Case and Research Letter
Usefulness of 2% Topical Diltiazem in Chondrodermatitis Nodularis Helicis: A Report of 2 Cases
Utilidad del diltiazem tópico al 2% en la condrodermatitis nodular del hélix: descripción de 2 casos
Read
7957
Timeswas read the article
2242
Total PDF
5715
Total HTML
Share statistics
array:24 [ "pii" => "S1578219019300368" "issn" => "15782190" "doi" => "10.1016/j.adengl.2019.02.004" "estado" => "S300" "fechaPublicacion" => "2019-04-01" "aid" => "1904" "copyright" => "Elsevier España, S.L.U. and AEDV" "copyrightAnyo" => "2018" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2019;110:251-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3 "formatos" => array:2 [ "HTML" => 2 "PDF" => 1 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731018300589" "issn" => "00017310" "doi" => "10.1016/j.ad.2017.10.019" "estado" => "S300" "fechaPublicacion" => "2019-04-01" "aid" => "1904" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2019;110:251-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 368 "formatos" => array:2 [ "HTML" => 266 "PDF" => 102 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científico-clínica</span>" "titulo" => "Utilidad del diltiazem tópico al 2% en la condrodermatitis nodular del hélix: descripción de 2 casos" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "251" "paginaFinal" => "253" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Usefulness of 2% Topical Diltiazem in Chondrodermatitis Nodularis Helicis: A Report of 2 Cases" ] ] "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" => 1875 "Ancho" => 1200 "Tamanyo" => 378890 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A: caso 1 previo inicio del tratamiento; B: caso 1 tras finalizar tratamiento con diltiazem tópico al 2%; C: caso 2 previo inicio del tratamiento; D: caso 2 tras finalizar el tratamiento con diltiazem tópico al 2%.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. de Quintana-Sancho, L. Carnero-González, R. González-Pérez, M. Drake-Monfort" "autores" => array:4 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "de Quintana-Sancho" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Carnero-González" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "González-Pérez" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Drake-Monfort" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219019300368" "doi" => "10.1016/j.adengl.2019.02.004" "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/S1578219019300368?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731018300589?idApp=UINPBA000044" "url" => "/00017310/0000011000000003/v1_201904030618/S0001731018300589/v1_201904030618/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S1578219019300344" "issn" => "15782190" "doi" => "10.1016/j.adengl.2019.02.002" "estado" => "S300" "fechaPublicacion" => "2019-04-01" "aid" => "2033" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2019;110:253-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2 "HTML" => 2 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Coexistence of Tumid Lupus Erythematosus and Discoid Lupus Erythematosus" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "253" "paginaFinal" => "255" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Coexistencia de lupus eritematoso túmido y lupus eritematoso discoide" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 530 "Ancho" => 750 "Tamanyo" => 142514 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Scalp biopsy showing perivascular and periadnexal lymphocytic dermatitis with epidermal atrophy, parakeratosis, and the presence of horny plugs in the follicular ostia (hematoxylin-eosin, original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>20).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "I. Abadías-Granado, J. Sánchez-Bernal, F. Felipo-Berlanga, M. Ara-Martín" "autores" => array:4 [ 0 => array:2 [ "nombre" => "I." "apellidos" => "Abadías-Granado" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Sánchez-Bernal" ] 2 => array:2 [ "nombre" => "F." "apellidos" => "Felipo-Berlanga" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Ara-Martín" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731018303521" "doi" => "10.1016/j.ad.2018.02.023" "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/S0001731018303521?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019300344?idApp=UINPBA000044" "url" => "/15782190/0000011000000003/v1_201904030645/S1578219019300344/v1_201904030645/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219019300423" "issn" => "15782190" "doi" => "10.1016/j.adengl.2019.02.008" "estado" => "S300" "fechaPublicacion" => "2019-04-01" "aid" => "1985" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2019;110:249-51" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4 "formatos" => array:3 [ "EPUB" => 1 "HTML" => 2 "PDF" => 1 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>" "titulo" => "Photodynamic Therapy in the Treatment of Cutaneous Leishmaniasis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "249" "paginaFinal" => "251" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Terapia fotodinámica en el tratamiento de la leishmaniasis cutánea" ] ] "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" => 781 "Ancho" => 2084 "Tamanyo" => 156520 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Microscopic views of the smear from the border of the eyelid lesion. A, Macrophages with amastigotes of <span class="elsevierStyleItalic">Leishmania major</span> (Riu's stain, magnification,<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>400). B, Greater magnification (Riu's stain, magnification,<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>1000).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L. Sainz-Gaspar, E. Rosón, J. Llovo, H. Vázquez-Veiga" "autores" => array:4 [ 0 => array:2 [ "nombre" => "L." "apellidos" => "Sainz-Gaspar" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Rosón" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Llovo" ] 3 => array:2 [ "nombre" => "H." "apellidos" => "Vázquez-Veiga" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731018302497" "doi" => "10.1016/j.ad.2018.02.018" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731018302497?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019300423?idApp=UINPBA000044" "url" => "/15782190/0000011000000003/v1_201904030645/S1578219019300423/v1_201904030645/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>" "titulo" => "Usefulness of 2% Topical Diltiazem in Chondrodermatitis Nodularis Helicis: A Report of 2 Cases" "tieneTextoCompleto" => true "saludo" => "To the Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "251" "paginaFinal" => "253" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A. de Quintana-Sancho, L. Carnero-González, R. González-Pérez, M. Drake-Monfort" "autores" => array:4 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "de Quintana-Sancho" "email" => array:1 [ 0 => "adriandeq@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "L." "apellidos" => "Carnero-González" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "R." "apellidos" => "González-Pérez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "M." "apellidos" => "Drake-Monfort" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Universitario Marqués de Valdecilla, Santander, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Universitario de Araba, Vitoria, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Utilidad del diltiazem tópico al 2% en la condrodermatitis nodular del hélix: descripción de 2 casos" ] ] "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" => 1875 "Ancho" => 1200 "Tamanyo" => 378890 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, Patient 1 before starting treatment. B, Patient 1 after finishing treatment with 2% topical diltiazem. C, Patient 2 before starting treatment. D, Patient 2 after finishing treatment with 2% topical diltiazem.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Chondrodermatitis nodularis helicis (CNH) is a benign inflammatory disease that affects the skin and cartilage of the helix and, less frequently, the antihelix. Intense pain on touching the affected area is reported by many patients with CNH, necessitating treatment. The etiology of CNH is unknown. However, it has been proposed that prolonged pressure on the atrial and perichondrial cartilage, an anatomical region with little protective subcutaneous cellular tissue, may result in local ischemia followed by transepithelial removal of degenerated material. Consequently, many authors consider CNH a form of perforating dermatosis.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> Risk factors include chronic actinic damage, exposure to low temperatures, and repeated local trauma.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> Treatment is challenging. Several therapeutic approaches, with varying cure rates, are described. We present 2 cases of CNH treated successfully with 2% topical diltiazem, a therapeutic option not described to date.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The first patient was a 74-year-old man who was seen for an erythematous nodule with central ulceration on the left antihelix (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). The lesion was painful to the touch and had appeared 4 months earlier. The second patient was a 46-year-old man with a history of chronic hepatitis C virus infection and parenteral drug addiction who was seen for a painful nodule with severe ulceration on the right antihelix (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C). The lesion had appeared 6 months earlier and had not responded to corticosteroids or topical antibiotic treatment. In both cases, a clinical diagnosis of CNH was established and the patients were treated with an extemporaneous preparation of 2% diltiazem gel applied 3 times per day for 3 months (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). No other concurrent treatments were administered during this period. By the end of the treatment period both patients showed marked improvements in the clinical appearance of the lesions and reported almost complete disappearance of the pain (<a class="elsevierStyleCrossRef" href="#fig0005">Figs. 1B and 1D</a>). No adverse effects associated with the procedure were observed.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">There are a range of therapeutic options for CNH, including cryotherapy, scraping, devices to protect the ear from external pressure, topical or intralesional corticosteroids, carbon dioxide laser, photodynamic therapy with methyl-aminolevulinate,<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> and nitroglycerin administered at different concentrations either topically or via a transdermal patch. Cure rates of up to 92% have been reported in patients treated with 2% nitroglycerin gel, the most common adverse effect of which was transient headache (17% of patients).<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4,5</span></a> Comparable cure rates and markedly better tolerance have been reported in patients treated with 0.2% nitroglycerin.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> Surgical procedures, of which several are described,<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">8,9</span></a> offer cure rates of up to 82%.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Diltiazem acts by selectively blocking calcium channels in muscle, inducing vasodilation. Oral diltiazem is used to treat arterial hypertension and angina pectoris, and as an antiarrhythmic agent. In CNH, topical diltiazem has an effect similar to that of topical nitroglycerin, inducing relaxation of the arteriolar smooth muscle, restoring local blood flow, and reversing ischemia in cartilage. The low dose of diltiazem administered in topical formulations results in absorption of a very small quantity of the drug, likely reducing the probability of systemic adverse effects.</p><p id="par0025" class="elsevierStylePara elsevierViewall">In general surgery, topical diltiazem has been used successfully for many years for the treatment of chronic anal fissure. In this context, diltiazem has shown greater clinical efficacy than nitroglycerin in randomized controlled trials, and almost no adverse effects.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">We have carried out an exhaustive review of the literature and found no existing reports describing the use of topical diltiazem to treat CNH. Further research will be needed to determine whether the use of other excipients (e.g., oil/water emulsion instead of gel) increases the therapeutic efficacy of topical diltiazem. A limitation of this report is that it consists of only 2 clinical cases. Nonetheless, because topical diltiazem shows good efficacy, is well tolerated, and has a known mechanism of action, we feel that it should be considered as a novel therapeutic option for CNH.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of Interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: de Quintana-Sancho A, Carnero-González L, González-Pérez R, Drake-Monfort M. Utilidad del diltiazem tópico al 2% en la condrodermatitis nodular del hélix: descripción de 2 casos. Actas Dermosifiliogr. 2019;110:251–253.</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" => 1875 "Ancho" => 1200 "Tamanyo" => 378890 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, Patient 1 before starting treatment. B, Patient 1 after finishing treatment with 2% topical diltiazem. C, Patient 2 before starting treatment. D, Patient 2 after finishing treatment with 2% topical diltiazem.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Diltiazem hydrochloride: 2<span class="elsevierStyleHsp" style=""></span>g \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Propylene glycol: 10<span class="elsevierStyleHsp" style=""></span>mL \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Hydroxyethylcellulose: 2<span class="elsevierStyleHsp" style=""></span>g \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sterile water to 100<span class="elsevierStyleHsp" style=""></span>mL \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2003861.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Extemporaneous Preparation of 2% Diltiazem Gel for the Treatment of CNH</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "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" => "A case of chondrodermatitis nodularis chronica helicis with an autoantibody to denatured type II collagen" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E. Yoshinaga" 1 => "U. Enomoto" 2 => "N. Fujimoto" 3 => "Y. Ohnishi" 4 => "S. Tajima" 5 => "A. Ishibashi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/00015550152384308" "Revista" => array:6 [ "tituloSerie" => "Acta Derm Venereol" "fecha" => "2001" "volumen" => "81" "paginaInicial" => "137" "paginaFinal" => "138" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11501653" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical appearance, differential diagnoses and therapeutical options of chondrodermatitis nodularis helicis Winkler" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G. Wagner" 1 => "J. Liefeith" 2 => "M.M. Sachse" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1610-0387.2011.07601.x" "Revista" => array:6 [ "tituloSerie" => "J Dtsch Dermatol Ges" "fecha" => "2011" "volumen" => "9" "paginaInicial" => "287" "paginaFinal" => "291" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21276202" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Observational study of chondrodermatitis nodularis helicis treated with methyl aminolevulinate photodynamic therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.J. García-Malinis" 1 => "L. Turrión-Merino" 2 => "B. Pérez-García" 3 => "D. Saceda-Corralo" 4 => "A. Harto-Castaño" 5 => "Y. Gilaberte" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2016.12.019" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2017" "volumen" => "76" "paginaInicial" => "1103" "paginaFinal" => "1108" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28215445" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Topical nitroglycerin: a promising treatment option for chondrodermatitis nodularis helicis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "V. Flynn" 1 => "C. Chisholm" 2 => "R. Grimwood" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2010.06.012" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2011" "volumen" => "65" "paginaInicial" => "531" "paginaFinal" => "536" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21529999" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Condrodermatitis nodularis helicis tratada con éxito con nitroglicerina al 2% en gel" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "O. Yélamos" 1 => "J. Dalmau" 2 => "L. Puig" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2013" "volumen" => "104" "paginaInicial" => "531" "paginaFinal" => "532" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "La utilidad de la nitroglicerina tópica al 0,2% en la condrodermatitis nodular del hélix" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V. Sanz-Motilva" 1 => "A. Martorell-Calatayud" 2 => "C. Gutiérrez García-Rodrigo" 3 => "L. Hueso-Gabriel" 4 => "M.L. García-Melgares" 5 => "C. Pelufo-Enguix" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ad.2015.04.004" "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2015" "volumen" => "106" "paginaInicial" => "555" "paginaFinal" => "561" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26001657" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of chondrodermatitis nodularis helicis: a systematic review and treatment algorithm" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E. Kechichian" 1 => "S. Jabbour" 2 => "R. Haber" 3 => "Y. Abdelmassih" 4 => "R. Tomb" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/DSS.0000000000000817" "Revista" => array:6 [ "tituloSerie" => "Dermatol Surg" "fecha" => "2016" "volumen" => "42" "paginaInicial" => "1125" "paginaFinal" => "1134" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27399947" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Surgical treatment of chondrodermatitis nodularis helicis via a retroauricular incision" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "N.M. Bruns" 1 => "S. Hessam" 2 => "K. Valavanis" 3 => "L. Scholl" 4 => "F.G. Bechara" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ddg.140_12706" "Revista" => array:6 [ "tituloSerie" => "J Dtsch Dermatol Ges" "fecha" => "2015" "volumen" => "13" "paginaInicial" => "1049" "paginaFinal" => "1052" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26408482" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of chondrodermatitis nodularis with removal of the underlying cartilage alone: Retrospective analysis of experience in 37 lesions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.A. De Ru" 1 => "P.J. Lohuis" 2 => "H.A. Saleh" 3 => "H.D. Vuyk" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1258/002221502760237939" "Revista" => array:6 [ "tituloSerie" => "J Laryngol Otol" "fecha" => "2002" "volumen" => "116" "paginaInicial" => "677" "paginaFinal" => "681" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12437799" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Local treatment of a chronic anal fissure with diltiazem vs nitroglycerin. A comparative study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.J. Puche" 1 => "M.J. García-Coret" 2 => "F.L. Villalba" 3 => "I. Ali-Mahmoud" 4 => "J.V. Roig" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ciresp.2009.12.013" "Revista" => array:6 [ "tituloSerie" => "Cir Esp" "fecha" => "2010" "volumen" => "87" "paginaInicial" => "224" "paginaFinal" => "230" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20206340" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011000000003/v1_201904030645/S1578219019300368/v1_201904030645/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/15782190/0000011000000003/v1_201904030645/S1578219019300368/v1_201904030645/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019300368?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 11 | 14 | 25 |
| 2024 October | 183 | 57 | 240 |
| 2024 September | 151 | 44 | 195 |
| 2024 August | 243 | 63 | 306 |
| 2024 July | 207 | 62 | 269 |
| 2024 June | 179 | 64 | 243 |
| 2024 May | 161 | 86 | 247 |
| 2024 April | 150 | 57 | 207 |
| 2024 March | 143 | 51 | 194 |
| 2024 February | 148 | 40 | 188 |
| 2024 January | 159 | 44 | 203 |
| 2023 December | 134 | 30 | 164 |
| 2023 November | 133 | 37 | 170 |
| 2023 October | 145 | 42 | 187 |
| 2023 September | 95 | 47 | 142 |
| 2023 August | 98 | 24 | 122 |
| 2023 July | 103 | 58 | 161 |
| 2023 June | 76 | 35 | 111 |
| 2023 May | 83 | 43 | 126 |
| 2023 April | 87 | 42 | 129 |
| 2023 March | 142 | 31 | 173 |
| 2023 February | 111 | 49 | 160 |
| 2023 January | 82 | 37 | 119 |
| 2022 December | 90 | 49 | 139 |
| 2022 November | 57 | 46 | 103 |
| 2022 October | 60 | 35 | 95 |
| 2022 September | 48 | 62 | 110 |
| 2022 August | 30 | 59 | 89 |
| 2022 July | 26 | 56 | 82 |
| 2022 June | 31 | 34 | 65 |
| 2022 May | 144 | 49 | 193 |
| 2022 April | 186 | 31 | 217 |
| 2022 March | 210 | 59 | 269 |
| 2022 February | 178 | 32 | 210 |
| 2022 January | 171 | 43 | 214 |
| 2021 December | 109 | 48 | 157 |
| 2021 November | 107 | 40 | 147 |
| 2021 October | 89 | 53 | 142 |
| 2021 September | 70 | 36 | 106 |
| 2021 August | 83 | 40 | 123 |
| 2021 July | 74 | 21 | 95 |
| 2021 June | 55 | 24 | 79 |
| 2021 May | 62 | 49 | 111 |
| 2021 April | 122 | 105 | 227 |
| 2021 March | 121 | 26 | 147 |
| 2021 February | 105 | 31 | 136 |
| 2021 January | 54 | 15 | 69 |
| 2020 December | 45 | 16 | 61 |
| 2020 November | 49 | 18 | 67 |
| 2020 October | 49 | 15 | 64 |
| 2020 September | 42 | 15 | 57 |
| 2020 August | 47 | 15 | 62 |
| 2020 July | 49 | 13 | 62 |
| 2020 June | 36 | 18 | 54 |
| 2020 May | 48 | 15 | 63 |
| 2020 April | 23 | 10 | 33 |
| 2020 March | 17 | 6 | 23 |
| 2020 February | 2 | 0 | 2 |
| 2019 May | 1 | 1 | 2 |
| 2019 April | 1 | 0 | 1 |
Show all
