Cases and Research Letters
Follicular Lymphoma With Paraneoplastic Autoimmune Multiorgan Syndrome
Síndrome multiorgánico autoinmune paraneoplásico asociado a linfoma folicular
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A Review of 14 Cases" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "246" "paginaFinal" => "250" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hemangiomas abortivos o mínimamente proliferativos. Revisión de 14 casos" ] ] "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" => 2422 "Ancho" => 1596 "Tamanyo" => 566829 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Abortive hemangiomas at the maximum point of growth and after regression. Segmental lesion on the forearm with minimal spread to the wrist at 45 days (A) and 3 years (B) of age. Partially segmental hemangioma on the hand at 45 days (C) and 4 years (D) of age.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Martín-Santiago, A. Bauzá, L.J. del Pozo, P. Carrillo" "autores" => array:4 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Martín-Santiago" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Bauzá" ] 2 => array:2 [ "nombre" => "L.J." "apellidos" => "del Pozo" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Carrillo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731011004248" "doi" => "10.1016/j.ad.2011.03.030" "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/S0001731011004248?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012001035?idApp=UINPBA000044" "url" => "/15782190/0000010300000003/v1_201304241257/S1578219012001035/v1_201304241257/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219012001102" "issn" => "15782190" "doi" => "10.1016/j.adengl.2012.04.013" "estado" => "S300" "fechaPublicacion" => "2012-04-01" "aid" => "468" "copyright" => "Elsevier España, S.L. and AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2012;103:243-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 6651 "formatos" => array:3 [ "EPUB" => 53 "HTML" => 5374 "PDF" => 1224 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and research letters</span>" "titulo" => "Jellyfish Sting or Tattoo?" 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"apellidos" => "Gómez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731011003437" "doi" => "10.1016/j.ad.2011.02.020" "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/S0001731011003437?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012001102?idApp=UINPBA000044" "url" => "/15782190/0000010300000003/v1_201304241257/S1578219012001102/v1_201304241257/en/main.assets" ] "en" => array:17 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Cases and Research Letters</span>" "titulo" => "Follicular Lymphoma With Paraneoplastic Autoimmune Multiorgan Syndrome" "tieneTextoCompleto" => true "saludo" => "To the Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "244" "paginaFinal" => "246" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "I. Hidalgo, F. Martinez, C. Grau, I. Gil, A. Azón" "autores" => array:5 [ 0 => array:4 [ "nombre" => "I." "apellidos" => "Hidalgo" "email" => array:1 [ 0 => "ihidalgoparra@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" => "F." "apellidos" => "Martinez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "C." "apellidos" => "Grau" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "I." "apellidos" => "Gil" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "A." "apellidos" => "Azón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Sección de Dermatología, Hospital Universitari Sant Joan, Reus, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Oncologia, Hospital Universitari Sant Joan, Reus, 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" => "Síndrome multiorgánico autoinmune paraneoplásico asociado a linfoma folicular" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 745 "Ancho" => 996 "Tamanyo" => 244620 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Lichenoid interface dermatitis with necrotic keratinocytes (hematoxylin–eosin, ×100).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Paraneoplastic pemphigus is a rare entity first described by Anhalt et al. in 1990.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> It is an autoimmune disease of the skin and mucosa, associated with neoplasm, which is generally lymphoid in origin. Because several organs are involved as well as the skin and because the physiopathologic mechanisms associated with the mucosal, skin and internal-organ lesions are not limited to the presence of antibodies specific to adhesion molecules, in 2001, Nguyen et al.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> proposed the term paraneoplastic autoimmune multiorgan syndrome (PAMS).</p><p id="par0010" class="elsevierStylePara elsevierViewall">We describe a patient with PAMS associated with non-Hodgkin lymphoma.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Case Description</span><p id="par0015" class="elsevierStylePara elsevierViewall">A 69-year-old man with a personal history of cerebrovascular accident and type 2 diabetes mellitus visited our department with oral erosions and ulcers that had appeared 6 months earlier.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Physical examination revealed erosive glossitis, cheilitis, pseudomembranous conjunctivitis, and ulcerative keratitis. The patient also presented erythematous scaly lesions on the scalp, maculopapular lesions and reddish-purple plaques on the torso and legs, hyperkeratosis with fissures on the palms and soles, and erosive lesions on the glans and scrotum (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a>); all these signs appeared 2 months before the patient visited our department.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">A skin biopsy showed lichenoid interface dermatitis with necrotic keratinocytes (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). Direct immunofluorescence showed intercellular deposits of immunoglobulin (Ig) G and IgC3 in the epidermis. Indirect immunofluorescence showed intercellular deposits when monkey esophagus was used as a substrate and was negative when rat bladder was used. Immunoblotting identified envoplakin (210<span class="elsevierStyleHsp" style=""></span>kDa) and periplakin (190<span class="elsevierStyleHsp" style=""></span>kDa) antibodies.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">A study was performed to search for an occult neoplasm. Computed tomography of the chest and abdomen revealed enlarged mesenteric, mediastinal, and axillary lymph nodes, and a mass in the retroperitoneal soft tissue.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Lymph-node and bone-marrow biopsies were compatible with non-Hodgkin follicular lymphoma and a diagnosis of PAMS associated with non-Hodgkin follicular lymphoma was reached. Treatment of the underlying neoplasm was instated with 8 cycles of chemotherapy using vincristine, rituximab, cyclophosphamide, and prednisone; 5<span class="elsevierStyleHsp" style=""></span>mg/kg/day of ciclosporin and 1<span class="elsevierStyleHsp" style=""></span>mg/kg/day of methylprednisone were also administered at gradually decreasing doses to treat the cutaneous manifestations. Complete remission of the lymphoma was achieved with no recurrences to date, and the skin lesions resolved completely in 2 weeks. After 3 years of follow-up, the patient presents only mild stomatitis, which is being treated with 100<span class="elsevierStyleHsp" style=""></span>mg/day of ciclosporin.</p><p id="par0040" class="elsevierStylePara elsevierViewall">PAMS is a heterogeneous autoimmune syndrome that involves several internal organs; it is associated with a neoplasm and presents clearly defined clinical, histologic, and immunologic characteristics. The clinical findings of paraneoplastic pemphigus are varied and may resemble pemphigus, lichen planus, erythema multiforme, or graft-versus-host disease. Stomatitis is usually present and often an early sign of the disease—so much so that its absence should call a diagnosis of paraneoplastic pemphigus into question. It is characterized by very painful erosive lesions.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Anatomic pathology may show acantholysis but, unlike in common pemphigus, this is less marked and may be accompanied by an intense lichenoid mononuclear infiltrate in the dermal–epidermal junction, with vacuolar degeneration, suprabasal desquamation, and keratinocyte necrosis (lichenoid dermatitis).<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Direct-immunofluorescence findings show intercellular immunoreactants (IgG and complement), as in pemphigus, although IgG and/or complement are also commonly found in the basement membrane; this fact is useful in the differential diagnosis of common pemphigus with paraneoplastic pemphigus or PAMS. It should be remembered that, in some cases, direct immunofluorescence tests may be negative, possibly because of the predominance of lichenoid lesions or the presence of necrotic tissue in the biopsies.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Serum antibodies against plakins (envoplakin, periplakin, desmoplakin 1 and 2, plectin, and an uncharacterized 170<span class="elsevierStyleHsp" style=""></span>kDa protein) have been detected in all epithelia. However, in a particular subgroup of patients, antidesmoplakin antibodies may be absent and antienvoplakin and antiperiplakin antibodies are therefore considered to be more specific in PAMS.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Paraneoplastic pemphigus is a mucocutaneous manifestation of a severe PAMS and precedes diagnosis of the neoplasm in approximately a third of patients. Clinical suspicion of paraneoplastic pemphigus is essential for early diagnosis and treatment of both PAMS and the neoplasm, and thus for preventing fatal complications, such as bronchiolitis obliterans.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7,8</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Our patient presented with a case of PAMS associated with lymphoma. Diagnosis was made early and, unlike most cases associated with malignant tumors reported in the literature, the outcome was excellent, with the patient alive more than 2 years after diagnosis.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Case Description" ] 2 => array:2 [ "identificador" => "xack35215" "titulo" => "Acknowledgments" ] 3 => 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: Hidalgo I, et al. Síndrome multiorgánico autoinmune asociado a linfoma folicular. Actas Dermosifiliogr. 2012;103:244–246.</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" => 749 "Ancho" => 999 "Tamanyo" => 110013 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Reddish-purple maculopapular lesions grouped in plaques on the back.</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" => 745 "Ancho" => 995 "Tamanyo" => 153274 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Tongue erosions and erosive cheilitis with crusting.</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" => 745 "Ancho" => 996 "Tamanyo" => 244620 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Lichenoid interface dermatitis with necrotic keratinocytes (hematoxylin–eosin, ×100).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Paraneoplastic pemphigus: an autoimmune mucocutaneous disease associated with neoplasia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G.J. Anhalt" 1 => "S.C. Kim" 2 => "J.R. Stanley" 3 => "N.J. Korman" 4 => "D.A. Jabs" 5 => "M. Kory" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM199012203232503" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "1990" "volumen" => "323" "paginaInicial" => "1729" "paginaFinal" => "1735" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2247105" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Classification, clinical manifestation an immunopathological mechanisms of the epithelial variant of paraneoplastic autoimmune multiorgan syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V. Nguyen" 1 => "A. Ndoye" 2 => "K. Bassler" 3 => "L. Schultz" 4 => "M. Shields" 5 => "B. Ruben" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Dermatol" "fecha" => "2001" "volumen" => "137" "paginaInicial" => "193" "paginaFinal" => "206" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11176692" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pénfigo paraneoplásico" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Mascaró" 1 => "P. Iranzo" 2 => "C. Herrero" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Piel" "fecha" => "2007" "volumen" => "22" "paginaInicial" => "63" "paginaFinal" => "71" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Paraneoplastic pemphigus/paraneoplastic autoinmune multiorgan syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "V. Seghal" 1 => "G. Srivastava" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-4632.2009.03995.x" "Revista" => array:6 [ "tituloSerie" => "Int J Dermatol" "fecha" => "2009" "volumen" => "48" "paginaInicial" => "162" "paginaFinal" => "169" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19200194" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pénfigo paraneoplásico/síndrome multiorgánico autoinmune paraneoplásico. Presentación de dos casos en la edad infantil, Revisión de la literatura" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Cervini" 1 => "V. Tosi" 2 => "S. Kim" 3 => "M. Bocian" 4 => "G. Chantada" 5 => "C. Nousari" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Actas Dermosifilogr" "fecha" => "2010" "volumen" => "101" "paginaInicial" => "879" "paginaFinal" => "886" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical and immunopathological spectrum of paraneoplastic pemphigus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Zimmermann" 1 => "F. Bahmer" 2 => "C. Rose" 3 => "D. Zillikens" 4 => "E. Schmid" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1610-0387.2010.07380.x" "Revista" => array:7 [ "tituloSerie" => "J Dtsch Dermatol Ges" "fecha" => "2010" "volumen" => "8" "paginaInicial" => "598" "paginaFinal" => "606" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20180886" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0140673699043949" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bronquiolitis obliterante y pénfigo paraneoplásico: un síndrome paraneoplásico autoinmune multiorgánico" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P. Iranzo" 1 => "A. Xaubet" 2 => "C. Carrera" 3 => "J.M. Mascaró" 4 => "E. Campo" 5 => "C. Herrero" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2004" "volumen" => "40" "paginaInicial" => "240" "paginaFinal" => "243" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15117625" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Paraneoplastic pemphigus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "X. Zhu" 1 => "B. Zhang" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Dermatol" "fecha" => "2007" "volumen" => "3450" "paginaInicial" => "3" "paginaFinal" => "11" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:3 [ "identificador" => "xack35215" "titulo" => "Acknowledgments" "texto" => "<p id="par0070" class="elsevierStylePara elsevierViewall">The authors would like to thank Professor J. Manuel Mascaró-Galy, Hospital Clinic Barcelona, Spain, and Josep Herrero, Dermatology Department, Hospital del Mar, Barcelona, Spain, for performing the immunoblotting technique.</p>" ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010300000003/v1_201304241257/S1578219012000996/v1_201304241257/en/main.assets" "Apartado" => array:4 [ "identificador" => "6169" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Cases and Research Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010300000003/v1_201304241257/S1578219012000996/v1_201304241257/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012000996?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 7 | 6 | 13 |
| 2024 Octubre | 86 | 36 | 122 |
| 2024 Septiembre | 67 | 24 | 91 |
| 2024 Agosto | 93 | 54 | 147 |
| 2024 Julio | 78 | 43 | 121 |
| 2024 Junio | 103 | 44 | 147 |
| 2024 Mayo | 103 | 33 | 136 |
| 2024 Abril | 87 | 34 | 121 |
| 2024 Marzo | 62 | 27 | 89 |
| 2024 Febrero | 55 | 37 | 92 |
| 2024 Enero | 57 | 30 | 87 |
| 2023 Diciembre | 50 | 18 | 68 |
| 2023 Noviembre | 64 | 22 | 86 |
| 2023 Octubre | 80 | 14 | 94 |
| 2023 Septiembre | 66 | 29 | 95 |
| 2023 Agosto | 49 | 21 | 70 |
| 2023 Julio | 61 | 49 | 110 |
| 2023 Junio | 51 | 28 | 79 |
| 2023 Mayo | 51 | 25 | 76 |
| 2023 Abril | 41 | 20 | 61 |
| 2023 Marzo | 78 | 23 | 101 |
| 2023 Febrero | 48 | 28 | 76 |
| 2023 Enero | 49 | 32 | 81 |
| 2022 Diciembre | 70 | 42 | 112 |
| 2022 Noviembre | 65 | 30 | 95 |
| 2022 Octubre | 32 | 23 | 55 |
| 2022 Septiembre | 29 | 33 | 62 |
| 2022 Agosto | 23 | 36 | 59 |
| 2022 Julio | 17 | 28 | 45 |
| 2022 Junio | 21 | 28 | 49 |
| 2022 Mayo | 33 | 38 | 71 |
| 2022 Abril | 52 | 35 | 87 |
| 2022 Marzo | 51 | 44 | 95 |
| 2022 Febrero | 46 | 21 | 67 |
| 2022 Enero | 45 | 40 | 85 |
| 2021 Diciembre | 44 | 41 | 85 |
| 2021 Noviembre | 50 | 49 | 99 |
| 2021 Octubre | 56 | 54 | 110 |
| 2021 Septiembre | 62 | 40 | 102 |
| 2021 Agosto | 43 | 48 | 91 |
| 2021 Julio | 30 | 36 | 66 |
| 2021 Junio | 30 | 41 | 71 |
| 2021 Mayo | 43 | 46 | 89 |
| 2021 Abril | 83 | 46 | 129 |
| 2021 Marzo | 58 | 22 | 80 |
| 2021 Febrero | 34 | 25 | 59 |
| 2021 Enero | 26 | 22 | 48 |
| 2020 Diciembre | 34 | 21 | 55 |
| 2020 Noviembre | 20 | 29 | 49 |
| 2020 Octubre | 27 | 13 | 40 |
| 2020 Septiembre | 38 | 13 | 51 |
| 2020 Agosto | 26 | 29 | 55 |
| 2020 Julio | 15 | 18 | 33 |
| 2020 Junio | 23 | 29 | 52 |
| 2020 Mayo | 18 | 19 | 37 |
| 2020 Abril | 42 | 22 | 64 |
| 2020 Marzo | 18 | 23 | 41 |
| 2020 Febrero | 3 | 8 | 11 |
| 2020 Enero | 4 | 4 | 8 |
| 2019 Diciembre | 6 | 6 | 12 |
| 2019 Noviembre | 4 | 1 | 5 |
| 2019 Agosto | 6 | 3 | 9 |
| 2019 Julio | 4 | 7 | 11 |
| 2019 Junio | 4 | 9 | 13 |
| 2019 Mayo | 4 | 16 | 20 |
| 2019 Abril | 4 | 15 | 19 |
| 2019 Marzo | 2 | 7 | 9 |
| 2019 Febrero | 0 | 2 | 2 |
| 2019 Enero | 2 | 5 | 7 |
| 2018 Noviembre | 2 | 0 | 2 |
| 2018 Octubre | 2 | 0 | 2 |
| 2018 Septiembre | 2 | 0 | 2 |
| 2018 Mayo | 0 | 3 | 3 |
| 2018 Marzo | 0 | 1 | 1 |
| 2018 Febrero | 102 | 7 | 109 |
| 2018 Enero | 82 | 5 | 87 |
| 2017 Diciembre | 113 | 9 | 122 |
| 2017 Noviembre | 74 | 7 | 81 |
| 2017 Octubre | 55 | 8 | 63 |
| 2017 Septiembre | 49 | 8 | 57 |
| 2017 Agosto | 62 | 10 | 72 |
| 2017 Julio | 61 | 7 | 68 |
| 2017 Junio | 74 | 14 | 88 |
| 2017 Mayo | 75 | 14 | 89 |
| 2017 Abril | 68 | 14 | 82 |
| 2017 Marzo | 52 | 44 | 96 |
| 2017 Febrero | 60 | 16 | 76 |
| 2017 Enero | 53 | 10 | 63 |
| 2016 Diciembre | 63 | 6 | 69 |
| 2016 Noviembre | 72 | 11 | 83 |
| 2016 Octubre | 129 | 19 | 148 |
| 2016 Septiembre | 197 | 23 | 220 |
| 2016 Agosto | 154 | 15 | 169 |
| 2016 Julio | 42 | 7 | 49 |
| 2016 Junio | 13 | 13 | 26 |
| 2016 Mayo | 10 | 10 | 20 |
| 2016 Abril | 8 | 12 | 20 |
| 2016 Marzo | 11 | 3 | 14 |
| 2016 Febrero | 5 | 13 | 18 |
| 2016 Enero | 9 | 11 | 20 |
| 2015 Diciembre | 6 | 2 | 8 |
| 2015 Noviembre | 35 | 7 | 42 |
| 2015 Octubre | 25 | 4 | 29 |
| 2015 Septiembre | 19 | 1 | 20 |
| 2015 Agosto | 16 | 9 | 25 |
| 2015 Julio | 184 | 5 | 189 |
| 2015 Junio | 121 | 11 | 132 |
| 2015 Mayo | 119 | 18 | 137 |
| 2015 Abril | 121 | 8 | 129 |
| 2015 Marzo | 118 | 15 | 133 |
| 2015 Febrero | 152 | 9 | 161 |
| 2015 Enero | 116 | 13 | 129 |
| 2014 Diciembre | 103 | 9 | 112 |
| 2014 Noviembre | 73 | 6 | 79 |
| 2014 Octubre | 93 | 16 | 109 |
| 2014 Septiembre | 74 | 10 | 84 |
| 2014 Agosto | 74 | 12 | 86 |
| 2014 Julio | 100 | 19 | 119 |
| 2014 Junio | 111 | 19 | 130 |
| 2014 Mayo | 122 | 13 | 135 |
| 2014 Abril | 80 | 12 | 92 |
| 2014 Marzo | 58 | 7 | 65 |
| 2014 Febrero | 50 | 6 | 56 |
| 2014 Enero | 46 | 8 | 54 |
| 2013 Diciembre | 50 | 6 | 56 |
| 2013 Noviembre | 44 | 10 | 54 |
| 2013 Octubre | 24 | 5 | 29 |
| 2013 Septiembre | 21 | 5 | 26 |
| 2013 Agosto | 16 | 12 | 28 |
| 2013 Julio | 11 | 40 | 51 |
| 2013 Junio | 10 | 30 | 40 |
| 2013 Mayo | 20 | 21 | 41 |
| 2013 Abril | 17 | 26 | 43 |
| 2013 Marzo | 20 | 20 | 40 |
| 2013 Febrero | 39 | 7 | 46 |
| 2013 Enero | 42 | 13 | 55 |
| 2012 Diciembre | 16 | 6 | 22 |
| 2012 Noviembre | 0 | 3 | 3 |
| 2012 Octubre | 4 | 5 | 9 |
| 2012 Septiembre | 1 | 0 | 1 |
| 2012 Julio | 1 | 0 | 1 |
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