Case for Diagnosis
Telangiectatic Macules in a 90-Year-Old Woman
Lesiones maculares telangiectásicas en mujer de 90 años
A. Martín-Fuentes
, M.A. Pastor-Nieto, E. De Eusebio-Murillo
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Departamento de Dermatología, Hospital Universitario de Guadalajara, Guadalajara, Spain
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Martín-Fuentes, M.A. Pastor-Nieto, E. De Eusebio-Murillo" "autores" => array:3 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Martín-Fuentes" "email" => array:1 [ 0 => "adriana.mar.fuen@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "M.A." "apellidos" => "Pastor-Nieto" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "De Eusebio-Murillo" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Departamento de Dermatología, Hospital Universitario de Guadalajara, Guadalajara, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Lesiones maculares telangiectásicas en mujer de 90 años" ] ] "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" => 660 "Ancho" => 899 "Tamanyo" => 266973 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Hematoxylin–eosin, original magnification 10× and 50×.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Medical History</span><p id="par0005" class="elsevierStylePara elsevierViewall">The patient was a 90-year-old woman who had a personal history of severe hypoacusis and osteoporosis and was not receiving chronic treatment. She consulted for several asymptomatic lesions on her chest, shoulders, and upper back. The lesions had appeared suddenly 5 years earlier, had never been treated, and had been stable since first onset.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Physical Examination</span><p id="par0010" class="elsevierStylePara elsevierViewall">Physical examination revealed multiple well-defined erythematous-violaceous telangiectatic macules ranging in diameter from 5<span class="elsevierStyleHsp" style=""></span>mm to 4<span class="elsevierStyleHsp" style=""></span>cm (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The lesions did not blanch with pressure and were negative for the Darier sign.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Histopathology</span><p id="par0015" class="elsevierStylePara elsevierViewall">Histologic examination revealed dilated vascular structures in the superficial capillary plexus with peripheral inflammatory infiltrate characterized by a predominance of mast cells (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Staining showed the mast cells to be tryptase-positive (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">What Is Your Diagnosis?</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Diagnosis</span><p id="par0025" class="elsevierStylePara elsevierViewall">Telangiectasia macularis eruptiva perstans (TMEP)</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Clinical Course and Treatment</span><p id="par0030" class="elsevierStylePara elsevierViewall">The laboratory workup included a complete blood cell count, biochemistry, liver and kidney function tests, and a serum tryptase test. Serum tryptase was slightly elevated at 16.3<span class="elsevierStyleHsp" style=""></span>μg/L (13.5<span class="elsevierStyleHsp" style=""></span>μg/L being the upper limit of normal). Despite this finding, the patient and her family declined to continue with the exploration due to the patient's advanced age.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Comment</span><p id="par0035" class="elsevierStylePara elsevierViewall">Mastocytosis comprises a group of diseases characterized by an excessive accumulation of mast cells in the skin, and occasionally in the tissue of other organs.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Three clinical variants of mastocytosis with cutaneous involvement have been described: urticaria pigmentosa (either its typical clinical manifestation of plaques and nodules or TMEP), diffuse cutaneous mastocytosis, and mastocytoma.</p><p id="par0045" class="elsevierStylePara elsevierViewall">TMEP was first described by Weber in 1930.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Thought to be a rare subtype of urticaria pigmentosa, it occurs in less than 1% of mastocytosis patients. TMEP occurs mainly in young and middle-aged adults, although cases of pediatric onset have been reported. A familial form of TMEP was described in 4 pediatric patients in 3 generations of a single family.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">It manifests clinically as erythematous macules comprising purplish or brownish asymptomatic telangiectasias that are negative for the Darier sign and located primarily on the trunk and upper limbs. Unilateral segmental manifestations of TMEP that may lead to a differential diagnosis with unilateral nevoid telangiectasia have also been reported.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Histologically, TMEP is characterized by an increase in the relative number of mast cells distributed around dilated capillaries and venules in the superficial capillary plexus. In most cases of TMEP, the number of mast cells does not increase very much in absolute terms, making it difficult to diagnose the disease by means of hematoxylin–eosin staining. Therefore, immunohistochemical staining for tryptase and/or c-kit (CD 117) is recommended.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Although TMEP has been considered to be a form of mastocytosis that only affects the skin, it can cause systemic symptoms, such as hypotension, flushing, pruritus, abdominal pain, and anaphylaxis due to the release of mediators by mast cells. In other cases, it can lead to symptoms caused by the infiltration of other organs, such as splenomegaly, adenopathy, hepatomegaly, and anemia. Finally, in isolated cases, this variant of mastocytosis has been associated with myeloproliferative, lymphoproliferative, and myelodysplastic syndromes.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">The choice of treatment depends on whether systemic or exclusively cutaneous involvement is detected. Cases involving only the skin have been treated satisfactorily with topical and intralesional corticosteroids, topical calcineurin inhibitors, 585<span class="elsevierStyleHsp" style=""></span>nm vascular laser treatment, and psoralen-UV-A (PUVA) therapy.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflicts of Interest</span><p id="par0070" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Medical History" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Physical Examination" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Histopathology" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Diagnosis" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Clinical Course and Treatment" ] 5 => array:2 [ "identificador" => "sec0030" "titulo" => "Comment" ] 6 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflicts of Interest" ] 7 => array:2 [ "identificador" => "xack35207" "titulo" => "Acknowledgments" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Martín-Fuentes A, et al. Lesiones maculares telangiectásicas en una mujer de 90 años. Actas Dermosifiliogr. 2012;103:65–6.</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" => 820 "Ancho" => 897 "Tamanyo" => 132600 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Telangiectatic macules with well-defined borders.</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" => 660 "Ancho" => 899 "Tamanyo" => 266973 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Hematoxylin–eosin, original magnification 10× and 50×.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 678 "Ancho" => 897 "Tamanyo" => 189448 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Immunohistochemistry: tryptase, original magnification 40×.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Telangiectasia Macularis Eruptiva Perstans—probably a telangiectatic variety of urticaria pigmentosa in an adult" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "F.P. Weber" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Proc R Soc Med" "fecha" => "1930 Dec" "volumen" => "24" "paginaInicial" => "96" "paginaFinal" => "97" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19987891" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Familial telangiectasia macularis eruptiva perstans" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "I. Neri" 1 => "E. Guareschi" 2 => "V. Guerrini" 3 => "A. Patrizi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1525-1470.2005.00123.x" "Revista" => array:6 [ "tituloSerie" => "Pediatr Dermatol" "fecha" => "2005" "volumen" => "22" "paginaInicial" => "488" "paginaFinal" => "489" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16191009" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Telangiectasia maculosa eruptiva persistente unilateral: aportación de un caso y revisión de la literatura" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A.I. Bernal Ruiz" 1 => "A. Gónzales Ruiz" 2 => "H. Aragoneses Fraile" 3 => "C. Gutiérrez Rodríguez" 4 => "M. García Muñoz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2001" "volumen" => "92" "paginaInicial" => "358" "paginaFinal" => "361" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Two cases of telangiectasia macularis eruptiva perstans demonstrated by immunohistochemistry for c-kit (CD 117)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.W. Lee" 1 => "Y.I. Jeong" 2 => "J.C. Choi" 3 => "M.W. Lee" 4 => "J.H. Choi" 5 => "K.C. Moon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Dermatol" "fecha" => "2005" "volumen" => "32" "paginaInicial" => "817" "paginaFinal" => "820" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16361734" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Unusual cutaneous findings of urticaria pigmentosa and telangiectasia macularis eruptiva perstans associated with marked myelofibrosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "I. Turchin" 1 => "B. Barankin" 2 => "E. Schloss" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-4632.2006.02648.x" "Revista" => array:6 [ "tituloSerie" => "Int J Dermatol" "fecha" => "2006" "volumen" => "45" "paginaInicial" => "1215" "paginaFinal" => "1217" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17040445" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Telangiectasia macularis eruptive perstans successfully treated with PUVA therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E. Sotiriou" 1 => "Z. Apalla" 2 => "D. Ioannides" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1600-0781.2009.00480.x" "Revista" => array:6 [ "tituloSerie" => "Photodermatol Photoimmunol Photomed" "fecha" => "2010" "volumen" => "26" "paginaInicial" => "46" "paginaFinal" => "47" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20070840" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:3 [ "identificador" => "xack35207" "titulo" => "Acknowledgments" "texto" => "<p id="par0075" class="elsevierStylePara elsevierViewall">The authors would like to thank Jesús Cuevas Santos and Luis Cristian Perna Monroy for providing the histopathological images.</p>" ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010300000001/v1_201304241248/S1578219012000546/v1_201304241248/en/main.assets" "Apartado" => array:4 [ "identificador" => "6154" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case for Diagnosis" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010300000001/v1_201304241248/S1578219012000546/v1_201304241248/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012000546?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 4 | 7 | 11 |
| 2024 Octubre | 70 | 58 | 128 |
| 2024 Septiembre | 96 | 54 | 150 |
| 2024 Agosto | 118 | 95 | 213 |
| 2024 Julio | 124 | 57 | 181 |
| 2024 Junio | 110 | 56 | 166 |
| 2024 Mayo | 92 | 59 | 151 |
| 2024 Abril | 147 | 53 | 200 |
| 2024 Marzo | 88 | 38 | 126 |
| 2024 Febrero | 102 | 46 | 148 |
| 2024 Enero | 58 | 37 | 95 |
| 2023 Diciembre | 58 | 28 | 86 |
| 2023 Noviembre | 79 | 39 | 118 |
| 2023 Octubre | 66 | 22 | 88 |
| 2023 Septiembre | 74 | 44 | 118 |
| 2023 Agosto | 66 | 31 | 97 |
| 2023 Julio | 83 | 57 | 140 |
| 2023 Junio | 57 | 41 | 98 |
| 2023 Mayo | 90 | 43 | 133 |
| 2023 Abril | 63 | 33 | 96 |
| 2023 Marzo | 48 | 31 | 79 |
| 2023 Febrero | 68 | 30 | 98 |
| 2023 Enero | 51 | 39 | 90 |
| 2022 Diciembre | 63 | 60 | 123 |
| 2022 Noviembre | 37 | 39 | 76 |
| 2022 Octubre | 33 | 36 | 69 |
| 2022 Septiembre | 49 | 54 | 103 |
| 2022 Agosto | 28 | 39 | 67 |
| 2022 Julio | 24 | 45 | 69 |
| 2022 Junio | 36 | 50 | 86 |
| 2022 Mayo | 43 | 63 | 106 |
| 2022 Abril | 66 | 41 | 107 |
| 2022 Marzo | 67 | 65 | 132 |
| 2022 Febrero | 42 | 44 | 86 |
| 2022 Enero | 61 | 38 | 99 |
| 2021 Diciembre | 37 | 39 | 76 |
| 2021 Noviembre | 45 | 39 | 84 |
| 2021 Octubre | 66 | 51 | 117 |
| 2021 Septiembre | 50 | 45 | 95 |
| 2021 Agosto | 64 | 27 | 91 |
| 2021 Julio | 26 | 16 | 42 |
| 2021 Junio | 35 | 51 | 86 |
| 2021 Mayo | 57 | 48 | 105 |
| 2021 Abril | 149 | 51 | 200 |
| 2021 Marzo | 100 | 33 | 133 |
| 2021 Febrero | 69 | 27 | 96 |
| 2021 Enero | 34 | 19 | 53 |
| 2020 Diciembre | 46 | 23 | 69 |
| 2020 Noviembre | 39 | 26 | 65 |
| 2020 Octubre | 20 | 21 | 41 |
| 2020 Septiembre | 51 | 15 | 66 |
| 2020 Agosto | 23 | 21 | 44 |
| 2020 Julio | 32 | 20 | 52 |
| 2020 Junio | 31 | 26 | 57 |
| 2020 Mayo | 29 | 24 | 53 |
| 2020 Abril | 42 | 27 | 69 |
| 2020 Marzo | 43 | 23 | 66 |
| 2020 Febrero | 6 | 7 | 13 |
| 2020 Enero | 4 | 5 | 9 |
| 2019 Diciembre | 8 | 9 | 17 |
| 2019 Noviembre | 4 | 2 | 6 |
| 2019 Octubre | 0 | 5 | 5 |
| 2019 Septiembre | 4 | 10 | 14 |
| 2019 Agosto | 4 | 13 | 17 |
| 2019 Julio | 7 | 11 | 18 |
| 2019 Junio | 4 | 7 | 11 |
| 2019 Mayo | 7 | 25 | 32 |
| 2019 Abril | 4 | 22 | 26 |
| 2019 Marzo | 0 | 11 | 11 |
| 2019 Febrero | 4 | 0 | 4 |
| 2019 Enero | 1 | 4 | 5 |
| 2018 Diciembre | 2 | 0 | 2 |
| 2018 Noviembre | 2 | 0 | 2 |
| 2018 Octubre | 3 | 0 | 3 |
| 2018 Septiembre | 2 | 0 | 2 |
| 2018 Julio | 0 | 2 | 2 |
| 2018 Abril | 0 | 13 | 13 |
| 2018 Febrero | 52 | 10 | 62 |
| 2018 Enero | 89 | 10 | 99 |
| 2017 Diciembre | 87 | 9 | 96 |
| 2017 Noviembre | 61 | 10 | 71 |
| 2017 Octubre | 56 | 4 | 60 |
| 2017 Septiembre | 52 | 1 | 53 |
| 2017 Agosto | 103 | 11 | 114 |
| 2017 Julio | 62 | 11 | 73 |
| 2017 Junio | 82 | 44 | 126 |
| 2017 Mayo | 68 | 20 | 88 |
| 2017 Abril | 70 | 10 | 80 |
| 2017 Marzo | 73 | 31 | 104 |
| 2017 Febrero | 67 | 11 | 78 |
| 2017 Enero | 54 | 22 | 76 |
| 2016 Diciembre | 75 | 18 | 93 |
| 2016 Noviembre | 101 | 23 | 124 |
| 2016 Octubre | 151 | 12 | 163 |
| 2016 Septiembre | 210 | 14 | 224 |
| 2016 Agosto | 97 | 11 | 108 |
| 2016 Julio | 75 | 12 | 87 |
| 2016 Junio | 13 | 15 | 28 |
| 2016 Mayo | 8 | 15 | 23 |
| 2016 Abril | 2 | 1 | 3 |
| 2016 Marzo | 11 | 23 | 34 |
| 2016 Febrero | 2 | 19 | 21 |
| 2016 Enero | 12 | 19 | 31 |
| 2015 Diciembre | 7 | 10 | 17 |
| 2015 Noviembre | 35 | 23 | 58 |
| 2015 Octubre | 32 | 17 | 49 |
| 2015 Septiembre | 8 | 9 | 17 |
| 2015 Agosto | 8 | 5 | 13 |
| 2015 Julio | 120 | 10 | 130 |
| 2015 Junio | 70 | 9 | 79 |
| 2015 Mayo | 115 | 17 | 132 |
| 2015 Abril | 75 | 10 | 85 |
| 2015 Marzo | 57 | 11 | 68 |
| 2015 Febrero | 43 | 11 | 54 |
| 2015 Enero | 45 | 12 | 57 |
| 2014 Diciembre | 46 | 9 | 55 |
| 2014 Noviembre | 47 | 7 | 54 |
| 2014 Octubre | 64 | 17 | 81 |
| 2014 Septiembre | 57 | 9 | 66 |
| 2014 Agosto | 55 | 14 | 69 |
| 2014 Julio | 101 | 15 | 116 |
| 2014 Junio | 70 | 12 | 82 |
| 2014 Mayo | 92 | 14 | 106 |
| 2014 Abril | 76 | 9 | 85 |
| 2014 Marzo | 71 | 16 | 87 |
| 2014 Febrero | 70 | 13 | 83 |
| 2014 Enero | 61 | 15 | 76 |
| 2013 Diciembre | 27 | 4 | 31 |
| 2013 Noviembre | 37 | 8 | 45 |
| 2013 Octubre | 17 | 3 | 20 |
| 2013 Septiembre | 12 | 5 | 17 |
| 2013 Agosto | 9 | 8 | 17 |
| 2013 Julio | 11 | 10 | 21 |
| 2013 Junio | 10 | 13 | 23 |
| 2013 Mayo | 17 | 11 | 28 |
| 2013 Abril | 7 | 8 | 15 |
| 2013 Marzo | 18 | 4 | 22 |
| 2013 Febrero | 23 | 2 | 25 |
| 2013 Enero | 27 | 7 | 34 |
| 2012 Diciembre | 11 | 3 | 14 |
| 2012 Noviembre | 2 | 3 | 5 |
| 2012 Octubre | 1 | 1 | 2 |
| 2012 Agosto | 1 | 0 | 1 |
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