Case and Research Letters
Marjolin Ulcer: A Report of 2 Cases of Squamous Cell Carcinoma Arising From Posttraumatic Soft-Tissue Scarring
Úlcera de majorlin: 2 casos de carcinoma escamoso sobre cicatriz por trauma en tejidos blandos
Read
6546
Timeswas read the article
1870
Total PDF
4676
Total HTML
Share statistics
array:25 [ "pii" => "S1578219019303567" "issn" => "15782190" "doi" => "10.1016/j.adengl.2018.06.031" "estado" => "S300" "fechaPublicacion" => "2020-01-01" "aid" => "2251" "copyright" => "AEDV" "copyrightAnyo" => "2019" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2020;111:81-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:20 [ "pii" => "S0001731019303011" "issn" => "00017310" "doi" => "10.1016/j.ad.2018.06.025" "estado" => "S300" "fechaPublicacion" => "2020-01-01" "aid" => "2251" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2020;111:81-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 17 "formatos" => array:2 [ "HTML" => 11 "PDF" => 6 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Cartas científico-clínicas</span>" "titulo" => "Úlcera de Marjolin: 2 casos de carcinoma escamoso sobre cicatriz por trauma en tejidos blandos" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "81" "paginaFinal" => "83" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Marjolin Ulcer: A Report of 2 Cases of Squamous Cell Carcinoma Arising From Posttraumatic Soft-Tissue Scarring" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1374 "Ancho" => 1505 "Tamanyo" => 422151 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A) Tumor verrugoso ulcerado antebrazo derecho. B) Carcinoma escamoso infiltrante bien diferenciado (H&E 10×). C) Mitosis, pleomorfismo nuclear (H&E ×40).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "V.L. Dávila Osorio, L. Méndez Gaviria, J.R. Amador Patarroyo, M.I. González Coral" "autores" => array:4 [ 0 => array:2 [ "nombre" => "V.L." "apellidos" => "Dávila Osorio" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Méndez Gaviria" ] 2 => array:2 [ "nombre" => "J.R." "apellidos" => "Amador Patarroyo" ] 3 => array:2 [ "nombre" => "M.I." "apellidos" => "González Coral" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219019303567" "doi" => "10.1016/j.adengl.2018.06.031" "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/S1578219019303567?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731019303011?idApp=UINPBA000044" "url" => "/00017310/0000011100000001/v3_202009190630/S0001731019303011/v3_202009190630/es/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S1578219019303543" "issn" => "15782190" "doi" => "10.1016/j.adengl.2019.12.004" "estado" => "S300" "fechaPublicacion" => "2020-01-01" "aid" => "2077" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2020;111:83-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Classic Ehlers-Danlos Syndrome: Clinical and Ultrasound Findings" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "83" "paginaFinal" => "85" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Síndrome de Ehlers-Danlos clásico: hallazgos clínicos y ecográficos" ] ] "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" => 1112 "Ancho" => 1505 "Tamanyo" => 172216 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Characteristic clinical signs of classic Ehlers-Danlos syndrome. A, Joint hypermobility with hyperextension of the fingers. B, Atrophic scars with a cigarette-paper-like appearance. C, Skin hyperlaxity. D, Hyperextension of the tongue (Gorlin sign).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Herrero-Moyano, L. Noguera-Morel, A. Torrelo, A. Hernández-Martín" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Herrero-Moyano" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Noguera-Morel" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Torrelo" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Hernández-Martín" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731018304435" "doi" => "10.1016/j.ad.2018.05.012" "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/S0001731018304435?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019303543?idApp=UINPBA000044" "url" => "/15782190/0000011100000001/v2_202004200619/S1578219019303543/v2_202004200619/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S1578219019303555" "issn" => "15782190" "doi" => "10.1016/j.adengl.2019.12.005" "estado" => "S300" "fechaPublicacion" => "2020-01-01" "aid" => "2224" "copyright" => "AEDV" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2020;111:78-80" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Annular Hair Loss and Persistent Crusting in a Baby" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "78" "paginaFinal" => "80" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Bebé con alopecia anular y costras persistentes" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1130 "Ancho" => 1505 "Tamanyo" => 657197 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Histological characteristics (hematoxylin-eosin staining). A, Sclerotic dermis with dense collagen and a scar-like appearance (original magnification ×10). B, Detail of a broken hair follicle (original magnification ×40). C, Peripheral multinucleated giant cells (original magnification ×40).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "E. Macías del Toro, M.A. González Domingo, F. Alfageme Roldán" "autores" => array:3 [ 0 => array:2 [ "nombre" => "E." "apellidos" => "Macías del Toro" ] 1 => array:2 [ "nombre" => "M.A." "apellidos" => "González Domingo" ] 2 => array:2 [ "nombre" => "F." "apellidos" => "Alfageme Roldán" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731019301899" "doi" => "10.1016/j.ad.2018.06.022" "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/S0001731019301899?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019303555?idApp=UINPBA000044" "url" => "/15782190/0000011100000001/v2_202004200619/S1578219019303555/v2_202004200619/en/main.assets" ] "en" => array:17 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Marjolin Ulcer: A Report of 2 Cases of Squamous Cell Carcinoma Arising From Posttraumatic Soft-Tissue Scarring" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "81" "paginaFinal" => "83" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "V.L. Dávila Osorio, L. Méndez Gaviria, J.R. Amador Patarroyo, M.I. González" "autores" => array:4 [ 0 => array:4 [ "nombre" => "V.L." "apellidos" => "Dávila Osorio" "email" => array:1 [ 0 => "dra.daviladermatologa@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" => "Méndez Gaviria" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "J.R." "apellidos" => "Amador Patarroyo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "M.I." "apellidos" => "González" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Dermatología, Hospital Militar Central, Universidad Militar Nueva Granada, Bogotá, Colombia" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Patología, Hospital Militar Central, Bogotá, Colombia" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Úlcera de majorlin: 2 casos de carcinoma escamoso sobre cicatriz por trauma en tejidos blandos" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1374 "Ancho" => 1505 "Tamanyo" => 422151 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, Ulcerated verrucous tumor on the right forearm. B, Well-differentiated infiltrating squamous cell carcinoma (hematoxylin-eosin, original magnification ×10). C, Mitosis, nuclear pleomorphism (hematoxylin-eosin, original magnification ×40).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">To the Editor:</span></p><p id="par0010" class="elsevierStylePara elsevierViewall">Marjolin ulcer is an invasive neoplasm that arises from chronic wounds of any etiology, including traumatic wounds, chronic ulcers, and partial or total skin grafts.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> Squamous cell carcinoma, although rare, is the most frequently produced neoplasm.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Here, we present 2 representative cases.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Case Descriptions</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Case 1</span><p id="par0015" class="elsevierStylePara elsevierViewall">The patient was a 56-year-old man with a history of soft-tissue trauma caused by crushing of the left leg, for which he had undergone allograft reconstruction 38 years earlier. He was seen for a progressively enlarging verrucous, ulcerated lesion on the left leg that had appeared 1 year earlier (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). A biopsy was performed on suspicion of malignancy and revealed an infiltrating squamous cell carcinoma (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B and C). Imaging studies showed bone infiltration, which necessitated amputation of the affected limb.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Case 2</span><p id="par0020" class="elsevierStylePara elsevierViewall">The patient was a 51-year-old man with a history of soft-tissue trauma with circumferential compromise and tissue avulsion caused by a crush injury received in a traffic accident 30 years earlier. He was seen for a progressively enlarging verrucous, ulcerated lesion, located on the scar on his right forearm that had appeared 1 year earlier (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A). A biopsy was performed on suspicion of malignancy and revealed an infiltrating squamous cell carcinoma (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>B and C). The patient underwent chemotherapy and radiation therapy, after which tumor recurrence necessitated amputation of the affected limb.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Discussion</span><p id="par0025" class="elsevierStylePara elsevierViewall">Squamous cell carcinoma is the second most common cutaneous neoplasm after basal cell carcinoma. This tumor type can occur de novo or can arise from precancerous lesions or from lesions caused by prior trauma.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Tumors that arise from chronic wounds, including chronic ulcers, are known as Marjolin ulcers, and have an estimated incidence of 1.3%–2.2%, which increases with the chronicity of the pre-existing lesion.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Development of Marjolin ulcer has been reported up to 65 years after the appearance of the initial lesion, although the mean latency is approximately 40 years.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> In our 2 cases the mean latency to lesion appearance was 34 years after the initial trauma. The inflammatory environment of ulcers (large amounts of cytotoxic products derived from macrophage activity within the wound, cells with a high mitotic capacity, an ischemic environment, and poor lymphatic drainage) favors carcinogenesis and the formation of tumors such as Marjolin ulcer.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,4,5</span></a> In cases of clinical suspicion of this tumor type histology should be performed to confirm the diagnosis. Histology reveals findings compatible with squamous cell carcinoma. The degree of tumor differentiation is the primary long-term prognostic factor; greater degrees of differentiation, ulceration, and dermal infiltration by tumor cells are associated with a higher rate of recurrence.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Tumor staging should be performed to evaluate lymph node involvement distant from the tumor and to determine the appropriate therapeutic approach. Surgery is the treatment of choice, with reported 2-year survival rates of 66%–80%.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Adjuvant treatments such as radiotherapy or chemotherapy may be useful in patients with inoperable tumors or those who refuse surgery.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusion</span><p id="par0030" class="elsevierStylePara elsevierViewall">Lesion chronicity, clinical findings, and clinical-pathological correlation are key to the diagnosis of Marjolin ulcer. A high index of suspicion is necessary to establish an early diagnosis and thereby provide patients with timely treatment.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conflict 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:5 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Case Descriptions" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Case 1" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Case 2" ] ] ] 1 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 2 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusion" ] 3 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflict of Interest" ] 4 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-02-28" "fechaAceptado" => "2018-06-07" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Dávila Osorio VL, Méndez Gaviria L, Amador Patarroyo JR, González MI. Úlcera de majorlin: 2 casos de carcinoma escamoso sobre cicatriz por trauma en tejidos blandos. Actas Dermosifiliogr. 2020;111:81–82.</p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1293 "Ancho" => 1505 "Tamanyo" => 345198 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, Ulcerated verrucous tumor on the left leg. B, Nests of squamous cells infiltrating the dermis (hematoxylin-eosin, original magnification ×10). C, Nuclear pleomorphism (hematoxylin-eosin, original magnification ×40).</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1374 "Ancho" => 1505 "Tamanyo" => 422151 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, Ulcerated verrucous tumor on the right forearm. B, Well-differentiated infiltrating squamous cell carcinoma (hematoxylin-eosin, original magnification ×10). C, Mitosis, nuclear pleomorphism (hematoxylin-eosin, original magnification ×40).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ten years of experience in chronic ulcers and malignant transformation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.G. Onesti" 1 => "P. Fino" 2 => "P. Fioramonti" 3 => "V. Amorosi" 4 => "N. Scuderi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/iwj.12134" "Revista" => array:6 [ "tituloSerie" => "Int Wound J" "fecha" => "2015" "volumen" => "12" "paginaInicial" => "447" "paginaFinal" => "450" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23865503" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Marjolin’s warty ulcer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Sharma" 1 => "R.A. Schwartz" 2 => "K.G. Swan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/jso.21783" "Revista" => array:6 [ "tituloSerie" => "J Surg Oncol" "fecha" => "2011" "volumen" => "103" "paginaInicial" => "193" "paginaFinal" => "195" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21259256" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Úlcera de Marjolin: carcinoma sobre cicatriz por quemadura" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "I. García-Morales" 1 => "A. Pérez-Gil" 2 => "F. Camacho" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0001-7310(06)73457-3" "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2006" "volumen" => "97" "paginaInicial" => "529" "paginaFinal" => "532" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17067533" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Early diagnosis is vital in the management of squamous cell carcinomas associated with chronic non healing ulcers: A case series and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Enoch" 1 => "D.R. Miller" 2 => "P.E. Price" 3 => "K.G. Harding" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1742-4801.2004.00056.x" "Revista" => array:6 [ "tituloSerie" => "Int Wound J" "fecha" => "2004" "volumen" => "1" "paginaInicial" => "165" "paginaFinal" => "175" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16722875" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Is surgery an effective and adequate treatment in advanced Marjolin’s ulcer?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E. Aydo˘gdu" 1 => "S. Yildirim" 2 => "T. Aköz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.burns.2005.02.008" "Revista" => array:6 [ "tituloSerie" => "Burns" "fecha" => "2005" "volumen" => "31" "paginaInicial" => "421" "paginaFinal" => "431" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15896503" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011100000001/v2_202004200619/S1578219019303567/v2_202004200619/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/15782190/0000011100000001/v2_202004200619/S1578219019303567/v2_202004200619/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019303567?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 10 | 8 | 18 |
| 2024 October | 94 | 38 | 132 |
| 2024 September | 106 | 28 | 134 |
| 2024 August | 138 | 56 | 194 |
| 2024 July | 92 | 38 | 130 |
| 2024 June | 95 | 43 | 138 |
| 2024 May | 106 | 38 | 144 |
| 2024 April | 84 | 31 | 115 |
| 2024 March | 87 | 30 | 117 |
| 2024 February | 65 | 29 | 94 |
| 2024 January | 88 | 38 | 126 |
| 2023 December | 81 | 15 | 96 |
| 2023 November | 141 | 29 | 170 |
| 2023 October | 108 | 35 | 143 |
| 2023 September | 100 | 34 | 134 |
| 2023 August | 70 | 21 | 91 |
| 2023 July | 109 | 40 | 149 |
| 2023 June | 70 | 32 | 102 |
| 2023 May | 124 | 47 | 171 |
| 2023 April | 91 | 35 | 126 |
| 2023 March | 111 | 36 | 147 |
| 2023 February | 87 | 34 | 121 |
| 2023 January | 76 | 36 | 112 |
| 2022 December | 82 | 57 | 139 |
| 2022 November | 70 | 38 | 108 |
| 2022 October | 81 | 35 | 116 |
| 2022 September | 89 | 41 | 130 |
| 2022 August | 80 | 39 | 119 |
| 2022 July | 68 | 41 | 109 |
| 2022 June | 49 | 29 | 78 |
| 2022 May | 84 | 62 | 146 |
| 2022 April | 116 | 49 | 165 |
| 2022 March | 96 | 72 | 168 |
| 2022 February | 98 | 36 | 134 |
| 2022 January | 107 | 40 | 147 |
| 2021 December | 67 | 47 | 114 |
| 2021 November | 78 | 41 | 119 |
| 2021 October | 84 | 57 | 141 |
| 2021 September | 64 | 25 | 89 |
| 2021 August | 66 | 21 | 87 |
| 2021 July | 79 | 21 | 100 |
| 2021 June | 49 | 29 | 78 |
| 2021 May | 45 | 49 | 94 |
| 2021 April | 278 | 50 | 328 |
| 2021 March | 168 | 23 | 191 |
| 2021 February | 93 | 26 | 119 |
| 2021 January | 57 | 17 | 74 |
| 2020 December | 60 | 14 | 74 |
| 2020 November | 59 | 14 | 73 |
| 2020 October | 43 | 17 | 60 |
| 2020 September | 37 | 15 | 52 |
| 2020 August | 32 | 16 | 48 |
| 2020 July | 21 | 14 | 35 |
| 2020 June | 16 | 16 | 32 |
| 2020 May | 61 | 13 | 74 |
| 2020 April | 40 | 21 | 61 |
| 2020 March | 24 | 12 | 36 |
| 2020 February | 2 | 2 | 4 |
Show all
