Case and Research Letters
Nevus Oligemicus on the Breasts: A Report of 2 Cases
Nevus oligemicus localizado en mamas: a propósito de 2 casos
E. Gutiérrez-Paredes
, V. López-Castillo, Á. Revert-Fernández, E. Jordá-Cuevas
Autor para correspondencia
Servicio de Dermatología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, Spain
Leído
11264
Vecesse ha leído el artículo
2477
Total PDF
8787
Total HTML
Compartir estadísticas
array:24 [ "pii" => "S157821901200176X" "issn" => "15782190" "doi" => "10.1016/j.adengl.2012.06.010" "estado" => "S300" "fechaPublicacion" => "2012-06-01" "aid" => "535" "copyright" => "Elsevier España, S.L. and AEDV" "copyrightAnyo" => "2011" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2012;103:443-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5713 "formatos" => array:3 [ "EPUB" => 62 "HTML" => 5037 "PDF" => 614 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S000173101100528X" "issn" => "00017310" "doi" => "10.1016/j.ad.2011.10.009" "estado" => "S300" "fechaPublicacion" => "2012-06-01" "aid" => "535" "copyright" => "Elsevier España, S.L. y AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2012;103:443-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5622 "formatos" => array:3 [ "EPUB" => 3 "HTML" => 4306 "PDF" => 1313 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científico clínica</span>" "titulo" => "<span class="elsevierStyleItalic">Nevus oligemicus</span> localizado en mamas: a propósito de 2 casos" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "443" "paginaFinal" => "444" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "<span class="elsevierStyleItalic">Nevus Oligemicus</span> on the Breasts: A Report of 2 Cases" ] ] "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" => 1188 "Ancho" => 1583 "Tamanyo" => 372211 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Hematoxilina-eosina 10x. Ectasia vascular en dermis papilar.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "E. Gutiérrez-Paredes, V. López-Castillo, Á. Revert-Fernández, E. Jordá-Cuevas" "autores" => array:4 [ 0 => array:2 [ "nombre" => "E." "apellidos" => "Gutiérrez-Paredes" ] 1 => array:2 [ "nombre" => "V." "apellidos" => "López-Castillo" ] 2 => array:2 [ "nombre" => "Á." "apellidos" => "Revert-Fernández" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Jordá-Cuevas" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S157821901200176X" "doi" => "10.1016/j.adengl.2012.06.010" "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/S157821901200176X?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S000173101100528X?idApp=UINPBA000044" "url" => "/00017310/0000010300000005/v1_201304241408/S000173101100528X/v1_201304241408/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219012001667" "issn" => "15782190" "doi" => "10.1016/j.adengl.2012.06.001" "estado" => "S300" "fechaPublicacion" => "2012-06-01" "aid" => "536" "copyright" => "Elsevier España, S.L. and AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2012;103:444-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 7575 "formatos" => array:3 [ "EPUB" => 60 "HTML" => 6282 "PDF" => 1233 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Infantile Hemangioma of the Eyelid Treated with Timolol Gel" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "444" "paginaFinal" => "446" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hemangioma infantil palpebral tratado con timolol gel" ] ] "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" => 250 "Ancho" => 950 "Tamanyo" => 51129 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Infantile hemangioma of the eyelid after 4<span class="elsevierStyleHsp" style=""></span>months of treatment.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.D. Fernández-Ballesteros, Á. Vera-Casaño, J. Escudero-Gómez, A. Hiraldo-Gamero" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M.D." "apellidos" => "Fernández-Ballesteros" ] 1 => array:2 [ "nombre" => "Á." "apellidos" => "Vera-Casaño" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Escudero-Gómez" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Hiraldo-Gamero" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731011005291" "doi" => "10.1016/j.ad.2011.06.014" "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/S0001731011005291?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012001667?idApp=UINPBA000044" "url" => "/15782190/0000010300000005/v1_201304241308/S1578219012001667/v1_201304241308/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219012001655" "issn" => "15782190" "doi" => "10.1016/j.adengl.2011.05.010" "estado" => "S300" "fechaPublicacion" => "2012-06-01" "aid" => "524" "copyright" => "Elsevier España, S.L. and AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2012;103:441-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4181 "formatos" => array:3 [ "EPUB" => 51 "HTML" => 3402 "PDF" => 728 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Efficacy of Topical Imiquimod 5% in a Patient with Chronic Radiodermatitis on the Hands" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "441" "paginaFinal" => "442" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Eficacia de imiquimod tópico al 5% en paciente con radiodermitis crónica en las manos" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "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" => 713 "Ancho" => 951 "Tamanyo" => 127916 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Clinical image after treatment with imiquimod cream, 5%.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "V. López, V. Alonso, E. Jordá" "autores" => array:3 [ 0 => array:2 [ "nombre" => "V." "apellidos" => "López" ] 1 => array:2 [ "nombre" => "V." "apellidos" => "Alonso" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Jordá" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731011005175" "doi" => "10.1016/j.ad.2011.05.021" "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/S0001731011005175?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219012001655?idApp=UINPBA000044" "url" => "/15782190/0000010300000005/v1_201304241308/S1578219012001655/v1_201304241308/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "<span class="elsevierStyleItalic">Nevus Oligemicus</span> on the Breasts: A Report of 2 Cases" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "443" "paginaFinal" => "444" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "E. Gutiérrez-Paredes, V. López-Castillo, Á. Revert-Fernández, E. Jordá-Cuevas" "autores" => array:4 [ 0 => array:4 [ "nombre" => "E." "apellidos" => "Gutiérrez-Paredes" "email" => array:1 [ 0 => "ev_gutierrez@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "V." "apellidos" => "López-Castillo" ] 2 => array:2 [ "nombre" => "Á." "apellidos" => "Revert-Fernández" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Jordá-Cuevas" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Dermatología, Hospital Clínico Universitario de Valencia, Universidad de Valencia, Spain" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "<span class="elsevierStyleItalic">Nevus oligemicus</span> localizado en mamas: a propósito de 2 casos" ] ] "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" => 713 "Ancho" => 951 "Tamanyo" => 213687 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Hematoxylin-eosin, original magnification x100. Vascular ectasia in the papillary dermis.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Nevus oligemicus is a recently described dermatologic entity, first mentioned by Davies et al.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> in 1981; few cases have been reported to date.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We report 2 cases of women aged 66 and 81 years, identified as patient 1 and patient 2, respectively; the women were evaluated in our department in an interval of approximately 1 year due to the appearance of macules on both breasts. Physical examination revealed erythematous-violaceous telangiectatic macules on the breasts; the macules measured several centimeters and had irregular, poorly defined edges. Palpation caused the macules to turn white and revealed a local temperature that was markedly lower than that of the adjacent healthy tissue, with no signs of arterial ischemia (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The lesions had appeared a year earlier and were asymptomatic. The patients stated that they had not experienced previous local trauma or an infection, or applied topical products. Patient 2 was hypertensive and had osteoporosis and early-stage Alzheimer disease, for which she had been receiving drug therapy for many years. The analyses carried out included a full blood count, biochemistry, coagulation assay, kidney and liver function tests, anticardiolipin antibody assay, antinuclear antibody and cryoglobulin assay, and serology for <span class="elsevierStyleItalic">Borrelia burgdorferi</span>, and all results were normal or negative. A skin biopsy was performed only in patient 2 and showed vascular ectasia in the papillary dermis (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The lesions were diagnosed as nevus oligemicus and remained stable during a follow-up period of approximately 2 years; no new lesions appeared in this time.Nevus oligemicus is rarely reported in the literature; this may be because it is asymptomatic and sometimes not easily noticed, and is therefore underreported by patients or underdiagnosed. The etiology and pathogenesis are unknown, but an abnormality of the adrenergic receptors with increased sympathetic tone in the deep dermal vascular plexus has been suggested. This would lead to reduced deep vascular flow, which is responsible for regulating skin temperature, thereby causing the lesion to be cold to the touch, and relative vasodilation of the superficial vascular plexus, which feeds the tissue, thereby causing the erythema. The term <span class="elsevierStyleItalic">nevus oligemicus</span> may be translated as poorly vascularized nevus, and some authors consider it to be a functional rather than an anatomical disorder.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a></p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The disease manifests clinically as fixed, acquired erythematous-violaceous macules and sometimes in the form of whitish telangiectatic macules,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> with poorly defined, irregular edges. Palpation of the lesions causes them to turn white and, when measured using a thermometer, their temperature is at least 2<span class="elsevierStyleHsp" style=""></span>°C lower than that of adjacent healthy skin. The lesions are usually located on the abdomen and thighs,<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,4–6</span></a> and less frequently on the breasts<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7,8</span></a> and hands.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> They are asymptomatic and only 1 case of abnormal local heat sensitivity has been reported.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Although diagnosis is essentially clinical, histology, if performed, shows dilation of the vessels in the papillary dermis and occlusion of the vessels in the reticular dermis, with a normal number of vessels. Results of vasomotor tests are normal in both the uninvolved and involved skin<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3,5</span></a> and the finding supports the hypothesis that this is a functional anomaly. The only recognized trigger is prolonged bathing in cold water, which has led to the appearance of nevus oligemicus on the hands.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Contributing factors such as obesity, a sedentary lifestyle, and proximal pressure (such as that caused by a tight belt) have been suggested for lesions located on the abdomen, but weight loss and removing the pressure failed to resolve the lesions.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Our patients were overweight, predominantly around the abdomen, and had large, sagging breasts.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The differential diagnosis should include inflammatory erythema (mastitis, cellulitis, erysipelas), which involves warm lesions that tend to resolve, capillary malformations with no changes in local temperature and with characteristic histologic signs, and livedo reticularis, which is characterized by an erythematous-violaceous reticular pattern.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,6,8</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">In our patients, the lesions remained stable over time, with no changes in size or appearance, and no new lesions developed. Treatment with systemic corticosteroids was ineffective.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In conclusion, we report 2 cases of nevus oligemicus on the breasts, which is a rare site; the only previously reported case on this site involved a single breast.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> The key to diagnosis is the finding of permanent local hypothermia; it is therefore important to palpate the lesion to detect a reduction of between 2 and 2.5<span class="elsevierStyleHsp" style=""></span>°C in local temperature. We consider that the frequency of this entity is probably greater than indicated by a review of the literature, but that it may go unnoticed or unreported by patients.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Gutiérrez-Paredes E, et al. <span class="elsevierStyleItalic">Nevus oligemicus</span> localizado en mamas: a propósito de 2 casos. Actas Dermosifiliogr.2012;103:443-4.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 521 "Ancho" => 1401 "Tamanyo" => 100310 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Patient 2. Erythematous-violaceous telangiectatic macules, more evident on the right breast.</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" => 713 "Ancho" => 951 "Tamanyo" => 213687 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Hematoxylin-eosin, original magnification x100. Vascular ectasia in the papillary dermis.</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" => "Nevus oligemicus. A variant of nevus anemicus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.G. Davies" 1 => "M.W. Greaves" 2 => "A. Coutts" 3 => "A.K. Black" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Dermatol" "fecha" => "1981" "volumen" => "117" "paginaInicial" => "111" "paginaFinal" => "113" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7469431" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nevus oligemicus with sensory changes" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Dupre" 1 => "R. Viraben" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Dermatol Venereol" "fecha" => "1983" "volumen" => "63" "paginaInicial" => "177" "paginaFinal" => "180" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Naevus pharmacologiques ou fonctionnels. Hamartomes cutanés par anomalies des récepteurs hormonaux" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Friedel" 1 => "E. Heid" 2 => "J.M. Dallara" 3 => "E. Grosshans" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Ann Dermatol Venerol" "fecha" => "1991" "volumen" => "118" "paginaInicial" => "645" "paginaFinal" => "654" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hamartome oligemicus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Fays" 1 => "F. Truchetet" 2 => "J.F. Cuny" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Ann Dermatol Venereol" "fecha" => "2001" "volumen" => "128" "paginaInicial" => "1334" "paginaFinal" => "1335" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11908137" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0002939409004097" "estado" => "S300" "issn" => "00029394" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Nevus oligemicus</span>. Aportación de seis casos" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Mallo-García" 1 => "P. Coto-Segura" 2 => "C. Galache-Osuna" 3 => "J. Santos-Juanes-Jiménez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2008" "volumen" => "99" "paginaInicial" => "301" "paginaFinal" => "304" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18394407" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Un nuevo caso de nevus oligemicus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L. Sempau" 1 => "T. Alonso-Alonso" 2 => "A. González-Morán" 3 => "C. Prada" 4 => "M. Lamoca-Martín" 5 => "M.A. Rodríguez-Prieto" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Dermatol Online J" "fecha" => "2010" "volumen" => "15" "paginaInicial" => "16" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19951652" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nevus oligemicus: a new case" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P. Plantin" 1 => "J.P. Leroy" 2 => "G. Guillet" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "1992" "volumen" => "26" "numero" => "2 Pt 1" "paginaInicial" => "268" "paginaFinal" => "269" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1552071" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Máculas eritemato-violáceas frías en ambas mamas de una paciente de 66 años" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "V. López" 1 => "A. Revert" 2 => "D. Ramón" 3 => "E. Jordá" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2010" "volumen" => "101" "paginaInicial" => "641" "paginaFinal" => "642" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20858391" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010300000005/v1_201304241308/S157821901200176X/v1_201304241308/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/15782190/0000010300000005/v1_201304241308/S157821901200176X/v1_201304241308/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157821901200176X?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 14 | 17 | 31 |
| 2024 Octubre | 102 | 44 | 146 |
| 2024 Septiembre | 108 | 32 | 140 |
| 2024 Agosto | 149 | 54 | 203 |
| 2024 Julio | 91 | 42 | 133 |
| 2024 Junio | 114 | 43 | 157 |
| 2024 Mayo | 103 | 42 | 145 |
| 2024 Abril | 89 | 18 | 107 |
| 2024 Marzo | 94 | 41 | 135 |
| 2024 Febrero | 112 | 36 | 148 |
| 2024 Enero | 99 | 30 | 129 |
| 2023 Diciembre | 83 | 21 | 104 |
| 2023 Noviembre | 105 | 28 | 133 |
| 2023 Octubre | 81 | 24 | 105 |
| 2023 Septiembre | 104 | 36 | 140 |
| 2023 Agosto | 70 | 22 | 92 |
| 2023 Julio | 85 | 30 | 115 |
| 2023 Junio | 71 | 26 | 97 |
| 2023 Mayo | 89 | 44 | 133 |
| 2023 Abril | 72 | 34 | 106 |
| 2023 Marzo | 63 | 27 | 90 |
| 2023 Febrero | 70 | 23 | 93 |
| 2023 Enero | 40 | 30 | 70 |
| 2022 Diciembre | 65 | 45 | 110 |
| 2022 Noviembre | 44 | 44 | 88 |
| 2022 Octubre | 28 | 24 | 52 |
| 2022 Septiembre | 34 | 53 | 87 |
| 2022 Agosto | 28 | 40 | 68 |
| 2022 Julio | 17 | 32 | 49 |
| 2022 Junio | 29 | 24 | 53 |
| 2022 Mayo | 55 | 35 | 90 |
| 2022 Abril | 78 | 47 | 125 |
| 2022 Marzo | 57 | 56 | 113 |
| 2022 Febrero | 92 | 27 | 119 |
| 2022 Enero | 135 | 40 | 175 |
| 2021 Diciembre | 67 | 38 | 105 |
| 2021 Noviembre | 66 | 54 | 120 |
| 2021 Octubre | 55 | 52 | 107 |
| 2021 Septiembre | 58 | 46 | 104 |
| 2021 Agosto | 61 | 31 | 92 |
| 2021 Julio | 47 | 30 | 77 |
| 2021 Junio | 35 | 23 | 58 |
| 2021 Mayo | 41 | 45 | 86 |
| 2021 Abril | 117 | 87 | 204 |
| 2021 Marzo | 75 | 26 | 101 |
| 2021 Febrero | 48 | 29 | 77 |
| 2021 Enero | 47 | 23 | 70 |
| 2020 Diciembre | 46 | 11 | 57 |
| 2020 Noviembre | 27 | 13 | 40 |
| 2020 Octubre | 38 | 8 | 46 |
| 2020 Septiembre | 44 | 11 | 55 |
| 2020 Agosto | 30 | 26 | 56 |
| 2020 Julio | 33 | 18 | 51 |
| 2020 Junio | 43 | 31 | 74 |
| 2020 Mayo | 29 | 11 | 40 |
| 2020 Abril | 41 | 12 | 53 |
| 2020 Marzo | 29 | 22 | 51 |
| 2020 Febrero | 5 | 6 | 11 |
| 2020 Enero | 4 | 13 | 17 |
| 2019 Diciembre | 8 | 5 | 13 |
| 2019 Noviembre | 4 | 1 | 5 |
| 2019 Octubre | 0 | 1 | 1 |
| 2019 Septiembre | 8 | 6 | 14 |
| 2019 Agosto | 4 | 6 | 10 |
| 2019 Julio | 4 | 13 | 17 |
| 2019 Junio | 6 | 11 | 17 |
| 2019 Mayo | 6 | 15 | 21 |
| 2019 Abril | 2 | 22 | 24 |
| 2019 Marzo | 18 | 4 | 22 |
| 2019 Febrero | 2 | 5 | 7 |
| 2019 Enero | 1 | 0 | 1 |
| 2018 Diciembre | 1 | 0 | 1 |
| 2018 Noviembre | 1 | 0 | 1 |
| 2018 Octubre | 2 | 0 | 2 |
| 2018 Septiembre | 3 | 0 | 3 |
| 2018 Junio | 0 | 4 | 4 |
| 2018 Mayo | 0 | 2 | 2 |
| 2018 Abril | 0 | 2 | 2 |
| 2018 Marzo | 0 | 3 | 3 |
| 2018 Febrero | 86 | 5 | 91 |
| 2018 Enero | 160 | 10 | 170 |
| 2017 Diciembre | 119 | 9 | 128 |
| 2017 Noviembre | 110 | 8 | 118 |
| 2017 Octubre | 144 | 6 | 150 |
| 2017 Septiembre | 178 | 7 | 185 |
| 2017 Agosto | 193 | 10 | 203 |
| 2017 Julio | 220 | 7 | 227 |
| 2017 Junio | 213 | 10 | 223 |
| 2017 Mayo | 209 | 8 | 217 |
| 2017 Abril | 141 | 9 | 150 |
| 2017 Marzo | 70 | 25 | 95 |
| 2017 Febrero | 60 | 9 | 69 |
| 2017 Enero | 64 | 9 | 73 |
| 2016 Diciembre | 80 | 5 | 85 |
| 2016 Noviembre | 90 | 13 | 103 |
| 2016 Octubre | 149 | 12 | 161 |
| 2016 Septiembre | 239 | 8 | 247 |
| 2016 Agosto | 165 | 5 | 170 |
| 2016 Julio | 73 | 11 | 84 |
| 2016 Junio | 14 | 16 | 30 |
| 2016 Mayo | 11 | 11 | 22 |
| 2016 Abril | 9 | 4 | 13 |
| 2016 Marzo | 21 | 7 | 28 |
| 2016 Febrero | 12 | 5 | 17 |
| 2016 Enero | 8 | 1 | 9 |
| 2015 Diciembre | 10 | 1 | 11 |
| 2015 Noviembre | 32 | 3 | 35 |
| 2015 Octubre | 29 | 5 | 34 |
| 2015 Septiembre | 15 | 3 | 18 |
| 2015 Agosto | 13 | 5 | 18 |
| 2015 Julio | 90 | 7 | 97 |
| 2015 Junio | 118 | 7 | 125 |
| 2015 Mayo | 117 | 10 | 127 |
| 2015 Abril | 107 | 9 | 116 |
| 2015 Marzo | 107 | 6 | 113 |
| 2015 Febrero | 87 | 4 | 91 |
| 2015 Enero | 77 | 11 | 88 |
| 2014 Diciembre | 109 | 11 | 120 |
| 2014 Noviembre | 78 | 11 | 89 |
| 2014 Octubre | 97 | 15 | 112 |
| 2014 Septiembre | 62 | 8 | 70 |
| 2014 Agosto | 84 | 12 | 96 |
| 2014 Julio | 109 | 15 | 124 |
| 2014 Junio | 110 | 15 | 125 |
| 2014 Mayo | 60 | 8 | 68 |
| 2014 Abril | 48 | 1 | 49 |
| 2014 Marzo | 56 | 6 | 62 |
| 2014 Febrero | 84 | 6 | 90 |
| 2014 Enero | 66 | 4 | 70 |
| 2013 Diciembre | 53 | 5 | 58 |
| 2013 Noviembre | 37 | 6 | 43 |
| 2013 Octubre | 28 | 6 | 34 |
| 2013 Septiembre | 24 | 4 | 28 |
| 2013 Agosto | 35 | 10 | 45 |
| 2013 Julio | 28 | 13 | 41 |
| 2013 Junio | 15 | 8 | 23 |
| 2013 Mayo | 15 | 7 | 22 |
| 2013 Abril | 12 | 8 | 20 |
| 2013 Marzo | 15 | 8 | 23 |
| 2013 Febrero | 45 | 5 | 50 |
| 2013 Enero | 28 | 3 | 31 |
| 2012 Diciembre | 21 | 3 | 24 |
| 2012 Agosto | 2 | 1 | 3 |
Mostrar todo
