elevation of the acute phase reactants&#46; Antinuclear antibodies&#44; C3&#44; C4&#44; ferritin&#44; rheumatoid factor&#44; serology for hepatitis B and C viruses&#44; and cryoglobulins remained normal or negative&#46; In September 2009&#44; a monoclonal IgM-&#954; band of 2&#46;61 was detected &#40;upper limit of normal&#44; 2&#46;30&#41;&#44; enabling us to make a diagnosis of Schnitzler syndrome&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Sequential treatment was started with colchicine&#44; 100<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#44; oral prednisone&#44; 0&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;d&#44; dapsone&#44; 50<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#44; and methotrexate&#44; 15<span class="elsevierStyleHsp" style=""></span>mg&#47;wk&#44; with no improvement&#46; In 2010&#44; the patient commenced treatment with subcutaneous anakinra&#44; 100<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#44; leading to complete resolution of all her symptoms&#44; including the nonspecific bone pain&#44; within a week of starting treatment&#46; The acute phase reactants normalized and no complications have arisen&#46; At the time of writing&#44; the monoclonal IgM-&#954; band persisted at levels between 2&#46;40 and 2&#46;85&#46; Attempts to withdraw anakinra have led to immediate recurrence of the patient&#39;s symptoms&#44; and she is currently asymptomatic on subcutaneous anakinra at a dose of 100<span class="elsevierStyleHsp" style=""></span>mg every 48<span class="elsevierStyleHsp" style=""></span>hours&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The first case of Schnitzler syndrome was reported in 1972 by Liliana Schnitzler&#46; It is now considered the paradigm of acquired or late-onset autoinflammatory diseases&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> The diagnostic criteria were proposed by Lipsker et al&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> in 2001 and are still used with minor modifications made at the expert meeting in Strasbourg in 2012&#46; It is a diagnosis of exclusion&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">The presence of an urticarial rash is an obligate criterion for the diagnosis of Schnitzler syndrome&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> Histologically&#44; the syndrome is included in the group of neutrophilic urticarial dermatoses&#44; and leukocytoclasia is a constant finding&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6&#44;7</span></a> Involvement of the eccrine ducts by the neutrophils&#44; as found in our patient&#44; has been reported as an epiphenomenon&#44; and the presence of an intraepidermal neutrophilic infiltrate has recently been proposed as a marker of the neutrophilic dermatoses&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6&#44;8</span></a> Vasculitis is observed in 20&#37; of cases&#44;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> but this is questioned by some authors<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> who have critically reviewed biopsies and a number of literature reports and have found no clear evidence of vasculitis&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">The other major diagnostic criterion is the presence of a monoclonal IgM-&#954; band&#44; observed in 90&#37; of cases&#44;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> although an IgG variant has also been described&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> The minor diagnostic criteria include fever&#44; joint pain and arthritis&#44; bone pain&#44; palpable lymphadenopathy&#44; hepatosplenomegaly&#44; elevation of the erythrocyte sedimentation rate&#44; leukocytosis&#44; and x-ray changes&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;3</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The two main complications reported during the course of the disease are AA amyloidosis and lymphoproliferative disorders&#46; These develop in approximately 10&#37; of patients&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Although the etiology and pathogenesis of Schnitzler syndrome remain unknown&#44; the rapid response of the majority of patients to anakinra&#44; an IL-1 receptor inhibitor&#44; and more recently to canakinumab&#44; an IL-1&#946; inhibitor&#44; would suggest a pivotal role for this interleukin in the etiology and pathogenesis of the disease and a relationship with cryopyrine-associated periodic syndromes&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">8&#44;9</span></a> A mutation in the <span class="elsevierStyleItalic">NLRP3</span> gene has been detected in some cases&#59; that study was not performed in our patient&#46; Although patient follow-up of up to 35 years has been reported&#44; the relatively recent introduction of anakinra to the treatment of this disease means we cannot yet determine if it will reduce the frequency of blood dyscrasias&#44; although a reduction in the frequency of amyloidosis is assumed&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3&#44;10</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">We consider it important to report this case to draw attention to diagnostic difficulty of this syndrome and the need to follow-up atypical presentations&#44; given the progressive appearance of symptoms and of alterations in the blood tests&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0070" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflicts of Interest"
        ]
        1 => array:1 [
          "titulo" => "R&#233;f&#233;rences"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Hidalgo-Garc&#237;a Y&#44; Garc&#237;a-Fern&#225;ndez E&#44; Palacio-Aller L&#44; Gonzalvo P&#46; S&#237;ndrome de Schnitzler con respuesta a anakinra en monoterapia&#58; 7 a&#241;os de seguimiento&#46; Actas Dermosifiliogr&#46; 2017&#59;108&#58;956&#8211;958&#46;</p>"
      ]
    ]
    "multimedia" => array:2 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1106
            "Ancho" => 2450
            "Tamanyo" => 360514
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A and B&#44; Urticarial rash of fleeting pink edematous papules and plaques on the trunk and limbs&#44; with no desquamation&#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" => 1244
            "Ancho" => 3367
            "Tamanyo" => 1330440
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A&#44; Superficial and deep perivascular inflammatory infiltrate with involvement of the interstitium&#46; Hematoxylin and eosin &#40;H&#38;E&#41;&#44; original magnification<span class="elsevierStyleHsp" style=""></span>&#215;20&#46; B&#44; Predominantly neutrophilic infiltrate with leukocytoclasia without vasculitis&#46; H&#38;E&#44; original magnification<span class="elsevierStyleHsp" style=""></span>&#215;40&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "R&#233;f&#233;rences"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Schnitzler&#39;s syndrome&#58; Diagnosis&#44; treatment and follow-up"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Simon"
                            1 => "B&#46; Asli"
                            2 => "M&#46; Braun-Falco"
                            3 => "H&#46; de Koning"
                            4 => "J&#46;P&#46; Ferrand"
                            5 => "C&#46; Grattan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/all.12129"
                      "Revista" => array:6 [
                        "tituloSerie" => "Allergy"
                        "fecha" => "2013"
                        "volumen" => "68"
                        "paginaInicial" => "562"
                        "paginaFinal" => "568"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23480774"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Schnitzler syndrome&#58; Four new cases and review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "D&#46; Lipsker"
                            1 => "Y&#46; Veran"
                            2 => "F&#46; Grunenberger"
                            3 => "B&#46; Cribier"
                            4 => "E&#46; Heid"
                            5 => "E&#46; Grosshans"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Medicine"
                        "fecha" => "2001"
                        "volumen" => "80"
                        "paginaInicial" => "37"
                        "paginaFinal" => "44"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11204501"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Schnitzler syndrome&#58; Beyond the case reports&#58; Review and follow-up of 94 patients with an emphasis on prognosis and treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H&#46;D&#46; De Koning"
                            1 => "E&#46;J&#46; Bodar"
                            2 => "J&#46;W&#46; van der Meer"
                            3 => "A&#46; Simon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.semarthrit.2007.04.001"
                      "Revista" => array:6 [
                        "tituloSerie" => "Semin Arthritis Rheum"
                        "fecha" => "2007"
                        "volumen" => "37"
                        "paginaInicial" => "137"
                        "paginaFinal" => "148"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17586002"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Schnitzler syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46; Lipsker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1750-1172-5-38"
                      "Revista" => array:5 [
                        "tituloSerie" => "Orphanet J Rare Dis"
                        "fecha" => "2010"
                        "volumen" => "5"
                        "paginaInicial" => "38"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21143856"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Schnitzler syndrome&#58; Validation and applicability of diagnostic criteria in real-life patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46; Gusdorf"
                            1 => "B&#46; Asli"
                            2 => "S&#46; Barbarot"
                            3 => "A&#46; N&#233;el"
                            4 => "A&#46; Masseau"
                            5 => "X&#46; Pu&#233;chal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/all.13035"
                      "Revista" => array:6 [
                        "tituloSerie" => "Allergy"
                        "fecha" => "2017"
                        "volumen" => "72"
                        "paginaInicial" => "177"
                        "paginaFinal" => "182"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27564982"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neutrophilic urticarial dermatosis&#46; A variant of neutrophilic urticaria strongly associated with systemic disease report of 9 new cases and review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Kieffer"
                            1 => "B&#46; Cribier"
                            2 => "D&#46; Lipsker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/MD.0b013e3181943f5e"
                      "Revista" => array:6 [
                        "tituloSerie" => "Medicine"
                        "fecha" => "2009"
                        "volumen" => "88"
                        "paginaInicial" => "23"
                        "paginaFinal" => "31"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19352297"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Neutrophilic epitheliotropism is a histopathological clue to neutrophilic urticarial dermatosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;M&#46; Broekaert"
                            1 => "A&#46; B&#246;er-Auer"
                            2 => "K&#46; Kerl"
                            3 => "I&#46; Herrgott"
                            4 => "X&#46; Schulz"
                            5 => "G&#46; Bonsmann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/DAD.0000000000000390"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Dermatopathol"
                        "fecha" => "2016"
                        "volumen" => "38"
                        "paginaInicial" => "39"
                        "paginaFinal" => "49"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26317390"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Efficacy and safety of canakinumab in Schnitzler&#39;s syndrome&#58; A multi-center&#44; randomized placebo-controlled study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Krause"
                            1 => "A&#46; Tsianakas"
                            2 => "N&#46; Wagner"
                            3 => "J&#46; Fischer"
                            4 => "K&#46; Weller"
                            5 => "M&#46; Metz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaci.2016.07.041"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol"
                        "fecha" => "2017"
                        "volumen" => "139"
                        "paginaInicial" => "1311"
                        "paginaFinal" => "1320"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27658762"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The role of interleukin-1&#946; in the pathophysiology of Schnitzler syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46;D&#46; De Koning"
                            1 => "J&#46; Schalkwijk"
                            2 => "M&#46; Stoffels"
                            3 => "J&#46; Jongekrijg"
                            4 => "J&#46;F&#46; Jacobs"
                            5 => "E&#46; Verwiel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/s13075-015-0696-0"
                      "Revista" => array:5 [
                        "tituloSerie" => "Arthritis Res Ther"
                        "fecha" => "2015"
                        "volumen" => "17"
                        "paginaInicial" => "187"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26198339"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Long-term effectiveness and safety of interleukin-1 receptor antagonist &#40;anakinra&#41; in Schnitzler&#39;s syndrome&#58; A French multicentre study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; N&#233;el"
                            1 => "B&#46; Henry"
                            2 => "S&#46; Barbarot"
                            3 => "A&#46; Massaveu"
                            4 => "F&#46; Perrin"
                            5 => "C&#46; Bernier"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Autoinmun Rev"
                        "fecha" => "2014"
                        "volumen" => "13"
                        "paginaInicial" => "1035"
                        "paginaFinal" => "1041"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000010800000010/v1_201711300824/S1578219017303402/v1_201711300824/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "6157"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Case and Research Letters"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010800000010/v1_201711300824/S1578219017303402/v1_201711300824/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017303402?idApp=UINPBA000044"
]
Article information
ISSN: 15782190
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 6 10 16
2024 October 87 44 131
2024 September 96 20 116
2024 August 120 33 153
2024 July 94 34 128
2024 June 102 65 167
2024 May 71 29 100
2024 April 81 23 104
2024 March 90 24 114
2024 February 71 32 103
2024 January 62 31 93
2023 December 57 18 75
2023 November 86 31 117
2023 October 94 28 122
2023 September 108 37 145
2023 August 56 19 75
2023 July 72 43 115
2023 June 49 30 79
2023 May 79 31 110
2023 April 82 35 117
2023 March 74 28 102
2023 February 56 36 92
2023 January 56 32 88
2022 December 78 51 129
2022 November 49 31 80
2022 October 37 26 63
2022 September 36 52 88
2022 August 29 48 77
2022 July 28 44 72
2022 June 21 22 43
2022 May 48 55 103
2022 April 51 34 85
2022 March 55 59 114
2022 February 66 29 95
2022 January 85 38 123
2021 December 54 44 98
2021 November 93 58 151
2021 October 50 56 106
2021 September 45 47 92
2021 August 69 37 106
2021 July 38 28 66
2021 June 47 29 76
2021 May 56 56 112
2021 April 153 83 236
2021 March 102 42 144
2021 February 61 31 92
2021 January 42 24 66
2020 December 68 22 90
2020 November 50 28 78
2020 October 26 16 42
2020 September 24 8 32
2020 August 32 21 53
2020 July 28 13 41
2020 June 34 33 67
2020 May 19 14 33
2020 April 29 16 45
2020 March 22 17 39
2020 February 1 1 2
2020 January 4 0 4
2019 December 6 0 6
2019 November 4 0 4
2019 October 1 0 1
2019 September 10 0 10
2019 August 4 0 4
2019 July 4 0 4
2019 June 6 0 6
2019 May 4 1 5
2019 April 2 0 2
2019 March 5 0 5
2019 January 1 0 1
2018 December 3 0 3
2018 November 1 0 1
2018 October 2 0 2
2018 September 3 0 3
2018 February 34 6 40
2018 January 40 9 49
2017 December 158 34 192
2017 November 7 15 22
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?