Impact of the COVID-19 Pandemic on Immunomodulatory and Immunosuppressive Therapies in Dermatology: Patient and Physician Attitudes in Argentina

array:24 ["pii" => "S1578219020302870" "issn" => "15782190" "doi" => "10.1016/j.adengl.2020.10.010" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "2333" "copyright" => "AEDV" "copyrightAnyo" => "2020" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2020;111:806-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:20 [ "pii" => "S0001731020301095" "issn" => "00017310" "doi" => "10.1016/j.ad.2020.04.004" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "2333" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2020;111:806-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "Carta científico-clínica" "titulo" => "Impacto de la pandemia COVID-19 en los tratamientos inmunomoduladores e inmunosupresores en dermatología: actitudes de los pacientes y los dermatólogos en Argentina" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "806" "paginaFinal" => "807" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Impact of the COVID-19 Pandemic on Immunomodulatory and Immunosuppressive Therapies in Dermatology: Patient and Physician Attitudes in Argentina" ] ] "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" => 870 "Ancho" => 1330 "Tamanyo" => 56175 ] ] "descripcion" => array:1 [ "es" => "Medios de consulta." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S. Zimman, M.J. Cura, P.C. Luna, C.M. Echeverría, L.D. Mazzuoccolo" "autores" => array:5 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Zimman" ] 1 => array:2 [ "nombre" => "M.J." "apellidos" => "Cura" ] 2 => array:2 [ "nombre" => "P.C." "apellidos" => "Luna" ] 3 => array:2 [ "nombre" => "C.M." "apellidos" => "Echeverría" ] 4 => array:2 [ "nombre" => "L.D." "apellidos" => "Mazzuoccolo" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219020302870" "doi" => "10.1016/j.adengl.2020.10.010" "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/S1578219020302870?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731020301095?idApp=UINPBA000044" "url" => "/00017310/0000011100000009/v1_202011260611/S0001731020301095/v1_202011260611/es/main.assets" ] ] "itemAnterior" => array:19 [ "pii" => "S157821902030278X" "issn" => "15782190" "doi" => "10.1016/j.adengl.2020.10.003" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "2366" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2020;111:804-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "Case and Research Letters" "titulo" => "Eosinophilic Panniculitis Associated With COVID-19" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "804" "paginaFinal" => "805" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Paniculitis eosinofílica secundaria a infección por COVID-19" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 680 "Ancho" => 905 "Tamanyo" => 55080 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Nodular lesion (2 cm in diameter) with a brownish surface located on the outer aspect of the right leg." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "V.M. Leis-Dosil, A. Sáez Vicente, M.M. Lorido-Cortés" "autores" => array:3 [ 0 => array:2 [ "nombre" => "V.M." "apellidos" => "Leis-Dosil" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Sáez Vicente" ] 2 => array:2 [ "nombre" => "M.M." "apellidos" => "Lorido-Cortés" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731020301630" "doi" => "10.1016/j.ad.2020.05.003" "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/S0001731020301630?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157821902030278X?idApp=UINPBA000044" "url" => "/15782190/0000011100000009/v1_202012010756/S157821902030278X/v1_202012010756/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "Case and Research Letters" "titulo" => "Impact of the COVID-19 Pandemic on Immunomodulatory and Immunosuppressive Therapies in Dermatology: Patient and Physician Attitudes in Argentina" "tieneTextoCompleto" => true "saludo" => "To the Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "806" "paginaFinal" => "807" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "S. Zimman, M.J. Cura, P.C. Lun, C.M. Echeverría, L.D. Mazzuoccol" "autores" => array:5 [ 0 => array:4 [ "nombre" => "S." "apellidos" => "Zimman" "email" => array:1 [ 0 => "sabina.zimman@hospitalitaliano.org.ar" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "M.J." "apellidos" => "Cura" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "P.C." "apellidos" => "Lun" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "C.M." "apellidos" => "Echeverría" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "L.D." "apellidos" => "Mazzuoccol" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Hospital Italiano de Buenos Aires, Servicio de Dermatología, Tte Gral Juan D. Perón, Ciudad Autónoma de Buenos Aires, Argentina" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Hospital Alemán, Servicio de Dermatología, Ciudad Autónoma de Buenos Aires, Argentina" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Instituto Rehabilitación Psicofísica (IREP), Ciudad Autónoma de Buenos Aires, Argentina" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Impacto de la pandemia COVID-19 en los tratamientos inmunomoduladores e inmunosupresores en dermatología: actitudes de los pacientes y los dermatólogos en Argentina" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 672 "Ancho" => 2357 "Tamanyo" => 101219 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0030" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "A, Patients’ sources of information. B, Dermatologists’ sources of information." ] ] ] "textoCompleto" => "On 20 March 2020, lockdown was decreed in Argentina due to the Coronavirus disease 2019 (COVID-19) pandemic.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> We proposed examining the behavior of patients and of dermatologists in relation to their patients undergoing immunomodulating/immunosuppressant treatment.We performed a cross-sectional study using 2 questionnaires. The first questionnaire, which was aimed at patients with inflammatory skin disease susceptible to immunomodulating/immunosuppressant treatment (psoriasis [Ps], atopic dermatitis [AD], hidradenitis suppurativa [HS], and others), consisted of 5 questions on age, dermatologic disease, current treatment, sources of information regarding COVID-19, and preventive measures. The questionnaire was sent to 1500 patients of the Civil Association for Psoriasis Patients (AEPSO). The second questionnaire, which was aimed at dermatologists, consisted of 12 questions on communication routes and patient care, sources of information, and behavior regarding treatments. The questionnaire was sent to 350 dermatologists of the Argentinian Psoriasis Society (SOARPSO) and the Argentinian Dermatology Society (SAD). Both questionnaires were sent via WhatsApp or e-mail on 19 March 2020. Responses were accepted up to March 27, 2020. Qualitative variables were expressed as absolute numbers and percentages. The STATA (StataCorp, version 14.2) statistical software package was used to perform the statistical analysis. The study complied with the ethical principles of the Helsinki declaration.Of the 504 patients who responded, 81.9% had Ps, 8.9% had AD, and 4.2% had HS. A total of 88.6% of patients were between 18 and 60 years old. Forty-nine percent (245) were undergoing immunomodulatory/immunosuppressant treatment (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). The most commonly used sources of information were radio and television (44.2%) and websites (39.7%) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>a). The most frequent preventive measures were handwashing (95.1%), use of hand sanitizer (73.1%), and keeping social distance (62.9%). Although 28.2% self-isolated because they belonged to an at-risk group, 62.5% decided to self-isolate prior to the official declaration. Twelve percent of patients suspended immunomodulating/immunosuppressant treatment without consulting their physician.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia>Responses to the survey were received from 146 dermatologists. In terms of sources of information, 83.9% consulted the websites of scientific societies and 74.8% followed the recommendations of noted colleagues (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B). A total of 86% of the dermatologists were consulted by their patients for queries relating to COVID-19 (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). In terms of in-person care, half of respondents suspended all visits, one-fifth spaced the visits out, and one-third saw only emergencies. Half of the physicians used electronic means for handling consultations (WhatsApp or e-mail). Although only 13% used telemedicine, 100% felt that it would be of use at this time. With regard to conventional immunomodulating/immunosuppressant treatment, 64.9% evaluated each case individually to define continuity, 25.7% only reinforced alarm guidelines, and 8.8% made no changes. In terms of biologic treatments, 78.8%, 17.4%, and 2.3% took the same measures, respectively. One dermatologist suspended conventional treatments and 2 suspended biologic agents.<elsevierMultimedia ident="fig0010"></elsevierMultimedia>Our study examined the behavior of patients and dermatologists at the start of the pandemic in Argentina. The fact that most patients had self-isolated before the health care authority issued the indication appears to be intuitively reasonable. However, future studies must determine its plausibility, as isolation may be impracticable in a context of poverty, overcrowding, and cessation of income.This is the first pandemic to occur during the rise of information and communication technology, where the variety of easily accessible digital media and resources can generate a paradoxical effect of disinformation and inappropriate behavior. Hence the importance of the active role of dermatologists and scientific societies in the dissemination of appropriate information.<a class="elsevierStyleCrossRefs" href="#bib0010">2–4</a>Furthermore, the fact that both dermatologists and patients prefer virtual means of communication for visits highlights the need for mass implementation of telemedicine during the pandemic.<a class="elsevierStyleCrossRef" href="#bib0025">5</a>We highlight the fact that the initial reflex of the dermatologists was not to systematically suspend immunomodulating/immunosuppressant treatment but to evaluate the risk-benefit relationship in each case.<a class="elsevierStyleCrossRefs" href="#bib0030">6–10</a> Mass suspension could lead to severe episodes requiring hospitalization at a time of relative scarcity of beds.A strength of this study is that we believe it to be the first survey to examine the perspective of patients with dermatologic diseases undergoing immunomodulating/immunosuppressant treatment and that of dermatologists in the context of the COVID-19 pandemic. As limiting factors, we acknowledge selection and comprehension bias and missing data.In conclusion, understanding the sources of information of patients and physicians in the event of a pandemic may be useful for improving communication strategies. Furthermore, due to the imposed social isolation, telemedicine is poised to be an essential tool for sustaining patient care.<a class="elsevierStyleCrossRef" href="#bib0025">5</a>Conflicts of InterestThe authors declare that they have no conflicts of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of Interest" ] 1 => array:2 [ "identificador" => "xack497199" "titulo" => "Acknowledgments" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-04-04" "fechaAceptado" => "2020-04-21" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Zimman S, Cura MJ, Lun PC, Echeverría CM, Mazzuoccol LD, Luna PC, Mazzuoccolo LD. Impacto de la pandemia COVID-19 en los tratamientos inmunomoduladores e inmunosupresores en dermatología: actitudes de los pacientes y los dermatólogos en Argentina. Actas Dermosifiliogr. 2020. https://doi.org/10.1016/j.ad.2020.04.004" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 672 "Ancho" => 2357 "Tamanyo" => 101219 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0030" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "A, Patients’ sources of information. B, Dermatologists’ sources of information." ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 870 "Ancho" => 1330 "Tamanyo" => 56175 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0035" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Consultation media." ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0040" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Abbreviations: Anti-TNFɑ indicates tumor necrosis factor ɑ inhibitor; anti-IL 12/23, interleukin 12 and 23 inhibitor; anti-IL 17, interleukin 17 inhibitor; anti-IL 23, interleukin 23 inhibitor; DMARDS, disease-modifying antirheumatic drugs; JAK inhibitor, Janus kinase enzyme inhibitor." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Number \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Percent \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Methotrexate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">99 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">40.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Anti-TNFα \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">57 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Anti-IL 17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">32 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">JAK inhibitors \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Oral corticosteroids \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ciclosporin \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Anti-IL 12/23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.5 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Apremilast \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Anti-IL 23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Other DMARDS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dupilumab \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.4 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2442613.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Immunomodulating/Immunosuppressant Treatments." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "BOLETIN OFICIAL REPUBLICA ARGENTINA - AISLAMIENTO SOCIAL PREVENTIVO Y OBLIGATORIO - Decreto 297/2020. [cited 27 Mar 2020]. Available: https://www.boletinoficial.gob.ar/detalleAviso/primera/227042." ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Soarpso. ACTUALIZACIÓN DE RECOMENDACIONES CORONAVIRUS (COVID-19). In: SOARPSO [Internet]. [cited 27 Mar 2020]. Available: https://www.soarpso.org/noticia_detalle.php?IdNoticia=1427." ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Managing your practice through the COVID-19 outbreak. [cited 27 Mar 2020]. Available: https://www.aad.org/member/practice/managing/coronavirus." ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "López PPÁ. Coronavirus: “Los pacientes dermatológicos no deben suspender sus tratamientos” | Academia Española de Dermatología y Venereología. In: Academia Española de Dermatología y Venereología [Internet]. 24 Mar 2020 [cited 27 Mar 2020]. Available: https://aedv.es/coronavirus-los-pacientes-dermatologicos-no-deben-suspender-sus-tratamiento/." ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Telehealth: Helping Your Patients and Practice Survive and Thrive During the COVID-19 Crisis with Rapid Quality Implementation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "I. Lee" 1 => "C. Kovarik" 2 => "T. Tejasvi" 3 => "M. Pizarro" 4 => "J.B. Lipoff" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2020.03.052" "Revista" => array:2 [ "tituloSerie" => "J Am Acad Dermatol." "fecha" => "2020" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Should patients stop their biologic treatment during the COVID-19 pandemic" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.M. Bashyam" 1 => "S.R. Feldman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/09546634.2020.1836312" "Revista" => array:5 [ "tituloSerie" => "J Dermatolog Treat." "fecha" => "2020" "paginaInicial" => "1" "paginaFinal" => "2" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33054453" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Advice regarding COVID-19 and use of immunomodulators, in patients with severe dermatological diseases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Rademaker" 1 => "C. Baker" 2 => "P. Foley" 3 => "J. Sullivan" 4 => "C. Wang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ajd.13295" "Revista" => array:2 [ "tituloSerie" => "Australas J Dermatol." "fecha" => "2020" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Should biologics for psoriasis be interrupted in the era of COVID-19?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Lebwohl" 1 => "R. Rivera-Oyola" 2 => "D.F. Murrell" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2020.03.031" "Revista" => array:2 [ "tituloSerie" => "J Am Acad Dermatol." "fecha" => "2020" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "COVID-19 and Immunomodulator/Immunosuppressant Use in Dermatology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "K.N. Price" 1 => "J.W. Frew" 2 => "J.L. Hsiao" 3 => "V.Y. Shi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2020.03.046" "Revista" => array:2 [ "tituloSerie" => "J Am Acad Dermatol." "fecha" => "2020" ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Menter" 1 => "B.E. Strober" 2 => "D.H. Kaplan" 3 => "D. Kivelevitch" 4 => "E.F. Prater" 5 => "B. Stoff" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2018.11.057" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol." "fecha" => "2019" "volumen" => "80" "paginaInicial" => "1029" "paginaFinal" => "1072" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30772098" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack497199" "titulo" => "Acknowledgments" "texto" => "The authors would like to thank Silvia Fernández Barrio, chair of AEPSO, for her help with the dissemination of the survey." "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011100000009/v1_202012010756/S1578219020302870/v1_202012010756/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/15782190/0000011100000009/v1_202012010756/S1578219020302870/v1_202012010756/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020302870?idApp=UINPBA000044"]

Statistics

Case and Research Letters

Impact of the COVID-19 Pandemic on Immunomodulatory and Immunosuppressive Therapies in Dermatology: Patient and Physician Attitudes in Argentina

Impacto de la pandemia COVID-19 en los tratamientos inmunomoduladores e inmunosupresores en dermatología: actitudes de los pacientes y los dermatólogos en Argentina

S. Zimmana,

Corresponding author

sabina.zimman@hospitalitaliano.org.ar

Corresponding author.

, M.J. Curaa, P.C. Lunb, C.M. Echeverríac, L.D. Mazzuoccola

a Hospital Italiano de Buenos Aires, Servicio de Dermatología, Tte Gral Juan D. Perón, Ciudad Autónoma de Buenos Aires, Argentina

b Hospital Alemán, Servicio de Dermatología, Ciudad Autónoma de Buenos Aires, Argentina

c Instituto Rehabilitación Psicofísica (IREP), Ciudad Autónoma de Buenos Aires, Argentina

Read

6023

Times
was read the article

2450

Total PDF

3573

Total HTML

Share statistics

 array:24 [
  "pii" => "S1578219020302870"
  "issn" => "15782190"
  "doi" => "10.1016/j.adengl.2020.10.010"
  "estado" => "S300"
  "fechaPublicacion" => "2020-11-01"
  "aid" => "2333"
  "copyright" => "AEDV"
  "copyrightAnyo" => "2020"
  "documento" => "article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "crp"
  "cita" => "Actas Dermosifiliogr. 2020;111:806-7"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:20 [
      "pii" => "S0001731020301095"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2020.04.004"
      "estado" => "S300"
      "fechaPublicacion" => "2020-11-01"
      "aid" => "2333"
      "copyright" => "AEDV"
      "documento" => "simple-article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "crp"
      "cita" => "Actas Dermosifiliogr. 2020;111:806-7"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fico-cl&#237;nica</span>"
        "titulo" => "Impacto de la pandemia COVID-19 en los tratamientos inmunomoduladores e inmunosupresores en dermatolog&#237;a&#58; actitudes de los pacientes y los dermat&#243;logos en Argentina"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "806"
            "paginaFinal" => "807"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Impact of the COVID-19 Pandemic on Immunomodulatory and Immunosuppressive Therapies in Dermatology&#58; Patient and Physician Attitudes in Argentina"
          ]
        ]
        "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" => 870
                "Ancho" => 1330
                "Tamanyo" => 56175
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Medios de consulta&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "S&#46; Zimman, M&#46;J&#46; Cura, P&#46;C&#46; Luna, C&#46;M&#46; Echeverr&#237;a, L&#46;D&#46; Mazzuoccolo"
            "autores" => array:5 [
              0 => array:2 [
                "nombre" => "S&#46;"
                "apellidos" => "Zimman"
              ]
              1 => array:2 [
                "nombre" => "M&#46;J&#46;"
                "apellidos" => "Cura"
              ]
              2 => array:2 [
                "nombre" => "P&#46;C&#46;"
                "apellidos" => "Luna"
              ]
              3 => array:2 [
                "nombre" => "C&#46;M&#46;"
                "apellidos" => "Echeverr&#237;a"
              ]
              4 => array:2 [
                "nombre" => "L&#46;D&#46;"
                "apellidos" => "Mazzuoccolo"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1578219020302870"
          "doi" => "10.1016/j.adengl.2020.10.010"
          "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/S1578219020302870?idApp=UINPBA000044"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731020301095?idApp=UINPBA000044"
      "url" => "/00017310/0000011100000009/v1_202011260611/S0001731020301095/v1_202011260611/es/main.assets"
    ]
  ]
  "itemAnterior" => array:19 [
    "pii" => "S157821902030278X"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2020.10.003"
    "estado" => "S300"
    "fechaPublicacion" => "2020-11-01"
    "aid" => "2366"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2020;111:804-5"
    "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" => "Eosinophilic Panniculitis Associated With COVID-19"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "804"
          "paginaFinal" => "805"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Paniculitis eosinof&#237;lica secundaria a infecci&#243;n por COVID-19"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 680
              "Ancho" => 905
              "Tamanyo" => 55080
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0005"
              "detalle" => "Figure "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Nodular lesion &#40;2&#8239;cm in diameter&#41; with a brownish surface located on the outer aspect of the right leg&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "V&#46;M&#46; Leis-Dosil, A&#46; S&#225;ez Vicente, M&#46;M&#46; Lorido-Cort&#233;s"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "V&#46;M&#46;"
              "apellidos" => "Leis-Dosil"
            ]
            1 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "S&#225;ez Vicente"
            ]
            2 => array:2 [
              "nombre" => "M&#46;M&#46;"
              "apellidos" => "Lorido-Cort&#233;s"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731020301630"
        "doi" => "10.1016/j.ad.2020.05.003"
        "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/S0001731020301630?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157821902030278X?idApp=UINPBA000044"
    "url" => "/15782190/0000011100000009/v1_202012010756/S157821902030278X/v1_202012010756/en/main.assets"
  ]
  "en" => array:19 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
    "titulo" => "Impact of the COVID-19 Pandemic on Immunomodulatory and Immunosuppressive Therapies in Dermatology&#58; Patient and Physician Attitudes in Argentina"
    "tieneTextoCompleto" => true
    "saludo" => "<span class="elsevierStyleItalic">To the Editor</span>&#58;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "806"
        "paginaFinal" => "807"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "S&#46; Zimman, M&#46;J&#46; Cura, P&#46;C&#46; Lun, C&#46;M&#46; Echeverr&#237;a, L&#46;D&#46; Mazzuoccol"
        "autores" => array:5 [
          0 => array:4 [
            "nombre" => "S&#46;"
            "apellidos" => "Zimman"
            "email" => array:1 [
              0 => "sabina.zimman@hospitalitaliano.org.ar"
            ]
            "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" => "M&#46;J&#46;"
            "apellidos" => "Cura"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "P&#46;C&#46;"
            "apellidos" => "Lun"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "C&#46;M&#46;"
            "apellidos" => "Echeverr&#237;a"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "L&#46;D&#46;"
            "apellidos" => "Mazzuoccol"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Hospital Italiano de Buenos Aires&#44; Servicio de Dermatolog&#237;a&#44; Tte Gral Juan D&#46; Per&#243;n&#44; Ciudad Aut&#243;noma de Buenos Aires&#44; Argentina"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Hospital Alem&#225;n&#44; Servicio de Dermatolog&#237;a&#44; Ciudad Aut&#243;noma de Buenos Aires&#44; Argentina"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Instituto Rehabilitaci&#243;n Psicof&#237;sica &#40;IREP&#41;&#44; Ciudad Aut&#243;noma de Buenos Aires&#44; Argentina"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Impacto de la pandemia COVID-19 en los tratamientos inmunomoduladores e inmunosupresores en dermatolog&#237;a&#58; actitudes de los pacientes y los dermat&#243;logos en Argentina"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 672
            "Ancho" => 2357
            "Tamanyo" => 101219
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0030"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A&#44; Patients&#8217; sources of information&#46; B&#44; Dermatologists&#8217; sources of information&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">On 20 March 2020&#44; lockdown was decreed in Argentina due to the <span class="elsevierStyleItalic">Coronavirus disease 2019</span> &#40;COVID-19&#41; pandemic&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> We proposed examining the behavior of patients and of dermatologists in relation to their patients undergoing immunomodulating&#47;immunosuppressant treatment&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">We performed a cross-sectional study using 2 questionnaires&#46; The first questionnaire&#44; which was aimed at patients with inflammatory skin disease susceptible to immunomodulating&#47;immunosuppressant treatment &#40;psoriasis &#91;Ps&#93;&#44; atopic dermatitis &#91;AD&#93;&#44; hidradenitis suppurativa &#91;HS&#93;&#44; and others&#41;&#44; consisted of 5 questions on age&#44; dermatologic disease&#44; current treatment&#44; sources of information regarding COVID-19&#44; and preventive measures&#46; The questionnaire was sent to 1500 patients of the Civil Association for Psoriasis Patients &#40;AEPSO&#41;&#46; The second questionnaire&#44; which was aimed at dermatologists&#44; consisted of 12 questions on communication routes and patient care&#44; sources of information&#44; and behavior regarding treatments&#46; The questionnaire was sent to 350 dermatologists of the Argentinian Psoriasis Society &#40;SOARPSO&#41; and the Argentinian Dermatology Society &#40;SAD&#41;&#46; Both questionnaires were sent via WhatsApp or e-mail on 19 March 2020&#46; Responses were accepted up to March 27&#44; 2020&#46; Qualitative variables were expressed as absolute numbers and percentages&#46; The STATA &#40;StataCorp&#44; version 14&#46;2&#41; statistical software package was used to perform the statistical analysis&#46; The study complied with the ethical principles of the Helsinki declaration&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Of the 504 patients who responded&#44; 81&#46;9&#37; had Ps&#44; 8&#46;9&#37; had AD&#44; and 4&#46;2&#37; had HS&#46; A total of 88&#46;6&#37; of patients were between 18 and 60 years old&#46; Forty-nine percent &#40;245&#41; were undergoing immunomodulatory&#47;immunosuppressant treatment &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; The most commonly used sources of information were radio and television &#40;44&#46;2&#37;&#41; and websites &#40;39&#46;7&#37;&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>a&#41;&#46; The most frequent preventive measures were handwashing &#40;95&#46;1&#37;&#41;&#44; use of hand sanitizer &#40;73&#46;1&#37;&#41;&#44; and keeping social distance &#40;62&#46;9&#37;&#41;&#46; Although 28&#46;2&#37; self-isolated because they belonged to an at-risk group&#44; 62&#46;5&#37; decided to self-isolate prior to the official declaration&#46; Twelve percent of patients suspended immunomodulating&#47;immunosuppressant treatment without consulting their physician&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Responses to the survey were received from 146 dermatologists&#46; In terms of sources of information&#44; 83&#46;9&#37; consulted the websites of scientific societies and 74&#46;8&#37; followed the recommendations of noted colleagues &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41;&#46; A total of 86&#37; of the dermatologists were consulted by their patients for queries relating to COVID-19 &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; In terms of in-person care&#44; half of respondents suspended all visits&#44; one-fifth spaced the visits out&#44; and one-third saw only emergencies&#46; Half of the physicians used electronic means for handling consultations &#40;WhatsApp or e-mail&#41;&#46; Although only 13&#37; used telemedicine&#44; 100&#37; felt that it would be of use at this time&#46; With regard to conventional immunomodulating&#47;immunosuppressant treatment&#44; 64&#46;9&#37; evaluated each case individually to define continuity&#44; 25&#46;7&#37; only reinforced alarm guidelines&#44; and 8&#46;8&#37; made no changes&#46; In terms of biologic treatments&#44; 78&#46;8&#37;&#44; 17&#46;4&#37;&#44; and 2&#46;3&#37; took the same measures&#44; respectively&#46; One dermatologist suspended conventional treatments and 2 suspended biologic agents&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Our study examined the behavior of patients and dermatologists at the start of the pandemic in Argentina&#46; The fact that most patients had self-isolated before the health care authority issued the indication appears to be intuitively reasonable&#46; However&#44; future studies must determine its plausibility&#44; as isolation may be impracticable in a context of poverty&#44; overcrowding&#44; and cessation of income&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">This is the first pandemic to occur during the rise of information and communication technology&#44; where the variety of easily accessible digital media and resources can generate a paradoxical effect of disinformation and inappropriate behavior&#46; Hence the importance of the active role of dermatologists and scientific societies in the dissemination of appropriate information&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#8211;4</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Furthermore&#44; the fact that both dermatologists and patients prefer virtual means of communication for visits highlights the need for mass implementation of telemedicine during the pandemic&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">We highlight the fact that the initial reflex of the dermatologists was not to systematically suspend immunomodulating&#47;immunosuppressant treatment but to evaluate the risk-benefit relationship in each case&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#8211;10</span></a> Mass suspension could lead to severe episodes requiring hospitalization at a time of relative scarcity of beds&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">A strength of this study is that we believe it to be the first survey to examine the perspective of patients with dermatologic diseases undergoing immunomodulating&#47;immunosuppressant treatment and that of dermatologists in the context of the COVID-19 pandemic&#46; As limiting factors&#44; we acknowledge selection and comprehension bias and missing data&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">In conclusion&#44; understanding the sources of information of patients and physicians in the event of a pandemic may be useful for improving communication strategies&#46; Furthermore&#44; due to the imposed social isolation&#44; telemedicine is poised to be an essential tool for sustaining patient care&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:3 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflicts of Interest"
        ]
        1 => array:2 [
          "identificador" => "xack497199"
          "titulo" => "Acknowledgments"
        ]
        2 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2020-04-04"
    "fechaAceptado" => "2020-04-21"
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Zimman S&#44; Cura MJ&#44; Lun PC&#44; Echeverr&#237;a CM&#44; Mazzuoccol LD&#44; Luna PC&#44; Mazzuoccolo LD&#46; Impacto de la pandemia COVID-19 en los tratamientos inmunomoduladores e inmunosupresores en dermatolog&#237;a&#58; actitudes de los pacientes y los dermat&#243;logos en Argentina&#46; Actas Dermosifiliogr&#46; 2020&#46; <span class="elsevierStyleInterRef" id="intr0005" href="https://doi.org/10.1016/j.ad.2020.04.004">https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1016&#47;j&#46;ad&#46;2020&#46;04&#46;004</span></p>"
      ]
    ]
    "multimedia" => array:3 [
      0 => array:8 [
        "identificador" => "fig0005"
        "etiqueta" => "Fig&#46; 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 672
            "Ancho" => 2357
            "Tamanyo" => 101219
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0030"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A&#44; Patients&#8217; sources of information&#46; B&#44; Dermatologists&#8217; sources of information&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "fig0010"
        "etiqueta" => "Fig&#46; 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 870
            "Ancho" => 1330
            "Tamanyo" => 56175
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0035"
            "detalle" => "Fig&#46; "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Consultation media&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0040"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; Anti-TNF&#593; indicates tumor necrosis factor &#593; inhibitor&#59; anti-IL 12&#47;23&#44; interleukin 12 and 23 inhibitor&#59; anti-IL 17&#44; interleukin 17 inhibitor&#59; anti-IL 23&#44; interleukin 23 inhibitor&#59; DMARDS&#44; disease-modifying antirheumatic drugs&#59; JAK inhibitor&#44; Janus kinase enzyme inhibitor&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Number&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Percent&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Methotrexate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">99&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">40&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti-TNF&#945;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti-IL 17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">JAK inhibitors&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Oral corticosteroids&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ciclosporin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti-IL 12&#47;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Apremilast&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anti-IL 23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Other DMARDS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dupilumab&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2442613.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Immunomodulating&#47;Immunosuppressant Treatments&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "BOLETIN OFICIAL REPUBLICA ARGENTINA - AISLAMIENTO SOCIAL PREVENTIVO Y OBLIGATORIO - Decreto 297&#47;2020&#46; &#91;cited 27 Mar 2020&#93;&#46; Available&#58; https&#58;&#47;&#47;www&#46;boletinoficial&#46;gob&#46;ar&#47;detalleAviso&#47;primera&#47;227042&#46;"
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Soarpso&#46; ACTUALIZACI&#211;N DE RECOMENDACIONES CORONAVIRUS &#40;COVID-19&#41;&#46; In&#58; SOARPSO &#91;Internet&#93;&#46; &#91;cited 27 Mar 2020&#93;&#46; Available&#58; https&#58;&#47;&#47;www&#46;soarpso&#46;org&#47;noticia&#95;detalle&#46;php&#63;IdNoticia&#61;1427&#46;"
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Managing your practice through the COVID-19 outbreak&#46; &#91;cited 27 Mar 2020&#93;&#46; Available&#58; https&#58;&#47;&#47;www&#46;aad&#46;org&#47;member&#47;practice&#47;managing&#47;coronavirus&#46;"
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "L&#243;pez PP&#193;&#46; Coronavirus&#58; &#8220;Los pacientes dermatol&#243;gicos no deben suspender sus tratamientos&#8221; &#124; Academia Espa&#241;ola de Dermatolog&#237;a y Venereolog&#237;a&#46; In&#58; Academia Espa&#241;ola de Dermatolog&#237;a y Venereolog&#237;a &#91;Internet&#93;&#46; 24 Mar 2020 &#91;cited 27 Mar 2020&#93;&#46; Available&#58; https&#58;&#47;&#47;aedv&#46;es&#47;coronavirus-los-pacientes-dermatologicos-no-deben-suspender-sus-tratamiento&#47;&#46;"
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Telehealth&#58; Helping Your Patients and Practice Survive and Thrive During the COVID-19 Crisis with Rapid Quality Implementation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "I&#46; Lee"
                            1 => "C&#46; Kovarik"
                            2 => "T&#46; Tejasvi"
                            3 => "M&#46; Pizarro"
                            4 => "J&#46;B&#46; Lipoff"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2020.03.052"
                      "Revista" => array:2 [
                        "tituloSerie" => "J Am Acad Dermatol&#46;"
                        "fecha" => "2020"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Should patients stop their biologic treatment during the COVID-19 pandemic"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46;M&#46; Bashyam"
                            1 => "S&#46;R&#46; Feldman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/09546634.2020.1836312"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Dermatolog Treat&#46;"
                        "fecha" => "2020"
                        "paginaInicial" => "1"
                        "paginaFinal" => "2"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33054453"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Advice regarding COVID-19 and use of immunomodulators&#44; in patients with severe dermatological diseases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Rademaker"
                            1 => "C&#46; Baker"
                            2 => "P&#46; Foley"
                            3 => "J&#46; Sullivan"
                            4 => "C&#46; Wang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/ajd.13295"
                      "Revista" => array:2 [
                        "tituloSerie" => "Australas J Dermatol&#46;"
                        "fecha" => "2020"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Should biologics for psoriasis be interrupted in the era of COVID-19&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Lebwohl"
                            1 => "R&#46; Rivera-Oyola"
                            2 => "D&#46;F&#46; Murrell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2020.03.031"
                      "Revista" => array:2 [
                        "tituloSerie" => "J Am Acad Dermatol&#46;"
                        "fecha" => "2020"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "COVID-19 and Immunomodulator&#47;Immunosuppressant Use in Dermatology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46;N&#46; Price"
                            1 => "J&#46;W&#46; Frew"
                            2 => "J&#46;L&#46; Hsiao"
                            3 => "V&#46;Y&#46; Shi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2020.03.046"
                      "Revista" => array:2 [
                        "tituloSerie" => "J Am Acad Dermatol&#46;"
                        "fecha" => "2020"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with biologics"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Menter"
                            1 => "B&#46;E&#46; Strober"
                            2 => "D&#46;H&#46; Kaplan"
                            3 => "D&#46; Kivelevitch"
                            4 => "E&#46;F&#46; Prater"
                            5 => "B&#46; Stoff"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2018.11.057"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol&#46;"
                        "fecha" => "2019"
                        "volumen" => "80"
                        "paginaInicial" => "1029"
                        "paginaFinal" => "1072"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30772098"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack497199"
        "titulo" => "Acknowledgments"
        "texto" => "<p id="par0060" class="elsevierStylePara elsevierViewall">The authors would like to thank Silvia Fern&#225;ndez Barrio&#44; chair of AEPSO&#44; for her help with the dissemination of the survey&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000011100000009/v1_202012010756/S1578219020302870/v1_202012010756/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/15782190/0000011100000009/v1_202012010756/S1578219020302870/v1_202012010756/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020302870?idApp=UINPBA000044"
]

Article information

ISSN: 15782190
Original language: English

DOI:10.1016/j.adengl.2020.10.010

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	4	5	9
2024 October	91	51	142
2024 September	103	25	128
2024 August	95	65	160
2024 July	83	39	122
2024 June	76	23	99
2024 May	66	29	95
2024 April	79	33	112
2024 March	72	28	100
2024 February	70	29	99
2024 January	57	31	88
2023 December	60	16	76
2023 November	81	44	125
2023 October	54	32	86
2023 September	49	41	90
2023 August	51	25	76
2023 July	61	39	100
2023 June	54	29	83
2023 May	76	295	371
2023 April	46	19	65
2023 March	86	25	111
2023 February	53	27	80
2023 January	55	32	87
2022 December	89	47	136
2022 November	36	37	73
2022 October	24	20	44
2022 September	21	43	64
2022 August	29	50	79
2022 July	19	34	53
2022 June	26	41	67
2022 May	61	43	104
2022 April	72	45	117
2022 March	83	83	166
2022 February	67	37	104
2022 January	96	50	146
2021 December	78	45	123
2021 November	92	64	156
2021 October	81	90	171
2021 September	87	62	149
2021 August	97	39	136
2021 July	63	50	113
2021 June	72	51	123
2021 May	89	82	171
2021 April	209	172	381
2021 March	175	75	250
2021 February	84	52	136
2021 January	127	68	195
2020 December	113	57	170
2020 November	37	20	57
2020 October	24	11	35

Show all

Indexed in:

Follow us:

Statistics

Indexed in:

Follow us:

Statistics

Subscribe to our newsletter