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insufficient evidence to support or reject the use of an intervention&#44; but sufficient evidence to support recommendations or suggestions&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">-</span><p id="par0065" class="elsevierStylePara elsevierViewall">Very useful&#58; strong evidence to support or reject the use of an intervention&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">-</span><p id="par0070" class="elsevierStylePara elsevierViewall">Unclassifiable&#46;</p></li></ul></p><p id="par0075" class="elsevierStylePara elsevierViewall">The 2 reviewers &#40;PDS and AB&#41; independently collected the information and recorded it in Microsoft Excel 2007&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">When the 2 principal reviewers did not agree on the classification of an article&#44; the review in question was evaluated by a third investigator &#40;IGD&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0085" class="elsevierStylePara elsevierViewall">All 55 systematic reviews identified by the search strategy were analyzed in their entirety &#40;<a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1 and 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">In 14 of the reviews &#40;25&#46;5&#37;&#41;&#44; the evidence was insufficient to support the rejection or recommendation of any of the interventions studied &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">In 16 &#40;29&#46;1&#37;&#41;&#44; the results obtained provided strong evidence to support or reject the use of at least 1 of the interventions studied &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Finally&#44; 25 of the 55 reviews &#40;45&#46;5&#37;&#41; provided moderate evidence &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#44; sufficient to support recommendations or suggestions&#59; these articles also highlighted the lack of strong evidence and the need for good quality randomized clinical trials to remedy this deficit&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The 2 principal reviewers did not initially agree on the classification of 9 of the 55 systematic reviews&#46; These discrepancies were resolved when they reassessed these reviews together&#44; and no further assessment on the part of the third reviewer was needed&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0110" class="elsevierStylePara elsevierViewall">Dermatology has taken longer than other specialties to incorporate evidence-based medical practice&#46; This delayed adoption is reflected in the smaller number of high-quality clinical trials that have been undertaken to assess dermatologic therapies as compared to other specialties such as cardiology&#44; rheumatology&#44; and internal medicine&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;11&#44;12</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">The efficacy of many of the therapies referred to in dermatology as &#8220;classic&#8221; has never been proven in randomized clinical trials&#44; and most of them have never been tested in placebo-controlled trials&#46; Possibly&#44; dermatologists&#8217; acceptance of empirical therapies is a result of the belief that better evidence is unavailable&#46; This assertion should not&#44; however&#44; be made until at least one high-quality systematic review has been performed&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The more information we have at our disposal&#44; the more we need tools&#44; such as systematic reviews&#44; that synthesize the information and reduce our need to access multiple primary sources&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">In this study&#44; we analyzed all the reviews published by the Cochrane Skin Group before August 2012&#46; The results obtained demonstrate the practical usefulness of these reviews since over 70&#37; provide useful evidence concerning the use of therapeutic and preventive interventions in dermatology&#46; Only 26&#37; of these reviews did not provide sufficient evidence to support any recommendations&#46; Although a systematic review that does not find sufficient evidence is of little use to the clinician&#44; it is still of use to the specialty because it underscores the need for quality research to address a knowledge deficit and stimulates further research in the area in question&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">One of the strengths of our study is the high level of reproducibility of the method used to classify the studies&#44; which generated few doubts&#46; Another strength is that we only evaluated systematic reviews published by the Cochrane Skin Group&#44; thereby ensuring the quality of the review articles and the reliability of the recommendations&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">However&#44; a limitation is our exclusive focus on the reviews by the Cochrane Skin Group rather than including other&#44; increasingly numerous&#44; sources of systematic reviews that may be relevant to dermatologic practice&#59; among candidates for inclusion would have been systematic reviews produced by other working groups in the Cochrane Collaboration&#46; It should also be remembered that systematic reviews are updated periodically and that conclusions may change over time&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Our findings demonstrate an improvement over the results obtained by Parker et al&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> in 2001&#46; Those authors analyzed the systematic reviews on dermatologic issues in the Database of Abstracts of Reviews of Effectiveness &#40;DARE&#41; and The Cochrane Collaboration&#46; We note that while the selection and classification methods used in that study and ours were slightly different&#44; we found a significantly higher percentage of reviews that provided sufficient evidence to support recommendations &#40;74&#46;5&#37;&#41; than Parker et al did&#46; &#40;40&#37;&#41;&#46; This discrepancy could be explained by differences in design&#44; the growing number of high-quality randomized trials being carried out in dermatology&#44; or by the choice of systematic review topics more oriented to fields with sufficient evidence&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusions</span><p id="par0145" class="elsevierStylePara elsevierViewall">The present study demonstrates the practical use of the systematic reviews published by the Cochrane Skin Group&#46; Three fourths of these reviews provided sufficient evidence to make some kind of recommendation or suggestion in favor or against a particular intervention&#46; These recommendations could serve to improve our daily clinical practice&#44; help us in our decisions&#44; and lead us to question certain commonly established practices&#46; Systematic reviews that do not provide enough evidence to support useful recommendations are also useful in that they guide future research&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Comparing our practice with the recommendations of the Cochrane Skin Group reviews is a good way to improve the care we give our patients&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Ethical Disclosures</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Protection of human and animal subjects</span><p id="par0155" class="elsevierStylePara elsevierViewall">The authors state that no experiments were performed on humans or animals for this investigation&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Confidentiality of data</span><p id="par0160" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their workplace concerning the publication of patient data&#44; and that all the patients included in this study were appropriately informed and gave their written consent to participate in this study&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Right to privacy and informed consent</span><p id="par0165" class="elsevierStylePara elsevierViewall">The authors declare that no private patient data are disclosed in this article&#46;</p></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Conflicts of Interest</span><p id="par0170" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:12 [
        0 => array:2 [
          "identificador" => "xres276220"
          "titulo" => array:5 [
            0 => "Abstract"
            1 => "Background and objective"
            2 => "Material and methods"
            3 => "Results"
            4 => "Conclusions"
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec258196"
          "titulo" => "Keywords"
        ]
        2 => array:2 [
          "identificador" => "xres276221"
          "titulo" => array:5 [
            0 => "Resumen"
            1 => "Introducci&#243;n y objetivos"
            2 => "Material y m&#233;todos"
            3 => "Resultados"
            4 => "Conclusiones"
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec258195"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Materials and Methods"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Conclusions"
        ]
        9 => array:3 [
          "identificador" => "sec0030"
          "titulo" => "Ethical Disclosures"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Protection of human and animal subjects"
            ]
            1 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Confidentiality of data"
            ]
            2 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Right to privacy and informed consent"
            ]
          ]
        ]
        10 => array:2 [
          "identificador" => "sec0050"
          "titulo" => "Conflicts of Interest"
        ]
        11 => array:1 [
          "titulo" => "References"
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    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2012-09-18"
    "fechaAceptado" => "2012-12-16"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec258196"
          "palabras" => array:8 [
            0 => "Database"
            1 => "Bibliographic"
            2 => "Dermatology"
            3 => "Evidence-based medicine"
            4 => "Cochrane Skin Group"
            5 => "Systematic reviews"
            6 => "Review literature as topic"
            7 => "Bibliometrics"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec258195"
          "palabras" => array:8 [
            0 => "Bases de datos"
            1 => "Bibliogr&#225;fico"
            2 => "Dermatolog&#237;a"
            3 => "Medicina-basada en la evidencia"
            4 => "Cochrane Skin Group"
            5 => "Revisiones sistem&#225;ticas"
            6 => "Revisi&#243;n de la literatura como tema"
            7 => "Bibliometr&#237;a"
          ]
        ]
      ]
    ]
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    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Background and objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Systematic reviews are one of the most important sources of information for evidence-based medicine&#46; However&#44; there is a general impression that these reviews rarely report results that provide sufficient evidence to change clinical practice&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The aim of this study was to determine the percentage of Cochrane Skin Group reviews reporting results with the potential to guide clinical decision-making&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We performed a bibliometric analysis of all the systematic reviews published by the Cochrane Skin Group up to 16 August&#44; 2012&#46; We retrieved 55 reviews&#44; which were analyzed and graded independently by 2 investigators into 3 categories&#58; 0 &#40;insufficient evidence to support or reject the use of an intervention&#41;&#44; 1 &#40;insufficient evidence to support or reject the use of an intervention but sufficient evidence to support recommendations or suggestions&#41;&#44; and 2 &#40;sufficient evidence to support or reject the use of an intervention&#41;&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Our analysis showed that 25&#46;5&#37; &#40;14&#47;55&#41; of the studies did not provide sufficient evidence to support or reject the use of the interventions studied&#44; 45&#46;5&#37; &#40;25&#47;25&#41; provided sufficient but not strong evidence to support recommendations or suggestions&#44; and 29&#46;1&#37; &#40;16&#47;55&#41; provided strong evidence to support or reject the use of 1 or more of the interventions studied&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Most of the systematic reviews published by the Cochrane Skin Group provide useful information to improve clinical practice&#46; Clinicians should read these reviews and reconsider their current practice&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n y objetivos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Las revisiones sistem&#225;ticas son una de las fuentes m&#225;s importantes de Medicina basada en la evidencia&#46; No obstante&#44; existe una impresi&#243;n de que estas revisiones rara vez aportan resultados con evidencia suficiente para cambiar nuestra pr&#225;ctica&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El objetivo de este trabajo es determinar el porcentaje de revisiones publicadas por el <span class="elsevierStyleItalic">Cochrane Skin Group</span> &#40;Grupo Cochrane de Piel&#41; con resultados &#250;tiles para guiar nuestras decisiones cl&#237;nicas&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se ha realizado un an&#225;lisis bibliom&#233;trico de las revisiones sistem&#225;ticas realizadas por el <span class="elsevierStyleItalic">Cochrane Skin Group</span> y publicadas hasta el 16 de agosto de 2012&#46; Se obtuvieron un total de 55 revisiones&#44; las cuales fueron analizadas y clasificadas de forma independiente por 2 investigadores en&#58; 0&#41; no existe evidencia suficiente para apoyar o rechazar ninguna intervenci&#243;n&#59; 1&#41; no existe evidencia suficiente para rechazar o apoyar una intervenci&#243;n pero s&#237; existe suficiente evidencia para hacer recomendaciones o sugerencias&#59; y 2&#41; existe una fuerte evidencia para apoyar o rechazar una intervenci&#243;n&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Del total de las revisiones publicadas por el <span class="elsevierStyleItalic">Cochrane Skin Group</span> el 25&#44;5&#37; &#40;14&#47;55&#41; no mostraban evidencia suficiente en ninguna de las intervenciones estudiadas para sustentar su rechazo o aprobaci&#243;n&#46; Un 29&#44;1&#37; &#40;16&#47;55&#41; obtuvo resultados con una fuerte evidencia a favor o en contra de alguna de las intervenciones estudiadas y el 45&#44;5&#37; &#40;25&#47;55&#41; mostraba evidencia suficiente&#44; aunque no fuerte&#44; para hacer sugerencias o recomendaciones&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">La mayor&#237;a de las revisiones sistem&#225;ticas del <span class="elsevierStyleItalic">Cochrane Skin Group</span> aportan informaci&#243;n &#250;til para mejorar nuestra actividad cl&#237;nica&#46; Los cl&#237;nicos deber&#237;an leerlas y compararlas con su pr&#225;ctica actual&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Davila-Seijo P&#44; et al&#46; Utilidad de las revisiones del <span class="elsevierStyleItalic">Cochrane Skin Group</span> para la pr&#225;ctica cl&#237;nica&#46; Actas Dermosifiliogr&#46; 2013&#59;104&#58;679&#8211;84&#46;</p>"
      ]
    ]
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      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
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        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Classification of Cochrane Skin Group systematic reviews according to clinical usefulness&#58; not useful for clinical practice &#40;insufficient evidence to support any recommendation for or against the interventions studied&#41;&#59; useful &#40;the evidence found is not strong but is sufficient to make recommendations or suggestions on some of the interventions studied&#41;&#59; and very useful &#40;strong evidence was found for or against at least 1 of the interventions studied&#41;&#46;</p>"
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        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; PUVA&#44; psoralen UV-A phototherapy&#46;</p>"
          "tablatextoimagen" => array:1 [
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                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">Title&nbsp;\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">Recommendations&nbsp;\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">Interventions for bullous pemphigoid&nbsp;\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">Starting dosages of prednisolone higher than 0&#46;75<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;d do not offer any additional benefit&#46; Lower doses &#40;0&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;d&#41; may be sufficient to control disease in most patients&#46; The low-dose regimen could reduce the incidence and severity of the adverse effects associated with treatment &#40;especially mortality&#41;&#46;Very potent topical corticosteroids &#40;for example&#44; clobetasol propionate&#41; are effective and appear to have fewer adverse effects than high-dose regimens of systemic corticosteroids&#59; however&#44; their use in extensive disease may be limited by practical factors relating to their application&#46; They should be considered as the first-line therapy whenever possible&#44; particularly when disease is localized&#46; The use of large quantities can lead to systemic absorption of the corticosteroid and adverse events&#46;&nbsp;\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">Interventions for chronic palmoplantar pustulosis&nbsp;\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">The efficacy of topical corticosteroids increases when hydrocolloid dressings are used to occlude the treated area&#58; clearing was achieved in 2 out of 3 patients within 12 days&#46; Oral PUVA can induce clearance in 2 out of 5 patients&#46; Systemic retinoids at 0&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;d produced improvement in 2 out of 3 patients and a good to excellent response in 2 out of 5&#46; Maintenance therapy with retinoids reduces the incidence of recurrence&#46; Combining retinoid therapy with PUVA appears to enhance the efficacy of both therapies and induce clearing in 2 out of 3 patients&#46; There is evidence that tetracycline antibiotics and ciclosporin can be beneficial in the treatment of palmoplantar pustulosis&nbsp;\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">Interventions for female pattern hair loss&nbsp;\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">Evidence supports the efficacy and safety of topical minoxidil in the treatment of female pattern hair loss&#46; Studies are needed to compare the application of minoxidil<span class="elsevierStyleHsp" style=""></span>5&#37; once a day to minoxidil<span class="elsevierStyleHsp" style=""></span>2&#37; twice daily&#46;&nbsp;\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">Interventions for the skin infection impetigo&nbsp;\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">Good evidence suggests that topical mupirocin and topical fusidic acid are equally&#44; or more&#44; effective than oral treatment in patients with limited disease&#46; Both have shown similar efficacy&#46; It is unclear whether oral antibiotic therapy is superior to topical antibiotics in patients with extensive disease&#46; Penicillin was found to be less effective than other oral antibiotics&#46; The pattern of antibiotic resistance should be taken into account when choosing appropriate antibiotic therapy&#46;&nbsp;\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">Interventions for ingrowing toenails&nbsp;\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">Surgical interventions are more effective than nonsurgical treatments in preventing the recurrence of an ingrowing toenail&#46; Surgical intervention in combination with nail matrix phenolization appears to prevent recurrence more effectively than surgery alone&#46; No evidence is available to support the use of the postoperative administration of prophylactic antibiotics to reduce the risk of complications&#46;&nbsp;\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">Interventions for mucous membrane pemphigoid and epidermolysis bullosa acquisita&nbsp;\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">Benign mucous membrane pemphigoid with mild to moderate activity responds to dapsone in most patients&#46; Dapsone should therefore be the first-line treatment&#44; given that it is less toxic than cyclophosphamide&#46; There is moderate evidence for a response to cyclophosphamide combined with topical steroids&nbsp;\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">Interventions for photodamaged skin&nbsp;\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">Clear evidence shows that topical tretinoin improves the appearance of mild to moderate photodamage on the face and forearms in the short term&#46; However&#44; scaling&#44; dryness&#44; irritation&#44; and burning may initially be experienced&#46;&nbsp;\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">Interventions for rosacea&nbsp;\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">Topical metronidazole&#44; azelaic acid&#44; and anti-inflammatory doses of doxycycline &#40;40<span class="elsevierStyleHsp" style=""></span>mg&#41; appear to be safe and effective for papulopustular rosacea in the short term&#46; There is evidence that a doxycycline dosage of 40<span class="elsevierStyleHsp" style=""></span>mg&#47;d is as effective as 100<span class="elsevierStyleHsp" style=""></span>mg&#47;d and that the lower dose is associated with fewer adverse effects&#46;&nbsp;\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">Interventions for toxic epidermal necrolysis&nbsp;\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">Treatment with thalidomide has not been shown to be effective and has been associated with higher mortality in placebo-controlled trials&#46; There are no randomized clinical trials in this setting assessing the efficacy and safety of other interventions&#44; such as systemic corticosteroids&#44; ciclosporin&#44; and immunoglobulins&#46;&nbsp;\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">Lasers or light sources for treating port-wine stains&nbsp;\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">Pulsed dye laser treatment leads to clinically relevant clearance of port-wine stains&nbsp;\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">Oral treatments for fungal infections of the skin of the foot&nbsp;\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">Terbinafine appears to be more effective than griseofulvin in the treatment of tinea pedis&#46; Terbinafine and itraconazole are more effective than placebo&#46; Terbinafine &#40;2 wks&#41; is more effective than itraconazole &#40;2 wks&#41;&#46; No significant differences were found between terbinafine &#40;2 wks&#41; and itraconazole &#40;4 wks&#41;&#44; between fluconazole and either ketoconazole or itraconazole&#44; between griseofulvin and ketoconazole&#44; or between different doses of fluconazole&#46;&nbsp;\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">Systemic antifungal therapy for tinea capitis in children&nbsp;\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">Terbinafine&#44; fluconazole&#44; and itraconazole are as effective as griseofulvin in the treatment of tinea capitis caused by <span class="elsevierStyleItalic">Trichophyton</span> species in children&#46; Shorter treatment durations of these antifungals may improve adherence&#59; the safety profile of such short regimens is good in children&#46;&nbsp;\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">Topical pimecrolimus for eczema&nbsp;\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">Topical pimecrolimus is less effective than moderate and potent topical corticosteroids and tacrolimus 0&#46;1&#37;&#46;&nbsp;\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">Topical treatments for chronic plaque psoriasis&nbsp;\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">Evidence suggests that vitamin D analogs are more effective than the emollient alone&#46; Potent and very potent corticosteroids are also effective and very potent corticosteroids are more effective than either potent corticosteroids or vitamin D analogs&#46; The effectiveness of dithranol and tazarotene appears to be similar to that of vitamin D analogs&#46; Corticosteroids appear to be more effective than vitamin D in psoriasis of the scalp&#44; whereas these treatments are equally effective for psoriasis on the rest of the body&#46; Combined treatment with vitamin D and corticosteroids is more effective than either treatment in monotherapy&#46; Vitamin D is more effective than coal tar&#44; but the results on the relative effectiveness of vitamin D and dithranol were mixed&#46; Occlusion improves the effectiveness of vitamin D analogs if the application is done twice daily rather than once a day&#46;&nbsp;\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">Topical treatments for cutaneous warts&nbsp;\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">There is clear evidence that topical formulations containing salicylic acid are effective&#46; There is less evidence supporting cryotherapy&#44; a treatment that does not appear to offer better results than simpler and safer methods&#46;&nbsp;\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">Topical treatments for fungal infections of the skin and nails of the foot&nbsp;\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">Topical allylamines and azoles produce much higher cure rates than placebo in athlete&#39;s foot&#46; Allylamines were associated with a slightly higher cure rate than azoles&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">List of Cochrane Skin Group Systematic Reviews Considered Very Useful in Clinical Practice &#40;Strong Evidence to Support Recommendations Concerning One or More of the Therapeutic Interventions Reviewed&#41; Together With a Summary of the Authors&#8217; Recommendations&#46;</p>"
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                  <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">Title&nbsp;\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"><span class="elsevierStyleItalic">Reviews classified as &#8220;useful in clinical practice&#8221;</span>&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Chinese herbal medicine for atopic eczema&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Dietary exclusion for established atopic eczema&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Drugs for discoid lupus erythematosus&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for American cutaneous and mucocutaneous leishmaniasis&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for Old World cutaneous leishmaniasis&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for basal cell carcinoma of the skin&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for cellulitis and erysipelas&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for erosive lichen planus affecting muscosal sites&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for erythema nodosum leprosum&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for infantile hemangiomas &#40;strawberry birthmarks&#41; of the skin&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for melasma&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for pemphigus vulgaris and pemphigus foliaceus&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for pityriasis rosea&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for preventing non-melanoma skin cancers in high-risk groups&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for preventing occupational irritant hand dermatitis&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for skin changes caused by nerve damage in leprosy&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for vitiligo&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions to reduce <span class="elsevierStyleItalic">Staphylococcus aureus</span> in the management of atopic dermatitis&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Laser and photoepilation for unwanted hair growth&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Probiotics for treating eczema&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Psychological and educational interventions for atopic eczema in children&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Safety of topical corticosteroids in pregnancy&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Systemic treatments for metastatic cutaneous melanoma&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Topical interventions for genital lichen sclerosus&nbsp;\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"><span class="elsevierStyleVsp" style="height:0.5px"></span>&nbsp;\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"><span class="elsevierStyleItalic">Reviews classified as &#8220;not useful in clinical practice&#8221;</span>&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Antistreptococcal interventions for guttate and chronic plaque psoriasis&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Chemoimmunotherapy versus chemotherapy in metastatic malignant melanoma&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Disposable nappies for preventing napkin dermatitis in children&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Histamine H<span class="elsevierStyleInf">2</span>-receptor antagonists for urticaria&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for alopecia areata&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for cutaneous molluscum contagiosum&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for guttate psoriasis&nbsp;\t\t\t\t\t\t\n
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Original Article
Usefulness of Cochrane Skin Group Reviews for Clinical Practice
Utilidad de las revisiones del Cochrane Skin Group para la práctica clínica
P. Davila-Seijo
Autor para correspondencia
pauladavilaseijo@gmail.com

Corresponding author.
, A. Batalla, I. Garcia-Doval
Derpartamento de Dermatología, Complexo Hospitalario de Pontevedra (CHOP), Servicio Galego de Saúde (SERGAS), Pontevedra, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Evidence-based medicine is an approach to health care in which the clinician&#39;s decisions are taken on the basis of the available scientific evidence with a view to improving patient care&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Given the large quantity of biomedical information now available&#44; it is difficult for practitioners to keep abreast of the medical literature and to identify the most relevant and best evidence for each topic&#46; Thus we need tools&#44; such as systematic reviews&#44; that facilitate this process by evaluating the data and summarizing the strength of the available evidence&#44; which is rated according to study type&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In the biomedical evidence resource pyramid&#44; 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mainly because of the work of the Cochrane Collaboration&#44; an international network formed in 1993 to prepare and disseminate high-quality systematic reviews that examine the effects of health care interventions&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a> Cochrane reviews&#44; published in the Cochrane Database of Systematic Reviews&#44; are the product of working groups of volunteers from all over the world&#46; The systematic reviews these groups prepare are of high quality because they follow rigorous protocols and methods of review and evaluation that have been designed to minimize error and bias&#46; As a result&#44; the Cochrane database is one of the most reliable sources of biomedical evidence available&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;5&#44;6</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Until recently&#44; there were relatively few systematic reviews in the field of dermatology compared to other medical specialties&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> This situation is changing&#44; 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2012&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">No inclusion or exclusion criteria were applied&#59; that is&#44; all the group&#39;s published reviews were evaluated&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">In every case&#44; the full text was retrieved together with the full title and all author details&#44; the year of publication&#44; and the authors&#8217; conclusions&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">All the reviews were evaluated independently by 2 researchers&#44; who classified them according to their usefulness in clinical practice into the following categories&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0055" class="elsevierStylePara elsevierViewall">Not useful in clinical practice&#58; insufficient evidence to support or reject the use of an intervention&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0060" class="elsevierStylePara elsevierViewall">Useful&#58; insufficient evidence to support or reject the use of an intervention&#44; but sufficient evidence to support recommendations or suggestions&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">-</span><p id="par0065" class="elsevierStylePara elsevierViewall">Very useful&#58; strong evidence to support or reject the use of an intervention&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">-</span><p id="par0070" class="elsevierStylePara elsevierViewall">Unclassifiable&#46;</p></li></ul></p><p id="par0075" class="elsevierStylePara elsevierViewall">The 2 reviewers &#40;PDS and AB&#41; independently collected the information and recorded it in Microsoft Excel 2007&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">When the 2 principal reviewers did not agree on the classification of an article&#44; the review in question was evaluated by a third investigator &#40;IGD&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0085" class="elsevierStylePara elsevierViewall">All 55 systematic reviews identified by the search strategy were analyzed in their entirety &#40;<a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1 and 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">In 14 of the reviews &#40;25&#46;5&#37;&#41;&#44; the evidence was insufficient to support the rejection or recommendation of any of the interventions studied &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0095" class="elsevierStylePara elsevierViewall">In 16 &#40;29&#46;1&#37;&#41;&#44; the results obtained provided strong evidence to support or reject the use of at least 1 of the interventions studied &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Finally&#44; 25 of the 55 reviews &#40;45&#46;5&#37;&#41; provided moderate evidence &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#44; sufficient to support recommendations or suggestions&#59; these articles also highlighted the lack of strong evidence and the need for good quality randomized clinical trials to remedy this deficit&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">The 2 principal reviewers did not initially agree on the classification of 9 of the 55 systematic reviews&#46; These discrepancies were resolved when they reassessed these reviews together&#44; and no further assessment on the part of the third reviewer was needed&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0110" class="elsevierStylePara elsevierViewall">Dermatology has taken longer than other specialties to incorporate evidence-based medical practice&#46; This delayed adoption is reflected in the smaller number of high-quality clinical trials that have been undertaken to assess dermatologic therapies as compared to other specialties such as cardiology&#44; rheumatology&#44; and internal medicine&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;11&#44;12</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">The efficacy of many of the therapies referred to in dermatology as &#8220;classic&#8221; has never been proven in randomized clinical trials&#44; and most of them have never been tested in placebo-controlled trials&#46; Possibly&#44; dermatologists&#8217; acceptance of empirical therapies is a result of the belief that better evidence is unavailable&#46; This assertion should not&#44; however&#44; be made until at least one high-quality systematic review has been performed&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">The more information we have at our disposal&#44; the more we need tools&#44; such as systematic reviews&#44; that synthesize the information and reduce our need to access multiple primary sources&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">In this study&#44; we analyzed all the reviews published by the Cochrane Skin Group before August 2012&#46; The results obtained demonstrate the practical usefulness of these reviews since over 70&#37; provide useful evidence concerning the use of therapeutic and preventive interventions in dermatology&#46; Only 26&#37; of these reviews did not provide sufficient evidence to support any recommendations&#46; Although a systematic review that does not find sufficient evidence is of little use to the clinician&#44; it is still of use to the specialty because it underscores the need for quality research to address a knowledge deficit and stimulates further research in the area in question&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">One of the strengths of our study is the high level of reproducibility of the method used to classify the studies&#44; which generated few doubts&#46; Another strength is that we only evaluated systematic reviews published by the Cochrane Skin Group&#44; thereby ensuring the quality of the review articles and the reliability of the recommendations&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">However&#44; a limitation is our exclusive focus on the reviews by the Cochrane Skin Group rather than including other&#44; increasingly numerous&#44; sources of systematic reviews that may be relevant to dermatologic practice&#59; among candidates for inclusion would have been systematic reviews produced by other working groups in the Cochrane Collaboration&#46; It should also be remembered that systematic reviews are updated periodically and that conclusions may change over time&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Our findings demonstrate an improvement over the results obtained by Parker et al&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> in 2001&#46; Those authors analyzed the systematic reviews on dermatologic issues in the Database of Abstracts of Reviews of Effectiveness &#40;DARE&#41; and The Cochrane Collaboration&#46; We note that while the selection and classification methods used in that study and ours were slightly different&#44; we found a significantly higher percentage of reviews that provided sufficient evidence to support recommendations &#40;74&#46;5&#37;&#41; than Parker et al did&#46; &#40;40&#37;&#41;&#46; This discrepancy could be explained by differences in design&#44; the growing number of high-quality randomized trials being carried out in dermatology&#44; or by the choice of systematic review topics more oriented to fields with sufficient evidence&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusions</span><p id="par0145" class="elsevierStylePara elsevierViewall">The present study demonstrates the practical use of the systematic reviews published by the Cochrane Skin Group&#46; Three fourths of these reviews provided sufficient evidence to make some kind of recommendation or suggestion in favor or against a particular intervention&#46; These recommendations could serve to improve our daily clinical practice&#44; help us in our decisions&#44; and lead us to question certain commonly established practices&#46; Systematic reviews that do not provide enough evidence to support useful recommendations are also useful in that they guide future research&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">Comparing our practice with the recommendations of the Cochrane Skin Group reviews is a good way to improve the care we give our patients&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Ethical Disclosures</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Protection of human and animal subjects</span><p id="par0155" class="elsevierStylePara elsevierViewall">The authors state that no experiments were performed on humans or animals for this investigation&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Confidentiality of data</span><p id="par0160" class="elsevierStylePara elsevierViewall">The authors declare that they have followed the protocols of their workplace concerning the publication of patient data&#44; 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          "titulo" => "Keywords"
        ]
        2 => array:2 [
          "identificador" => "xres276221"
          "titulo" => array:5 [
            0 => "Resumen"
            1 => "Introducci&#243;n y objetivos"
            2 => "Material y m&#233;todos"
            3 => "Resultados"
            4 => "Conclusiones"
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec258195"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Materials and Methods"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Results"
        ]
        7 => array:2 [
          "identificador" => "sec0020"
          "titulo" => "Discussion"
        ]
        8 => array:2 [
          "identificador" => "sec0025"
          "titulo" => "Conclusions"
        ]
        9 => array:3 [
          "identificador" => "sec0030"
          "titulo" => "Ethical Disclosures"
          "secciones" => array:3 [
            0 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Protection of human and animal subjects"
            ]
            1 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Confidentiality of data"
            ]
            2 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Right to privacy and informed consent"
            ]
          ]
        ]
        10 => array:2 [
          "identificador" => "sec0050"
          "titulo" => "Conflicts of Interest"
        ]
        11 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2012-09-18"
    "fechaAceptado" => "2012-12-16"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec258196"
          "palabras" => array:8 [
            0 => "Database"
            1 => "Bibliographic"
            2 => "Dermatology"
            3 => "Evidence-based medicine"
            4 => "Cochrane Skin Group"
            5 => "Systematic reviews"
            6 => "Review literature as topic"
            7 => "Bibliometrics"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec258195"
          "palabras" => array:8 [
            0 => "Bases de datos"
            1 => "Bibliogr&#225;fico"
            2 => "Dermatolog&#237;a"
            3 => "Medicina-basada en la evidencia"
            4 => "Cochrane Skin Group"
            5 => "Revisiones sistem&#225;ticas"
            6 => "Revisi&#243;n de la literatura como tema"
            7 => "Bibliometr&#237;a"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Background and objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Systematic reviews are one of the most important sources of information for evidence-based medicine&#46; However&#44; there is a general impression that these reviews rarely report results that provide sufficient evidence to change clinical practice&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The aim of this study was to determine the percentage of Cochrane Skin Group reviews reporting results with the potential to guide clinical decision-making&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">We performed a bibliometric analysis of all the systematic reviews published by the Cochrane Skin Group up to 16 August&#44; 2012&#46; We retrieved 55 reviews&#44; which were analyzed and graded independently by 2 investigators into 3 categories&#58; 0 &#40;insufficient evidence to support or reject the use of an intervention&#41;&#44; 1 &#40;insufficient evidence to support or reject the use of an intervention but sufficient evidence to support recommendations or suggestions&#41;&#44; and 2 &#40;sufficient evidence to support or reject the use of an intervention&#41;&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Our analysis showed that 25&#46;5&#37; &#40;14&#47;55&#41; of the studies did not provide sufficient evidence to support or reject the use of the interventions studied&#44; 45&#46;5&#37; &#40;25&#47;25&#41; provided sufficient but not strong evidence to support recommendations or suggestions&#44; and 29&#46;1&#37; &#40;16&#47;55&#41; provided strong evidence to support or reject the use of 1 or more of the interventions studied&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Most of the systematic reviews published by the Cochrane Skin Group provide useful information to improve clinical practice&#46; Clinicians should read these reviews and reconsider their current practice&#46;</p>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0035">Introducci&#243;n y objetivos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Las revisiones sistem&#225;ticas son una de las fuentes m&#225;s importantes de Medicina basada en la evidencia&#46; No obstante&#44; existe una impresi&#243;n de que estas revisiones rara vez aportan resultados con evidencia suficiente para cambiar nuestra pr&#225;ctica&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El objetivo de este trabajo es determinar el porcentaje de revisiones publicadas por el <span class="elsevierStyleItalic">Cochrane Skin Group</span> &#40;Grupo Cochrane de Piel&#41; con resultados &#250;tiles para guiar nuestras decisiones cl&#237;nicas&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se ha realizado un an&#225;lisis bibliom&#233;trico de las revisiones sistem&#225;ticas realizadas por el <span class="elsevierStyleItalic">Cochrane Skin Group</span> y publicadas hasta el 16 de agosto de 2012&#46; Se obtuvieron un total de 55 revisiones&#44; las cuales fueron analizadas y clasificadas de forma independiente por 2 investigadores en&#58; 0&#41; no existe evidencia suficiente para apoyar o rechazar ninguna intervenci&#243;n&#59; 1&#41; no existe evidencia suficiente para rechazar o apoyar una intervenci&#243;n pero s&#237; existe suficiente evidencia para hacer recomendaciones o sugerencias&#59; y 2&#41; existe una fuerte evidencia para apoyar o rechazar una intervenci&#243;n&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Del total de las revisiones publicadas por el <span class="elsevierStyleItalic">Cochrane Skin Group</span> el 25&#44;5&#37; &#40;14&#47;55&#41; no mostraban evidencia suficiente en ninguna de las intervenciones estudiadas para sustentar su rechazo o aprobaci&#243;n&#46; Un 29&#44;1&#37; &#40;16&#47;55&#41; obtuvo resultados con una fuerte evidencia a favor o en contra de alguna de las intervenciones estudiadas y el 45&#44;5&#37; &#40;25&#47;55&#41; mostraba evidencia suficiente&#44; aunque no fuerte&#44; para hacer sugerencias o recomendaciones&#46;</p> <span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">La mayor&#237;a de las revisiones sistem&#225;ticas del <span class="elsevierStyleItalic">Cochrane Skin Group</span> aportan informaci&#243;n &#250;til para mejorar nuestra actividad cl&#237;nica&#46; Los cl&#237;nicos deber&#237;an leerlas y compararlas con su pr&#225;ctica actual&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Davila-Seijo P&#44; et al&#46; Utilidad de las revisiones del <span class="elsevierStyleItalic">Cochrane Skin Group</span> para la pr&#225;ctica cl&#237;nica&#46; Actas Dermosifiliogr&#46; 2013&#59;104&#58;679&#8211;84&#46;</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" => 712
            "Ancho" => 1670
            "Tamanyo" => 72423
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Classification of Cochrane Skin Group systematic reviews according to clinical usefulness&#58; not useful for clinical practice &#40;insufficient evidence to support any recommendation for or against the interventions studied&#41;&#59; useful &#40;the evidence found is not strong but is sufficient to make recommendations or suggestions on some of the interventions studied&#41;&#59; and very useful &#40;strong evidence was found for or against at least 1 of the interventions studied&#41;&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; PUVA&#44; psoralen UV-A phototherapy&#46;</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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Title&nbsp;\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">Recommendations&nbsp;\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">Interventions for bullous pemphigoid&nbsp;\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">Starting dosages of prednisolone higher than 0&#46;75<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;d do not offer any additional benefit&#46; Lower doses &#40;0&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;d&#41; may be sufficient to control disease in most patients&#46; The low-dose regimen could reduce the incidence and severity of the adverse effects associated with treatment &#40;especially mortality&#41;&#46;Very potent topical corticosteroids &#40;for example&#44; clobetasol propionate&#41; are effective and appear to have fewer adverse effects than high-dose regimens of systemic corticosteroids&#59; however&#44; their use in extensive disease may be limited by practical factors relating to their application&#46; They should be considered as the first-line therapy whenever possible&#44; particularly when disease is localized&#46; The use of large quantities can lead to systemic absorption of the corticosteroid and adverse events&#46;&nbsp;\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">Interventions for chronic palmoplantar pustulosis&nbsp;\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">The efficacy of topical corticosteroids increases when hydrocolloid dressings are used to occlude the treated area&#58; clearing was achieved in 2 out of 3 patients within 12 days&#46; Oral PUVA can induce clearance in 2 out of 5 patients&#46; Systemic retinoids at 0&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;d produced improvement in 2 out of 3 patients and a good to excellent response in 2 out of 5&#46; Maintenance therapy with retinoids reduces the incidence of recurrence&#46; Combining retinoid therapy with PUVA appears to enhance the efficacy of both therapies and induce clearing in 2 out of 3 patients&#46; There is evidence that tetracycline antibiotics and ciclosporin can be beneficial in the treatment of palmoplantar pustulosis&nbsp;\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">Interventions for female pattern hair loss&nbsp;\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">Evidence supports the efficacy and safety of topical minoxidil in the treatment of female pattern hair loss&#46; Studies are needed to compare the application of minoxidil<span class="elsevierStyleHsp" style=""></span>5&#37; once a day to minoxidil<span class="elsevierStyleHsp" style=""></span>2&#37; twice daily&#46;&nbsp;\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">Interventions for the skin infection impetigo&nbsp;\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">Good evidence suggests that topical mupirocin and topical fusidic acid are equally&#44; or more&#44; effective than oral treatment in patients with limited disease&#46; Both have shown similar efficacy&#46; It is unclear whether oral antibiotic therapy is superior to topical antibiotics in patients with extensive disease&#46; Penicillin was found to be less effective than other oral antibiotics&#46; The pattern of antibiotic resistance should be taken into account when choosing appropriate antibiotic therapy&#46;&nbsp;\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">Interventions for ingrowing toenails&nbsp;\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">Surgical interventions are more effective than nonsurgical treatments in preventing the recurrence of an ingrowing toenail&#46; Surgical intervention in combination with nail matrix phenolization appears to prevent recurrence more effectively than surgery alone&#46; No evidence is available to support the use of the postoperative administration of prophylactic antibiotics to reduce the risk of complications&#46;&nbsp;\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">Interventions for mucous membrane pemphigoid and epidermolysis bullosa acquisita&nbsp;\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">Benign mucous membrane pemphigoid with mild to moderate activity responds to dapsone in most patients&#46; Dapsone should therefore be the first-line treatment&#44; given that it is less toxic than cyclophosphamide&#46; There is moderate evidence for a response to cyclophosphamide combined with topical steroids&nbsp;\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">Interventions for photodamaged skin&nbsp;\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">Clear evidence shows that topical tretinoin improves the appearance of mild to moderate photodamage on the face and forearms in the short term&#46; However&#44; scaling&#44; dryness&#44; irritation&#44; and burning may initially be experienced&#46;&nbsp;\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">Interventions for rosacea&nbsp;\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">Topical metronidazole&#44; azelaic acid&#44; and anti-inflammatory doses of doxycycline &#40;40<span class="elsevierStyleHsp" style=""></span>mg&#41; appear to be safe and effective for papulopustular rosacea in the short term&#46; There is evidence that a doxycycline dosage of 40<span class="elsevierStyleHsp" style=""></span>mg&#47;d is as effective as 100<span class="elsevierStyleHsp" style=""></span>mg&#47;d and that the lower dose is associated with fewer adverse effects&#46;&nbsp;\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">Interventions for toxic epidermal necrolysis&nbsp;\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">Treatment with thalidomide has not been shown to be effective and has been associated with higher mortality in placebo-controlled trials&#46; There are no randomized clinical trials in this setting assessing the efficacy and safety of other interventions&#44; such as systemic corticosteroids&#44; ciclosporin&#44; and immunoglobulins&#46;&nbsp;\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">Lasers or light sources for treating port-wine stains&nbsp;\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">Pulsed dye laser treatment leads to clinically relevant clearance of port-wine stains&nbsp;\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">Oral treatments for fungal infections of the skin of the foot&nbsp;\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">Terbinafine appears to be more effective than griseofulvin in the treatment of tinea pedis&#46; Terbinafine and itraconazole are more effective than placebo&#46; Terbinafine &#40;2 wks&#41; is more effective than itraconazole &#40;2 wks&#41;&#46; No significant differences were found between terbinafine &#40;2 wks&#41; and itraconazole &#40;4 wks&#41;&#44; between fluconazole and either ketoconazole or itraconazole&#44; between griseofulvin and ketoconazole&#44; or between different doses of fluconazole&#46;&nbsp;\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">Systemic antifungal therapy for tinea capitis in children&nbsp;\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">Terbinafine&#44; fluconazole&#44; and itraconazole are as effective as griseofulvin in the treatment of tinea capitis caused by <span class="elsevierStyleItalic">Trichophyton</span> species in children&#46; Shorter treatment durations of these antifungals may improve adherence&#59; the safety profile of such short regimens is good in children&#46;&nbsp;\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">Topical pimecrolimus for eczema&nbsp;\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">Topical pimecrolimus is less effective than moderate and potent topical corticosteroids and tacrolimus 0&#46;1&#37;&#46;&nbsp;\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">Topical treatments for chronic plaque psoriasis&nbsp;\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">Evidence suggests that vitamin D analogs are more effective than the emollient alone&#46; Potent and very potent corticosteroids are also effective and very potent corticosteroids are more effective than either potent corticosteroids or vitamin D analogs&#46; The effectiveness of dithranol and tazarotene appears to be similar to that of vitamin D analogs&#46; Corticosteroids appear to be more effective than vitamin D in psoriasis of the scalp&#44; whereas these treatments are equally effective for psoriasis on the rest of the body&#46; Combined treatment with vitamin D and corticosteroids is more effective than either treatment in monotherapy&#46; Vitamin D is more effective than coal tar&#44; but the results on the relative effectiveness of vitamin D and dithranol were mixed&#46; Occlusion improves the effectiveness of vitamin D analogs if the application is done twice daily rather than once a day&#46;&nbsp;\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">Topical treatments for cutaneous warts&nbsp;\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">There is clear evidence that topical formulations containing salicylic acid are effective&#46; There is less evidence supporting cryotherapy&#44; a treatment that does not appear to offer better results than simpler and safer methods&#46;&nbsp;\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">Topical treatments for fungal infections of the skin and nails of the foot&nbsp;\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">Topical allylamines and azoles produce much higher cure rates than placebo in athlete&#39;s foot&#46; Allylamines were associated with a slightly higher cure rate than azoles&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">List of Cochrane Skin Group Systematic Reviews Considered Very Useful in Clinical Practice &#40;Strong Evidence to Support Recommendations Concerning One or More of the Therapeutic Interventions Reviewed&#41; Together With a Summary of the Authors&#8217; Recommendations&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
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              "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">Title&nbsp;\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"><span class="elsevierStyleItalic">Reviews classified as &#8220;useful in clinical practice&#8221;</span>&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Chinese herbal medicine for atopic eczema&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Dietary exclusion for established atopic eczema&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Drugs for discoid lupus erythematosus&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for American cutaneous and mucocutaneous leishmaniasis&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for Old World cutaneous leishmaniasis&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for basal cell carcinoma of the skin&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for cellulitis and erysipelas&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for erosive lichen planus affecting muscosal sites&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for erythema nodosum leprosum&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for infantile hemangiomas &#40;strawberry birthmarks&#41; of the skin&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for melasma&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for pemphigus vulgaris and pemphigus foliaceus&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for pityriasis rosea&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for preventing non-melanoma skin cancers in high-risk groups&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for preventing occupational irritant hand dermatitis&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for skin changes caused by nerve damage in leprosy&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for vitiligo&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions to reduce <span class="elsevierStyleItalic">Staphylococcus aureus</span> in the management of atopic dermatitis&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Laser and photoepilation for unwanted hair growth&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Probiotics for treating eczema&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Psychological and educational interventions for atopic eczema in children&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Safety of topical corticosteroids in pregnancy&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Systemic treatments for metastatic cutaneous melanoma&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Topical interventions for genital lichen sclerosus&nbsp;\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"><span class="elsevierStyleVsp" style="height:0.5px"></span>&nbsp;\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"><span class="elsevierStyleItalic">Reviews classified as &#8220;not useful in clinical practice&#8221;</span>&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Antistreptococcal interventions for guttate and chronic plaque psoriasis&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Chemoimmunotherapy versus chemotherapy in metastatic malignant melanoma&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Disposable nappies for preventing napkin dermatitis in children&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Histamine H<span class="elsevierStyleInf">2</span>-receptor antagonists for urticaria&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for alopecia areata&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for cutaneous molluscum contagiosum&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for guttate psoriasis&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Interventions for non-metastatic squamous cell carcinoma of the skin&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Laser resurfacing for facial acne scars&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Minocycline for acne vulgaris&#58; efficacy and safety&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Oral potassium iodide for the treatment of sporotrichosis&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Statins and fibrates for preventing melanoma&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Surgical excision margins for primary cutaneous melanoma&nbsp;\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"><span class="elsevierStyleHsp" style=""></span>Topical vitamin A&#44; or its derivatives&#44; for treating and preventing napkin dermatitis in infants&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab397362.png"
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        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">List of Cochrane Skin Group Systematic Reviews Not Included in Table 1 &#40;Not Classified as &#8220;Very Useful&#8221;&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:12 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evidence-based medicine in a nutshell&#46; A guide to finding and using the best evidence in caring for patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46; Bigby"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "1998"
                        "volumen" => "134"
                        "paginaInicial" => "1609"
                        "paginaFinal" => "1618"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9875202"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Methodology and reports of systematic reviews and meta-analyses&#58; A comparison of Cochrane reviews with articles published in paper-based journals"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46;R&#46; Jadad"
                            1 => "D&#46;J&#46; Cook"
                            2 => "A&#46; Jones"
                            3 => "T&#46;P&#46; Klassen"
                            4 => "P&#46; Tugwell"
                            5 => "M&#46; Moher"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "1998"
                        "volumen" => "280"
                        "paginaInicial" => "278"
                        "paginaFinal" => "280"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9676681"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Cochrane collaboration&#58; Preparing&#44; maintaining&#44; and disseminating systematic reviews of the effects of health care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "I&#46; Chalmers"
                          ]
                        ]
                      ]
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