Case and Research Letters
Fibrosing Cutaneous Sarcoidosis
Paniculitis sarcoidea fibrosante
M. Llamas-Velasco
, A. Godoy, J. Fraga, J. Sánchez-Pérez
Autor para correspondencia
Servicio de Dermatología, Hospital Universitario de La Princesa, Madrid, Spain
Leído
11319
Vecesse ha leído el artículo
2688
Total PDF
8631
Total HTML
Compartir estadísticas
array:24 [ "pii" => "S1578219012001436" "issn" => "15782190" "doi" => "10.1016/j.adengl.2012.05.010" "estado" => "S300" "fechaPublicacion" => "2012-05-01" "aid" => "503" "copyright" => "Elsevier España, S.L. and AEDV" "copyrightAnyo" => "2011" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2012;103:331-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4804 "formatos" => array:3 [ "EPUB" => 50 "HTML" => 3948 "PDF" => 806 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731011004686" "issn" => "00017310" "doi" => "10.1016/j.ad.2011.06.009" "estado" => "S300" "fechaPublicacion" => "2012-05-01" "aid" => "503" "copyright" => "Elsevier España, S.L. y AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2012;103:331-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5081 "formatos" => array:3 [ "EPUB" => 3 "HTML" => 3544 "PDF" => 1534 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científico-clínica</span>" "titulo" => "Paniculitis sarcoidea fibrosante" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "331" "paginaFinal" => "333" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Fibrosing Cutaneous Sarcoidosis" ] ] "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" => 1205 "Ancho" => 1494 "Tamanyo" => 350029 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Izquierda: macromicrofotografía (imágenes de H-E x2 ensambladas con Photomerge®): epidermis y dermis normal. Lesión nodular subcutánea compuesta de granulomas sarcoideos y acompañada por fibroplasia perigranulomatosa. Derecha: H-E x2: imágenes representativas de la zona de aspecto nodular.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Llamas-Velasco, A. Godoy, J. Fraga, J. Sánchez-Pérez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Llamas-Velasco" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Godoy" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Fraga" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Sánchez-Pérez" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219012001436" "doi" => "10.1016/j.adengl.2012.05.010" "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/S1578219012001436?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731011004686?idApp=UINPBA000044" "url" => "/00017310/0000010300000004/v1_201304241404/S0001731011004686/v1_201304241404/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219012001448" "issn" => "15782190" "doi" => "10.1016/j.adengl.2012.05.011" "estado" => "S300" "fechaPublicacion" => "2012-05-01" "aid" => "504" "copyright" => "Elsevier España, S.L. and AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2012;103:333-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3644 "formatos" => array:3 [ "EPUB" => 56 "HTML" => 2995 "PDF" => 593 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Crusted Pustular Lesions After Cryotherapy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "333" "paginaFinal" => "334" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Lesiones costrosas y pustulosas después de aplicar crioterapia" ] ] "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" => 627 "Ancho" => 950 "Tamanyo" => 152782 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Crusted pustular lesions on the forehead after cryotherapy.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Á. Palomo-Arellano, I. Cervigón-González, F. Idrovo-Mora, L.M. Torres-Iglesias" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Á." "apellidos" => "Palomo-Arellano" ] 1 => array:2 [ "nombre" => "I." "apellidos" => "Cervigón-González" ] 2 => array:2 [ "nombre" => "F." "apellidos" => "Idrovo-Mora" ] 3 => array:2 [ "nombre" => "L.M." "apellidos" => "Torres-Iglesias" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731011004698" "doi" => "10.1016/j.ad.2011.05.019" "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/S0001731011004698?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012001448?idApp=UINPBA000044" "url" => "/15782190/0000010300000004/v1_201304241303/S1578219012001448/v1_201304241303/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219012001357" "issn" => "15782190" "doi" => "10.1016/j.adengl.2012.05.002" "estado" => "S300" "fechaPublicacion" => "2012-05-01" "aid" => "497" "copyright" => "Elsevier España, S.L. and AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2012;103:329-31" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 10555 "formatos" => array:3 [ "EPUB" => 62 "HTML" => 9251 "PDF" => 1242 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Cases and Research Letters</span>" "titulo" => "Eruptive Dysplastic Nevi Following Melanotan Use" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "329" "paginaFinal" => "331" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Nevos displásicos eruptivos tras el consumo de Melanotan" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "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" => 1448 "Ancho" => 951 "Tamanyo" => 574774 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A, Proliferation of melanocytes at the dermoepidermal junction and in the dermis (hematoxylin-eosin, original magnification ×40). B, Nests parallel to the skin surface; note their tendency to fuse. Focal cell atypia can be observed (hematoxylin-eosin, original magnification ×200).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L. Hueso-Gabriel, L. Mahiques Santos, L. Terrádez Mas, N. Santonja López" "autores" => array:4 [ 0 => array:2 [ "nombre" => "L." "apellidos" => "Hueso-Gabriel" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Mahiques Santos" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Terrádez Mas" ] 3 => array:2 [ "nombre" => "N." "apellidos" => "Santonja López" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731011004625" "doi" => "10.1016/j.ad.2011.10.001" "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/S0001731011004625?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012001357?idApp=UINPBA000044" "url" => "/15782190/0000010300000004/v1_201304241303/S1578219012001357/v1_201304241303/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Fibrosing Cutaneous Sarcoidosis" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor:</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "331" "paginaFinal" => "333" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M. Llamas-Velasco, A. Godoy, J. Fraga, J. Sánchez-Pérez" "autores" => array:4 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "Llamas-Velasco" "email" => array:1 [ 0 => "mar.llamasvelasco@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Godoy" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Fraga" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Sánchez-Pérez" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Dermatología, Hospital Universitario de La Princesa, Madrid, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Paniculitis sarcoidea fibrosante" ] ] "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" => 1205 "Ancho" => 1494 "Tamanyo" => 350885 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Left, Low-magnification photomicrograph showing normal epidermis and dermis (hematoxylin-eosin, original magnification ×2; images merged using Photomerge). Subcutaneous nodular lesion composed of sarcoid granulomas with perigranulomatous fibroplasia. Right, representative areas of the nodular lesion (hematoxylin-eosin, original magnification ×2).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Subcutaneous sarcoidosis accounts for between 1.4% and 6% of skin lesions attributable to sarcoidosis, making it the least common subtype of specific lesion of this disease. It mainly affects white women in the fifth and sixth decades of life.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The lesions are typically firm, round or fusiform nodules with a diameter of between 0.5 and 2<span class="elsevierStyleHsp" style=""></span>cm; they are mainly found in varying numbers on the upper limbs and are usually bilateral and asymmetric.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Diagnosis requires histologic evidence of noncaseating granulomas in the subcutaneous tissue, without microorganisms.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We report the case of a 78-year-old woman with intrinsic asthma diagnosed 3 years earlier who developed subcutaneous sarcoidosis with marked fibroplasia. The patient had consulted for a mass that had appeared on her left forearm a year earlier, a similar mass on her right forearm, which had appeared a month later, and a third mass, which had appeared on her right elbow 3 months before consultation. Both she and her family commented that the size of the lesions had remained stable and that they were slightly tender. The only systemic symptom she reported was occasional joint pain in her upper limbs. Physical examination revealed 2 hard nodules, one on the left forearm and one in the right cubital region, measuring 2.5 and 5<span class="elsevierStyleHsp" style=""></span>cm respectively. They were not fixed to the deeper layers and there were no visible epidermal changes. A third, similar lesion, with a stony-hard consistency and also not adherent to the deeper layers, was observed on the right forearm (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>, A and B). Biopsy of the nodule on the right elbow showed a central area of sclerotic tissue with numerous sarcoid granulomas visible in the subcutaneous tissue (<a class="elsevierStyleCrossRefs" href="#fig0010">Figs. 2 and 3</a>). Also visible was a discrete lymphocytic infiltrate. There were no foci of necrosis. An ultrasound scan of the right forearm showed a well-circumscribed, nonencapsulated, oval mass measuring 4.3<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>1.2<span class="elsevierStyleHsp" style=""></span>cm, with no muscle or bone involvement; the mass was slightly hyperechogenic and contained hypoechoic areas that gave it a mottled appearance. The chest scan showed hilar enlargement, which was confirmed on high-resolution computed tomography, which also revealed a reticulonodular infiltrate in both lungs. Spirometry showed an obstructive pattern, with a forced expiratory volume in the first second to forced vital capacity ratio of 66% of predicted. The electrocardiogram was normal and the Mantoux test was negative. Laboratory tests revealed an elevated creatinine level (2.08<span class="elsevierStyleHsp" style=""></span>mg/dL), an increased calcium to creatinine clearance ratio (0.64; normal range, 0.07-0.17<span class="elsevierStyleHsp" style=""></span>mg/dL), and decreased tubular reabsorption of phosphate (51%; normal range, 79%-89%). Serum levels of vitamin D, parathyroid hormone, calcium, phosphorous, and angiotensin-converting enzyme were within normal limits. No eye alterations were detected. Once the diagnosis of sarcoidosis was confirmed by clinical, histologic, and radiologic findings, the patient was started on prednisone, 30<span class="elsevierStyleHsp" style=""></span>mg once daily, for 6 weeks; the treatment resulted in a considerable improvement in the respiratory symptoms and a reduction in the size of the nodules.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Clinically, the nodules of subcutaneous sarcoidosis are rather nonspecific, although Pérez-Cejudo et al.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> remarked that they could adopt an elongated form, but without forming cords as occurs in interstitial granulomatous dermatitis with arthritis.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Nevertheless, because of the nodular nature of the lesions, the differential diagnosis must include conditions associated with substance deposition, cysts, lipomas, calcinosis, rheumatoid nodules, metastases, tuberculosis, cellulitis, and even breast cancer.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">While few studies have analyzed the histologic features of subcutaneous sarcoidosis, it has been suggested that it is a predominantly lobular panniculitis.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4</span></a> It is therefore important to differentiate it from other forms of granulomatous lobular panniculitis such as Q fever.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Additionally, because of its granulomatous nature, subcutaneous sarcoidosis needs to be differentiated from certain forms of granulomatous septal panniculitis (which are occasionally induced by drugs<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6,7</span></a> or trauma)<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> as well as from erythema nodosum. Although this last entity is classified as a predominantly septal panniculitis, when it involves epithelioid granulomas, histology findings can resemble those seen in what has been described by some authors as granulomatous and fibrosing predominantly lobular panniculitis.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Fibroplasia in subcutaneous sarcoidosis, while not mentioned in most text books, is a characteristic finding and should be expected as it tends to occur extensively in pulmonary sarcoidosis.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> There are several factors that distinguish subcutaneous sarcoidosis from erythema nodosum with epithelioid granulomas, the main differential diagnosis: it is predominantly lobular rather than septal, it has a larger granulomatous than fibroplastic component, the fibroplasia tends to be limited to the perigranulomatous area, there is no evidence of Miescher's radial granulomas, and eosinophils and neutrophils are rarely seen in the inflammatory infiltrate.</p><p id="par0025" class="elsevierStylePara elsevierViewall">It is not yet known whether the extent of fibroplasia is related to the duration of the lesions or to the intensity of the lymphocytic infiltrate,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> but a histologic finding of fibrosing granulomatous panniculitis may be considered to be highly specific for subcutaneous sarcoidosis.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></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. Paniculitis sarcoidea fibrosante. Actas Dermosifiliogr.2012;103:331-3.</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" => 852 "Ancho" => 950 "Tamanyo" => 139357 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, A firm, skin-colored nodule with well-circumscribed borders. B, Detail of the lesion showing an absence of epidermal changes.</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" => 1205 "Ancho" => 1494 "Tamanyo" => 350885 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Left, Low-magnification photomicrograph showing normal epidermis and dermis (hematoxylin-eosin, original magnification ×2; images merged using Photomerge). Subcutaneous nodular lesion composed of sarcoid granulomas with perigranulomatous fibroplasia. Right, representative areas of the nodular lesion (hematoxylin-eosin, original magnification ×2).</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" => 713 "Ancho" => 950 "Tamanyo" => 375841 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Detail of the lesion: there are well-defined granulomas that predominate over the striking surrounding fibroplasia (hematoxylin-eosin, original magnification ×10).</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" => "Subcutaneous sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Marcoval" 1 => "A. Moreno" 2 => "J. Mana" 3 => "J. Peyri" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.det.2008.05.003" "Revista" => array:6 [ "tituloSerie" => "Dermatol Clin" "fecha" => "2008" "volumen" => "26" "paginaInicial" => "553" "paginaFinal" => "556" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18793989" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sarcoidosis subcutánea, lesiones nodulares que adoptan configuraciones cordonales o en bandas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.A. Pérez-Cejudo" 1 => "E. Piqué" 2 => "S.L. Palacios" 3 => "M. Martinez-Martin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2006" "volumen" => "97" "paginaInicial" => "223" "paginaFinal" => "224" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16796976" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical spectrum and histological analysis of 32 cases of specific cutaneous sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. Mangas" 1 => "M.T. Fernández-Figueras" 2 => "E. Fite" 3 => "N. Fernández-Chico" 4 => "M. Sabat" 5 => "C. Ferrandiz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1600-0560.2006.00563.x" "Revista" => array:6 [ "tituloSerie" => "J Cutan Pathol" "fecha" => "2006" "volumen" => "33" "paginaInicial" => "772" "paginaFinal" => "777" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17177936" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Subcutaneous sarcoidosis: clinicopathological study of 10 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Marcoval" 1 => "J. Mana" 2 => "A. Moreno" 3 => "J. Peyri" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2133.2005.06815.x" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2005" "volumen" => "153" "paginaInicial" => "790" "paginaFinal" => "794" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16181462" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Q fever: a new cause of ‘doughnut’ granulomatous lobular panniculitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "C. Galache" 1 => "J. Santos-Juanes" 2 => "S. Blanco" 3 => "E. Rodriguez" 4 => "A. Martinez" 5 => "J. Soto" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2133.2004.06125.x" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2004" "volumen" => "151" "paginaInicial" => "685" "paginaFinal" => "687" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15377359" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Granulomatous septal panniculitis associated with capecitabine (Xeloda)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Dalmau" 1 => "E. Roe" 2 => "L. Puig" 3 => "A. Alomar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1468-3083.2007.02287.x" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2008" "volumen" => "22" "paginaInicial" => "121" "paginaFinal" => "122" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18181993" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Trastuzumab-induced cytoplasmic anti-neutrophilic cytoplasmic antibody necrotizing granulomatous panniculitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Kalayciyan" 1 => "T. Makosz" 2 => "C. Assaf" 3 => "C.C. Geilen" 4 => "C.E. Orfanos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2006" "volumen" => "54" "paginaInicial" => "249" "paginaFinal" => "251" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A complication of mesotherapy: noninfectious granulomatous panniculitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.D. Davis" 1 => "T.I. Wright" 2 => "J.M. Shehan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archderm.144.6.808" "Revista" => array:7 [ "tituloSerie" => "Arch Dermatol" "fecha" => "2008" "volumen" => "144" "paginaInicial" => "808" "paginaFinal" => "809" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18559780" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0002939410004095" "estado" => "S300" "issn" => "00029394" ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The findings do not conform precisely: fibrosing sarcoidal expressions of panniculitis as example" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "K.S. Resnik" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Dermatopathol" "fecha" => "2004" "volumen" => "26" "paginaInicial" => "156" "paginaFinal" => "161" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15024198" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Subcutaneous sarcoidosis histopathologically manifested as fibrosing granulomatous panniculitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "K.S. Resnik" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2006.04.080" "Revista" => array:7 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2006" "volumen" => "55" "paginaInicial" => "918" "paginaFinal" => "919" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17052515" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0002939410004095" "estado" => "S300" "issn" => "00029394" ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010300000004/v1_201304241303/S1578219012001436/v1_201304241303/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/15782190/0000010300000004/v1_201304241303/S1578219012001436/v1_201304241303/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012001436?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 12 | 13 | 25 |
| 2024 Octubre | 89 | 39 | 128 |
| 2024 Septiembre | 88 | 28 | 116 |
| 2024 Agosto | 125 | 59 | 184 |
| 2024 Julio | 106 | 38 | 144 |
| 2024 Junio | 107 | 53 | 160 |
| 2024 Mayo | 95 | 40 | 135 |
| 2024 Abril | 87 | 22 | 109 |
| 2024 Marzo | 77 | 33 | 110 |
| 2024 Febrero | 109 | 37 | 146 |
| 2024 Enero | 81 | 30 | 111 |
| 2023 Diciembre | 86 | 18 | 104 |
| 2023 Noviembre | 129 | 29 | 158 |
| 2023 Octubre | 129 | 27 | 156 |
| 2023 Septiembre | 85 | 31 | 116 |
| 2023 Agosto | 98 | 22 | 120 |
| 2023 Julio | 114 | 37 | 151 |
| 2023 Junio | 78 | 26 | 104 |
| 2023 Mayo | 88 | 25 | 113 |
| 2023 Abril | 99 | 31 | 130 |
| 2023 Marzo | 82 | 19 | 101 |
| 2023 Febrero | 88 | 25 | 113 |
| 2023 Enero | 75 | 29 | 104 |
| 2022 Diciembre | 78 | 40 | 118 |
| 2022 Noviembre | 36 | 24 | 60 |
| 2022 Octubre | 70 | 28 | 98 |
| 2022 Septiembre | 72 | 43 | 115 |
| 2022 Agosto | 99 | 42 | 141 |
| 2022 Julio | 72 | 38 | 110 |
| 2022 Junio | 78 | 31 | 109 |
| 2022 Mayo | 150 | 49 | 199 |
| 2022 Abril | 174 | 51 | 225 |
| 2022 Marzo | 135 | 57 | 192 |
| 2022 Febrero | 144 | 43 | 187 |
| 2022 Enero | 128 | 35 | 163 |
| 2021 Diciembre | 68 | 40 | 108 |
| 2021 Noviembre | 92 | 54 | 146 |
| 2021 Octubre | 86 | 68 | 154 |
| 2021 Septiembre | 64 | 43 | 107 |
| 2021 Agosto | 71 | 33 | 104 |
| 2021 Julio | 69 | 35 | 104 |
| 2021 Junio | 80 | 39 | 119 |
| 2021 Mayo | 84 | 44 | 128 |
| 2021 Abril | 127 | 26 | 153 |
| 2021 Marzo | 94 | 30 | 124 |
| 2021 Febrero | 61 | 30 | 91 |
| 2021 Enero | 47 | 36 | 83 |
| 2020 Diciembre | 62 | 29 | 91 |
| 2020 Noviembre | 36 | 22 | 58 |
| 2020 Octubre | 41 | 11 | 52 |
| 2020 Septiembre | 32 | 9 | 41 |
| 2020 Agosto | 31 | 26 | 57 |
| 2020 Julio | 28 | 16 | 44 |
| 2020 Junio | 35 | 24 | 59 |
| 2020 Mayo | 34 | 12 | 46 |
| 2020 Abril | 31 | 21 | 52 |
| 2020 Marzo | 43 | 37 | 80 |
| 2020 Febrero | 6 | 6 | 12 |
| 2020 Enero | 4 | 3 | 7 |
| 2019 Diciembre | 4 | 1 | 5 |
| 2019 Noviembre | 4 | 0 | 4 |
| 2019 Octubre | 0 | 2 | 2 |
| 2019 Septiembre | 4 | 0 | 4 |
| 2019 Agosto | 4 | 2 | 6 |
| 2019 Julio | 4 | 3 | 7 |
| 2019 Junio | 4 | 9 | 13 |
| 2019 Mayo | 5 | 6 | 11 |
| 2019 Abril | 2 | 7 | 9 |
| 2019 Marzo | 0 | 7 | 7 |
| 2019 Febrero | 2 | 4 | 6 |
| 2019 Enero | 0 | 1 | 1 |
| 2018 Diciembre | 2 | 6 | 8 |
| 2018 Noviembre | 2 | 0 | 2 |
| 2018 Octubre | 1 | 0 | 1 |
| 2018 Septiembre | 3 | 0 | 3 |
| 2018 Junio | 0 | 1 | 1 |
| 2018 Mayo | 0 | 4 | 4 |
| 2018 Abril | 0 | 5 | 5 |
| 2018 Marzo | 3 | 1 | 4 |
| 2018 Febrero | 110 | 8 | 118 |
| 2018 Enero | 151 | 16 | 167 |
| 2017 Diciembre | 140 | 7 | 147 |
| 2017 Noviembre | 87 | 11 | 98 |
| 2017 Octubre | 76 | 5 | 81 |
| 2017 Septiembre | 78 | 19 | 97 |
| 2017 Agosto | 74 | 17 | 91 |
| 2017 Julio | 45 | 2 | 47 |
| 2017 Junio | 69 | 22 | 91 |
| 2017 Mayo | 51 | 24 | 75 |
| 2017 Abril | 48 | 5 | 53 |
| 2017 Marzo | 35 | 12 | 47 |
| 2017 Febrero | 65 | 8 | 73 |
| 2017 Enero | 47 | 10 | 57 |
| 2016 Diciembre | 76 | 8 | 84 |
| 2016 Noviembre | 87 | 15 | 102 |
| 2016 Octubre | 132 | 14 | 146 |
| 2016 Septiembre | 234 | 13 | 247 |
| 2016 Agosto | 155 | 7 | 162 |
| 2016 Julio | 62 | 15 | 77 |
| 2016 Junio | 11 | 15 | 26 |
| 2016 Mayo | 6 | 10 | 16 |
| 2016 Abril | 3 | 6 | 9 |
| 2016 Marzo | 8 | 9 | 17 |
| 2016 Febrero | 6 | 11 | 17 |
| 2016 Enero | 3 | 9 | 12 |
| 2015 Diciembre | 10 | 5 | 15 |
| 2015 Noviembre | 21 | 6 | 27 |
| 2015 Octubre | 32 | 7 | 39 |
| 2015 Septiembre | 22 | 2 | 24 |
| 2015 Agosto | 12 | 10 | 22 |
| 2015 Julio | 116 | 10 | 126 |
| 2015 Junio | 89 | 14 | 103 |
| 2015 Mayo | 109 | 17 | 126 |
| 2015 Abril | 82 | 9 | 91 |
| 2015 Marzo | 99 | 18 | 117 |
| 2015 Febrero | 77 | 18 | 95 |
| 2015 Enero | 92 | 41 | 133 |
| 2014 Diciembre | 80 | 18 | 98 |
| 2014 Noviembre | 70 | 17 | 87 |
| 2014 Octubre | 110 | 18 | 128 |
| 2014 Septiembre | 62 | 15 | 77 |
| 2014 Agosto | 99 | 15 | 114 |
| 2014 Julio | 92 | 20 | 112 |
| 2014 Junio | 121 | 11 | 132 |
| 2014 Mayo | 116 | 18 | 134 |
| 2014 Abril | 51 | 2 | 53 |
| 2014 Marzo | 55 | 9 | 64 |
| 2014 Febrero | 52 | 8 | 60 |
| 2014 Enero | 46 | 7 | 53 |
| 2013 Diciembre | 46 | 11 | 57 |
| 2013 Noviembre | 35 | 7 | 42 |
| 2013 Octubre | 28 | 5 | 33 |
| 2013 Septiembre | 23 | 7 | 30 |
| 2013 Agosto | 27 | 11 | 38 |
| 2013 Julio | 11 | 18 | 29 |
| 2013 Junio | 10 | 8 | 18 |
| 2013 Mayo | 15 | 17 | 32 |
| 2013 Abril | 21 | 16 | 37 |
| 2013 Marzo | 13 | 8 | 21 |
| 2013 Febrero | 36 | 7 | 43 |
| 2013 Enero | 33 | 7 | 40 |
| 2012 Diciembre | 26 | 8 | 34 |
Mostrar todo
