Case and Research Letters
Crusted Pustular Lesions After Cryotherapy
Lesiones costrosas y pustulosas después de aplicar crioterapia
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Palomo-Arellano, I. Cervigón-González, F. Idrovo-Mora, L.M. Torres-Iglesias" "autores" => array:4 [ 0 => array:3 [ "nombre" => "Á." "apellidos" => "Palomo-Arellano" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "I." "apellidos" => "Cervigón-González" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:4 [ "nombre" => "F." "apellidos" => "Idrovo-Mora" "email" => array:1 [ 0 => "icervigon@sescam.jccm.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 3 => array:3 [ "nombre" => "L.M." "apellidos" => "Torres-Iglesias" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Dermatología, Hospital General Nuestra Señora del Prado, Talavera de la Reina, Toledo, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Unidad de Dermatología, Hospital General Nuestra Señora del Prado, Talavera de la Reina, Toledo, 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" => "Lesiones costrosas y pustulosas después de aplicar crioterapia" ] ] "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>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We describe the case of an 84-year-old woman who consulted our dermatology department with facial actinic keratosis that had been treated with cryotherapy on several occasions. Her medical history included a gastric adenocarcinoma treated with gastrectomy over 30 years earlier.</p><p id="par0010" class="elsevierStylePara elsevierViewall">She presented with persistent crusted pustular lesions that had appeared on her forehead (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) 3 months earlier, following the application of liquid nitrogen. Biopsy showed multiple pustules with acute inflammation and a large number of septate hyphae measuring approximately 2<span class="elsevierStyleHsp" style=""></span>μm in diameter with dichotomous acute-angle branching (45°) (<a class="elsevierStyleCrossRefs" href="#fig0010">Figs. 2 and 3</a>). Culture of one of the lesions was positive for <span class="elsevierStyleItalic">Aspergillus niger</span> and <span class="elsevierStyleItalic">Klebsiella oxytoca.</span></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">A full laboratory workup showed iron-deficiency anemia but all the other results were within normal limits. There was no evidence of masses or infiltrates on the chest radiograph.</p><p id="par0020" class="elsevierStylePara elsevierViewall">We established a diagnosis of primary cutaneous aspergillosis following cryotherapy in an immunocompetent patient. Based on the antibiogram, we initiated treatment with oral ciprofloxacin (500<span class="elsevierStyleHsp" style=""></span>mg/12<span class="elsevierStyleHsp" style=""></span>h) for 2 weeks and oral itraconazole (100<span class="elsevierStyleHsp" style=""></span>mg/12<span class="elsevierStyleHsp" style=""></span>h) for 6 weeks. At follow-up, the lesions had resolved and the culture findings were negative.</p><p id="par0025" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Aspergillus</span> species are filamentous fungi found in humid environments or in decaying organic matter.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> They are among the most common fungi as they can tolerate a wide range of temperatures and produce large numbers of spores, which are easily dispersed by air. They form part of the normal outdoor flora but they also tend to enter hospital buildings through windows and ventilation systems. They can cause allergic hypersensitivity and may act as opportunistic pathogens causing local or disseminated infection. The main routes of entry are inhalation of spores or penetration of spores during surgery or other invasive procedures, or following a break in skin integrity.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Primary cutaneous aspergillosis is a chronic skin infection that does not appear to affect other organs. It is very uncommon as it is caused by the direct inoculation of the fungus into injured skin. It tends to affect preterm neonates<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> and immunocompromised patients and is much rarer in immunocompetent individuals.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3-5</span></a> The lesions, which are usually located at the site of inoculation, are nonspecific and include erythematous macules, pustules, plaques, and nodules that can become necrotic.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,5-7</span></a> The differential diagnosis should include other fungal or bacterial infections, insect bites, noninfectious pustulosis, vasculitis, ecthyma, polyarteritis nodosum, and pyoderma gangrenosum.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> It is essential to rule out systemic disease in immunocompromised patients, as there is a risk of progression to invasive disease, with spread to other organs and high associated morbidity and mortality. Diagnosis is based on histologic examination, which reveals hyaline septate hyphae with a diameter of between 2 and 4<span class="elsevierStyleHsp" style=""></span>μm and dichotomous acute-angle branching (45°).<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6</span></a> Culture of a lesion or biopsy sample enables identification of the species.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Immunocompetent individuals with exclusive skin involvement can be treated with oral itraconzole,<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,5,6</span></a> but the treatment of choice in patients with invasive disease is voriconazol.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,7</span></a> Echinocandins (caspofungin, micafungin, and anidulafungin) are licensed for use in invasive aspergillosis that is refractory to standard treatment. Surgical resection with wide margins is recommended in patients with extensive tissue necrosis.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Secondary cutaneous aspergillosis occurs when the infection spreads to the skin from another organ by hematogenous dissemination. It is a very serious condition that affects immunodepressed patients.</p><p id="par0040" class="elsevierStylePara elsevierViewall">In a review of the indexed literature, we found no reports of primary cutaneous aspergillosis following cryotherapy, although cases associated with burns due to other causes have been reported.</p><p id="par0045" class="elsevierStylePara elsevierViewall">The <span class="elsevierStyleItalic">Klebsiella oxytoca</span> isolated in the culture was probably a contaminant as this bacterium seldom causes infections of the skin and soft tissue.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Palomo-Arellano A, et al. Lesiones costrosas y pustulosas después de aplicar crioterapia. Actas Dermosifiliogr.2012;103:333-334.</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" => 627 "Ancho" => 950 "Tamanyo" => 152782 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Crusted pustular lesions on the forehead after cryotherapy.</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" => 715 "Ancho" => 950 "Tamanyo" => 180356 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Pustules with acute inflammation (hematoxylin-eosin, original magnification ×20).</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" => 716 "Ancho" => 950 "Tamanyo" => 152389 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Septate hyphae measuring approximately 2<span class="elsevierStyleHsp" style=""></span>μm in diameter with dichotomous acute-angle branching (45°).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:7 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary cutaneous aspergillosis in an inmunocompetent individual" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Ajith" 1 => "S. Dogra" 2 => "B.D. Radotra" 3 => "ChakrabartiS" 4 => "B. Kumar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1468-3083.2006.01465.x" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2006" "volumen" => "20" "paginaInicial" => "738" "paginaFinal" => "739" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16836509" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Neonatal Primary Cutaneus Aspergillosis: Case report and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.A. Woodruff" 1 => "A.A. Hebert" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Pediatr Dermatol" "fecha" => "2002" "volumen" => "19" "paginaInicial" => "439" "paginaFinal" => "444" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12383104" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary cutaneous aspergillosis in an immunocompetent patient: successful treatment with oral voriconazole" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B. Graiglow" 1 => "G. Hinds" 2 => "R. Antaya" 3 => "M. Girardi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1525-1470.2009.00971.x" "Revista" => array:6 [ "tituloSerie" => "Pediatr Dermatol" "fecha" => "2009" "volumen" => "26" "paginaInicial" => "493" "paginaFinal" => "495" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19689543" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary cutaneous aspergillosis in an immunocompetent child" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C.M. Mowad" 1 => "T.V. Nguyen" 2 => "C. Jaworsky" 3 => "P.J. Honig" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "1995" "volumen" => "33" "paginaInicial" => "136" "paginaFinal" => "137" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7601934" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary cutaneous aspergillosis due to Aspergillus niger in an immunocompetent patient" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Mohapatra" 1 => "I. Xess" 2 => "J.V. Swettha" 3 => "N. Tanveer" 4 => "D. Asati" 5 => "M. Ramam" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/0255-0857.55462" "Revista" => array:6 [ "tituloSerie" => "Indian J Med Microbiol" "fecha" => "2009" "volumen" => "27" "paginaInicial" => "367" "paginaFinal" => "370" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19736412" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary cutaneous aspergillosis: Our experience in 10 years" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Chakrabarti" 1 => "V. Gupta" 2 => "G. Biswas" 3 => "B. Kumar" 4 => "K. Sakhuja" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Infect" "fecha" => "1998" "volumen" => "37" "paginaInicial" => "24" "paginaFinal" => "27" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9756366" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary cutaneous aspergillosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P.V. Prasad" 1 => "A. Babu" 2 => "P.K. Kaviarasan" 3 => "C. Anandhi" 4 => "P. Viswanatha" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Indian J Dermatol Venereol Leprol" "fecha" => "2005" "volumen" => "71" "paginaInicial" => "133" "paginaFinal" => "134" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16394395" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010300000004/v1_201304241303/S1578219012001448/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/S1578219012001448/v1_201304241303/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012001448?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 9 | 7 | 16 |
| 2024 Octubre | 86 | 28 | 114 |
| 2024 Septiembre | 89 | 27 | 116 |
| 2024 Agosto | 99 | 62 | 161 |
| 2024 Julio | 84 | 29 | 113 |
| 2024 Junio | 88 | 28 | 116 |
| 2024 Mayo | 105 | 31 | 136 |
| 2024 Abril | 77 | 17 | 94 |
| 2024 Marzo | 94 | 31 | 125 |
| 2024 Febrero | 76 | 32 | 108 |
| 2024 Enero | 64 | 31 | 95 |
| 2023 Diciembre | 64 | 15 | 79 |
| 2023 Noviembre | 66 | 22 | 88 |
| 2023 Octubre | 76 | 24 | 100 |
| 2023 Septiembre | 73 | 27 | 100 |
| 2023 Agosto | 48 | 23 | 71 |
| 2023 Julio | 62 | 31 | 93 |
| 2023 Junio | 74 | 20 | 94 |
| 2023 Mayo | 64 | 27 | 91 |
| 2023 Abril | 64 | 20 | 84 |
| 2023 Marzo | 70 | 22 | 92 |
| 2023 Febrero | 37 | 24 | 61 |
| 2023 Enero | 46 | 25 | 71 |
| 2022 Diciembre | 47 | 38 | 85 |
| 2022 Noviembre | 25 | 31 | 56 |
| 2022 Octubre | 35 | 26 | 61 |
| 2022 Septiembre | 23 | 37 | 60 |
| 2022 Agosto | 35 | 30 | 65 |
| 2022 Julio | 30 | 36 | 66 |
| 2022 Junio | 33 | 27 | 60 |
| 2022 Mayo | 54 | 44 | 98 |
| 2022 Abril | 58 | 35 | 93 |
| 2022 Marzo | 54 | 53 | 107 |
| 2022 Febrero | 47 | 36 | 83 |
| 2022 Enero | 37 | 39 | 76 |
| 2021 Diciembre | 28 | 40 | 68 |
| 2021 Noviembre | 48 | 48 | 96 |
| 2021 Octubre | 51 | 61 | 112 |
| 2021 Septiembre | 47 | 48 | 95 |
| 2021 Agosto | 48 | 42 | 90 |
| 2021 Julio | 42 | 42 | 84 |
| 2021 Junio | 64 | 39 | 103 |
| 2021 Mayo | 37 | 41 | 78 |
| 2021 Abril | 73 | 47 | 120 |
| 2021 Marzo | 80 | 26 | 106 |
| 2021 Febrero | 50 | 33 | 83 |
| 2021 Enero | 42 | 16 | 58 |
| 2020 Diciembre | 28 | 18 | 46 |
| 2020 Noviembre | 31 | 27 | 58 |
| 2020 Octubre | 14 | 17 | 31 |
| 2020 Septiembre | 22 | 29 | 51 |
| 2020 Agosto | 34 | 45 | 79 |
| 2020 Julio | 27 | 16 | 43 |
| 2020 Junio | 30 | 26 | 56 |
| 2020 Mayo | 31 | 23 | 54 |
| 2020 Abril | 35 | 22 | 57 |
| 2020 Marzo | 41 | 22 | 63 |
| 2020 Febrero | 1 | 7 | 8 |
| 2020 Enero | 4 | 2 | 6 |
| 2019 Diciembre | 4 | 4 | 8 |
| 2019 Noviembre | 4 | 0 | 4 |
| 2019 Octubre | 0 | 1 | 1 |
| 2019 Septiembre | 4 | 1 | 5 |
| 2019 Agosto | 4 | 5 | 9 |
| 2019 Julio | 4 | 3 | 7 |
| 2019 Junio | 4 | 3 | 7 |
| 2019 Mayo | 4 | 3 | 7 |
| 2019 Abril | 4 | 8 | 12 |
| 2019 Marzo | 0 | 5 | 5 |
| 2019 Febrero | 2 | 2 | 4 |
| 2019 Enero | 0 | 2 | 2 |
| 2018 Diciembre | 0 | 8 | 8 |
| 2018 Noviembre | 2 | 0 | 2 |
| 2018 Octubre | 3 | 0 | 3 |
| 2018 Septiembre | 2 | 0 | 2 |
| 2018 Marzo | 3 | 0 | 3 |
| 2018 Febrero | 33 | 3 | 36 |
| 2018 Enero | 41 | 3 | 44 |
| 2017 Diciembre | 63 | 6 | 69 |
| 2017 Noviembre | 39 | 3 | 42 |
| 2017 Octubre | 38 | 9 | 47 |
| 2017 Septiembre | 44 | 6 | 50 |
| 2017 Agosto | 65 | 5 | 70 |
| 2017 Julio | 48 | 5 | 53 |
| 2017 Junio | 67 | 7 | 74 |
| 2017 Mayo | 56 | 2 | 58 |
| 2017 Abril | 58 | 8 | 66 |
| 2017 Marzo | 46 | 9 | 55 |
| 2017 Febrero | 40 | 3 | 43 |
| 2017 Enero | 28 | 6 | 34 |
| 2016 Diciembre | 55 | 4 | 59 |
| 2016 Noviembre | 68 | 2 | 70 |
| 2016 Octubre | 105 | 11 | 116 |
| 2016 Septiembre | 181 | 1 | 182 |
| 2016 Agosto | 109 | 8 | 117 |
| 2016 Julio | 34 | 8 | 42 |
| 2016 Junio | 13 | 6 | 19 |
| 2016 Mayo | 6 | 5 | 11 |
| 2016 Abril | 6 | 4 | 10 |
| 2016 Marzo | 9 | 0 | 9 |
| 2016 Febrero | 7 | 1 | 8 |
| 2016 Enero | 6 | 3 | 9 |
| 2015 Diciembre | 5 | 0 | 5 |
| 2015 Noviembre | 13 | 4 | 17 |
| 2015 Octubre | 15 | 5 | 20 |
| 2015 Septiembre | 6 | 7 | 13 |
| 2015 Agosto | 10 | 5 | 15 |
| 2015 Julio | 75 | 12 | 87 |
| 2015 Junio | 71 | 11 | 82 |
| 2015 Mayo | 86 | 17 | 103 |
| 2015 Abril | 83 | 15 | 98 |
| 2015 Marzo | 65 | 8 | 73 |
| 2015 Febrero | 59 | 18 | 77 |
| 2015 Enero | 86 | 22 | 108 |
| 2014 Diciembre | 71 | 7 | 78 |
| 2014 Noviembre | 74 | 15 | 89 |
| 2014 Octubre | 71 | 10 | 81 |
| 2014 Septiembre | 66 | 12 | 78 |
| 2014 Agosto | 76 | 15 | 91 |
| 2014 Julio | 82 | 18 | 100 |
| 2014 Junio | 83 | 13 | 96 |
| 2014 Mayo | 98 | 26 | 124 |
| 2014 Abril | 48 | 3 | 51 |
| 2014 Marzo | 41 | 8 | 49 |
| 2014 Febrero | 31 | 9 | 40 |
| 2014 Enero | 41 | 9 | 50 |
| 2013 Diciembre | 44 | 8 | 52 |
| 2013 Noviembre | 30 | 9 | 39 |
| 2013 Octubre | 27 | 7 | 34 |
| 2013 Septiembre | 22 | 11 | 33 |
| 2013 Agosto | 28 | 13 | 41 |
| 2013 Julio | 19 | 21 | 40 |
| 2013 Junio | 15 | 22 | 37 |
| 2013 Mayo | 17 | 13 | 30 |
| 2013 Abril | 13 | 16 | 29 |
| 2013 Marzo | 11 | 14 | 25 |
| 2013 Febrero | 29 | 5 | 34 |
| 2013 Enero | 44 | 5 | 49 |
| 2012 Diciembre | 26 | 4 | 30 |
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