Case and Research Letters
Cutaneous Polyarteritis Nodosa With Manifestations of Livedoid Vasculopathy
Panarteritis nodosa cutánea con clínica de vasculopatía livedoide
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Necrosis incipiente de la epidermis y, en la dermis, imágenes de congestión vascular con extravasación hemática y trombosis e hialinosis parietal. De forma parcheada, en los vasos dermohipodérmicos, focos de necrosis fibrinoide segmentaria con leucocitoclasia e infiltrado mixto.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Llamas-Velasco, D. de Argila, J. Fraga, A. García-Diez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Llamas-Velasco" ] 1 => array:2 [ "nombre" => "D." "apellidos" => "de Argila" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Fraga" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "García-Diez" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219011000114" "doi" => "10.1016/j.adengl.2010.10.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219011000114?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731011000706?idApp=UINPBA000044" "url" => "/00017310/0000010200000006/v1_201304241329/S0001731011000706/v1_201304241329/es/main.assets" ] ] "itemAnterior" => array:19 [ "pii" => "S1578219011000126" "issn" => "15782190" "doi" => "10.1016/j.adengl.2010.10.005" "estado" => "S300" "fechaPublicacion" => "2011-08-01" "aid" => "346" "copyright" => "Elsevier España, S.L. and AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2011;102:475-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5622 "formatos" => array:3 [ "EPUB" => 38 "HTML" => 4352 "PDF" => 1232 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>" "titulo" => "Primary Nonessential Cutis Verticis Gyrata" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "475" "paginaFinal" => "476" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cutis verticis gyrata primaria no esencial" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 754 "Ancho" => 952 "Tamanyo" => 118211 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinical image of furrows and folds on the patient's scalp.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "V. López, E. Montesinos, E. Jordá" "autores" => array:3 [ 0 => array:2 [ "nombre" => "V." "apellidos" => "López" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Montesinos" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Jordá" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731011000718" "doi" => "10.1016/j.ad.2010.06.031" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731011000718?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219011000126?idApp=UINPBA000044" "url" => "/15782190/0000010200000006/v1_201304241225/S1578219011000126/v1_201304241225/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Cutaneous Polyarteritis Nodosa With Manifestations of Livedoid Vasculopathy" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor:</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "477" "paginaFinal" => "479" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M. Llamas-Velasco, D. de Argila, J. Fraga, A. García-Diez" "autores" => array:4 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "Llamas-Velasco" "email" => array:1 [ 0 => "mar.llamasvelasco@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "D." "apellidos" => "de Argila" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "J." "apellidos" => "Fraga" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "A." "apellidos" => "García-Diez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Universitario de La Princesa, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Universitario de La Princesa, Madrid, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Panarteritis nodosa cutánea con clínica de vasculopatía livedoide" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 976 "Ancho" => 1300 "Tamanyo" => 457310 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Incipient necrosis of the epidermis and, in the dermis, signs of vascular congestion with extravasation of red blood cells, thrombosis, and hyalinosis of the vessel walls. Patchy foci of segmental fibrinoid necrosis with leukocytoclasia and mixed infiltrates in the dermal and hypodermal vessels (hematoxylin-eosin, original magnification x4).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In a young woman, the differential diagnosis of ulcerated skin lesions on the lower limbs that heal leaving atrophic scars should include vasculitis and occlusive vasculopathy. Cutaneous polyarteritis nodosa (CPN) is characterized by the presence of painful nodules that typically develop on the lower limbs, frequently ulcerate, and usually heal without residual hyperpigmentation.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Its diagnosis requires demonstration of necrotizing arteritis affecting medium-sized arteries. Livedoid vasculopathy (LV) is an occlusive vasculopathy with painful lesions in the form of punched-out ulcers that heal leaving white atrophic scars with peripheral telangiectasia.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Light microscopy shows a mild superficial perivascular infiltrate and extravasation of red blood cells without vasculitis, although some arteries may present hyalinization of the wall and intraluminal fibrin deposits.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We present a case in which the lesions showed the clinical and histological features of both disorders.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The patient was 29-year-old woman with no past medical history of interest, who had been receiving aspirin 100 mg/24 h and pentoxifylline 400 mg/12 h for the last 8 years due to a skin disorder identified in another hospital as livedo reticularis. She was seen in our department for a 4-year history of outbreaks on the lower limbs of painful isolated lesions, sometimes ulcerated with serosanguineous crusts, and that disappeared after several months, occasionally leaving residual hyperpigmentation. The outbreaks appeared at random intervals and with no seasonal relationship. She had been treated with betamethasone plus gentamicin ointment, which, according to the patient, accelerated remission. She did not present Raynaud's phenomenon or other systemic symptoms.</p><p id="par0020" class="elsevierStylePara elsevierViewall">There were 3 relevant findings on physical examination: <span class="elsevierStyleItalic">a)</span> hypopigmented stellate macules on the ankle, dorsal surface of the foot, and left pretibial region (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A); <span class="elsevierStyleItalic">b)</span> an indurated erythematous red-brown plaque on the medial aspect of the left ankle with several well-defined ulcerated lesions (the largest being 0.8 cm in diameter) within its borders (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B); and <span class="elsevierStyleItalic">c)</span> very faint reticulated violaceous macules on the upper and lower limbs.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Skin biopsy from the area of the right lateral malleolus showed a necrotizing vasculitis affecting medium-sized vessels, with superficial changes consisting of vascular congestion with extravasation of red blood cells and, in some vessels, thrombosis and hyalinosis of the wall (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Blood analysis showed that antinuclear antibodies were negative (titer of 1:40) and cytoplasmic antineutrophil cytoplasmic antibodies (cANCA) were positive at a titer of 1:20 (antiproteinase 3 and antimyeloperoxidase were negative on enzyme-linked immunosorbent assay). A complete coagulation study was conducted which included prothrombin activity, cephalin and thrombin times, functional fibrinogen, protein C and protein S, antithrombin III, homocysteine, anticardiolipin and anti-β2-glycoprotein I antibodies, lupus anticoagulant, and cryoglobulins and cold agglutinins; the results led to the conclusion that the patient was heterozygous for the prothrombin gene 20210. The possibility of systemic involvement was excluded based on the results of blood and urine analysis, electroneurogram, chest x-ray, and assessment by the nephrology and hematology departments. No palpable skin nodules were detected during follow-up. Treatment for CPN was started with oral prednisone (tapering regimen, commencing with 0.7 mg/kg/d) with the subsequent addition of azathioprine 200 mg/d, leading to partial control of the symptoms; subsequent tests for cANCA were negative.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The recently established diagnostic criteria for CPN (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) allowed us to consider that this was the most likely diagnosis in our case. However, the patient also presented clinical and histological features characteristic of LV. The coexistence of clinical and histological features of CPN and LV has rarely been described, although this may be due to an underestimation of their incidence. In a study of 29 patients with atrophie blanche lesions (mean follow-up, 18 years), skin biopsy demonstrated the presence of arteritis affecting medium-sized arteries, consistent with a diagnosis of CPN, in 21% of cases.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Those authors suggested that occlusion of the dermal arteries by fibrin thrombi could be secondary to the partial obliteration of larger arteries affected by a primary necrotizing vasculitic process. The phenomenon is considered to be a reactive angioendotheliomatosis.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> In the case described, heterozygosity for prothrombin gene 20210, present in 1% to 5% of the white population, could be implicated in the occlusion of the dermal arteries that was observed concomitantly with the vasculitic changes. In this regard, there is a case report that describes a patient with LV who had the same genetic anomaly and a similar clinical presentation to that of our patient<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>; however, vasculitis was absent. It is well known that the pathogenesis of LV involves coagulation abnormalities such as decreased levels of activated protein C or increased levels of fibrinopeptide A.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Its diagnosis must fulfill both clinical and histological criteria in the absence of signs or symptoms of systemic involvement.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">In the case described, it appears improbable that the LV progressed to CPN, given the pathogenic differences between the 2 disorders,<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> although some authors have suggested that the initial thrombotic phenomenon of LV could trigger a necrotizing vasculitis in susceptible patients.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Finally, a case of pANCA-positive CPN associated with minocycline therapy has been described.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> In our case, we identified a low titer of cANCA which, together with the negative results of further tests following treatment, suggests that these antibodies were not relevant from a clinical point of view.</p><p id="par0050" class="elsevierStylePara elsevierViewall">In summary, atrophie blanche may be a clinical manifestation of CPN and may coexist with other more typical manifestations. Skin biopsies that include the deep subcutaneous tissue are required for diagnosis.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Llamas-Velasco M, et al. Panarteritis nodosa cutánea con clínica de vasculopatía livedoide Actas Dermosifiliogr. 2011;102:477-479.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 683 "Ancho" => 1300 "Tamanyo" => 122831 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, Pearly stellate macules on the pretibial region, surrounded by punctate erythematous lesions and brownish macules. B, Ulcer with well-defined, rounded borders and a clean base and slightly depressed whitish macules.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 976 "Ancho" => 1300 "Tamanyo" => 457310 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Incipient necrosis of the epidermis and, in the dermis, signs of vascular congestion with extravasation of red blood cells, thrombosis, and hyalinosis of the vessel walls. Patchy foci of segmental fibrinoid necrosis with leukocytoclasia and mixed infiltrates in the dermal and hypodermal vessels (hematoxylin-eosin, original magnification x4).</p>" ] ] 2 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Source: Adapted from Nakamura et al.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Findings \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Description \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Compatible clinical findings \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">Nodules, livedo, purpura, ulcers \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Necrotizing vasculitis \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">Small and medium-sized vessels \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The following should be excluded in patients without systemic involvement: \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">Fever >38<span class="elsevierStyleHsp" style=""></span>°C for more than 15 dWeight loss >6<span class="elsevierStyleHsp" style=""></span>kg in 6 moHypertensionRenal involvementIschemic or hemorrhagic strokeAcute myocardial infarction or pericarditisPleuritisIntestinal ischemia or hemorrhageNeuropathy in territories distant from the affected areaWidespread joint or muscle painCompatible changes on arteriography \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab181750.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Diagnostic Criteria for CPN.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cutaneous polyarteritis nodosa" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.L. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 9 | 12 | 21 |
| 2024 Octubre | 107 | 82 | 189 |
| 2024 Septiembre | 135 | 49 | 184 |
| 2024 Agosto | 173 | 95 | 268 |
| 2024 Julio | 113 | 62 | 175 |
| 2024 Junio | 162 | 60 | 222 |
| 2024 Mayo | 123 | 50 | 173 |
| 2024 Abril | 104 | 39 | 143 |
| 2024 Marzo | 118 | 43 | 161 |
| 2024 Febrero | 89 | 48 | 137 |
| 2024 Enero | 90 | 49 | 139 |
| 2023 Diciembre | 78 | 24 | 102 |
| 2023 Noviembre | 101 | 43 | 144 |
| 2023 Octubre | 73 | 29 | 102 |
| 2023 Septiembre | 96 | 41 | 137 |
| 2023 Agosto | 65 | 25 | 90 |
| 2023 Julio | 93 | 62 | 155 |
| 2023 Junio | 74 | 29 | 103 |
| 2023 Mayo | 107 | 31 | 138 |
| 2023 Abril | 48 | 21 | 69 |
| 2023 Marzo | 72 | 23 | 95 |
| 2023 Febrero | 57 | 28 | 85 |
| 2023 Enero | 45 | 35 | 80 |
| 2022 Diciembre | 68 | 42 | 110 |
| 2022 Noviembre | 36 | 30 | 66 |
| 2022 Octubre | 40 | 24 | 64 |
| 2022 Septiembre | 40 | 39 | 79 |
| 2022 Agosto | 43 | 43 | 86 |
| 2022 Julio | 33 | 38 | 71 |
| 2022 Junio | 60 | 31 | 91 |
| 2022 Mayo | 111 | 57 | 168 |
| 2022 Abril | 87 | 35 | 122 |
| 2022 Marzo | 56 | 48 | 104 |
| 2022 Febrero | 67 | 33 | 100 |
| 2022 Enero | 90 | 44 | 134 |
| 2021 Diciembre | 63 | 34 | 97 |
| 2021 Noviembre | 53 | 40 | 93 |
| 2021 Octubre | 79 | 65 | 144 |
| 2021 Septiembre | 51 | 55 | 106 |
| 2021 Agosto | 69 | 43 | 112 |
| 2021 Julio | 53 | 34 | 87 |
| 2021 Junio | 45 | 47 | 92 |
| 2021 Mayo | 79 | 34 | 113 |
| 2021 Abril | 141 | 51 | 192 |
| 2021 Marzo | 156 | 31 | 187 |
| 2021 Febrero | 113 | 29 | 142 |
| 2021 Enero | 48 | 18 | 66 |
| 2020 Diciembre | 44 | 29 | 73 |
| 2020 Noviembre | 30 | 9 | 39 |
| 2020 Octubre | 32 | 10 | 42 |
| 2020 Septiembre | 37 | 12 | 49 |
| 2020 Agosto | 25 | 19 | 44 |
| 2020 Julio | 20 | 9 | 29 |
| 2020 Junio | 30 | 31 | 61 |
| 2020 Mayo | 22 | 27 | 49 |
| 2020 Abril | 22 | 28 | 50 |
| 2020 Marzo | 23 | 17 | 40 |
| 2020 Febrero | 6 | 10 | 16 |
| 2020 Enero | 4 | 10 | 14 |
| 2019 Diciembre | 4 | 1 | 5 |
| 2019 Noviembre | 4 | 1 | 5 |
| 2019 Octubre | 0 | 3 | 3 |
| 2019 Septiembre | 0 | 6 | 6 |
| 2019 Agosto | 4 | 9 | 13 |
| 2019 Julio | 4 | 22 | 26 |
| 2019 Junio | 4 | 36 | 40 |
| 2019 Mayo | 4 | 49 | 53 |
| 2019 Abril | 2 | 44 | 46 |
| 2019 Marzo | 2 | 14 | 16 |
| 2019 Febrero | 0 | 13 | 13 |
| 2019 Enero | 4 | 9 | 13 |
| 2018 Diciembre | 1 | 8 | 9 |
| 2018 Noviembre | 0 | 8 | 8 |
| 2018 Octubre | 1 | 0 | 1 |
| 2018 Septiembre | 3 | 2 | 5 |
| 2018 Agosto | 0 | 16 | 16 |
| 2018 Julio | 0 | 1 | 1 |
| 2018 Junio | 0 | 6 | 6 |
| 2018 Mayo | 0 | 3 | 3 |
| 2018 Abril | 0 | 1 | 1 |
| 2018 Marzo | 3 | 0 | 3 |
| 2018 Febrero | 47 | 6 | 53 |
| 2018 Enero | 76 | 10 | 86 |
| 2017 Diciembre | 74 | 9 | 83 |
| 2017 Noviembre | 65 | 10 | 75 |
| 2017 Octubre | 61 | 7 | 68 |
| 2017 Septiembre | 63 | 17 | 80 |
| 2017 Agosto | 85 | 6 | 91 |
| 2017 Julio | 82 | 12 | 94 |
| 2017 Junio | 87 | 17 | 104 |
| 2017 Mayo | 77 | 26 | 103 |
| 2017 Abril | 55 | 34 | 89 |
| 2017 Marzo | 47 | 6 | 53 |
| 2017 Febrero | 44 | 17 | 61 |
| 2017 Enero | 49 | 7 | 56 |
| 2016 Diciembre | 65 | 10 | 75 |
| 2016 Noviembre | 74 | 16 | 90 |
| 2016 Octubre | 113 | 17 | 130 |
| 2016 Septiembre | 152 | 16 | 168 |
| 2016 Agosto | 69 | 12 | 81 |
| 2016 Julio | 53 | 15 | 68 |
| 2016 Junio | 11 | 16 | 27 |
| 2016 Mayo | 6 | 6 | 12 |
| 2016 Abril | 5 | 1 | 6 |
| 2016 Marzo | 10 | 5 | 15 |
| 2016 Febrero | 5 | 1 | 6 |
| 2016 Enero | 7 | 1 | 8 |
| 2015 Diciembre | 10 | 1 | 11 |
| 2015 Noviembre | 16 | 2 | 18 |
| 2015 Octubre | 33 | 1 | 34 |
| 2015 Septiembre | 17 | 8 | 25 |
| 2015 Agosto | 9 | 5 | 14 |
| 2015 Julio | 86 | 16 | 102 |
| 2015 Junio | 53 | 10 | 63 |
| 2015 Mayo | 68 | 24 | 92 |
| 2015 Abril | 81 | 16 | 97 |
| 2015 Marzo | 63 | 12 | 75 |
| 2015 Febrero | 59 | 20 | 79 |
| 2015 Enero | 48 | 18 | 66 |
| 2014 Diciembre | 74 | 7 | 81 |
| 2014 Noviembre | 53 | 21 | 74 |
| 2014 Octubre | 70 | 36 | 106 |
| 2014 Septiembre | 51 | 29 | 80 |
| 2014 Agosto | 59 | 17 | 76 |
| 2014 Julio | 71 | 26 | 97 |
| 2014 Junio | 77 | 11 | 88 |
| 2014 Mayo | 104 | 16 | 120 |
| 2014 Abril | 69 | 16 | 85 |
| 2014 Marzo | 75 | 26 | 101 |
| 2014 Febrero | 38 | 20 | 58 |
| 2014 Enero | 59 | 23 | 82 |
| 2013 Diciembre | 56 | 24 | 80 |
| 2013 Noviembre | 46 | 20 | 66 |
| 2013 Octubre | 54 | 24 | 78 |
| 2013 Septiembre | 50 | 14 | 64 |
| 2013 Agosto | 53 | 16 | 69 |
| 2013 Julio | 60 | 37 | 97 |
| 2013 Junio | 12 | 26 | 38 |
| 2013 Mayo | 15 | 17 | 32 |
| 2013 Abril | 16 | 11 | 27 |
| 2013 Marzo | 14 | 29 | 43 |
| 2013 Febrero | 39 | 9 | 48 |
| 2013 Enero | 28 | 10 | 38 |
| 2012 Diciembre | 14 | 5 | 19 |
| 2012 Noviembre | 1 | 3 | 4 |
| 2012 Octubre | 1 | 4 | 5 |
| 2012 Septiembre | 0 | 5 | 5 |
| 2012 Agosto | 0 | 1 | 1 |
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