Case and Research Letters
Using the Common Terminology Criteria for Adverse Events (CTCAE – Version 5.0) to Evaluate the Severity of Adverse Events of Anticancer Therapies
CTCAE versión 5.0. Evaluación de la gravedad de los eventos adversos dermatológicos de las terapias antineoplásicas
a Servicio de Dermatología, Hospital Ruber Juan Bravo y Universidad Europea, Madrid, Spain
b Servicio de Dermatología, Hospital Universitario Doctor Negrín, Las Palmas de Gran Canaria, Gran Canaria, Spain
c Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain
d Canarias dermatológica, Las Palmas de Gran Canaria, Gran Canaria, Spain
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Freites-Martinez, N. Santana, S. Arias-Santiago, A. Viera" "autores" => array:4 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Freites-Martinez" "email" => array:1 [ 0 => "azaelfreites@yahoo.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "N." "apellidos" => "Santana" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "S." "apellidos" => "Arias-Santiago" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "A." "apellidos" => "Viera" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:4 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Ruber Juan Bravo y Universidad Europea, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Universitario Doctor Negrín, Las Palmas de Gran Canaria, Gran Canaria, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Universitario Virgen de las Nieves, Granada, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Canarias dermatológica, Las Palmas de Gran Canaria, Gran Canaria, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "CTCAE versión 5.0. Evaluación de la gravedad de los eventos adversos dermatológicos de las terapias antineoplásicas" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Cancer is one of the main causes of morbidity and mortality in developed countries, and survival has increased due to the advent of new therapies and their combinations.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Adverse events (AE) from antitumor therapies, however, are multiple. The skin, and its adnexa, is one of the main organs affected, with abnormalities in up to 25% of patients who receive immunotherapy,<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and up to 100% of patients who receive classical cytotoxic chemotherapy.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Today, both during clinical trials of oncologic drugs and in routine oncologic practice, AEs are graded using version 5.0 of the Common Terminology Criteria for Adverse Events (CTCAE v5.0),<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> published in November 2017 by the United States National Cancer Institute. This document aims to provide a standardized description of the terms that allow for an optimal exchange of information on the safety of antitumor therapies and the appropriate treatment of their AEs. The CTCAE v5.0 includes a number of signs, symptoms and abnormal test results attributed to antitumor therapies, and includes a total of 47 dermatologic AEs.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> The CTCAE v5.0 grades the AEs based on their severity on a 5-point scale, which goes from Grade 1 (mild, asymptomatic or with few associated symptoms, clinical observation, no intervention required, preventive treatment if available) to Grade 5 (death, which is not observed in most dermatologic AEs). (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Dermatologic AEs, such as pruritus, alopecia, rash, and vasculitis, are included because of their frequency and, indeed, their impact on the quality of life of the affected patients.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">The CTCAE has been used in studies recently published in the dermatologic literature to evaluate the severity of cutaneous AEs from antitumor therapies. For example, one of the AEs with the greatest impact on skin is alopecia; both persistent postchemotherapy alopecia and alopecia associated with endocrine therapies in patients with breast cancer, where even with a grade-1 alopecia on the CTCAE v5.0 (less than 50% hair loss, obvious to the patient and doctor but does not require a wig or hairpiece to camouflage), patients suffer from a major emotional impact (42/100 on the Hairdex questionnaire).<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> This simplified classification in 2 grades for alopecia is, however, nonspecific and does not help in assessing mild clinical improvement in patient follow-up, unlike other scores used in dermatology, which do permit this assessment, such as for male pattern baldness.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> Unlike alopecia, the CTCAE v5.0 allows for a good assessment of the severity of pruritus and facilitates its clinical treatment.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Guidelines exist with therapeutic recommendations for AEs from antitumor therapies based on their severity.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8,9</span></a> For example, if we diagnose grade-3 pruritus on the CTCAE v5.0 in a patient with metastatic melanoma who is undergoing immunotherapy, this will indicate to the oncologist that the pruritus is generalized and constant during the day, that it limits daily activities and even sleep, and suggests the use of systemic corticosteroids or other immunosuppressant therapies. Furthermore, the shared use of this terminology among dermatologists and oncologists would make it possible to create an appropriate database to facilitate future scientific or pharmacovigilance studies.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Rash or exanthema is one of the most frequent AEs in oncology (up to 50% of patients with ipilimumab, used in metastatic melanoma).<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Most published clinical trials of antitumor drugs do not discern between the different clinical-pathologic subtypes (maculopapular, acneiform, lichenoid, psoriasiform),<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and a biopsy is probably required to determine the etiology, at the appropriate moment in the course of the rash. For oncologists, however, this procedure is limited and it is where dermatologists should act to define and guide the diagnosis of that rash and its most appropriate treatment. This suggests the need to include dermatologists in the evaluation of AEs from antitumor drugs in order to also facilitate treatment of the AE and thus improve the quality of life of oncologic patients.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of Interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Freites-Martinez A, Santana N, Arias-Santiago S, Viera A. CTCAE versión 5.0. Evaluación de la gravedad de los eventos adversos dermatológicos de las terapias antineoplásicas. Actas Dermosifiliogr. 2021;112:90–92.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Activities of daily living (ADL): instrumental ADL refer to preparing meals, shopping for groceries or clothes, using the telephone, managing money, etc.; Self-care ADL refer to bathing, dressing and undressing, feeding self, using the toilet, taking medications. Grade 1 (mild): asymptomatic or mild symptoms; clinical observation only; treatment not indicated. Grade 2 (moderate): minimal, local or noninvasive intervention indicated; limiting age-appropriate instrumental ADL. Grade 3 (severe): severe or medically significant but not immediately life-threatening; hospitalization or prolongation of hospitalization indicated; disabling; limiting self-care ADL Grade 4 (life-threatening consequences): urgent intervention indicated. Level 5 (death) related to the adverse event.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Other dermatologic diagnoses are included on the official CTCAE v5 website <span class="elsevierStyleInterRef" id="intr0005" href="https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/ctcae_v5_quick_reference_5x7.pdf">https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/ctcae_v5_quick_reference_5x7.pdf</span>.</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">Adverse Event \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">Grade 1 \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">Grade 2 \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">Grade 3 \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">Grade 4 \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">Grade 5 \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">Alopecia \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">Hair loss of <50% of normal for that individual that is not obvious from a distance but only on close inspection; a different hair style may be required to cover the hair loss but it does not require a wig or hair piece to camouflage \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">Hair loss of ≥50% normal for that individual that is readily apparent to others; a wig or hair piece is necessary if the patient desires to completely camouflage the hair loss; associated with psychosocial impact \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">– \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">– \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">– \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">Eczema \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">Asymptomatic or mild symptoms; additional medical intervention not indicated \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">Moderate; topical or oral intervention indicated; additional medical intervention over baseline indicated \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">Severe or medically significant but not immediately life-threatening; IV intervention indicated \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">– \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">– \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">Pruritus \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">Mild or localized; topical intervention indicated \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">Widespread and intermittent; skin changes from scratching; oral intervention indicated; limiting instrumental ADL \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">Widespread and constant; limiting self-care ADL or sleep; systemic corticosteroid or immunosuppressive therapy indicated \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">– \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">– \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">Rash acneiform \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">Papules and/or pustules covering <10% of body surface area, which may or may not be associated with symptoms of pruritus or tenderness \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">Papules and/or pustules covering between 10% and 30% of body surface area, which may or may not be associated with symptoms of pruritus or tenderness; associated with psychosocial impact; limiting instrumental ADL; includes papules and/or pustules covering >30% of body surface area with or without mild symptoms \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">Papules and/or pustules covering >30% of body surface area with moderate or severe symptoms; limiting self-care ADL; associated with local superinfection; oral antibiotics indicated \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">Life-threatening; papules and/or pustules covering any % of body surface area, which may or may not be associated with symptoms of pruritus or tenderness and are associated; extensive superinfection; IV antibiotics indicated \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">Death \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">Rash maculopapular \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">Macules/papules covering <10% of body surface area with or without symptoms (e.g., pruritus, burning) \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">Macules/papules covering between 10% and 30% of body surface area with or without symptoms (e.g., pruritus, burning); limiting instrumental ADL; rash covering >30% of body surface area with or without mild symptoms \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">Macules/papules covering >30% of body surface area with moderate or severe symptoms; limiting self-care ADL \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">– \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">– \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2493591.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Most Frequent Adverse Events Included in the CTCAE v5.0.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cancer incidence and mortality worldwide: Sources, methods and major patterns in globocan 2012" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Ferlay" 1 => "I. Soerjomataram" 2 => "R. Dikshit" 3 => "S. Eser" 4 => "C. Mathers" 5 => "M. Rebelo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/ijc.29210" "Revista" => array:5 [ "tituloSerie" => "Int J Cancer" "fecha" => "2015" "volumen" => "1365" "paginaInicial" => "E359" "paginaFinal" => "E386" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The risk of rash associated with ipilimumab in patients with cancer: a systematic review of the literature and meta-analysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "K. Minkis" 1 => "B.C. Garden" 2 => "S. Wu" 3 => "M.P. Pulitzer" 4 => "M.E. Lacouture" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2012.12.963" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2013" "volumen" => "69" "paginaInicial" => "e121" "paginaFinal" => "e128" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23357570" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Docetaxel compared with sequential methotrexate and 5-fluorouracil in patients with advanced breast cancer after anthracycline failure: a randomised phase iii study with crossover on progression by the Scandinavian breast group" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Sjostrom" 1 => "C. Blomqvist" 2 => "H. Mouridsen" 3 => "A. Pluzanska" 4 => "S. Ottosson-Lonn" 5 => "N.O. Bengtsson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0959-8049(99)00122-7" "Revista" => array:6 [ "tituloSerie" => "Eur J Cancer" "fecha" => "1999" "volumen" => "35" "paginaInicial" => "1194" "paginaFinal" => "1201" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10615229" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Common Terminology Criteria for Adverse Events (CTCAE) Version 5. Published: November 27. US Department of Health and Human Services, National Institutes of Health, National Cancer Institute" ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical characterization of immunotherapy-related pruritus among patients seen in 2 oncodermatology clinics" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G.S. Phillips" 1 => "A. Freites-Martinez" 2 => "J. Wu" 3 => "D. Chan" 4 => "G. Fabbrocini" 5 => "M.D. Hellmann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamadermatol.2018.4560" "Revista" => array:5 [ "tituloSerie" => "JAMA Derm" "fecha" => "2019" "volumen" => "155" "paginaInicial" => "249" "paginaFinal" => "251" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Endocrine therapy-induced alopecia in patients with breast cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Freites-Martinez" 1 => "J. Shapiro" 2 => "D. Chan" 3 => "M. Fornier" 4 => "S. Modi" 5 => "D. Gajria" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamadermatol.2018.0454" "Revista" => array:5 [ "tituloSerie" => "JAMA Derm" "fecha" => "2018" "volumen" => "154" "paginaInicial" => "670" "paginaFinal" => "675" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A new classification of pattern hair loss that is universal for men and women: basic and specific (BASP) classification" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W.S. Lee" 1 => "B.I. Ro" 2 => "S.P. Hong" 3 => "H. Bak" 4 => "W.Y. Sim" 5 => "D.W. Kim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2006.12.029" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2007" "volumen" => "57" "paginaInicial" => "37" "paginaFinal" => "46" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17467851" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dermatologic adverse events from cancer treatments" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Wu" 1 => "A. Markova" 2 => "M.E. Lacouture" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "editores" => "N.H.Shear, R.P.Dodiuk-Gad" "titulo" => "Advances in diagnosis and management of cutaneous adverse drug reactions: current and future trends" "paginaInicial" => "131" "paginaFinal" => "173" "serieFecha" => "2019" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hair disorders in cancer survivors" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Freites-Martinez" 1 => "J. Shapiro" 2 => "C. van den Hurk" 3 => "S. Goldfarb" 4 => "J.J. Jimenez" 5 => "A.M. Rossi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2018.03.056" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2019" "volumen" => "80" "paginaInicial" => "1199" "paginaFinal" => "1213" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29660423" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011200000001/v1_202101161046/S1578219020303784/v1_202101161046/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/15782190/0000011200000001/v1_202101161046/S1578219020303784/v1_202101161046/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020303784?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 59 | 20 | 79 |
| 2024 October | 729 | 119 | 848 |
| 2024 September | 585 | 91 | 676 |
| 2024 August | 558 | 156 | 714 |
| 2024 July | 573 | 114 | 687 |
| 2024 June | 380 | 106 | 486 |
| 2024 May | 345 | 80 | 425 |
| 2024 April | 381 | 99 | 480 |
| 2024 March | 321 | 78 | 399 |
| 2024 February | 369 | 73 | 442 |
| 2024 January | 636 | 73 | 709 |
| 2023 December | 375 | 54 | 429 |
| 2023 November | 389 | 71 | 460 |
| 2023 October | 426 | 118 | 544 |
| 2023 September | 301 | 92 | 393 |
| 2023 August | 260 | 77 | 337 |
| 2023 July | 285 | 79 | 364 |
| 2023 June | 337 | 60 | 397 |
| 2023 May | 388 | 66 | 454 |
| 2023 April | 237 | 53 | 290 |
| 2023 March | 250 | 94 | 344 |
| 2023 February | 174 | 48 | 222 |
| 2023 January | 176 | 51 | 227 |
| 2022 December | 199 | 79 | 278 |
| 2022 November | 114 | 75 | 189 |
| 2022 October | 104 | 56 | 160 |
| 2022 September | 99 | 79 | 178 |
| 2022 August | 59 | 58 | 117 |
| 2022 July | 38 | 62 | 100 |
| 2022 June | 50 | 59 | 109 |
| 2022 May | 214 | 85 | 299 |
| 2022 April | 294 | 62 | 356 |
| 2022 March | 298 | 102 | 400 |
| 2022 February | 321 | 90 | 411 |
| 2022 January | 403 | 91 | 494 |
| 2021 December | 294 | 98 | 392 |
| 2021 November | 292 | 95 | 387 |
| 2021 October | 365 | 146 | 511 |
| 2021 September | 340 | 132 | 472 |
| 2021 August | 402 | 156 | 558 |
| 2021 July | 345 | 98 | 443 |
| 2021 June | 301 | 116 | 417 |
| 2021 May | 359 | 126 | 485 |
| 2021 April | 810 | 292 | 1102 |
| 2021 March | 485 | 124 | 609 |
| 2021 February | 358 | 114 | 472 |
| 2021 January | 199 | 57 | 256 |
| 2020 December | 72 | 18 | 90 |
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