Resident's Forum
Usefulness of Pulsed Dye Laser in Cutaneous Lupus Erythematosus
FR - Utilidad del láser de colorante pulsado en el lupus eritematoso cutáneo
a Departamento de Dermatología, Hospital Costa del Sol, Marbella, Málaga, Spain
b Departamento de Dermatología, Hospital Universitario de Guadalajara, Guadalajara, Spain
c Departamento de Dermatología, Hospital Universitario de Cruces, San Vicente de Barakaldo, Vizcaya, Spain
d Departamento de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, Spain
Read
6370
Timeswas read the article
2103
Total PDF
4267
Total HTML
Share statistics
array:24 [ "pii" => "S1578219019301192" "issn" => "15782190" "doi" => "10.1016/j.adengl.2018.03.020" "estado" => "S300" "fechaPublicacion" => "2019-06-01" "aid" => "2030" "copyright" => "Elsevier España, S.L.U. and AEDV" "copyrightAnyo" => "2018" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Actas Dermosifiliogr. 2019;110:398-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 26 "formatos" => array:3 [ "EPUB" => 1 "HTML" => 23 "PDF" => 2 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731018303491" "issn" => "00017310" "doi" => "10.1016/j.ad.2018.03.020" "estado" => "S300" "fechaPublicacion" => "2019-06-01" "aid" => "2030" "copyright" => "AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Actas Dermosifiliogr. 2019;110:398-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 169 "formatos" => array:2 [ "HTML" => 121 "PDF" => 48 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Foro de Residentes</span>" "titulo" => "FR - Utilidad del láser de colorante pulsado en el lupus eritematoso cutáneo" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "398" "paginaFinal" => "399" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Usefulness of Pulsed Dye Laser in Cutaneous Lupus Erythematosus" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "P. García-Montero, R. Pérez-Mesonero, A. Barrutia-Borque, P. Boixeda" "autores" => array:4 [ 0 => array:2 [ "nombre" => "P." "apellidos" => "García-Montero" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Pérez-Mesonero" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Barrutia-Borque" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Boixeda" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219019301192" "doi" => "10.1016/j.adengl.2018.03.020" "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/S1578219019301192?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731018303491?idApp=UINPBA000044" "url" => "/00017310/0000011000000005/v1_201906020639/S0001731018303491/v1_201906020639/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219019301180" "issn" => "15782190" "doi" => "10.1016/j.adengl.2019.04.007" "estado" => "S300" "fechaPublicacion" => "2019-06-01" "aid" => "2144" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Actas Dermosifiliogr. 2019;110:e13" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1 "HTML" => 1 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">e-Images in Dermatology</span>" "titulo" => "Fibrous Cephalic Plaque in Tuberous Sclerosis Complex: Treatment With 0.2% Rapamycin" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "e13" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Placa cefálica en esclerosis tuberosa: tratamiento con rapamicina al 0,2%" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1335 "Ancho" => 955 "Tamanyo" => 223963 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Giacaman, A. Martín-Santiago" "autores" => array:2 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Giacaman" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Martín-Santiago" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731019300158" "doi" => "10.1016/j.ad.2018.02.041" "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/S0001731019300158?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019301180?idApp=UINPBA000044" "url" => "/15782190/0000011000000005/v1_201906050857/S1578219019301180/v1_201906050857/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219019301167" "issn" => "15782190" "doi" => "10.1016/j.adengl.2019.04.005" "estado" => "S300" "fechaPublicacion" => "2019-06-01" "aid" => "1821" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2019;110:393-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Brief Comunications</span>" "titulo" => "Atypical Presentation of Herpes Simplex Virus Type 2 Infection Refractory to Treatment With Aciclovir in 2 Hematologic Patients" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "393" "paginaFinal" => "397" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Presentación atípica de infección por virus de herpes simple tipo <span class="elsevierStyleSmallCaps">ii</span> (VHS <span class="elsevierStyleSmallCaps">II</span>) refractaria a tratamiento con aciclovir en 2 pacientes hematológicos" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1317 "Ancho" => 2347 "Tamanyo" => 196778 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Management of aciclovir-resistant genital herpes.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "D. Nieto Rodríguez, E. Sendagorta Cudós, J.M. Rueda Carnero, P. Herranz Pinto" "autores" => array:4 [ 0 => array:2 [ "nombre" => "D. Nieto" "apellidos" => "Rodríguez" ] 1 => array:2 [ "nombre" => "E. Sendagorta" "apellidos" => "Cudós" ] 2 => array:2 [ "nombre" => "J.M. Rueda" "apellidos" => "Carnero" ] 3 => array:2 [ "nombre" => "P. Herranz" "apellidos" => "Pinto" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731017305550" "doi" => "10.1016/j.ad.2017.09.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731017305550?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019301167?idApp=UINPBA000044" "url" => "/15782190/0000011000000005/v1_201906050857/S1578219019301167/v1_201906050857/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Resident's Forum</span>" "titulo" => "Usefulness of Pulsed Dye Laser in Cutaneous Lupus Erythematosus" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "398" "paginaFinal" => "399" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "P. García-Montero, R. Pérez-Mesonero, A. Barrutia-Borque, P. Boixeda" "autores" => array:4 [ 0 => array:4 [ "nombre" => "P." "apellidos" => "García-Montero" "email" => array:1 [ 0 => "garciamonteropablo@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" => "R." "apellidos" => "Pérez-Mesonero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "A." "apellidos" => "Barrutia-Borque" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "P." "apellidos" => "Boixeda" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Departamento de Dermatología, Hospital Costa del Sol, Marbella, Málaga, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Dermatología, Hospital Universitario de Guadalajara, Guadalajara, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Dermatología, Hospital Universitario de Cruces, San Vicente de Barakaldo, Vizcaya, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Departamento de Dermatología, Hospital Universitario Ramón y Cajal, Madrid, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "FR - Utilidad del láser de colorante pulsado en el lupus eritematoso cutáneo" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Cutaneous lupus erythematosus (CLE) is a heterogeneous autoimmune disease with highly variable clinical manifestations, ranging from isolated skin lesions to severe systemic involvement. Cutaneous involvement is a common feature of the several distinct subtypes of CLE, each of which has well-defined clinical, histological, and analytical characteristics.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The 2017 CLE treatment guidelines published by the European Dermatology Forum advise against laser treatment of active CLE lesions, and specify that laser treatment should be administered by an accredited dermatologist and used only as an adjunctive treatment for selected lesions (telangiectasia).<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">These guidelines contrast significantly with previously published recommendations. Since 1986, when Henderson and coworkers successfully used carbon dioxide (CO<span class="elsevierStyleInf">2</span>) laser to treat a patient with disfiguring discoid lupus erythematosus, several case reports have described satisfactory outcomes using this modality.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> CO<span class="elsevierStyleInf">2</span> laser together with argon laser improves skin lesions, but causes unwanted side effects.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">By contrast, pulsed dye laser (PDL), the most widely used form of laser treatment for CLE, produces excellent results (improvement rate, 60%–88%) with minimal side effects (pain and pigmentary alterations). In CLE patients, PDL can be used to treat the erythematous-edematous component of the disease as well as telangiectasia, resulting in clinical and histological improvement and a reduction in the associated symptoms. PDL has been used to successfully treat subacute and chronic forms of CLE (lupus erythematosus tumidus and discoid CLE), and is effective in the treatment of recalcitrant lesions that do not respond to topical or systemic treatments, as well as acute lesions, minimizing the risk of secondary scarring.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> Other light sources including neodymium-doped yttrium aluminum garnet laser and intense pulsed light have also shown promise for the treatment of this disease, although supporting evidence remains scarce.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The safety profile of PDL treatment in lupus patients has been a topic of considerable debate. The wavelength of this laser (595 nm) is outside the ultraviolet spectrum of radiation, which causes photosensitivity in patients with lupus. The possibility that treatment induces the formation of new lesions as a consequence of the Koebner effect has not been confirmed to date.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The mechanism underlying the therapeutic effect of PDL is not entirely clear. A majority of authors subscribe to the hypothesis that PDL selectively destroys the microvasculature of CLE lesions, reducing inflammation and resulting in consequent clinical and histological improvements.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The high doses of topical and/or systemic immunosuppressive drugs administered to some CLE patients result in unsatisfactory responses and marked side effects. Despite its absence from clinical guidelines and algorithms, dermatologists should be familiar with PDL as an alternative treatment given its therapeutic potential and favorable side effect profile. Further studies of the usefulness of PDL in CLE will be necessary so that this treatment can be assigned an appropriate grade of recommendation and offered to patients.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1118224" "palabras" => array:6 [ 0 => "Cutaneous lupus erythematosus" 1 => "Pulsed dye laser" 2 => "Discoid lupus" 3 => "Tumidus lupus" 4 => "Subacute lupus" 5 => "Therapeutics" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: García-Montero P, Pérez-Mesonero R, Barrutia-Borque A, Boixeda P. FR - Utilidad del láser de colorante pulsado en el lupus eritematoso cutáneo. Actas Dermosifiliogr. 2019;110:398–399.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidemiological characteristics of patients with cutaneous lupus erythematosus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.A. Avilés Izquierdo" 1 => "N. Cano Martínez" 2 => "P. Lázaro Ochaita" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ad.2013.09.005" "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2014" "volumen" => "105" "paginaInicial" => "69" "paginaFinal" => "73" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24268922" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "S2k guideline for treatment of cutaneous lupus erythematosus - guided by the European Dermatology Forum (EDF) in cooperation with the European Academy of Dermatology and Venereology (EADV)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Kuhn" 1 => "E. Aberer" 2 => "Z. Bata-Csörgő" 3 => "M. Caproni" 4 => "A. Dreher" 5 => "C. Frances" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/jdv.14053" "Revista" => array:7 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2017" "volumen" => "31" "paginaInicial" => "389" "paginaFinal" => "404" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27859683" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0264410X16002875" "estado" => "S300" "issn" => "0264410X" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Laser treatment of discoid lupus (case report)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D.L. Henderson" 1 => "J.C. Odom" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Lasers Surg Med" "fecha" => "1986" "volumen" => "6" "paginaInicial" => "12" "paginaFinal" => "15" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/3959709" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0050" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Erfolgreiche Behandlung des chronisch diskoiden Lupus erythematodes mittels Argon-Laser" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "W. Nürnberg" 1 => "B. Algermissen" 2 => "B. Hermes" 3 => "B.M. Henz" 4 => "G. Kolde" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Der Hautarzt" "fecha" => "1996" "volumen" => "47" "paginaInicial" => "767" "paginaFinal" => "770" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulsed dye laser as an excellent choice of treatment for lupus tumidus: A prospective study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.T. Truchuelo" 1 => "P. Boixeda" 2 => "J. Alcántara" 3 => "C. Moreno" 4 => "E. de las Heras" 5 => "P.J. Olasolo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2012" "volumen" => "26" "paginaInicial" => "1272" "paginaFinal" => "1279" "itemHostRev" => array:3 [ "pii" => "S0140673608608399" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Histopathology and immunohistochemistry of cutaneous lupus erythematosus after pulsed dye laser treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.T. Díez" 1 => "P. Boixeda" 2 => "C. Moreno" 3 => "J.A. González" 4 => "M.L. Zamorano" 5 => "P.J. Olasolo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1524-4725.2011.02041.x" "Revista" => array:6 [ "tituloSerie" => "Dermatol Surg" "fecha" => "2011" "volumen" => "37" "paginaInicial" => "971" "paginaFinal" => "981" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21615604" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011000000005/v1_201906050857/S1578219019301192/v1_201906050857/en/main.assets" "Apartado" => array:4 [ "identificador" => "34945" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Resident's Forum" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000011000000005/v1_201906050857/S1578219019301192/v1_201906050857/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019301192?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 24 | 13 | 37 |
| 2024 October | 98 | 51 | 149 |
| 2024 September | 168 | 44 | 212 |
| 2024 August | 146 | 70 | 216 |
| 2024 July | 154 | 49 | 203 |
| 2024 June | 109 | 49 | 158 |
| 2024 May | 168 | 45 | 213 |
| 2024 April | 110 | 41 | 151 |
| 2024 March | 106 | 35 | 141 |
| 2024 February | 118 | 41 | 159 |
| 2024 January | 112 | 35 | 147 |
| 2023 December | 108 | 17 | 125 |
| 2023 November | 133 | 52 | 185 |
| 2023 October | 116 | 44 | 160 |
| 2023 September | 97 | 32 | 129 |
| 2023 August | 92 | 38 | 130 |
| 2023 July | 114 | 62 | 176 |
| 2023 June | 92 | 47 | 139 |
| 2023 May | 94 | 49 | 143 |
| 2023 April | 88 | 43 | 131 |
| 2023 March | 82 | 43 | 125 |
| 2023 February | 71 | 27 | 98 |
| 2023 January | 53 | 33 | 86 |
| 2022 December | 64 | 45 | 109 |
| 2022 November | 57 | 45 | 102 |
| 2022 October | 49 | 31 | 80 |
| 2022 September | 36 | 41 | 77 |
| 2022 August | 26 | 40 | 66 |
| 2022 July | 24 | 33 | 57 |
| 2022 June | 43 | 45 | 88 |
| 2022 May | 63 | 36 | 99 |
| 2022 April | 86 | 43 | 129 |
| 2022 March | 99 | 55 | 154 |
| 2022 February | 63 | 37 | 100 |
| 2022 January | 58 | 34 | 92 |
| 2021 December | 45 | 40 | 85 |
| 2021 November | 65 | 54 | 119 |
| 2021 October | 80 | 67 | 147 |
| 2021 September | 56 | 48 | 104 |
| 2021 August | 50 | 28 | 78 |
| 2021 July | 32 | 24 | 56 |
| 2021 June | 60 | 34 | 94 |
| 2021 May | 40 | 38 | 78 |
| 2021 April | 140 | 81 | 221 |
| 2021 March | 81 | 31 | 112 |
| 2021 February | 71 | 23 | 94 |
| 2021 January | 42 | 17 | 59 |
| 2020 December | 45 | 13 | 58 |
| 2020 November | 40 | 14 | 54 |
| 2020 October | 55 | 10 | 65 |
| 2020 September | 36 | 21 | 57 |
| 2020 August | 37 | 19 | 56 |
| 2020 July | 29 | 20 | 49 |
| 2020 June | 37 | 31 | 68 |
| 2020 May | 41 | 19 | 60 |
| 2020 April | 19 | 15 | 34 |
| 2020 March | 18 | 7 | 25 |
| 2020 February | 4 | 2 | 6 |
| 2019 May | 3 | 2 | 5 |
| 2019 April | 20 | 0 | 20 |
Show all
