Case and Research Letters
Anogenital Granulomatosis
Granulomatosis anogenitales
M. Villar
, G. Petiti, A. Guerra, F. Vanaclocha
Autor para correspondencia
Servicio de Dermatología, Hospital Universitario 12 de octubre, Madrid, Spain
Leído
10275
Vecesse ha leído el artículo
3030
Total PDF
7245
Total HTML
Compartir estadísticas
array:24 [ "pii" => "S1578219012000601" "issn" => "15782190" "doi" => "10.1016/j.adengl.2011.05.007" "estado" => "S300" "fechaPublicacion" => "2012-01-01" "aid" => "458" "copyright" => "Elsevier España, S.L. and AEDV" "copyrightAnyo" => "2011" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2012;103:76-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5013 "formatos" => array:3 [ "EPUB" => 50 "HTML" => 3841 "PDF" => 1122 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731011003334" "issn" => "00017310" "doi" => "10.1016/j.ad.2011.05.016" "estado" => "S300" "fechaPublicacion" => "2012-01-01" "aid" => "458" "copyright" => "Elsevier España, S.L. y AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2012;103:76-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 7945 "formatos" => array:3 [ "EPUB" => 2 "HTML" => 6390 "PDF" => 1553 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científico-clínica</span>" "titulo" => "Granulomatosis anogenitales" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "76" "paginaFinal" => "79" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Anogenital Granulomatosis" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2278 "Ancho" => 2167 "Tamanyo" => 1001665 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A) Presencia de un infiltrado linfocitario que ocupa la dermis reticular, en el cual se distinguen estructuras granulomatosas sin necrosis central (HE x1,25). B) Detalle de un granuloma constituido por células gigantes multinucleadas y epitelioides y rodeado por una corona linfocitaria (HE x40). C) Denso infiltrado linfocitario ocupando el corion (HE x4). D) A mayor detalle, se observan células epitelioides constituyendo granulomas no necrotizantes (HEx40).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Villar, G. Petiti, A. Guerra y F. Vanaclocha" "autores" => array:3 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Villar" ] 1 => array:2 [ "nombre" => "G." "apellidos" => "Petiti" ] 2 => array:2 [ "nombre" => "A. Guerra y F." "apellidos" => "Vanaclocha" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219012000601" "doi" => "10.1016/j.adengl.2011.05.007" "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/S1578219012000601?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731011003334?idApp=UINPBA000044" "url" => "/00017310/0000010300000001/v1_201304241349/S0001731011003334/v1_201304241349/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219012000522" "issn" => "15782190" "doi" => "10.1016/j.adengl.2011.01.006" "estado" => "S300" "fechaPublicacion" => "2012-01-01" "aid" => "459" "copyright" => "Elsevier España, S.L. and AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2012;103:79-81" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4792 "formatos" => array:3 [ "EPUB" => 38 "HTML" => 3714 "PDF" => 1040 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Atypical Calciphylaxis Secondary to Treatment With Acenocoumarol" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "79" "paginaFinal" => "81" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Calcifilaxia atípica secundaria al tratamiento con acenocumarol" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 749 "Ancho" => 499 "Tamanyo" => 59202 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Ulcer with necrotic eschar surrounded by a reticular purpuric plaque on the back of the left leg.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Álvarez-Pérez, E. Gutiérrez-González, D. Sánchez-Aguilar, J. Toribio" "autores" => array:4 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Álvarez-Pérez" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Gutiérrez-González" ] 2 => array:2 [ "nombre" => "D." "apellidos" => "Sánchez-Aguilar" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Toribio" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731011003346" "doi" => "10.1016/j.ad.2011.01.017" "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/S0001731011003346?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012000522?idApp=UINPBA000044" "url" => "/15782190/0000010300000001/v1_201304241248/S1578219012000522/v1_201304241248/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219012000595" "issn" => "15782190" "doi" => "10.1016/j.adengl.2011.02.005" "estado" => "S300" "fechaPublicacion" => "2012-01-01" "aid" => "457" "copyright" => "Elsevier España, S.L. and AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2012;103:75-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4019 "formatos" => array:3 [ "EPUB" => 53 "HTML" => 3178 "PDF" => 788 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Halo Nevi Associated With Interferon Beta-1a Therapy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "75" "paginaFinal" => "76" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Halo nevi asociados al tratamiento con interferón beta-1a" ] ] "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" => 709 "Ancho" => 948 "Tamanyo" => 59467 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Halo nevi on the back.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "E. Vera-Iglesias, M. García-Arpa, P. Sánchez-Caminero" "autores" => array:3 [ 0 => array:2 [ "nombre" => "E." "apellidos" => "Vera-Iglesias" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "García-Arpa" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Sánchez-Caminero" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731011003322" "doi" => "10.1016/j.ad.2011.02.018" "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/S0001731011003322?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012000595?idApp=UINPBA000044" "url" => "/15782190/0000010300000001/v1_201304241248/S1578219012000595/v1_201304241248/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Anogenital Granulomatosis" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor:</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "76" "paginaFinal" => "79" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M. Villar, G. Petiti, A. Guerra, F. Vanaclocha" "autores" => array:4 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "Villar" "email" => array:1 [ 0 => "mariavb20@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "G." "apellidos" => "Petiti" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Guerra" ] 3 => array:2 [ "nombre" => "F." "apellidos" => "Vanaclocha" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Dermatología, Hospital Universitario 12 de octubre, Madrid, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Granulomatosis anogenitales" ] ] "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" => 1367 "Ancho" => 1301 "Tamanyo" => 535322 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A) Lymphocytic infiltrate occupying the reticular dermis, showing granulomatous structures without central necrosis (hematoxylin–eosin, original magnification ×12.5). (B) Detail of a granuloma composed of multinucleated giant cells and epithelioid cells and surrounded by lymphocytes (hematoxylin–eosin, original magnification ×400). (C) Dense lymphocytic infiltrate occupying a mucous membrane (hematoxylin–eosin, original magnification ×40). (D) At higher magnification, epithelioid cells are seen forming nonnecrotizing granulomas (hematoxylin–eosin, original magnification ×400).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Chronic recurrent granulomatous processes in the anogenital area present with ulcers, fissures, and lymphedema; histopathology reveals nonnecrotizing granulomatous inflammation. Crohn disease is the most common etiologic factor, but cases in which no underlying cause is evident have been grouped under the term anogenital granulomatosis.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The first case we report is that of a 52-year-old woman with excrescent lesions that had a pseudocondylomatous appearance and fissures in the gluteal cleft that had started 6 months earlier. The lesions were excised but she did not return until 5 years later, when she sought care for chronic recurrent vulvar and perineal lesions. She had ulcers, marked edema of the vulva, longitudinal fissures in the folds, and indurated plaques that were excrescent in the gluteal cleft (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Histopathology of both the vulvar and the perianal areas revealed a lymphocytic infiltrate in the reticular dermis with nonnecrotizing granulomas consisting of multinucleated giant cells (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A and B). Additional tests, including complete blood count, biochemistry, chest radiograph, and cultures yielded no findings, except for an elevated erythrocyte sedimentation rate (ESR) of 52<span class="elsevierStyleHsp" style=""></span>mm/h. A colonoscopy with colorectal biopsies ruled out inflammatory bowel disease. The patient was treated with topical corticosteroids, salicylates, and oral corticosteroids; the lesions responded fully to the last treatment but recurred when they were suspended. She was subsequently treated with adalimumab (40<span class="elsevierStyleHsp" style=""></span>mg/15<span class="elsevierStyleHsp" style=""></span>d) but showed no response after 4 months. Fifteen years after the initial episode the patient had not developed systemic symptoms.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The second case is that of a 51-year-old woman who presented with painful erosions and vulvar edema dating from 5 months earlier. For 6 years she had also had recurrent perianal suppurative plaques and fissures that had been diagnosed as hidradenitis suppurativa. Physical examination revealed the granulomatous appearance of the vulvar mucosa, erosions on the inside of the labia minora (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>), and longitudinal fissures in the gluteal cleft. Two vulvar biopsies revealed a dense lymphocytic infiltrate of epithelioid cells and multinucleated giant cells forming granulomas without central necrosis (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>C and D). Additional tests (complete blood count, biochemistry, cultures, and chest radiograph) were normal or negative, except for a slightly elevated ESR of 25<span class="elsevierStyleHsp" style=""></span>mm/h. Crohn disease was ruled out after colonoscopy with biopsies. The patient had no systemic symptoms during the 18 months of follow-up and responded partially to treatment with oral corticosteroids but showed no response to salicylates or to adalimumab (40<span class="elsevierStyleHsp" style=""></span>mg/15<span class="elsevierStyleHsp" style=""></span>d), which was therefore suspended after 3 months.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">The differential diagnosis of chronic granulomatous diseases in the perineum includes extraintestinal Crohn disease, although this condition is unlikely in the absence of intestinal symptoms or perianal fistulas and with normal colonoscopy.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Other possible differential diagnoses are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. In view of the clinical presentation, the first diagnostic steps should be biopsy to obtain a specimen for histology (on the basis of special stains and cultures for fungi, bacteria, and mycobacteria). Additional tests useful to rule out underlying causes include complete blood count, biochemistry, iron profile, ESR, angiotensin-converting enzyme levels, serology for syphilis, and chest radiograph. Colonoscopy is recommended, even in the absence of digestive symptoms.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Chronic genital granulomatosis without direct communication with the gastrointestinal tract can be observed in metastatic Crohn disease. This condition is the least common cutaneous manifestation of Crohn disease and consists of skin lesions separated from the digestive tract by healthy skin. It usually affects women between the second and fourth decades of life and can appear anywhere, including on the genitals, although the lower limbs are the most frequent location.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Clinical manifestations in the genital region are similar to those observed in our patients.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Lesions are associated with involvement of the colon or rectum<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> but usually do not follow a course that runs parallel to the intestinal disease. Chronic genital granulomatosis is associated with long-standing intestinal Crohn disease in 80% of cases.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,6</span></a> When the granulomatous process presents first, intestinal involvement usually develops within 4 months to 2 years. The literature offers at least 5 cases<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> of cutaneous Crohn disease in the absence of previously recognized intestinal disease, which did not appear during follow-up either. Some authors nonetheless recommend reserving this diagnosis for cases in which intestinal involvement has been demonstrated.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Orofacial granulomatosis or cheilitis granulomatosa, considered a monosymptomatic form of Melkersson–Rosenthal syndrome, shares some of the clinical and histological features of the anogenital granulomatosis in our 2 cases. Cheilitis granulomatosa presents as persistent and recurrent labial swelling; nonnecrotizing granulomas are sometimes associated with ulceration and gingival hyperplasia or cobblestoning. Anogenital granulomatosis has been suggested to be the genital equivalent of cheilitis granulomatosa<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and although the co-occurrence of these 2 conditions in the same patient is rare, it has been reported.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> In 10%–48% of cases cheilitis granulomatosa and intestinal Crohn disease are associated.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The term anogenital granulomatosis<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> was introduced in 2003 to identify these chronic recurrent conditions with characteristic clinical and histopathologic features that may have different causes. This clinical entity is a unifying concept for others used in the literature (chronic hypertrophic vulvitis, vulvitis granulomatosa, chronic edema of the vulva, Melkersson–Rosenthal vulvitis and anoperineitis granulomatosa) and is especially useful for cases of unknown etiology and those highly suggestive of metastatic Crohn disease in the absence of established intestinal disease.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Therapeutic management of this condition is difficult and there is no set protocol to follow because of the lack of case series and randomized trials. Suggested treatments have obtained mixed and sometimes unsatisfactory results marked by frequent relapse after treatment is discontinued. The reported options include topical, intralesional, and oral corticosteroids,<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> salicylates, antibiotics<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> such as metronidazole<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,10</span></a> and ciprofloxacin,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and immunosuppressants such as azathioprine and ciclosporin.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,3</span></a> More recently, anti-tumor necrosis factor monoclonal antibodies such as infliximab and adalimumab have given good results.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">We have reported 2 cases of idiopathic anogenital granulomatosis in which possible underlying causes were ruled out and no associated systemic symptoms developed even after years of follow-up.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Villar M, Petiti G, Guerra A, Vanaclocha F. Granulomatosis anogenitales. Actas Dermosifiliogr. 2012;103:76–79.</p>" ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 830 "Ancho" => 1301 "Tamanyo" => 181332 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Vulva, showing numerous ulcers, fissures arranged longitudinally in the folds, and edema of the labia majora, labia minora, and clitoral hood. In the gluteal cleft, excrescent plaques with a pseudocondylomatous appearance and longitudinal cracks.</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" => 1367 "Ancho" => 1301 "Tamanyo" => 535322 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A) Lymphocytic infiltrate occupying the reticular dermis, showing granulomatous structures without central necrosis (hematoxylin–eosin, original magnification ×12.5). (B) Detail of a granuloma composed of multinucleated giant cells and epithelioid cells and surrounded by lymphocytes (hematoxylin–eosin, original magnification ×400). (C) Dense lymphocytic infiltrate occupying a mucous membrane (hematoxylin–eosin, original magnification ×40). (D) At higher magnification, epithelioid cells are seen forming nonnecrotizing granulomas (hematoxylin–eosin, original magnification ×400).</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" => 696 "Ancho" => 1301 "Tamanyo" => 166194 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Edematous vulvar mucosa, with a granulomatous appearance. Erosions on the inner surface of the labia minora.</p>" ] ] 3 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "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">Noninfectious Causes \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">Infectious Causes \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">Crohn disease \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">Tuberculosis \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">Sarcoidosis \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">Lymphogranuloma venereum \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">Foreign body granuloma \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">Granuloma inguinale \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">Hidradenitis suppurativa \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">Syphilis \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">Behçet disease \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">Leprosy \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">Pyoderma gangrenosum \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">Deep mycoses \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">Lymphoproliferative diseases \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"> \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">Melkersson–Rosenthal syndrome \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"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab181992.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Differential Diagnosis of Anogenital Granulomatosis.</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" => "Ano-genital granulomatosis: the counterpart of oro-facial granulomatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.R. van der Scheur" 1 => "R.I. van der Waal" 2 => "I. van der Waal" 3 => "T.J. Stoof" 4 => "S.J. van Deventer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2003" "volumen" => "17" "paginaInicial" => "184" "paginaFinal" => "189" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12705748" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vulvitis granulomatosa and anoperineitis granulomatosa" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H. Hackel" 1 => "A.A. Hartmann" 2 => "G. Burg" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Dermatologica" "fecha" => "1991" "volumen" => "182" "paginaInicial" => "128" "paginaFinal" => "131" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2050234" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Metastatic Crohn's disease: a review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "I. Palamaras" 1 => "J. El-Jabbour" 2 => "N. Pietropaolo" 3 => "P. Thomson" 4 => "S. Mann" 5 => "W. Robles" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1468-3083.2008.02741.x" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2008" "volumen" => "22" "paginaInicial" => "1033" "paginaFinal" => "1043" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18573158" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Enfermedad de Crohn metastásica: a propósito de un caso con afectación vulvar" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P. Gómez-Centeno" 1 => "L. Casas" 2 => "F. Valdés-Tascón" 3 => "C. Peteiro" 4 => "J. Toribio" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "1999" "volumen" => "90" "paginaInicial" => "100" "paginaFinal" => "103" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Linfedema vulvar: una manifestación infrecuente de la enfermedad de Crohn metastásica" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Bel Pla" 1 => "V. García-Patos Briones" 2 => "D. García Fernández" 3 => "G. Aparicio Español" 4 => "A. Castells Rodellas" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Gastroenterol Hepatol" "fecha" => "2001" "volumen" => "24" "paginaInicial" => "297" "paginaFinal" => "299" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11459566" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Vulvar inflammation as the only clinical manifestation of Crohn disease in an 8-year-old girl" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Shannon" 1 => "S.L. Corbett" 2 => "C.M. Walsh" 3 => "R.F. Spitzer" 4 => "B.Y. Ngan" 5 => "S. Kives" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1542/peds.2009-1829" "Revista" => array:6 [ "tituloSerie" => "Pediatrics" "fecha" => "2010" "volumen" => "125" "paginaInicial" => "e1518" "paginaFinal" => "e1522" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20457677" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Granulomatous vulvitis, granulomatous cheilitis: a single diagnosis?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Thiriar" 1 => "E. Deroux" 2 => "N. Dourov" 3 => "L. Evrard" 4 => "M.O. Peny" 5 => "P. Simon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Dermatology" "fecha" => "1998" "volumen" => "196" "paginaInicial" => "455" "paginaFinal" => "458" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9669130" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Orofacial granulomatosis as the initial presentation of Crohn's disease in an adolescent" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "T. Bogenrieder" 1 => "G. Rogler" 2 => "T. Vogt" 3 => "M. Landthaler" 4 => "W. Stolz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "68900" "Revista" => array:6 [ "tituloSerie" => "Dermatology" "fecha" => "2003" "volumen" => "206" "paginaInicial" => "273" "paginaFinal" => "278" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12673090" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Maladie de Crohn vulvaire: 3 observations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Fenniche" 1 => "M. Mokni" 2 => "S. Haouet" 3 => "A. Ben Osman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Dermatol Venereol" "fecha" => "1997" "volumen" => "124" "paginaInicial" => "629" "paginaFinal" => "632" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9739928" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anogenital granulomatosis treated with ciprofloxacin" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Roé" 1 => "M.A. Barnadas" 2 => "P. Bergua" 3 => "F. Sancho" 4 => "L. Matas" 5 => "R. Paredes" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1468-3083.2008.02710.x" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2009" "volumen" => "23" "paginaInicial" => "89" "paginaFinal" => "90" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18384555" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010300000001/v1_201304241248/S1578219012000601/v1_201304241248/en/main.assets" "Apartado" => array:4 [ "identificador" => "6157" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case and Research Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010300000001/v1_201304241248/S1578219012000601/v1_201304241248/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012000601?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 2 | 4 | 6 |
| 2024 Octubre | 99 | 39 | 138 |
| 2024 Septiembre | 90 | 24 | 114 |
| 2024 Agosto | 124 | 51 | 175 |
| 2024 Julio | 87 | 40 | 127 |
| 2024 Junio | 92 | 36 | 128 |
| 2024 Mayo | 81 | 40 | 121 |
| 2024 Abril | 78 | 23 | 101 |
| 2024 Marzo | 95 | 30 | 125 |
| 2024 Febrero | 87 | 46 | 133 |
| 2024 Enero | 94 | 41 | 135 |
| 2023 Diciembre | 72 | 15 | 87 |
| 2023 Noviembre | 72 | 28 | 100 |
| 2023 Octubre | 52 | 19 | 71 |
| 2023 Septiembre | 59 | 29 | 88 |
| 2023 Agosto | 45 | 19 | 64 |
| 2023 Julio | 86 | 35 | 121 |
| 2023 Junio | 54 | 21 | 75 |
| 2023 Mayo | 63 | 26 | 89 |
| 2023 Abril | 64 | 21 | 85 |
| 2023 Marzo | 57 | 18 | 75 |
| 2023 Febrero | 41 | 18 | 59 |
| 2023 Enero | 36 | 29 | 65 |
| 2022 Diciembre | 57 | 40 | 97 |
| 2022 Noviembre | 46 | 23 | 69 |
| 2022 Octubre | 37 | 29 | 66 |
| 2022 Septiembre | 27 | 27 | 54 |
| 2022 Agosto | 11 | 29 | 40 |
| 2022 Julio | 21 | 29 | 50 |
| 2022 Junio | 23 | 29 | 52 |
| 2022 Mayo | 48 | 23 | 71 |
| 2022 Abril | 65 | 41 | 106 |
| 2022 Marzo | 60 | 48 | 108 |
| 2022 Febrero | 72 | 28 | 100 |
| 2022 Enero | 79 | 36 | 115 |
| 2021 Diciembre | 62 | 35 | 97 |
| 2021 Noviembre | 70 | 41 | 111 |
| 2021 Octubre | 85 | 39 | 124 |
| 2021 Septiembre | 59 | 42 | 101 |
| 2021 Agosto | 77 | 43 | 120 |
| 2021 Julio | 65 | 28 | 93 |
| 2021 Junio | 61 | 28 | 89 |
| 2021 Mayo | 48 | 41 | 89 |
| 2021 Abril | 121 | 83 | 204 |
| 2021 Marzo | 70 | 28 | 98 |
| 2021 Febrero | 99 | 30 | 129 |
| 2021 Enero | 48 | 16 | 64 |
| 2020 Diciembre | 50 | 23 | 73 |
| 2020 Noviembre | 40 | 31 | 71 |
| 2020 Octubre | 28 | 20 | 48 |
| 2020 Septiembre | 47 | 17 | 64 |
| 2020 Agosto | 31 | 21 | 52 |
| 2020 Julio | 20 | 26 | 46 |
| 2020 Junio | 38 | 24 | 62 |
| 2020 Mayo | 28 | 20 | 48 |
| 2020 Abril | 42 | 22 | 64 |
| 2020 Marzo | 35 | 106 | 141 |
| 2020 Febrero | 6 | 182 | 188 |
| 2020 Enero | 6 | 19 | 25 |
| 2019 Diciembre | 4 | 9 | 13 |
| 2019 Noviembre | 4 | 52 | 56 |
| 2019 Octubre | 0 | 2 | 2 |
| 2019 Septiembre | 0 | 7 | 7 |
| 2019 Agosto | 4 | 1 | 5 |
| 2019 Julio | 4 | 4 | 8 |
| 2019 Junio | 4 | 17 | 21 |
| 2019 Mayo | 5 | 47 | 52 |
| 2019 Abril | 2 | 43 | 45 |
| 2019 Marzo | 2 | 20 | 22 |
| 2019 Febrero | 0 | 10 | 10 |
| 2019 Enero | 2 | 11 | 13 |
| 2018 Diciembre | 3 | 3 | 6 |
| 2018 Octubre | 3 | 0 | 3 |
| 2018 Septiembre | 1 | 1 | 2 |
| 2018 Agosto | 0 | 10 | 10 |
| 2018 Julio | 0 | 15 | 15 |
| 2018 Junio | 0 | 8 | 8 |
| 2018 Mayo | 0 | 18 | 18 |
| 2018 Abril | 0 | 3 | 3 |
| 2018 Marzo | 6 | 8 | 14 |
| 2018 Febrero | 48 | 12 | 60 |
| 2018 Enero | 55 | 8 | 63 |
| 2017 Diciembre | 60 | 6 | 66 |
| 2017 Noviembre | 62 | 10 | 72 |
| 2017 Octubre | 38 | 13 | 51 |
| 2017 Septiembre | 41 | 26 | 67 |
| 2017 Agosto | 73 | 14 | 87 |
| 2017 Julio | 74 | 8 | 82 |
| 2017 Junio | 87 | 19 | 106 |
| 2017 Mayo | 82 | 10 | 92 |
| 2017 Abril | 69 | 15 | 84 |
| 2017 Marzo | 55 | 18 | 73 |
| 2017 Febrero | 136 | 29 | 165 |
| 2017 Enero | 64 | 14 | 78 |
| 2016 Diciembre | 80 | 20 | 100 |
| 2016 Noviembre | 114 | 25 | 139 |
| 2016 Octubre | 127 | 18 | 145 |
| 2016 Septiembre | 145 | 12 | 157 |
| 2016 Agosto | 101 | 11 | 112 |
| 2016 Julio | 70 | 7 | 77 |
| 2016 Junio | 11 | 15 | 26 |
| 2016 Mayo | 4 | 8 | 12 |
| 2016 Abril | 9 | 1 | 10 |
| 2016 Marzo | 7 | 1 | 8 |
| 2016 Febrero | 11 | 4 | 15 |
| 2016 Enero | 9 | 3 | 12 |
| 2015 Diciembre | 9 | 1 | 10 |
| 2015 Noviembre | 14 | 7 | 21 |
| 2015 Octubre | 16 | 2 | 18 |
| 2015 Septiembre | 15 | 1 | 16 |
| 2015 Agosto | 20 | 5 | 25 |
| 2015 Julio | 94 | 12 | 106 |
| 2015 Junio | 86 | 8 | 94 |
| 2015 Mayo | 110 | 12 | 122 |
| 2015 Abril | 110 | 12 | 122 |
| 2015 Marzo | 99 | 11 | 110 |
| 2015 Febrero | 71 | 8 | 79 |
| 2015 Enero | 83 | 15 | 98 |
| 2014 Diciembre | 111 | 17 | 128 |
| 2014 Noviembre | 79 | 8 | 87 |
| 2014 Octubre | 104 | 22 | 126 |
| 2014 Septiembre | 84 | 11 | 95 |
| 2014 Agosto | 78 | 22 | 100 |
| 2014 Julio | 87 | 15 | 102 |
| 2014 Junio | 109 | 11 | 120 |
| 2014 Mayo | 119 | 15 | 134 |
| 2014 Abril | 91 | 13 | 104 |
| 2014 Marzo | 94 | 19 | 113 |
| 2014 Febrero | 73 | 23 | 96 |
| 2014 Enero | 80 | 24 | 104 |
| 2013 Diciembre | 35 | 7 | 42 |
| 2013 Noviembre | 22 | 12 | 34 |
| 2013 Octubre | 17 | 5 | 22 |
| 2013 Septiembre | 13 | 6 | 19 |
| 2013 Agosto | 11 | 11 | 22 |
| 2013 Julio | 11 | 7 | 18 |
| 2013 Junio | 19 | 20 | 39 |
| 2013 Mayo | 15 | 9 | 24 |
| 2013 Abril | 15 | 14 | 29 |
| 2013 Marzo | 16 | 7 | 23 |
| 2013 Febrero | 68 | 9 | 77 |
| 2013 Enero | 60 | 6 | 66 |
| 2012 Diciembre | 18 | 3 | 21 |
| 2012 Noviembre | 1 | 0 | 1 |
| 2012 Octubre | 0 | 2 | 2 |
| 2012 Septiembre | 0 | 3 | 3 |
Mostrar todo
