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Nail Psoriasis: Treatment With Tazarotene 0.1% Hydrophilic Ointment
Psoriasis ungueal: tratamiento con ungüento hidrófilo de tazaroteno al 0,1%
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Podemos observar una disminución notoria de la afectación ungueal, destacando la leve presencia de mancha de aceite y la ausencia de onicólisis.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "C. Fischer-Levancini, M. Sánchez-Regaña, F. Llambí, H. Collgros, V. Expósito-Serrano, P. Umbert-Millet" "autores" => array:6 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Fischer-Levancini" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Sánchez-Regaña" ] 2 => array:2 [ "nombre" => "F." "apellidos" => "Llambí" ] 3 => array:2 [ "nombre" => "H." "apellidos" => "Collgros" ] 4 => array:2 [ "nombre" => "V." "apellidos" => "Expósito-Serrano" ] 5 => array:2 [ "nombre" => "P." 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B, Thorax, with reduced intrathoracic fat and loss of subcutaneous adipose tissue. C, Abdomen with intraperitoneal fat, hepatomegaly, and an absence of subcutaneous fat. D, Pelvis: gluteal muscles of normal size.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Llamas-Velasco, E. Daudén, G. Martínez-Peñas, A. García-Diez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Llamas-Velasco" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Daudén" ] 2 => array:2 [ "nombre" => "G." "apellidos" => "Martínez-Peñas" ] 3 => array:2 [ "nombre" => "A." 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Fischer-Levancini, M. Sánchez-Regaña, F. Llambí, H. Collgros, V. Expósito-Serrano, P. Umbert-Millet" "autores" => array:6 [ 0 => array:4 [ "nombre" => "C." "apellidos" => "Fischer-Levancini" "email" => array:1 [ 0 => "cfischer2@hotmail.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" => "M." "apellidos" => "Sánchez-Regaña" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "F." "apellidos" => "Llambí" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "H." "apellidos" => "Collgros" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "V." "apellidos" => "Expósito-Serrano" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 5 => array:3 [ "nombre" => "P." "apellidos" => "Umbert-Millet" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Universitari Sagrat Cor, Barcelona, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "UT Galénica, Facultad de Farmacia, Universidad de Barcelona, Barcelona, 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" => "Psoriasis ungueal: tratamiento con ungüento hidrófilo de tazaroteno al 0,1%" ] ] "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" => 449 "Ancho" => 1300 "Tamanyo" => 103227 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Onycholysis before initiation of treatment (baseline). Right and left hands of the same patient. Note the nail involvement, especially oil spots and onycholysis.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Nail psoriasis is a therapeutic challenge for the dermatologist; consequently, new approaches to this condition should be investigated. Psoriasis is one of the diseases that most affect the nail bed, and the nails are involved in 10% to 50% of patients with psoriasis; we have observed a frequency of 53% among our patients.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The condition is less common in pediatric patients (7%-13%), but it increases to 80% in patients with psoriatic arthritis.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Nail psoriasis has a considerable psychosocial impact that affects quality of life and alters the patient's body image; in addition, associated pain can lead to a reduction in activities of daily living.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The clinical manifestations of nail dystrophy range from the more common ones, such as pitting, onycholysis, and subungual hyperkeratosis, to the less common splinter hemorrhages in the nail bed.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Today, the use of new vehicles and active substances at higher concentrations leads to better transungual absorption and increased penetration, thus considerably improving adherence to treatment and efficacy.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Tazarotene is a synthetic retinoid derived from vitamin A that has proven beneficial in modulating keratinocyte proliferation and in reducing inflammation, both of which are involved in the pathogenesis of nail psoriasis. It has beneficial effects on the matrix, bed, and periungual skin and induces few adverse effects.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">We analyze the efficacy and safety profile of tazarotene 0.1% hydrophilic ointment used to treat nail psoriasis.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Material and Methods</span><p id="par0030" class="elsevierStylePara elsevierViewall">We performed an open-label observational study of patients diagnosed with nail psoriasis in the dermatology clinic.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The study population comprised 6 patients with nail psoriasis affecting both the matrix and the bed. None of the patients was receiving systemic treatment or using topical agents.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Home treatment was started with tazarotene 0.1% ointment (compounded formula) applied under occlusive dressings at night for 6 months.</p><p id="par0045" class="elsevierStylePara elsevierViewall">The study started in October 2009 and ended in April 2010. All the patients gave their consent to participate in the study.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Patients underwent clinical assessment (including photographs of their lesions) at baseline, 3 months, and 6 months. The clinical parameters evaluated were subungual hyperkeratosis, onycholysis, splinter hemorrhage, oil spots, and pitting. The Nail Psoriasis Severity Index (NAPSI)<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> was also calculated at baseline, 3 months, and 6 months by the same observer (MSR).</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Results</span><p id="par0055" class="elsevierStylePara elsevierViewall">A statistically significant improvement in the lesions was observed at 3 months (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.003); this improvement increased at 6 months (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.007) (<a class="elsevierStyleCrossRefs" href="#fig0005">Figures 1 and 2</a>, <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). The NAPSI fell from a mean (SD) of 14.3 (6.34) at baseline (median, 15.0; 95% CI, 11.74-16.92) to 2.33 (1.21) at 6 months (median, 2.5; 95% CI, 1.84-2.83) (<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>.007). In percentage terms, the lesions had improved by 48% at 3 months and 88% at 6 months (<a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1 and 2</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">The most outstanding clinical feature in most cases was remission of subungual hyperkeratosis, onycholysis, and associated pain. Splinter hemorrhages disappeared in two-thirds of patients and oil spots in one-third. Pitting improved considerably in half of the patients (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">No treatment-related adverse effects were observed in any patient.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0070" class="elsevierStylePara elsevierViewall">The main topical treatments for nail psoriasis have traditionally comprised potent corticosteroids administered intralesionally and in the form of nail lacquer applied under an occlusive dressing.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,5</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Corticosteroid infiltrations can cause considerable pain, atrophy, hypochromia, secondary infection, inclusion cysts, and tendon rupture. These agents are only recommended as a last resort in severe cases of intense trachyonychia, and only if 1 or 2 fingers are involved.</p><p id="par0080" class="elsevierStylePara elsevierViewall">Favorable results have been observed with 8% clobetasol propionate lacquer, which improved pitting without producing atrophy.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Compared with tazarotene 0.1% hydrophilic ointment, clobetasol has a more marked effect on psoriasis of the matrix, whereas tazarotene acts more on the nail bed.</p><p id="par0125" class="elsevierStylePara elsevierViewall">Of the 3 vitamin D derivatives calcipotriol, tacalcitol, and calcitriol, the most widely studied in Spain is calcipotriol, which was effective in the nail bed (not in the matrix) and reduced hyperkeratosis. Calcipotriol should be administered in combination with corticosteroids.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5–7</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Psoralen (generally in the form of 8-methoxypsoralen) is another therapeutic option and can be administered topically or orally, followed by exposure to UV-A radiation (320-400<span class="elsevierStyleHsp" style=""></span>nm). Before the advent of clobetasol lacquer and vitamin D derivatives, psoralen UV-A was widely used to treat severe nail psoriasis. This approach continues to be effective, especially when treatment is combined with acitretin. Psoralen UV-A is particularly effective if psoriasis presents with pustules and hyperkeratosis.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">Also noteworthy are the usefulness and the favorable outcome obtained with photodynamic therapy and pulsed dye laser, which have even proven effective for treating the matrix; however, administration of the former is uncomfortable, and the cost of the latter is high.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">The therapeutic potential of tazarotene 0.1% gel was well established in 2 studies showing its safety and tolerability.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10,11</span></a> Other studies show the efficacy of tazarotene 0.1% cream on comparison with clobetasol 0.05% cream.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Notwithstanding, to our knowledge, this is the first study to examine tazarotene 0.1% hydrophilic ointment.</p><p id="par0105" class="elsevierStylePara elsevierViewall">We observed a clinically significant improvement in nail involvement, especially subungual hyperkeratosis and onycholysis, in all 6 patients.</p><p id="par0110" class="elsevierStylePara elsevierViewall">Despite its small sample size, our study reveals that tazarotene 0.1% ointment is a well-tolerated option for the treatment of nail psoriasis.</p><p id="par0115" class="elsevierStylePara elsevierViewall">More clinical studies with larger sample sizes should be performed to obtain more significant results.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflicts of Interest</span><p id="par0120" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:2 [ "identificador" => "xres96453" "titulo" => array:5 [ 0 => "Abstract" 1 => "Introduction" 2 => "Material and methods" 3 => "Results" 4 => "Conclusion" ] ] 1 => array:2 [ "identificador" => "xpalclavsec83611" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres96452" "titulo" => array:5 [ 0 => "Resumen" 1 => "Introducción" 2 => "Material y métodos" 3 => "Resultados" 4 => "Conclusión" ] ] 3 => array:2 [ "identificador" => "xpalclavsec83610" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Material and Methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of Interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2011-09-20" "fechaAceptado" => "2012-04-09" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec83611" "palabras" => array:3 [ 0 => "Nail diseases" 1 => "Nail psoriasis" 2 => "Tazarotene" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec83610" "palabras" => array:3 [ 0 => "Enfermedades de las uñas" 1 => "Psoriasis ungueal" 2 => "Tazaroteno" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Nail involvement is common in psoriasis and has a considerable impact on patient quality of life. Its clinical presentation depends on which part of the nail is affected: the bed or the matrix. Fifty percent of patients report associated pain. In this study, we analyzed the safety and effectiveness of tazarotene 0.1% in a hydrophilic ointment in the treatment of nail psoriasis.</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">We performed an open observational study of 6 patients diagnosed with nail psoriasis. The patients applied a compounded preparation of tazarotene 0.1% ointment under occlusion every night for 6 months in their homes. They were not receiving any other topical or systemic treatments. Nail psoriasis severity (assessed using the Nail Psoriasis Severity Index [NAPSI]), subungual hyperkeratosis, onycholysis, splinter hemorrhages, oil stains, and nail pitting were evaluated at baseline and at 3 and 6 months.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A statistically significant improvement between baseline and 6 months was observed in all patients: the mean (SD) NAPSI went from 14.3 (6.3; 95% CI, 11.74-16.92) to 2.3 (1.21; 95% CI, 1.84-2.3) while the median went from 15 to 2.5 (<span class="elsevierStyleItalic">P</span> = .007). The percentage improvement at the end of treatment was 87.9%. No adverse effects were observed.</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Our study shows the therapeutic potential of tazarotene ointment in nail psoriasis.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La afectación ungueal de la psoriasis es una presentación frecuente que interfiere de manera significativa en la calidad de vida de los pacientes. Su presentación clínica va a depender del área ungueal afecta: lecho o matriz. Un 50% de los pacientes refiere dolor asociado. En este estudio evaluamos la eficacia y seguridad del tazaroteno 0,1% en ungüento hidrófilo.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Estudio abierto y observacional de 6 pacientes diagnosticados de psoriasis ungueal. Se aplicó ungüento de tazaroteno 0,1% (fórmula magistral) en oclusión nocturna, en su domicilio durante 6 meses, sin otro tratamiento tópico o sistémico. Se determinó el <span class="elsevierStyleItalic">Nail Psoriasis Severity Index</span> (NAPSI) y se evaluaron la hiperqueratosis subungueal, onicólisis, hemorragias en astilla, manchas de aceite y piquiteado ungueal, en la visita basal, a los 3 y 6 meses.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Se observó una mejoría estadísticamente significativa en todos los pacientes: NAPSI basal, media<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>DE 14,3± 6,3; IC 95% 11,74-16,92; mediana 15; NAPSI a los 6 meses: media<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>DE 2,3 ±1,21; IC 95% 1,84-2,83; mediana 2,5; p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,007. El porcentaje de mejoría fue del 87,9% al final del tratamiento. No se registraron efectos adversos.</p> <span class="elsevierStyleSectionTitle">Conclusión</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Nuestro estudio muestra un potencial terapéutico del ungüento de tazaroteno en la psoriasis ungueal.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Fischer-Levancini C, Sánchez-Regaña M, Llambí F, Collgros H, Expósito-Serrano V, Umbert-Millet P. Psoriasis ungueal: tratamiento con ungüento. Actas Dermosifiliogr.2012;103:725-728.</p>" ] ] "multimedia" => array:5 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 449 "Ancho" => 1300 "Tamanyo" => 103227 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Onycholysis before initiation of treatment (baseline). Right and left hands of the same patient. Note the nail involvement, especially oil spots and onycholysis.</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" => 482 "Ancho" => 1300 "Tamanyo" => 91969 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Patient from Figure 1 after 2 months of treatment with tazarotene 0.1% ointment. Note the markedly diminished nail involvement, especially the minimal presence of oil spots and the absence of onycholysis.</p>" ] ] 2 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Abbreviations: CI, confidence interval.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Mean (SD) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Minimum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Maximum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Median \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">95% CI (Lower Limit) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">95% CI (Upper Limit) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">P</span> Value<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">At baseline \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.3 (6.3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11.74 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16.92 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">At 3 mo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 (3.29) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.66 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9.34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.007 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">At 6 mo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.3 (1.21) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.84 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.83 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">.003 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab182515.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara"><span class="elsevierStyleItalic">t</span> test.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Nail Psoriasis Severity Index Over Time.</p>" ] ] 3 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Patient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Baseline NAPSI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">NAPSI at 3 mo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">NAPSI at 6 mo \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">14.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.3 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Percentage improvement \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">44.1% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">87.9% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab182516.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Nail Psoriasis Severity Index (NAPSI) for Each of the Patients.</p>" ] ] 4 => array:7 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Baseline, No. of patients/Severity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">At 3 mo, No. of patients/Severity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">At 6 mo, No. of patients/Severity \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pitting \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4/Moderate2/Mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1/Moderate3/Mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3/Mild \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Subungual hyperkeratosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2/Severe2/Moderate2/Mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3/Moderate1/Mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1/Mild \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Onycholysis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3/Severe3/Moderate \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6/Mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3/Mild \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Splinter hemorrhages \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1/Moderate4/Mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3/Mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2/Mild \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Oil spots \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2/Severe3/Moderate1/Mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3/Mild \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4/Mild \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab182514.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Change in the Severity of the Signs Over Time.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Aspectos diagnósticos y terapéuticos de la psoriasis ungueal" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Sánchez-Regaña" 1 => "P. Umbert" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2008" "volumen" => "99" "paginaInicial" => "34" "paginaFinal" => "43" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18206085" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of psoriatic nails with tazarotene cream 0.1% vs clobetasol propionate 0.05% cream: a double bind study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D. Rigopoulos" 1 => "S. Gregoriou" 2 => "A. Katsambas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2340/00015555-0195" "Revista" => array:6 [ "tituloSerie" => "Acta Derm Venereol" "fecha" => "2007" "volumen" => "87" "paginaInicial" => "167" "paginaFinal" => "168" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17340027" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nail Psoriasis Severity Index: a useful tool for evaluation of nail psoriasis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P. Rich" 1 => "R.K. Scher" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2003" "volumen" => "49" "paginaInicial" => "206" "paginaFinal" => "212" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12894066" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of nail psoriasis with 8% clobetasol nail lacquer: positive experience in 10 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Sanchez Regaña" 1 => "G. Martin" 2 => "P. Umbert" 3 => "F. Llanbí" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1468-3083.2005.01253.x" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2005" "volumen" => "19" "paginaInicial" => "573" "paginaFinal" => "577" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16164711" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nail psoriasis: a combined treatment with 8% clobetasol nail lacquer and tacalcitol oinment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Sanchez Regaña" 1 => "G. Márquez" 2 => "P. Umbert" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1468-3083.2008.02679.x" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2008" "volumen" => "22" "paginaInicial" => "963" "paginaFinal" => "969" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18410337" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Empleo de calcipotriol tópico en la psoriasis ungueal" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Sánchez Regaña" 1 => "R. Ojeda" 2 => "P. Umbert" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Piel" "fecha" => "2002" "volumen" => "17" "paginaInicial" => "104" "paginaFinal" => "108" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tacalcitol ointment for the treatment of nail psoriasis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G. Marquez Balbas" 1 => "M. Sanchez Regaña" 2 => "P. Umbert Millet" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Dermatol Treat" "fecha" => "2009" "volumen" => "20" "paginaInicial" => "308" "paginaFinal" => "310" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nail psoriasis: a retrospective study on the effectiveness of systemic treatments (classical and biological therapy)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Sánchez-Regaña" 1 => "J. Sola-Ortigosa" 2 => "M. Alsina-Gibert" 3 => "M. Vidal-Fernandez" 4 => "P. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 16 | 8 | 24 |
| 2024 Octubre | 79 | 38 | 117 |
| 2024 Septiembre | 105 | 32 | 137 |
| 2024 Agosto | 143 | 59 | 202 |
| 2024 Julio | 87 | 37 | 124 |
| 2024 Junio | 105 | 41 | 146 |
| 2024 Mayo | 81 | 36 | 117 |
| 2024 Abril | 90 | 20 | 110 |
| 2024 Marzo | 77 | 30 | 107 |
| 2024 Febrero | 68 | 31 | 99 |
| 2024 Enero | 68 | 32 | 100 |
| 2023 Diciembre | 113 | 24 | 137 |
| 2023 Noviembre | 84 | 22 | 106 |
| 2023 Octubre | 97 | 35 | 132 |
| 2023 Septiembre | 75 | 28 | 103 |
| 2023 Agosto | 45 | 19 | 64 |
| 2023 Julio | 74 | 36 | 110 |
| 2023 Junio | 74 | 22 | 96 |
| 2023 Mayo | 67 | 25 | 92 |
| 2023 Abril | 65 | 26 | 91 |
| 2023 Marzo | 70 | 32 | 102 |
| 2023 Febrero | 66 | 26 | 92 |
| 2023 Enero | 49 | 30 | 79 |
| 2022 Diciembre | 65 | 41 | 106 |
| 2022 Noviembre | 42 | 31 | 73 |
| 2022 Octubre | 41 | 16 | 57 |
| 2022 Septiembre | 54 | 38 | 92 |
| 2022 Agosto | 35 | 35 | 70 |
| 2022 Julio | 48 | 38 | 86 |
| 2022 Junio | 35 | 35 | 70 |
| 2022 Mayo | 46 | 43 | 89 |
| 2022 Abril | 73 | 38 | 111 |
| 2022 Marzo | 74 | 55 | 129 |
| 2022 Febrero | 71 | 38 | 109 |
| 2022 Enero | 88 | 40 | 128 |
| 2021 Diciembre | 45 | 41 | 86 |
| 2021 Noviembre | 64 | 44 | 108 |
| 2021 Octubre | 64 | 67 | 131 |
| 2021 Septiembre | 58 | 54 | 112 |
| 2021 Agosto | 57 | 34 | 91 |
| 2021 Julio | 51 | 39 | 90 |
| 2021 Junio | 63 | 43 | 106 |
| 2021 Mayo | 44 | 34 | 78 |
| 2021 Abril | 114 | 102 | 216 |
| 2021 Marzo | 78 | 34 | 112 |
| 2021 Febrero | 70 | 25 | 95 |
| 2021 Enero | 45 | 14 | 59 |
| 2020 Diciembre | 45 | 23 | 68 |
| 2020 Noviembre | 36 | 16 | 52 |
| 2020 Octubre | 47 | 13 | 60 |
| 2020 Septiembre | 36 | 11 | 47 |
| 2020 Agosto | 37 | 19 | 56 |
| 2020 Julio | 39 | 14 | 53 |
| 2020 Junio | 53 | 34 | 87 |
| 2020 Mayo | 37 | 17 | 54 |
| 2020 Abril | 31 | 22 | 53 |
| 2020 Marzo | 34 | 18 | 52 |
| 2020 Febrero | 3 | 0 | 3 |
| 2020 Enero | 4 | 3 | 7 |
| 2019 Diciembre | 8 | 4 | 12 |
| 2019 Noviembre | 4 | 2 | 6 |
| 2019 Octubre | 0 | 3 | 3 |
| 2019 Septiembre | 10 | 5 | 15 |
| 2019 Agosto | 2 | 0 | 2 |
| 2019 Julio | 6 | 7 | 13 |
| 2019 Junio | 4 | 15 | 19 |
| 2019 Mayo | 6 | 22 | 28 |
| 2019 Abril | 2 | 26 | 28 |
| 2019 Marzo | 0 | 10 | 10 |
| 2019 Febrero | 4 | 1 | 5 |
| 2019 Enero | 0 | 4 | 4 |
| 2018 Diciembre | 4 | 0 | 4 |
| 2018 Noviembre | 3 | 0 | 3 |
| 2018 Octubre | 2 | 1 | 3 |
| 2018 Septiembre | 4 | 0 | 4 |
| 2018 Junio | 0 | 1 | 1 |
| 2018 Mayo | 0 | 2 | 2 |
| 2018 Marzo | 0 | 1 | 1 |
| 2018 Febrero | 55 | 8 | 63 |
| 2018 Enero | 90 | 11 | 101 |
| 2017 Diciembre | 89 | 10 | 99 |
| 2017 Noviembre | 77 | 11 | 88 |
| 2017 Octubre | 77 | 13 | 90 |
| 2017 Septiembre | 80 | 8 | 88 |
| 2017 Agosto | 79 | 10 | 89 |
| 2017 Julio | 64 | 10 | 74 |
| 2017 Junio | 94 | 25 | 119 |
| 2017 Mayo | 76 | 11 | 87 |
| 2017 Abril | 85 | 9 | 94 |
| 2017 Marzo | 84 | 50 | 134 |
| 2017 Febrero | 50 | 6 | 56 |
| 2017 Enero | 63 | 10 | 73 |
| 2016 Diciembre | 63 | 13 | 76 |
| 2016 Noviembre | 96 | 12 | 108 |
| 2016 Octubre | 133 | 15 | 148 |
| 2016 Septiembre | 167 | 9 | 176 |
| 2016 Agosto | 113 | 6 | 119 |
| 2016 Julio | 58 | 18 | 76 |
| 2016 Junio | 9 | 12 | 21 |
| 2016 Mayo | 9 | 12 | 21 |
| 2016 Abril | 5 | 1 | 6 |
| 2016 Marzo | 5 | 3 | 8 |
| 2016 Febrero | 18 | 1 | 19 |
| 2016 Enero | 14 | 3 | 17 |
| 2015 Diciembre | 15 | 2 | 17 |
| 2015 Noviembre | 37 | 2 | 39 |
| 2015 Octubre | 39 | 1 | 40 |
| 2015 Septiembre | 66 | 2 | 68 |
| 2015 Agosto | 46 | 6 | 52 |
| 2015 Julio | 103 | 12 | 115 |
| 2015 Junio | 94 | 12 | 106 |
| 2015 Mayo | 129 | 21 | 150 |
| 2015 Abril | 122 | 13 | 135 |
| 2015 Marzo | 86 | 8 | 94 |
| 2015 Febrero | 85 | 13 | 98 |
| 2015 Enero | 83 | 15 | 98 |
| 2014 Diciembre | 61 | 25 | 86 |
| 2014 Noviembre | 72 | 12 | 84 |
| 2014 Octubre | 86 | 16 | 102 |
| 2014 Septiembre | 63 | 6 | 69 |
| 2014 Agosto | 53 | 7 | 60 |
| 2014 Julio | 51 | 7 | 58 |
| 2014 Junio | 102 | 10 | 112 |
| 2014 Mayo | 92 | 8 | 100 |
| 2014 Abril | 73 | 5 | 78 |
| 2014 Marzo | 67 | 8 | 75 |
| 2014 Febrero | 43 | 15 | 58 |
| 2014 Enero | 78 | 11 | 89 |
| 2013 Diciembre | 48 | 7 | 55 |
| 2013 Noviembre | 52 | 23 | 75 |
| 2013 Octubre | 33 | 9 | 42 |
| 2013 Septiembre | 33 | 23 | 56 |
| 2013 Agosto | 14 | 30 | 44 |
| 2013 Julio | 16 | 46 | 62 |
| 2013 Junio | 11 | 28 | 39 |
| 2013 Mayo | 12 | 35 | 47 |
| 2013 Abril | 18 | 27 | 45 |
| 2013 Marzo | 25 | 12 | 37 |
| 2013 Febrero | 43 | 9 | 52 |
| 2013 Enero | 66 | 13 | 79 |
| 2012 Diciembre | 35 | 8 | 43 |
| 2012 Noviembre | 11 | 14 | 25 |
| 2012 Octubre | 1 | 13 | 14 |
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