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remitido a nuestro servicio para la valoraci&#243;n de una lesi&#243;n asintom&#225;tica de un a&#241;o de evoluci&#243;n situada en el dorso nasal&#46; El paciente mencionaba que le hab&#237;a aparecido sobre piel normal y hab&#237;a experimentado un lento crecimiento&#46; No refer&#237;a antecedentes familiares de lesiones similares&#46; Hace a&#241;os se le realiz&#243; criocirug&#237;a por queratosis act&#237;nicas faciales&#46;</p><p id="p0025" class="elsevierStylePara elsevierViewall">En la exploraci&#243;n se apreci&#243; un tumor negruzco de 2<span class="elsevierStyleHsp" style=""></span>mm de di&#225;metro y bordes netos&#44; localizado en el dorso nasal&#46; No presentaba otras lesiones en el resto de la superficie cut&#225;nea&#46;</p><p id="p0030" class="elsevierStylePara elsevierViewall">El estudio histopatol&#243;gico evidenci&#243;&#44; en la dermis media y profunda&#44; un tumor pigmentado bien delimitado &#40;<a class="elsevierStyleCrossRef" href="#f0005">fig&#46; 1</a>&#41;&#46; Estaba compuesto por una poblaci&#243;n celular bif&#225;sica formada por melanocitos&#44; algunos muy pigmentados&#44; con alguna figura de mitosis&#44; y por otro lado c&#233;lulas epiteliales de tama&#241;o variable y citoplasma eosin&#243;filo que de forma abrupta se convert&#237;an en c&#233;lulas sombra&#44; sin n&#250;cleo &#40;<a class="elsevierStyleCrossRef" href="#f0010">fig&#46; 2</a>&#41;&#46; Se apreciaban peque&#241;os focos de calcificaci&#243;n &#40;<a class="elsevierStyleCrossRef" href="#f0015">fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="f0005"></elsevierMultimedia><elsevierMultimedia ident="f0010"></elsevierMultimedia><elsevierMultimedia ident="f0015"></elsevierMultimedia><p id="p0035" class="elsevierStylePara elsevierViewall">El estudio inmunohistoqu&#237;mico mostr&#243; positividad de los elementos epiteliales para la citoqueratina AE1&#47;AE3 y el componente melanoc&#237;tico para el HMB-45 &#40;<a class="elsevierStyleCrossRef" href="#f0020">fig&#46; 4</a>&#41;&#46;</p><elsevierMultimedia ident="f0020"></elsevierMultimedia><p id="p0040" class="elsevierStylePara elsevierViewall">Todos los casos de matricoma melanoc&#237;tico publicados hasta la fecha son similares a &#233;ste &#40;<a class="elsevierStyleCrossRef" href="#t0005">tabla 1</a>&#41;&#46; Se caracterizan cl&#237;nicamente por ser lesiones negruzcas de menos de 1<span class="elsevierStyleHsp" style=""></span>cm de di&#225;metro&#44; sobre piel con da&#241;o solar de personas mayores &#40;60-80 a&#241;os&#41;&#44; con predominio de varones<a class="elsevierStyleCrossRefs" href="#bb0005"><span class="elsevierStyleSup">1-6</span></a>&#46; Hay un caso que ha aparecido en el rabo de un perro<a class="elsevierStyleCrossRef" href="#bb0035"><span class="elsevierStyleSup">7</span></a>&#46;</p><elsevierMultimedia ident="t0005"></elsevierMultimedia><p id="p0045" class="elsevierStylePara elsevierViewall">Su histopatolog&#237;a muestra una proliferaci&#243;n nodular pigmentada en la dermis compuesta por c&#233;lulas matriciales&#44; supramatriciales y c&#233;lulas sombra mezcladas con abundantes melanocitos dendr&#237;ticos muy pigmentados&#46; No es frecuente la calcificaci&#243;n ni la reacci&#243;n granulomatosa<a class="elsevierStyleCrossRefs" href="#bb0005"><span class="elsevierStyleSup">1-7</span></a>&#46;</p><p id="p0050" class="elsevierStylePara elsevierViewall">Los bordes bien definidos&#44; el peque&#241;o tama&#241;o y la ausencia de recidivas sugieren que se trata de una neoplasia benigna&#44; y no de un carcinoma matricial&#44; pese a mostrar una atipia citol&#243;gica variable y frecuentes figuras mit&#243;ticas &#40;esperables en un tumor de c&#233;lulas matriciales&#41;<a class="elsevierStyleCrossRefs" href="#bb0015"><span class="elsevierStyleSup">3&#44;8</span></a>&#46;</p><p id="p0055" class="elsevierStylePara elsevierViewall">Es conocido que el bulbo del fol&#237;culo piloso en anagen o fase de crecimiento contiene c&#233;lulas matriciales y supramatriciales&#44; y melanocitos pigmentados dendr&#237;ticos que le dan color al pelo&#46; Tambi&#233;n es frecuente observar figuras de mitosis&#46; Los melanocitos son m&#225;s prominentes en la fase anagen precoz&#44; por tanto el matricoma melanoc&#237;tico indica una fase precoz de la diferenciaci&#243;n folicular en anagen frente al pilomatricoma&#44; que representa una fase tard&#237;a<a class="elsevierStyleCrossRefs" href="#bb0015"><span class="elsevierStyleSup">3-6</span></a>&#46;</p><p id="p0060" class="elsevierStylePara elsevierViewall">Se debe realizar el diagn&#243;stico diferencial cl&#237;nico con el carcinoma basocelular pigmentado&#44; el melanoma maligno y el hemangioma&#59; y el histopatol&#243;gico con el carcinoma matricial con importante hiperplasia melanoc&#237;tica&#44; el melanoma maligno&#44; el matricoma&#44; el tricoblastoma&#44; el carcinoma basocelular con diferenciaci&#243;n matricial y el pilomatricoma pigmentado<a class="elsevierStyleCrossRefs" href="#bb0020"><span class="elsevierStyleSup">4&#44;6</span></a>&#46;</p><p id="p0065" class="elsevierStylePara elsevierViewall">Desde que Carlson et al describieran la entidad denominada matricoma melanoc&#237;tico se ha discutido la existencia de criterios clinicopatol&#243;gicos suficientes para considerarla una entidad independiente del matricoma<a class="elsevierStyleCrossRefs" href="#bb0045"><span class="elsevierStyleSup">9-13</span></a>&#46;</p><p id="p0070" class="elsevierStylePara elsevierViewall">Se plantea la posibilidad de que el carcinoma matricial con importante hiperplasia melanoc&#237;tica represente el matricoma melanoc&#237;tico maligno&#46; Se trata de un tumor mal definido&#44; 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        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:3 [
          "leyenda" => "<p id="sp0030" class="elsevierStyleSimplePara elsevierViewall">AP&#58; antecedentes personales&#59; Ca&#58; carcinoma&#59; M&#58; mujer&#59; MA&#58; macho&#59; QA&#58; queratosis act&#237;nicas&#59; V&#58; var&#243;n&#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"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Caso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sexo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AP dermatol&#243;gicos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Di&#225;metro &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Color&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Localizaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a>&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="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66&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">V&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">Ca&#46; basocelular&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&#44;8&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">Negro&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">Regi&#243;n pectoral izquierda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a>&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="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80&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">V&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">Da&#241;o solar&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&#44;5&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">Morado&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">Antebrazo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3<a class="elsevierStyleCrossRef" href="#bb0010"><span class="elsevierStyleSup">2</span></a>&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="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&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">M&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">Da&#241;o solar&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&#44;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">Hiperpigmentado&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">Dorso nasal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a>&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="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">78&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">V&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">Ca&#46; basocelular&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&#44;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">Negro-morado&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">&#193;rea preauricular izquierda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5<a class="elsevierStyleCrossRef" href="#bb0020"><span class="elsevierStyleSup">4</span></a>&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="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69&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">V&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">Da&#241;o solar&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&#44;5&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">Negro-marron&#225;ceo&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">Mejilla derecha&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6<a class="elsevierStyleCrossRef" href="#bb0025"><span class="elsevierStyleSup">5</span></a>&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="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66&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">M&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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">Hiperpigmentado&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">Hombro derecho&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7<a class="elsevierStyleCrossRef" href="#bb0030"><span class="elsevierStyleSup">6</span></a>&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="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70&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">V&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">Ca&#46; basocelular&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&#44;5&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">Negro&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">Dorso mano derecha&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8<a class="elsevierStyleCrossRef" href="#bb0030"><span class="elsevierStyleSup">6</span></a>&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="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">82&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">V&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">QA&#44; Ca&#46; espinocelular y basocelular&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&#44;5&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">Negro-morado&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">&#193;rea preauricular derecha&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9<a class="elsevierStyleCrossRef" href="#bb0030"><span class="elsevierStyleSup">6</span></a>&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="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">76&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">V&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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">Marr&#243;n-morado&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">Zona alta de la espalda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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Cartas al director
Matricoma melanocítico
B. Monteagudoa, L. Requenab, M.M. Used-Aznarc, M. Cabanillasa
a Servicio de Dermatología. Complejo Hospitalario Arquitecto Marcide-Novoa Santos. Ferrol. La Coruña. España
b Servicio de Dermatología. Fundación Jiménez Díaz. Universidad Autónoma. Madrid. España
c Servicio de Anatomía Patológica. Complejo Hospitalario Arquitecto Marcide-Novoa Santos. Ferrol. La Coruña. España
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remitido a nuestro servicio para la valoraci&#243;n de una lesi&#243;n asintom&#225;tica de un a&#241;o de evoluci&#243;n situada en el dorso nasal&#46; El paciente mencionaba que le hab&#237;a aparecido sobre piel normal y hab&#237;a experimentado un lento crecimiento&#46; No refer&#237;a antecedentes familiares de lesiones similares&#46; Hace a&#241;os se le realiz&#243; criocirug&#237;a por queratosis act&#237;nicas faciales&#46;</p><p id="p0025" class="elsevierStylePara elsevierViewall">En la exploraci&#243;n se apreci&#243; un tumor negruzco de 2<span class="elsevierStyleHsp" style=""></span>mm de di&#225;metro y bordes netos&#44; localizado en el dorso nasal&#46; No presentaba otras lesiones en el resto de la superficie cut&#225;nea&#46;</p><p id="p0030" class="elsevierStylePara elsevierViewall">El estudio histopatol&#243;gico evidenci&#243;&#44; en la dermis media y profunda&#44; un tumor pigmentado bien delimitado &#40;<a class="elsevierStyleCrossRef" href="#f0005">fig&#46; 1</a>&#41;&#46; Estaba compuesto por una poblaci&#243;n celular bif&#225;sica formada por melanocitos&#44; algunos muy pigmentados&#44; con alguna figura de mitosis&#44; y por otro lado c&#233;lulas epiteliales de tama&#241;o variable y citoplasma eosin&#243;filo que de forma abrupta se convert&#237;an en c&#233;lulas sombra&#44; sin n&#250;cleo &#40;<a class="elsevierStyleCrossRef" href="#f0010">fig&#46; 2</a>&#41;&#46; Se apreciaban peque&#241;os focos de calcificaci&#243;n &#40;<a class="elsevierStyleCrossRef" href="#f0015">fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="f0005"></elsevierMultimedia><elsevierMultimedia ident="f0010"></elsevierMultimedia><elsevierMultimedia ident="f0015"></elsevierMultimedia><p id="p0035" class="elsevierStylePara elsevierViewall">El estudio inmunohistoqu&#237;mico mostr&#243; positividad de los elementos epiteliales para la citoqueratina AE1&#47;AE3 y el componente melanoc&#237;tico para el HMB-45 &#40;<a class="elsevierStyleCrossRef" href="#f0020">fig&#46; 4</a>&#41;&#46;</p><elsevierMultimedia ident="f0020"></elsevierMultimedia><p id="p0040" class="elsevierStylePara elsevierViewall">Todos los casos de matricoma melanoc&#237;tico publicados hasta la fecha son similares a &#233;ste &#40;<a class="elsevierStyleCrossRef" href="#t0005">tabla 1</a>&#41;&#46; Se caracterizan cl&#237;nicamente por ser lesiones negruzcas de menos de 1<span class="elsevierStyleHsp" style=""></span>cm de di&#225;metro&#44; sobre piel con da&#241;o solar de personas mayores &#40;60-80 a&#241;os&#41;&#44; con predominio de varones<a class="elsevierStyleCrossRefs" href="#bb0005"><span class="elsevierStyleSup">1-6</span></a>&#46; Hay un caso que ha aparecido en el rabo de un perro<a class="elsevierStyleCrossRef" href="#bb0035"><span class="elsevierStyleSup">7</span></a>&#46;</p><elsevierMultimedia ident="t0005"></elsevierMultimedia><p id="p0045" class="elsevierStylePara elsevierViewall">Su histopatolog&#237;a muestra una proliferaci&#243;n nodular pigmentada en la dermis compuesta por c&#233;lulas matriciales&#44; supramatriciales y c&#233;lulas sombra mezcladas con abundantes melanocitos dendr&#237;ticos muy pigmentados&#46; No es frecuente la calcificaci&#243;n ni la reacci&#243;n granulomatosa<a class="elsevierStyleCrossRefs" href="#bb0005"><span class="elsevierStyleSup">1-7</span></a>&#46;</p><p id="p0050" class="elsevierStylePara elsevierViewall">Los bordes bien definidos&#44; el peque&#241;o tama&#241;o y la ausencia de recidivas sugieren que se trata de una neoplasia benigna&#44; y no de un carcinoma matricial&#44; pese a mostrar una atipia citol&#243;gica variable y frecuentes figuras mit&#243;ticas &#40;esperables en un tumor de c&#233;lulas matriciales&#41;<a class="elsevierStyleCrossRefs" href="#bb0015"><span class="elsevierStyleSup">3&#44;8</span></a>&#46;</p><p id="p0055" class="elsevierStylePara elsevierViewall">Es conocido que el bulbo del fol&#237;culo piloso en anagen o fase de crecimiento contiene c&#233;lulas matriciales y supramatriciales&#44; y melanocitos pigmentados dendr&#237;ticos que le dan color al pelo&#46; Tambi&#233;n es frecuente observar figuras de mitosis&#46; Los melanocitos son m&#225;s prominentes en la fase anagen precoz&#44; por tanto el matricoma melanoc&#237;tico indica una fase precoz de la diferenciaci&#243;n folicular en anagen frente al pilomatricoma&#44; que representa una fase tard&#237;a<a class="elsevierStyleCrossRefs" href="#bb0015"><span class="elsevierStyleSup">3-6</span></a>&#46;</p><p id="p0060" class="elsevierStylePara elsevierViewall">Se debe realizar el diagn&#243;stico diferencial cl&#237;nico con el carcinoma basocelular pigmentado&#44; el melanoma maligno y el hemangioma&#59; y el histopatol&#243;gico con el carcinoma matricial con importante hiperplasia melanoc&#237;tica&#44; el melanoma maligno&#44; el matricoma&#44; el tricoblastoma&#44; el carcinoma basocelular con diferenciaci&#243;n matricial y el pilomatricoma pigmentado<a class="elsevierStyleCrossRefs" href="#bb0020"><span class="elsevierStyleSup">4&#44;6</span></a>&#46;</p><p id="p0065" class="elsevierStylePara elsevierViewall">Desde que Carlson et al describieran la entidad denominada matricoma melanoc&#237;tico se ha discutido la existencia de criterios clinicopatol&#243;gicos suficientes para considerarla una entidad independiente del matricoma<a class="elsevierStyleCrossRefs" href="#bb0045"><span class="elsevierStyleSup">9-13</span></a>&#46;</p><p id="p0070" class="elsevierStylePara elsevierViewall">Se plantea la posibilidad de que el carcinoma matricial con importante hiperplasia melanoc&#237;tica represente el matricoma melanoc&#237;tico maligno&#46; Se trata de un tumor mal definido&#44; multinodular&#44; que infiltra en profundidad&#44; en el que se observan c&#233;lulas activas mit&#243;ticamente y &#225;reas de necrosis<a class="elsevierStyleCrossRef" href="#bb0040"><span class="elsevierStyleSup">8</span></a>&#46;</p><p id="p0075" class="elsevierStylePara elsevierViewall">El pilomatricoma se presenta en j&#243;venes como una neoplasia qu&#237;stica&#44; firme a la palpaci&#243;n&#44; localizada en la dermis profunda o en el tejido celular subcut&#225;neo&#44; con frecuente calcificaci&#243;n y reacci&#243;n granulomatosa<a class="elsevierStyleCrossRefs" href="#bb0070"><span class="elsevierStyleSup">14-16</span></a>&#46; El pilomatricoma pigmentado no muestra una hiperplasia melanoc&#237;tica prominente frente a la marcada proliferaci&#243;n de melanocitos dendr&#237;ticos pigmentados del matricoma melanoc&#237;tico<a class="elsevierStyleCrossRefs" href="#bb0080"><span class="elsevierStyleSup">16-19</span></a>&#46; La diferencia entre estas dos entidades se ha comparado con la existente entre la queratosis seborreica pigmentada y el melanoacantona<a class="elsevierStyleCrossRefs" href="#bb0015"><span class="elsevierStyleSup">3&#44;6</span></a>&#46;</p></span>"
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          "es" => "<p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">A mayor aumento&#44; el tumor est&#225; compuesto por una poblaci&#243;n celular bif&#225;sica formado por melanocitos &#40;&#42;&#41;&#44; con alguna figura de mitosis &#40;&#94;&#41;&#44; y c&#233;lulas epiteliales que de forma abrupta se convierten en c&#233;lulas sombra &#40;flecha&#41;&#46; &#40;Hematoxilina-eosina&#44; &#215;<span class="elsevierStyleHsp" style=""></span>200&#41;&#46;</p>"
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          "es" => "<p id="sp0015" class="elsevierStyleSimplePara elsevierViewall">C&#233;lulas sombra &#40;flecha&#41; y focos de calcificaci&#243;n &#40;&#42;&#41;&#46; &#40;Hematoxilina-eosina&#44; &#215;<span class="elsevierStyleHsp" style=""></span>400&#41;&#46;</p>"
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          "es" => "<p id="sp0020" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas inmunohistoqu&#237;micas&#46; &#40;A&#41; Los elementos epiteliales muestran positividad para la citoqueratina&#46; &#40;Citoqueratina AE1&#47;AE3&#44; x100&#41;&#46; &#40;B&#41; El componente melanoc&#237;tico expresa el HMB-45&#46; &#40;HMB-45&#44; &#215;<span class="elsevierStyleHsp" style=""></span>100&#41;&#46;</p>"
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          "leyenda" => "<p id="sp0030" class="elsevierStyleSimplePara elsevierViewall">AP&#58; antecedentes personales&#59; Ca&#58; carcinoma&#59; M&#58; mujer&#59; MA&#58; macho&#59; QA&#58; queratosis act&#237;nicas&#59; V&#58; var&#243;n&#46;</p>"
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                  <table border="0" frame="\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t">Caso&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">Edad&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">Sexo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">AP dermatol&#243;gicos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">Di&#225;metro &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">Color&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">Localizaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="right" valign="\n
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                  \t\t\t\t">1<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="right" valign="\n
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                  \t\t\t\t">66&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
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                  \t\t\t\t">V&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
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                  \t\t\t\t">Ca&#46; basocelular&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;8&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
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                  \t\t\t\t">Negro&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Regi&#243;n pectoral izquierda&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
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                  \t\t\t\t">2<a class="elsevierStyleCrossRef" href="#bb0005"><span class="elsevierStyleSup">1</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="right" valign="\n
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                  \t\t\t\t">80&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">V&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">Da&#241;o solar&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
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                  \t\t\t\t">0&#44;5&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
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                  \t\t\t\t">Morado&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
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                  \t\t\t\t">Antebrazo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3<a class="elsevierStyleCrossRef" href="#bb0010"><span class="elsevierStyleSup">2</span></a>&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="right" valign="\n
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                  \t\t\t\t">62&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
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                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
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                  \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">Da&#241;o solar&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&#44;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
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                  \t\t\t\t">Hiperpigmentado&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
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                  \t\t\t\t">Dorso nasal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4<a class="elsevierStyleCrossRef" href="#bb0015"><span class="elsevierStyleSup">3</span></a>&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="right" valign="\n
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                  \t\t\t\t">78&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">V&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">Ca&#46; basocelular&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&#44;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">Negro-morado&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">&#193;rea preauricular izquierda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5<a class="elsevierStyleCrossRef" href="#bb0020"><span class="elsevierStyleSup">4</span></a>&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="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69&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">V&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">Da&#241;o solar&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
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                  \t\t\t\t">0&#44;5&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
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                  \t\t\t\t">Negro-marron&#225;ceo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="right" valign="\n
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                  \t\t\t\t">66&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">M&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">V&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
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Negro&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">8<a class="elsevierStyleCrossRef" href="#bb0030"><span class="elsevierStyleSup">6</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="right" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">V&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#193;rea preauricular derecha&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="right" valign="\n
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                  \t\t\t\t">9<a class="elsevierStyleCrossRef" href="#bb0030"><span class="elsevierStyleSup">6</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="right" valign="\n
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                  \t\t\t\t">76&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">V&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">10<a class="elsevierStyleCrossRef" href="#bb0035"><span class="elsevierStyleSup">7</span></a> &#40;perro&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="right" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">11<a class="elsevierStyleCrossRef" href="#tf0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">V&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">QA&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">Dorso nasal&nbsp;\t\t\t\t\t\t\n
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ISSN: 00017310
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