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            2 => "melanocytic nevi"
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      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Background and objectives</span><p class="elsevierStyleSimplePara elsevierViewall">Pediatric dermatology is a relatively new subspecialty for which few epidemiological studies are available&#46; We aimed to determine the work load associated with this subspecialty and the most common presenting complaints among pediatric patients in the general dermatology clinic of our hospital&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">A descriptive study was performed based on hospital records to analyze patients aged 16 years or under seen in our department in 2005 and their diagnoses&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">Pediatric dermatology accounts for 12&#46;1&#37; of the work load in our department &#40;1329&#47;10 998 patients were &#8804; 16 years old&#41;&#46; By disease groups&#44; tumors and infections were the most common diagnoses and accounted for 55&#46;4&#37; of all cases&#46; A long way behind was eczema &#40;15&#46;0&#37;&#41; and diseases affecting hair follicles&#44; nails&#44; and sweat and sebaceous glands &#40;8&#46;8&#37;&#41;&#46; The most common individual diagnosis was melanocytic nevus &#40;19&#46;8&#37;&#41;&#44; followed by viral warts &#40;12&#46;1&#37;&#41;&#44; atopic dermatitis &#40;8&#46;9&#37;&#41;&#44; molluscum contagiosum &#40;8&#46;4&#37;&#41;&#44; and acne &#40;7&#46;0&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">In most developed countries&#44; atopic dermatitis is the most common dermatologic disease in children&#46; In our study&#44; however&#44; melanocytic nevus was the most common presenting complaint&#44; reflecting perhaps that there are more children in Spain with multiple nevi due to overexposure to sunlight or because of concern about melanoma among the population&#46; Another possibility is that Spain has fewer cases of atopic dermatitis than more industrialized countries in northern Europe&#46; Measures to avoid exposure to sunlight and use of sunscreen should be promoted during infancy&#46; This could help slow the increase of melanoma in the adult population&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n y objetivos</span><p class="elsevierStyleSimplePara elsevierViewall">La Dermatolog&#237;a Pedi&#225;trica es una subespecialidad relativamente nueva sobre la que existen pocos estudios epidemiol&#243;gicos&#46; Nos proponemos determinar la carga de trabajo que representa en una consulta de Dermatolog&#237;a general y cu&#225;les son los motivos de consulta m&#225;s frecuentes en nuestro centro en este grupo de edad&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo del registro del Servicio de Dermatolog&#237;a sobre las visitas realizadas a pacientes de &#8804; 16 a&#241;os de edad en el a&#241;o 2005 y sus diagn&#243;sticos&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">La Dermatolog&#237;a Pedi&#225;trica representa el 12&#44;1&#37; de nuestra carga de trabajo &#40;1&#46;329&#47;10&#46;998 visitas fueron a &#8804; 16 a&#241;os&#41;&#46; Por grupos&#44; los tumores y las infecciones fueron los diagn&#243;sticos m&#225;s frecuentes&#44; ya que entre ambos representan el 55&#44;4&#37; del total&#46; A distancia les siguen los eczemas &#40;15&#44;0&#37;&#41; y las enfermedades anexiales &#40;8&#44;8&#37;&#41;&#46; El diagn&#243;stico individual m&#225;s frecuente fue nevo melanoc&#237;tico &#40;19&#44;8&#37;&#41;&#44; seguido de verruga v&#237;rica &#40;12&#44;1&#37;&#41;&#44; dermatitis at&#243;pica &#40;8&#44;9&#37;&#41;&#44; molusco contagioso &#40;8&#44;4&#37;&#41; y acn&#233; &#40;7&#44;0&#37;&#41;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">En la mayor&#237;a de pa&#237;ses desarrollados la dermatitis at&#243;pica es el diagn&#243;stico m&#225;s frecuente en los ni&#241;os&#46; En nuestro estudio los nevos melanoc&#237;ticos ocupan el primer lugar&#44; lo que quiz&#225; refleje que existan m&#225;s ni&#241;os con m&#250;ltiples nevos porque se toma el sol en exceso&#44; o por la melanofobia existente entre la poblaci&#243;n&#46; Tambi&#233;n es posible que en nuestra &#225;rea exista menos dermatitis at&#243;pica que en pa&#237;ses m&#225;s industrializados del norte de Europa&#46; Se deber&#237;an impulsar conductas de fotoevitaci&#243;n y fotoprotecci&#243;n durante la &#233;poca infantil&#46; Ello podr&#237;a contribuir a frenar&#44; en nuestro medio&#44; el incremento del melanoma en el adulto&#46;</p>"
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                    0 => array:2 [
                      "titulo" => "A survey of skin disorders seen in pediatric general and dermatology clinics"
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                        0 => array:2 [
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                          "autores" => array:1 [
                            0 => "W&#46;W&#46; Tunnessen"
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                        "tituloSerie" => "Pediatr Dermatol"
                        "fecha" => "1984"
                        "volumen" => "1"
                        "paginaInicial" => "219"
                        "paginaFinal" => "222"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6494066"
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                          "autores" => array:1 [
                            0 => "G&#46;F&#46; Hayden"
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                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Dis Childhood"
                        "fecha" => "1985"
                        "volumen" => "139"
                        "paginaInicial" => "36"
                        "paginaFinal" => "38"
                      ]
                    ]
                  ]
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                      "titulo" => "Increasing incidence of skin disorders in children&#63; A comparison between 1987 and 2001"
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                      "titulo" => "Dermatologic services provided to children and adolescents by primary care and other physicians in the United States"
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                        "paginaFinal" => "203"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7971552"
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                      "titulo" => "Prevalence of pediatric skin diseases in rural Honduras"
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                            0 => "R&#46;K&#46; Kottenhahn"
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                      "titulo" => "Skin diseases of children in Mali&#58; a public health problem"
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                          "autores" => array:4 [
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                      "titulo" => "The prevalence of skin disease among school children in rural Ethiopia &#8211; a preliminary assessment of dermatologic needs"
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                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Dermatol"
                        "fecha" => "1996"
                        "volumen" => "13"
                        "paginaInicial" => "378"
                        "paginaFinal" => "381"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8893236"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of skin diseases in school children&#58; a study from northern India"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "S&#46; Dogra"
                            1 => "B&#46; Kumar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Dermatol"
                        "fecha" => "2003"
                        "volumen" => "20"
                        "paginaInicial" => "470"
                        "paginaFinal" => "473"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14651562"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The prevalence of skin conditions in Romanian school children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Popescu"
                            1 => "C&#46;M&#46; Popescu"
                            2 => "H&#46;C&#46; Williams"
                            3 => "D&#46; Forsea"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "1999"
                        "volumen" => "140"
                        "paginaInicial" => "891"
                        "paginaFinal" => "896"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10354028"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of skin conditions in primary school children in Turkey&#58; differences based on socioeconomic factors"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "I&#46; Inanir"
                            1 => "M&#46;T&#46; Sahin"
                            2 => "K&#46; Gunduz"
                            3 => "G&#46; Dinc"
                            4 => "A&#46; Turel"
                            5 => "S&#46; Ozturkcan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Dermatol"
                        "fecha" => "2002"
                        "volumen" => "19"
                        "paginaInicial" => "307"
                        "paginaFinal" => "311"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12220273"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of skin diseases among children in a referral skin clinic in Singapore"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;L&#46; Goh"
                            1 => "R&#46; Akarapanth"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Dermatol"
                        "fecha" => "1994"
                        "volumen" => "11"
                        "paginaInicial" => "125"
                        "paginaFinal" => "128"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8041651"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Epidemiology of pediatric dermatology and allergology in the region of Aargau&#44; Switzerland"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46; Wenk"
                            1 => "P&#46;H&#46; Itin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Dermatol"
                        "fecha" => "2003"
                        "volumen" => "20"
                        "paginaInicial" => "482"
                        "paginaFinal" => "487"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14651565"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Skin diseases in Chinese children at a pediatric Dermatology Center"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "K&#46;L&#46; Hon"
                            1 => "T&#46;F&#46; Leung"
                            2 => "Y&#46; Wong"
                            3 => "K&#46;C&#46; Ma"
                            4 => "T&#46;F&#46; Fok"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Ped Dermatol"
                        "fecha" => "2004"
                        "volumen" => "21"
                        "paginaInicial" => "109"
                        "paginaFinal" => "112"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of Skin Disorders in School Children in Ibadan&#44; Nigeria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;O&#46; Ogunbiyi"
                            1 => "E&#46; Owoaje"
                            2 => "A&#46; Ndahi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Ped Dermatol"
                        "fecha" => "2005"
                        "volumen" => "22"
                        "paginaInicial" => "6"
                        "paginaFinal" => "10"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The epidemiology of molluscum contagiosum in children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "M&#46;A&#46; Dohil"
                            1 => "P&#46; Lin"
                            2 => "J&#46; Lee"
                            3 => "A&#46;W&#46; Lucky"
                            4 => "A&#46;S&#46; Paller"
                            5 => "L&#46;F&#46; Eichenfield"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2005.08.035"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2006"
                        "volumen" => "54"
                        "paginaInicial" => "47"
                        "paginaFinal" => "54"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16384754"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Factores de riesgo asociados a la transmisi&#243;n de papilomavirus en un &#225;mbito escolar"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;V&#46; Rigo"
                            1 => "F&#46; Mart&#237;nez-Campillo"
                            2 => "M&#46; Verdu"
                            3 => "S&#46; Cilleruelo"
                            4 => "J&#46; Roda"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Aten Primaria"
                        "fecha" => "2003"
                        "volumen" => "31"
                        "paginaInicial" => "415"
                        "paginaFinal" => "420"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12735883"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pattern of skin disease at the Ethio-Swedish pediatric hospital&#44; Addis Ababa&#44; Ethiopia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46; Shibeshi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Pediatr Dermatol"
                        "fecha" => "2000"
                        "volumen" => "17"
                        "paginaInicial" => "357"
                        "paginaFinal" => "359"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11085661"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S014067360960249X"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tinea capitis&#46; Focus on African-American women"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "N&#46;B&#46; Silverberg"
                            1 => "J&#46;M&#46; Weinberg"
                            2 => "V&#46;A&#46; Delco"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2002"
                        "volumen" => "46"
                        "paginaInicial" => "120"
                        "paginaFinal" => "124"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Frecuencia de las enfermedades cut&#225;neas en una consulta monogr&#225;fica de Dermatolog&#237;a Pedi&#225;trica &#40;1990-1999&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Torrelo"
                            1 => "A&#46; Zambrano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2002"
                        "volumen" => "93"
                        "paginaInicial" => "369"
                        "paginaFinal" => "378"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Frequency and distribution pattern of melanocytic naevi in Swedish 8-9-year-old children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "I&#46; Synnerstad"
                            1 => "L&#46; Nilsson"
                            2 => "M&#46; Fredrikson"
                            3 => "I&#46; Rosdahl"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Derm Venereol"
                        "fecha" => "2004"
                        "volumen" => "84"
                        "paginaInicial" => "271"
                        "paginaFinal" => "360"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15339070"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Frequency and distribution pattern of melanocytic naevi in Estonian children and the influence of atopic dermatitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Kallas"
                            1 => "I&#46; Rosdahl"
                            2 => "M&#46; Fredriksson"
                            3 => "I&#46; Synnerstad"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1468-3083.2005.01379.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Eur Acad Dermatol Venereol"
                        "fecha" => "2006"
                        "volumen" => "20"
                        "paginaInicial" => "143"
                        "paginaFinal" => "148"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16441620"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The prevalence of common acquired melanocytic nevi and the relationship with skin type characteristics and sun exposure among children in Lithuania"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Valiukeviciene"
                            1 => "I&#46; Miseviciene"
                            2 => "H&#46; Gollnick"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archderm.141.5.579"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "2005"
                        "volumen" => "141"
                        "paginaInicial" => "579"
                        "paginaFinal" => "586"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15897379"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Melanoma risk in congenital melanocytic naevi&#58; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46; Krengel"
                            1 => "A&#46; Hauschild"
                            2 => "T&#46; Schafer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2133.2006.07218.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "2006"
                        "volumen" => "155"
                        "paginaInicial" => "1"
                        "paginaFinal" => "8"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16792745"
                            "web" => "Medline"
                          ]
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                      ]
                    ]
                  ]
                ]
              ]
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            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sun exposure and number of nevi in 5-to 6-year-old European children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Dulon"
                            1 => "M&#46; Weichenthal"
                            2 => "M&#46; Blettner"
                            3 => "M&#46; Breitbart"
                            4 => "M&#46; Hetzer"
                            5 => "R&#46; Greinert"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Epidemiol"
                        "fecha" => "2002"
                        "volumen" => "55"
                        "paginaInicial" => "1075"
                        "paginaFinal" => "1081"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12507670"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The body site distribution of melanocytic naevi in 6-7 year old European children"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Autier"
                            1 => "M&#46; Boniol"
                            2 => "G&#46; Severi"
                            3 => "G&#46; Giles"
                            4 => "M&#46;S&#46; Cattaruzza"
                            5 => "H&#46; Luther"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Melanoma Res"
                        "fecha" => "2001"
                        "volumen" => "11"
                        "paginaInicial" => "123"
                        "paginaFinal" => "131"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11333121"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27&#46;"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ultraviolet exposure and the development of banal and atypical naevi-a cross-sectional study on Curacao and in The Netherlands"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;B&#46; Crijns"
                            1 => "C&#46; Klaver"
                            2 => "A&#46; de Boer"
                            3 => "C&#46; Van Hees"
                            4 => "B&#46;J&#46; Vermeer"
                            5 => "J&#46; Vandenbroucke"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Melanoma Res"
                        "fecha" => "1997"
                        "volumen" => "7"
                        "paginaInicial" => "407"
                        "paginaFinal" => "416"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9429224"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ultraviolet light exposure&#44; pigmentary traits and the development of melanocytic naevi and cutaneous melanoma&#46; A case-control study of the German Central Malignant Melanoma Registry"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
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                            2 => "P&#46; Buttner"
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                            4 => "H&#46;P&#46; Soyer"
                            5 => "U&#46; Stocker"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
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                        "tituloSerie" => "Acta Derm Venereol"
                        "fecha" => "1997"
                        "volumen" => "77"
                        "paginaInicial" => "374"
                        "paginaFinal" => "378"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9298131"
                            "web" => "Medline"
                          ]
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                      ]
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                ]
              ]
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                  "contribucion" => array:1 [
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                      "titulo" => "Body-site distribution of melanocytic nevi in young Australian children"
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                            0 => "S&#46;L&#46; Harrison"
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                            2 => "R&#46; MacLennan"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
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                        "paginaInicial" => "47"
                        "paginaFinal" => "52"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9923780"
                            "web" => "Medline"
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                ]
              ]
            ]
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                      "titulo" => "Naevi and pigmentary characteristics as risk factors for melanoma in a high-risk population&#58; a casecontrol study in New South Wales&#44; Australia"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;E&#46; Grulich"
                            1 => "V&#46; Bataille"
                            2 => "A&#46;J&#46; Swerdlow"
                            3 => "J&#46;A&#46; Newton-Bishop"
                            4 => "J&#46; Cuzick"
                            5 => "P&#46; Hersey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1002/(SICI)1097-0215(19960807)67:4<485::AID-IJC4>3.0.CO;2-O"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Cancer"
                        "fecha" => "1996"
                        "volumen" => "67"
                        "paginaInicial" => "485"
                        "paginaFinal" => "491"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8759605"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The association between naevi and melanoma in populations with different levels of sun exposure&#58; a joint case-control study of melanoma in the UK and Australia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "V&#46; Bataille"
                            1 => "A&#46; Grulich"
                            2 => "P&#46; Sasieni"
                            3 => "A&#46; Swerdlow"
                            4 => "J&#46; Newton Bishop"
                            5 => "W&#46; McCarthy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Cancer"
                        "fecha" => "1998"
                        "volumen" => "77"
                        "paginaInicial" => "505"
                        "paginaFinal" => "510"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9472652"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib32"
              "etiqueta" => "32&#46;"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Ortega M&#46; Epidemiolog&#237;a del c&#225;ncer cut&#225;neo en la provincia de Lleida y factores de riesgo relacionados&#46; Tesis doctoral&#46; Universitat de Lleida&#46; 2004&#46;"
                ]
              ]
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                    0 => array:2 [
                      "titulo" => "Children and sun exposure in the northeast of Italy"
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                            0 => "G&#46; Stinco"
                            1 => "F&#46; Favot"
                            2 => "E&#46; Quinkenstein"
                            3 => "M&#46; Zanchi"
                            4 => "F&#46; Valent"
                            5 => "P&#46; Patrone"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1525-1470.2005.00131.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Dermatol"
                        "fecha" => "2005"
                        "volumen" => "22"
                        "paginaInicial" => "520"
                        "paginaFinal" => "524"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16354253"
                            "web" => "Medline"
                          ]
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                    ]
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                ]
              ]
            ]
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                      "titulo" => "A statistical analysis of a pediatric dermatology clinic"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
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Vol. 99. Núm. 2.
Páginas 111-118 (marzo 2008)
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Vol. 99. Núm. 2.
Páginas 111-118 (marzo 2008)
Original articles
Acceso a texto completo
Childhood Dermatosis in a Dermatology Clinic of a General University Hospital in Spain
Dermatosis Infantiles en la Consulta de Dermatología de un Hospital General Universitario en España
Visitas
6366
J.M. Casanova
Autor para correspondencia
jmcasanova@medicina.udl.es
http://www.dermatoweb.net

Correspondence: Servicio de Dermatología, Hospital Universitari Arnau de Vilanova de Lleida, Rovira Roure, 80, 25192 Lleida, Spain.
, V. Sanmartín, X. Soria, M. Baradad, R.M. Martí, A. Font
Servicio de Dermatología, Hospital Universitari Arnau de Vilanova de Lleida, Universitat de Lleida, Spain
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Abstract
Background and objectives

Pediatric dermatology is a relatively new subspecialty for which few epidemiological studies are available. We aimed to determine the work load associated with this subspecialty and the most common presenting complaints among pediatric patients in the general dermatology clinic of our hospital.

Methods

A descriptive study was performed based on hospital records to analyze patients aged 16 years or under seen in our department in 2005 and their diagnoses.

Results

Pediatric dermatology accounts for 12.1% of the work load in our department (1329/10 998 patients were ≤ 16 years old). By disease groups, tumors and infections were the most common diagnoses and accounted for 55.4% of all cases. A long way behind was eczema (15.0%) and diseases affecting hair follicles, nails, and sweat and sebaceous glands (8.8%). The most common individual diagnosis was melanocytic nevus (19.8%), followed by viral warts (12.1%), atopic dermatitis (8.9%), molluscum contagiosum (8.4%), and acne (7.0%).

Conclusions

In most developed countries, atopic dermatitis is the most common dermatologic disease in children. In our study, however, melanocytic nevus was the most common presenting complaint, reflecting perhaps that there are more children in Spain with multiple nevi due to overexposure to sunlight or because of concern about melanoma among the population. Another possibility is that Spain has fewer cases of atopic dermatitis than more industrialized countries in northern Europe. Measures to avoid exposure to sunlight and use of sunscreen should be promoted during infancy. This could help slow the increase of melanoma in the adult population.

Key words:
epidemiology
pediatric dermatology
melanocytic nevi
atopic dermatitis
Resumen
Introducción y objetivos

La Dermatología Pediátrica es una subespecialidad relativamente nueva sobre la que existen pocos estudios epidemiológicos. Nos proponemos determinar la carga de trabajo que representa en una consulta de Dermatología general y cuáles son los motivos de consulta más frecuentes en nuestro centro en este grupo de edad.

Métodos

Estudio descriptivo del registro del Servicio de Dermatología sobre las visitas realizadas a pacientes de ≤ 16 años de edad en el año 2005 y sus diagnósticos.

Resultados

La Dermatología Pediátrica representa el 12,1% de nuestra carga de trabajo (1.329/10.998 visitas fueron a ≤ 16 años). Por grupos, los tumores y las infecciones fueron los diagnósticos más frecuentes, ya que entre ambos representan el 55,4% del total. A distancia les siguen los eczemas (15,0%) y las enfermedades anexiales (8,8%). El diagnóstico individual más frecuente fue nevo melanocítico (19,8%), seguido de verruga vírica (12,1%), dermatitis atópica (8,9%), molusco contagioso (8,4%) y acné (7,0%).

Conclusiones

En la mayoría de países desarrollados la dermatitis atópica es el diagnóstico más frecuente en los niños. En nuestro estudio los nevos melanocíticos ocupan el primer lugar, lo que quizá refleje que existan más niños con múltiples nevos porque se toma el sol en exceso, o por la melanofobia existente entre la población. También es posible que en nuestra área exista menos dermatitis atópica que en países más industrializados del norte de Europa. Se deberían impulsar conductas de fotoevitación y fotoprotección durante la época infantil. Ello podría contribuir a frenar, en nuestro medio, el incremento del melanoma en el adulto.

Palabras clave:
epidemiología
Dermatología infantil
nevos melanocíticos
dermatitis atópica
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References
[1.]
W.W. Tunnessen.
A survey of skin disorders seen in pediatric general and dermatology clinics.
Pediatr Dermatol, 1 (1984), pp. 219-222
[2.]
G.F. Hayden.
Skin diseases encountered in a pediatric clinic. A one-year prospective study.
Am J Dis Childhood, 139 (1985), pp. 36-38
[3.]
R.S.A. Mohammedamin, J.C. van der Wouden, S. Koning, M.W. van der Linden, F.G. Schellevis, L.W.A. van Suijlekom-Smit, et al.
Increasing incidence of skin disorders in children? A comparison between 1987 and 2001.
BMC Dermatology, 6 (2006), pp. 4
[4.]
D.P. Krowchuk, D.D. Bradham, A.B. Fleischer Jr.
Dermatologic services provided to children and adolescents by primary care and other physicians in the United States.
Pediatr Dermatol, 11 (1994), pp. 199-203
[5.]
L.M. Bechelli, N. Haddad, W.P. Pimenta, P.M. Pagnano, E. Melchior Jr., R.C. Fregnan, et al.
Epidemiological survey of skin diseases in school children living in the Purus Valley (Acre State, Amazonia, Brazil).
Dermatologica, 163 (1981), pp. 78-93
[6.]
R.K. Kottenhahn, J.E. Heck.
Prevalence of pediatric skin diseases in rural Honduras.
Trop Doctors, 24 (1994), pp. 87-88
[7.]
A. Mahe, A. Prual, M. Konate, P. Bobin.
Skin diseases of children in Mali: a public health problem.
Trans R Soc Trop Med Hyg, 89 (1995), pp. 467-470
[8.]
J.I. Figueroa, L.C. Fuller, A. Abraha, R.J. Hay.
The prevalence of skin disease among school children in rural Ethiopia – a preliminary assessment of dermatologic needs.
Pediatr Dermatol, 13 (1996), pp. 378-381
[9.]
S. Dogra, B. Kumar.
Epidemiology of skin diseases in school children: a study from northern India.
Pediatr Dermatol, 20 (2003), pp. 470-473
[10.]
R. Popescu, C.M. Popescu, H.C. Williams, D. Forsea.
The prevalence of skin conditions in Romanian school children.
Br J Dermatol, 140 (1999), pp. 891-896
[11.]
I. Inanir, M.T. Sahin, K. Gunduz, G. Dinc, A. Turel, S. Ozturkcan.
Prevalence of skin conditions in primary school children in Turkey: differences based on socioeconomic factors.
Pediatr Dermatol, 19 (2002), pp. 307-311
[12.]
C.L. Goh, R. Akarapanth.
Epidemiology of skin diseases among children in a referral skin clinic in Singapore.
Pediatr Dermatol, 11 (1994), pp. 125-128
[13.]
C. Wenk, P.H. Itin.
Epidemiology of pediatric dermatology and allergology in the region of Aargau, Switzerland.
Pediatr Dermatol, 20 (2003), pp. 482-487
[14.]
K.L. Hon, T.F. Leung, Y. Wong, K.C. Ma, T.F. Fok.
Skin diseases in Chinese children at a pediatric Dermatology Center.
Ped Dermatol, 21 (2004), pp. 109-112
[15.]
A.O. Ogunbiyi, E. Owoaje, A. Ndahi.
Prevalence of Skin Disorders in School Children in Ibadan, Nigeria.
Ped Dermatol, 22 (2005), pp. 6-10
[16.]
M.A. Dohil, P. Lin, J. Lee, A.W. Lucky, A.S. Paller, L.F. Eichenfield.
The epidemiology of molluscum contagiosum in children.
J Am Acad Dermatol, 54 (2006), pp. 47-54
[17.]
M.V. Rigo, F. Martínez-Campillo, M. Verdu, S. Cilleruelo, J. Roda.
Factores de riesgo asociados a la transmisión de papilomavirus en un ámbito escolar.
Aten Primaria, 31 (2003), pp. 415-420
[18.]
D. Shibeshi.
Pattern of skin disease at the Ethio-Swedish pediatric hospital, Addis Ababa, Ethiopia.
Pediatr Dermatol, 17 (2000), pp. 357-359
[19.]
N.B. Silverberg, J.M. Weinberg, V.A. Delco.
Tinea capitis. Focus on African-American women.
J Am Acad Dermatol, 46 (2002), pp. 120-124
[20.]
A. Torrelo, A. Zambrano.
Frecuencia de las enfermedades cutáneas en una consulta monográfica de Dermatología Pediátrica (1990-1999).
Actas Dermosifiliogr, 93 (2002), pp. 369-378
[21.]
I. Synnerstad, L. Nilsson, M. Fredrikson, I. Rosdahl.
Frequency and distribution pattern of melanocytic naevi in Swedish 8-9-year-old children.
Acta Derm Venereol, 84 (2004), pp. 271-360
[22.]
M. Kallas, I. Rosdahl, M. Fredriksson, I. Synnerstad.
Frequency and distribution pattern of melanocytic naevi in Estonian children and the influence of atopic dermatitis.
J Eur Acad Dermatol Venereol, 20 (2006), pp. 143-148
[23.]
S. Valiukeviciene, I. Miseviciene, H. Gollnick.
The prevalence of common acquired melanocytic nevi and the relationship with skin type characteristics and sun exposure among children in Lithuania.
Arch Dermatol, 141 (2005), pp. 579-586
[24.]
S. Krengel, A. Hauschild, T. Schafer.
Melanoma risk in congenital melanocytic naevi: a systematic review.
Br J Dermatol, 155 (2006), pp. 1-8
[25.]
M. Dulon, M. Weichenthal, M. Blettner, M. Breitbart, M. Hetzer, R. Greinert, et al.
Sun exposure and number of nevi in 5-to 6-year-old European children.
J Clin Epidemiol, 55 (2002), pp. 1075-1081
[26.]
P. Autier, M. Boniol, G. Severi, G. Giles, M.S. Cattaruzza, H. Luther, et al.
The body site distribution of melanocytic naevi in 6-7 year old European children.
Melanoma Res, 11 (2001), pp. 123-131
[27.]
M.B. Crijns, C. Klaver, A. de Boer, C. Van Hees, B.J. Vermeer, J. Vandenbroucke, et al.
Ultraviolet exposure and the development of banal and atypical naevi-a cross-sectional study on Curacao and in The Netherlands.
Melanoma Res, 7 (1997), pp. 407-416
[28.]
M. Breitbart, C. Garbe, P. Buttner, J. Weiss, H.P. Soyer, U. Stocker, et al.
Ultraviolet light exposure, pigmentary traits and the development of melanocytic naevi and cutaneous melanoma. A case-control study of the German Central Malignant Melanoma Registry.
Acta Derm Venereol, 77 (1997), pp. 374-378
[29.]
S.L. Harrison, P.G. Buettner, R. MacLennan.
Body-site distribution of melanocytic nevi in young Australian children.
Arch Dermatol, 135 (1999), pp. 47-52
[30.]
A.E. Grulich, V. Bataille, A.J. Swerdlow, J.A. Newton-Bishop, J. Cuzick, P. Hersey, et al.
Naevi and pigmentary characteristics as risk factors for melanoma in a high-risk population: a casecontrol study in New South Wales, Australia.
[31.]
V. Bataille, A. Grulich, P. Sasieni, A. Swerdlow, J. Newton Bishop, W. McCarthy, et al.
The association between naevi and melanoma in populations with different levels of sun exposure: a joint case-control study of melanoma in the UK and Australia.
Br J Cancer, 77 (1998), pp. 505-510
[32.]
Ortega M. Epidemiología del cáncer cutáneo en la provincia de Lleida y factores de riesgo relacionados. Tesis doctoral. Universitat de Lleida. 2004.
[33.]
G. Stinco, F. Favot, E. Quinkenstein, M. Zanchi, F. Valent, P. Patrone.
Children and sun exposure in the northeast of Italy.
Pediatr Dermatol, 22 (2005), pp. 520-524
[34.]
L. Schachner, N.S. Ling, S. Press.
A statistical analysis of a pediatric dermatology clinic.
Pediatr Dermatol, 1 (1983), pp. 157-164
Copyright © 2008. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
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