Case and Research Letters
Granulomatous Balanitis After Intravesical Bacille Calmette-Guérin Instillation
Balanitis granulomatosa tras terapia intravesical con bacilo de Calmette-Guérin
Leído
9837
Vecesse ha leído el artículo
2587
Total PDF
7250
Total HTML
Compartir estadísticas
array:24 [ "pii" => "S1578219013000425" "issn" => "15782190" "doi" => "10.1016/j.adengl.2012.06.027" "estado" => "S300" "fechaPublicacion" => "2013-04-01" "aid" => "679" "copyright" => "Elsevier España, S.L. and AEDV" "copyrightAnyo" => "2012" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2013;104:251-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5785 "formatos" => array:3 [ "EPUB" => 55 "HTML" => 5090 "PDF" => 640 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731012003067" "issn" => "00017310" "doi" => "10.1016/j.ad.2012.06.008" "estado" => "S300" "fechaPublicacion" => "2013-04-01" "aid" => "679" "copyright" => "Elsevier España, S.L. y AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2013;104:251-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 6976 "formatos" => array:3 [ "EPUB" => 3 "HTML" => 5890 "PDF" => 1083 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científico-clínica</span>" "titulo" => "Balanitis granulomatosa tras terapia intravesical con bacilo de Calmette-Guérin" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "251" "paginaFinal" => "252" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Granulomatous Balanitis after Intravesical Bacille Calmette-Guérin Instillation" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1000 "Ancho" => 1333 "Tamanyo" => 207947 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Lesiones papulosas amarillentas en el glande, a las 48 horas de la sexta instilación del último ciclo.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. García Baldoví, M. Pérez-Crespo, J. Onrubia, M. Moragón" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "García Baldoví" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Pérez-Crespo" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Onrubia" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Moragón" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219013000425" "doi" => "10.1016/j.adengl.2012.06.027" "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/S1578219013000425?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731012003067?idApp=UINPBA000044" "url" => "/00017310/0000010400000003/v1_201304241344/S0001731012003067/v1_201304241344/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219013000437" "issn" => "15782190" "doi" => "10.1016/j.adengl.2012.03.025" "estado" => "S300" "fechaPublicacion" => "2013-04-01" "aid" => "676" "copyright" => "Elsevier España, S.L. and AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2013;104:253-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3434 "formatos" => array:3 [ "EPUB" => 43 "HTML" => 2820 "PDF" => 571 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Localized Cutaneous Argyria: A Report of 2 Cases" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "253" "paginaFinal" => "254" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Argiria cutánea localizada. A propósito de 2 casos" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1197 "Ancho" => 1608 "Tamanyo" => 195844 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A and B, The first patient presented several blue-gray macules on the dorsum of the fourth finger of the right hand and on the palmar surface of the fifth finger of the right hand. C, Dermoscopy revealed a homogeneous blue-gray pattern. D, The second patient presented similar lesions on the dorsum of both hands.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Garcias-Ladaria, P. Hernandez-Bel, J.L. Torregrosa-Calatayud, A. Martínez-Aparicio" "autores" => array:4 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Garcias-Ladaria" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "Hernandez-Bel" ] 2 => array:2 [ "nombre" => "J.L." "apellidos" => "Torregrosa-Calatayud" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Martínez-Aparicio" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731012003031" "doi" => "10.1016/j.ad.2012.03.013" "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/S0001731012003031?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219013000437?idApp=UINPBA000044" "url" => "/15782190/0000010400000003/v1_201304241622/S1578219013000437/v1_201304241622/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219013000413" "issn" => "15782190" "doi" => "10.1016/j.adengl.2012.07.024" "estado" => "S300" "fechaPublicacion" => "2013-04-01" "aid" => "722" "copyright" => "Elsevier España, S.L. and AEDV" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2013;104:249-50" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3318 "formatos" => array:3 [ "EPUB" => 53 "HTML" => 2700 "PDF" => 565 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case for Diagnosis</span>" "titulo" => "Reticulate Hyperpigmentation and Medullary Aplasia" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "249" "paginaFinal" => "250" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hiperpigmentación reticulada y aplasia medular" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1970 "Ancho" => 1417 "Tamanyo" => 273191 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Armengot-Carbó, B. Rodrigo-Nicolás, E. Gimeno-Carpio" "autores" => array:3 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Armengot-Carbó" ] 1 => array:2 [ "nombre" => "B." "apellidos" => "Rodrigo-Nicolás" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Gimeno-Carpio" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731012004383" "doi" => "10.1016/j.ad.2012.07.019" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731012004383?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219013000413?idApp=UINPBA000044" "url" => "/15782190/0000010400000003/v1_201304241622/S1578219013000413/v1_201304241622/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Granulomatous Balanitis After Intravesical Bacille Calmette-Guérin Instillation" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor</span>:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "251" "paginaFinal" => "252" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M. García Baldoví, M. Pérez-Crespo, J. Onrubia, M. Moragón" "autores" => array:4 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "García Baldoví" "email" => array:1 [ 0 => "maria_gbaldovi@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" => "Pérez-Crespo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "J." "apellidos" => "Onrubia" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "M." "apellidos" => "Moragón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Dermatología, Hospital Clínico de San Juan de Alicante, Alicante, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Dermatología Patológica, Hospital Clínico de San Juan de Alicante, Alicante, 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" => "Balanitis granulomatosa tras terapia intravesical con bacilo de Calmette-Guérin" ] ] "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" => 887 "Ancho" => 1335 "Tamanyo" => 159251 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Marked regression of the papular lesions after 2 weeks of treatment.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Transitional cell carcinoma of the bladder is an aggressive tumor with a high potential for malignant progression. Bacille Calmette-Guérin (BCG) has been used to treat malignant diseases for more than 20 years, and bladder cancer has been treated with it longer, since 1976.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a> BCG is an attenuated strain of <span class="elsevierStyleItalic">Mycobacterium bovis</span>; instilled in solution to treat bladder cancer, it delays recurrence and prevents the implantation of tumor cells.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,5</span></a> Most patients tolerate intravesical irrigation with BCG well, but complications are not unusual. Side effects consist mainly of local irritation and flu-like symptoms and are usually mild. Various systemic and local infections have also been reported following instillation of BCG, which is a live organism. Such infections have included pneumonitis, hepatitis, granulomatous prostatitis, epididymitis, and renal parenchymal abscess.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–4,6</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We present a case of granulomatous balanoposthitis that followed intravesical BCG therapy to prevent recurrence after transurethral resection of a transitional cell carcinoma.</p><p id="par0015" class="elsevierStylePara elsevierViewall">A 40-year-old man received intermittent cycles of intravesical BCG therapy to treat transitional cell carcinoma of the bladder starting in 2009. At 48<span class="elsevierStyleHsp" style=""></span>hours from the sixth instillation, which involved a difficult catheterization with slight extravasation of the product, the patient presented with yellowish papular lesions on the glans penis, large painful lymph nodes in the right groin, and dysuria (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). A biopsy was performed and cultures were ordered. In the differential diagnosis, we considered infectious diseases (herpetic primo-infection, syphilis, fungal infection, skin infection due to BCG) and neutrophilic diseases (pyoderma gangrenosum, Behçet disease).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Histology showed a substantial neutrophilic infiltrate in the dermis with no granulomas or multinucleated giant cells (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Ziehl-Neelsen and periodic acid-Schiff staining were negative for micro-organisms. The culture, which was negative for fungi, grew only <span class="elsevierStyleItalic">Streptococcus salivarius</span> (a saprophyte). Despite the negative results of the acid-fast staining, BCG infection was suspected because the other candidate diagnoses were unlikely. Empirical treatment with isoniazid and rifampicin was ordered and by 15 days had reduced the spread of the lesions. At this time, isoniazid-resistant <span class="elsevierStyleItalic">M bovis</span> was isolated in the initial culture in Lowenstein medium. Rifampicin, ethambutol, and moxifloxacin were then prescribed and the lesions had improved considerably after 2 weeks of treatment (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Intravesical BCG treatment is recognized as an effective therapy for superficial bladder cancer, although numerous side effects have been reported.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> The most common reactions are minor and include cystitis, hematuria, low-grade fever, general malaise, and nausea. More serious side effects include fever, granulomatous pneumonitis, hepatitis, renal abscess, and even fatal sepsis.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,3,7</span></a> Granulomatous reactions associated with BCG therapy can occur in the bladder, epididymis, prostate, kidney, lungs, and liver. However, involvement of the glans penis and urethra is quite rare: only 12 cases have been reported to date.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,8</span></a> In each case, pathology showed granulomas and, usually, caseating necrosis. These findings were not present in our patient, perhaps because the biopsy was performed promptly.</p><p id="par0030" class="elsevierStylePara elsevierViewall">A recently published study showed that polymorphonuclear cells play an essential role in the antitumor effect of BCG treatment. Instillation of BCG starts a primarily neutrophilic inflammatory reaction that triggers the migration of effector cells (lymphocytes and monocytes or macrophages) to the bladder.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,5</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Patients who are immunocompromised, have mucosal barrier disruption due to injury, or have positive reactions on tuberculin skin testing are at higher risk of presenting BCG side effects.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4,6,7</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Given the small number of published cases, no standard treatment has emerged. Some reviews recommend starting the treatment of prostatitis and granulomatous orchiepididymitis with 300<span class="elsevierStyleHsp" style=""></span>mg of oral isoniazid and 600<span class="elsevierStyleHsp" style=""></span>mg of rifampicin and continuing it for 3 to 6 months while discontinuing BCG therapy and testing for antibiotic resistance.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,7</span></a> Other authors recommend corticosteroid therapy at the start of treatment.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">This rare case of balanitis due to BCG demonstrates the need to consider this possible side effect when patients are undergoing BCG therapy.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: García Baldoví M, et al. Balanitis granulomatosa tras terapia intravesical con bacilo de Calmette- Guérin. Actas Dermosifiliogr. 2013;104:251–2.</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" => 1000 "Ancho" => 1335 "Tamanyo" => 167936 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Yellowish papules on the glans penis 48<span class="elsevierStyleHsp" style=""></span>hours after the sixth instillation of bacille Calmette-Guérin.</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" => 1230 "Ancho" => 1665 "Tamanyo" => 439557 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Significant neutrophilic infiltrate in the dermis with no granulomas or multinucleated giant cells. Hematoxylin-eosin, original magnification ×40.</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" => 887 "Ancho" => 1335 "Tamanyo" => 159251 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Marked regression of the papular lesions after 2 weeks of treatment.</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" => "Disseminated <span class="elsevierStyleItalic">Mycobacterium bovis</span> after intravesicular bacillus Calmette-Guerin treatments for bladder cancer" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Elkabani" 1 => "J.N. Greene" 2 => "A.L. Vincent" 3 => "S. VanHook" 4 => "R.L. Sandin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Cancer Control" "fecha" => "2000" "volumen" => "7" "paginaInicial" => "476" "paginaFinal" => "481" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11000618" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pulmonary disease following intravesical BCG treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Kesten" 1 => "L. Title" 2 => "B. Mullen" 3 => "R. Grossman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Thorax" "fecha" => "1990" "volumen" => "45" "paginaInicial" => "709" "paginaFinal" => "710" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2218978" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Granulomas of the penis: a rare complication of intravesical therapy with bacillus Calmette-Guerin" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S.I. Lestre" 1 => "C.D. Gameiro" 2 => "A. João" 3 => "M.J. Lopes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "An Bras Dermatol" "fecha" => "2011" "volumen" => "86" "paginaInicial" => "759" "paginaFinal" => "762" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21987145" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Caseating granulomas on the glans penis as a complication of bacille Calmette-Guérin intravesical therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C.G. French" 1 => "L. Hickey" 2 => "D.G. Bell" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Urol" "fecha" => "2001" "volumen" => "3" "paginaInicial" => "36" "paginaFinal" => "38" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16985688" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Discriminators of mouse bladder response to intravesical bacillus Calmette-Guerin (BCG)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.R. Saban" 1 => "C. Simpson" 2 => "C. Davis" 3 => "G. Wallis" 4 => "N. Knowlton" 5 => "M.B. Frank" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "BMC Immunol" "fecha" => "2007" "volumen" => "16" "paginaInicial" => "6" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "BCG infection of the glans penis after intravesical BCG therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "N. Michelet" 1 => "N. Spenatto" 2 => "R. Viraben" 3 => "J.F. Cuny" 4 => "J. Mazet" 5 => "P. Trechot" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.annder.2007.06.012" "Revista" => array:6 [ "tituloSerie" => "Ann Dermatol Venereol" "fecha" => "2008" "volumen" => "135" "paginaInicial" => "479" "paginaFinal" => "483" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18598797" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Granulomatous balanoposthitis after intravesical bacillus-Calmette-Guerin instillation therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "H. Yusuke" 1 => "H. Yoshinori" 2 => "M. Kenichi" 3 => "H. Akio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1442-2042.2006.01553.x" "Revista" => array:6 [ "tituloSerie" => "Int J Urol" "fecha" => "2006" "volumen" => "13" "paginaInicial" => "1361" "paginaFinal" => "1363" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17010022" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Balanitis and balanoposthitis: a review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Edwards" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Genitourin Med" "fecha" => "1996" "volumen" => "72" "paginaInicial" => "155" "paginaFinal" => "159" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8707315" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010400000003/v1_201304241622/S1578219013000425/v1_201304241622/en/main.assets" "Apartado" => array:4 [ "identificador" => "6157" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case and Research Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010400000003/v1_201304241622/S1578219013000425/v1_201304241622/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219013000425?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 7 | 11 | 18 |
| 2024 Octubre | 64 | 63 | 127 |
| 2024 Septiembre | 64 | 36 | 100 |
| 2024 Agosto | 85 | 84 | 169 |
| 2024 Julio | 72 | 53 | 125 |
| 2024 Junio | 83 | 56 | 139 |
| 2024 Mayo | 63 | 45 | 108 |
| 2024 Abril | 63 | 30 | 93 |
| 2024 Marzo | 56 | 44 | 100 |
| 2024 Febrero | 48 | 40 | 88 |
| 2024 Enero | 42 | 50 | 92 |
| 2023 Diciembre | 57 | 34 | 91 |
| 2023 Noviembre | 60 | 33 | 93 |
| 2023 Octubre | 44 | 24 | 68 |
| 2023 Septiembre | 56 | 28 | 84 |
| 2023 Agosto | 26 | 22 | 48 |
| 2023 Julio | 33 | 48 | 81 |
| 2023 Junio | 51 | 44 | 95 |
| 2023 Mayo | 30 | 31 | 61 |
| 2023 Abril | 36 | 24 | 60 |
| 2023 Marzo | 35 | 28 | 63 |
| 2023 Febrero | 21 | 23 | 44 |
| 2023 Enero | 25 | 50 | 75 |
| 2022 Diciembre | 49 | 41 | 90 |
| 2022 Noviembre | 18 | 24 | 42 |
| 2022 Octubre | 14 | 25 | 39 |
| 2022 Septiembre | 25 | 30 | 55 |
| 2022 Agosto | 24 | 39 | 63 |
| 2022 Julio | 23 | 37 | 60 |
| 2022 Junio | 19 | 23 | 42 |
| 2022 Mayo | 23 | 27 | 50 |
| 2022 Abril | 40 | 26 | 66 |
| 2022 Marzo | 41 | 46 | 87 |
| 2022 Febrero | 38 | 32 | 70 |
| 2022 Enero | 23 | 29 | 52 |
| 2021 Diciembre | 26 | 44 | 70 |
| 2021 Noviembre | 45 | 42 | 87 |
| 2021 Octubre | 36 | 62 | 98 |
| 2021 Septiembre | 29 | 50 | 79 |
| 2021 Agosto | 43 | 21 | 64 |
| 2021 Julio | 33 | 46 | 79 |
| 2021 Junio | 35 | 29 | 64 |
| 2021 Mayo | 25 | 39 | 64 |
| 2021 Abril | 45 | 56 | 101 |
| 2021 Marzo | 53 | 32 | 85 |
| 2021 Febrero | 47 | 38 | 85 |
| 2021 Enero | 31 | 23 | 54 |
| 2020 Diciembre | 22 | 14 | 36 |
| 2020 Noviembre | 34 | 20 | 54 |
| 2020 Octubre | 20 | 20 | 40 |
| 2020 Septiembre | 26 | 14 | 40 |
| 2020 Agosto | 19 | 25 | 44 |
| 2020 Julio | 24 | 19 | 43 |
| 2020 Junio | 28 | 18 | 46 |
| 2020 Mayo | 28 | 14 | 42 |
| 2020 Abril | 22 | 20 | 42 |
| 2020 Marzo | 28 | 18 | 46 |
| 2020 Febrero | 4 | 4 | 8 |
| 2020 Enero | 0 | 2 | 2 |
| 2019 Diciembre | 0 | 3 | 3 |
| 2019 Octubre | 0 | 3 | 3 |
| 2019 Septiembre | 0 | 1 | 1 |
| 2019 Julio | 0 | 1 | 1 |
| 2019 Mayo | 0 | 15 | 15 |
| 2019 Abril | 0 | 2 | 2 |
| 2019 Marzo | 0 | 7 | 7 |
| 2019 Enero | 1 | 0 | 1 |
| 2018 Noviembre | 1 | 0 | 1 |
| 2018 Octubre | 1 | 0 | 1 |
| 2018 Septiembre | 4 | 0 | 4 |
| 2018 Abril | 0 | 1 | 1 |
| 2018 Marzo | 5 | 2 | 7 |
| 2018 Febrero | 24 | 7 | 31 |
| 2018 Enero | 36 | 8 | 44 |
| 2017 Diciembre | 34 | 15 | 49 |
| 2017 Noviembre | 31 | 8 | 39 |
| 2017 Octubre | 37 | 5 | 42 |
| 2017 Septiembre | 29 | 9 | 38 |
| 2017 Agosto | 31 | 16 | 47 |
| 2017 Julio | 25 | 11 | 36 |
| 2017 Junio | 42 | 15 | 57 |
| 2017 Mayo | 31 | 5 | 36 |
| 2017 Abril | 40 | 9 | 49 |
| 2017 Marzo | 28 | 29 | 57 |
| 2017 Febrero | 26 | 7 | 33 |
| 2017 Enero | 45 | 16 | 61 |
| 2016 Diciembre | 72 | 3 | 75 |
| 2016 Noviembre | 64 | 3 | 67 |
| 2016 Octubre | 81 | 27 | 108 |
| 2016 Septiembre | 85 | 9 | 94 |
| 2016 Agosto | 68 | 7 | 75 |
| 2016 Julio | 50 | 6 | 56 |
| 2016 Junio | 10 | 9 | 19 |
| 2016 Mayo | 6 | 3 | 9 |
| 2016 Abril | 5 | 31 | 36 |
| 2016 Marzo | 3 | 12 | 15 |
| 2016 Febrero | 4 | 13 | 17 |
| 2016 Enero | 7 | 8 | 15 |
| 2015 Diciembre | 4 | 8 | 12 |
| 2015 Noviembre | 11 | 6 | 17 |
| 2015 Octubre | 7 | 4 | 11 |
| 2015 Septiembre | 5 | 2 | 7 |
| 2015 Agosto | 9 | 5 | 14 |
| 2015 Julio | 297 | 119 | 416 |
| 2015 Junio | 242 | 7 | 249 |
| 2015 Mayo | 288 | 19 | 307 |
| 2015 Abril | 281 | 15 | 296 |
| 2015 Marzo | 276 | 3 | 279 |
| 2015 Febrero | 222 | 2 | 224 |
| 2015 Enero | 190 | 6 | 196 |
| 2014 Diciembre | 157 | 5 | 162 |
| 2014 Noviembre | 141 | 4 | 145 |
| 2014 Octubre | 200 | 7 | 207 |
| 2014 Septiembre | 142 | 2 | 144 |
| 2014 Agosto | 131 | 4 | 135 |
| 2014 Julio | 138 | 6 | 144 |
| 2014 Junio | 145 | 8 | 153 |
| 2014 Mayo | 169 | 8 | 177 |
| 2014 Abril | 162 | 3 | 165 |
| 2014 Marzo | 155 | 14 | 169 |
| 2014 Febrero | 171 | 7 | 178 |
| 2014 Enero | 131 | 4 | 135 |
| 2013 Diciembre | 105 | 9 | 114 |
| 2013 Noviembre | 134 | 7 | 141 |
| 2013 Octubre | 107 | 5 | 112 |
| 2013 Septiembre | 59 | 4 | 63 |
| 2013 Agosto | 59 | 6 | 65 |
| 2013 Julio | 15 | 5 | 20 |
| 2013 Junio | 4 | 2 | 6 |
| 2013 Mayo | 4 | 5 | 9 |
| 2013 Abril | 2 | 0 | 2 |
Mostrar todo
