Case and research letter
Papular Mycosis Fungoides on the Legs: A Case Report
Micosis fungoide papular en las piernas, a propósito de un caso
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Santamarina-Albertos, R. Muñoz-Martínez, T. Alvarez-Gago, A. Miranda-Romero" "autores" => array:4 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Santamarina-Albertos" "email" => array:1 [ 0 => "alba.santamarina@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "R." "apellidos" => "Muñoz-Martínez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "T." "apellidos" => "Alvarez-Gago" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "A." "apellidos" => "Miranda-Romero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Clínico Universitario de Valladolid, Valladolid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Micosis fungoide papular en las piernas, a propósito de un caso" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 757 "Ancho" => 951 "Tamanyo" => 198237 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Detail of the skin surface showing red papules, some of which are covered with scales.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present the case of a 55-year-old man who came to our clinic with asymptomatic lesions on the legs that had appeared gradually over the previous year. The patient had no personal history of interest and was not taking medication. Physical examination revealed nonfollicular erythematous papules measuring 1 to 2<span class="elsevierStyleHsp" style=""></span>mm that were distributed symmetrically on the anterior and internal aspects of the legs (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Some were covered with fine whitish scale (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The lesions were isolated and did not coalesce to form plaques.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">The lesions on the anterior surface of the legs were biopsied, and the results revealed lymphocyte aggregates in the superficial dermis (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>A) interspersed with infiltrate-free areas. The infiltrate was composed of atypical small-to-medium lymphocytes, with an irregular nucleus. There was marked epidermotropism (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>B and C), and isolated areas of the basement membrane had been destroyed. Immunohistochemistry (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>D) revealed a particularly intense infiltrate composed of CD3<span class="elsevierStyleSup">+</span> and CD4<span class="elsevierStyleSup">+</span> cells, with less intense staining of CD8<span class="elsevierStyleSup">+</span> cells and CD30<span class="elsevierStyleSup">–</span> cells. The hair follicles and eccrine glands were not involved, and no dermal mucin deposits were found. Polymerase chain reaction assay of gene rearrangement in the T-cell receptor from the skin biopsy revealed monoclonal T-cell proliferation. These findings confirmed a diagnosis of papular mycosis fungoides.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Laboratory tests disclosed mild hypercholesterolemia; the remaining values, including lactate dehydrogenase and ß2-microglobulin were within the reference range. There were no palpable lymph nodes in the groin or axillas. Chest radiograph and abdominal ultrasound findings were normal.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The patient was treated with high-potency local topical corticosteroids (clobetasol cream 0.05%) once daily for 3 weeks. Since his condition improved only slightly, treatment with psoralen-UV-A (PUVA) (18 sessions) was started (oral methoxsalen at 20<span class="elsevierStyleHsp" style=""></span>mg before PUVA). The cutaneous symptoms disappeared almost completely with this treatment. Today, 18 months later, the patient is free of lesions and other signs of mycosis fungoides.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Mycosis fungoides is considered to be the most common form of cutaneous T-cell lymphoma. It tends to takes the form of blotches that appear on areas of the body usually not exposed to sunlight. However, the clinical manifestations of mycosis fungoides vary considerably,<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> and up to 50 variants have been described.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> One such variant is papular mycosis fungoides, an uncommon entity first described by Kodama et al.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> in 2005; only 11 cases have been published in the literature.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Mycosis fungoides usually presents as an asymptomatic persistent eruption of reddish papules generally affecting the trunk in middle-aged patients. The clinical, histopathological, and immunohistochemical findings in our case are similar to those reported for previously published cases.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3–7</span></a> All those authors<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3–6</span></a> concur that this presentation of mycosis fungoides is not very aggressive but also agree that patients should be followed up, because in 1 case it has been reported to progress to plaque-phase mycosis fungoides .<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Prognosis is favorable in this subtype, except in patients with previous symptoms of mycosis fungoides, in whom it indicates disease progression.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The differential diagnosis can be made with lymphomatoid papulosis, especially type B,<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3–5,8</span></a> which usually manifests with ulcerated and crusted lesions that tend to resolve spontaneously. It can also be made with pityriasis lichenoides et varioliformis acuta and pityriasis lichenoides chronica, both of which usually yield intraepidermal neutrophils and necrotic keratinocytes<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> in the histopathology study. Diagnosis can even be made with follicular mycosis fungoides, which is characterized by infiltrate in the follicular epithelium, a certain degree of syringotropism, or both.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Neri et al.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> proposed a differential diagnosis with aggressive epidermotropic CD8 cytotoxic T-cell lymphoma, after detecting an infiltrate composed of CD8<span class="elsevierStyleSup">+</span>CD4<span class="elsevierStyleSup">–</span> cells in the case of papular mycosis fungoides they report.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The main therapeutic option for papular mycosis fungoides is PUVA, which is generally successful.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,5</span></a> Other options that have been applied in the initial stages<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> include coadjuvant topical retinoids,<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> UV-B radiation,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and topical corticosteroids in monotherapy.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Given the good response with PUVA in the present case and the evidence provided by previously published cases (improvement in 8 out of 12 patients treated), we propose PUVA as the most appropriate alternative, although we do recognize that the small population could limit interpretation of our results.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Finally, we would like to highlight the wide clinical variability of mycosis fungoides, an entity that can go unnoticed and present in an unremarkable manner over several months as a papular eruption, which is often asymptomatic.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Santamarina-Albertos A, Muñoz-Martínez R, Alvarez-Gago T, Miranda-Romero A. Micosis fungoide papular en las piernas, a propósito de un caso. Actas Dermosifiliogr. 2014;105:87–89.</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" => 1217 "Ancho" => 951 "Tamanyo" => 181809 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Reddish papules distributed symmetrically on the legs.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 757 "Ancho" => 951 "Tamanyo" => 198237 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Detail of the skin surface showing red papules, some of which are covered with scales.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1204 "Ancho" => 1600 "Tamanyo" => 602777 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A, Focal lymphocytic infiltrates in the superficial dermis interspersed with infiltrate-free hypodermis and dermis (hematoxylin-eosin [H-E], original magnification ×2). B, Detail of well-defined lymphocytic infiltrate in the dermis (H-E, original magnification ×10). C, Small and medium atypical lymphocytes and visible epidermotropism (H-E, original magnification ×40). D, CD3<span class="elsevierStyleSup">+</span> cells are visible throughout the infiltrate (CD3, original magnification, ×10).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinicopathological spectrum of mycosis fungoides" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.V. Kazakov" 1 => "G. Burg" 2 => "W. Kempf" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1468-3083.2004.00937.x" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2004" "volumen" => "18" "paginaInicial" => "397" "paginaFinal" => "415" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15196152" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mycosis fungoides: A dematological masquerader" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D. Nashan" 1 => "D. Faulhaber" 2 => "S. Ständer" 3 => "T.A. Luger" 4 => "R. Stadler" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2133.2007.07861.x" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2007" "volumen" => "156" "paginaInicial" => "1" "paginaFinal" => "10" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17488399" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Papular mycosis fungoides: a new clinical variant of early mycosis fungoides" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "K. Kodama" 1 => "R. Fink-Puches" 2 => "C. Massone" 3 => "H. Kerl" 4 => "L. Cerroni" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2004.12.018" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2005" "volumen" => "52" "paginaInicial" => "694" "paginaFinal" => "698" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15793526" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A case of papular mycosis fungoides: New clinical variant of early mycosis fungoides" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "A. Uddin" 1 => "M. Bennett" 2 => "K. Nayeem" 3 => "P. Marren" 4 => "H. Abushaira" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1468-3083.2006.01983.x" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2007" "volumen" => "21" "paginaInicial" => "685" "paginaFinal" => "687" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17447987" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Papular mycosis fungoides: Two new cases of a recently described clinicopathological variant of early mycosis fungoides" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Martorell-Calatayud" 1 => "R. Botella-Estrada" 2 => "O. Sanmartín-Jimenez" 3 => "C. Requena" 4 => "C. Guillén-Barona" 5 => "O.P. Sangüeza" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1600-0560.2009.01417.x" "Revista" => array:6 [ "tituloSerie" => "J Cutan Pathol" "fecha" => "2010" "volumen" => "37" "paginaInicial" => "330" "paginaFinal" => "335" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19737334" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Papular mycosis fungoides: A new clinic variant of early and benign mycosis fungoides?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Ze-Hu" 1 => "W. Yi-Ling" 2 => "C. Shu-Yue" 3 => "Z. Jun-Hui" 4 => "Q. Gang" 5 => "S. Hong" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/JCO.2010.32.8369" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "2011" "volumen" => "29" "paginaInicial" => "e381" "paginaFinal" => "e383" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21343551" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Papular mycosis fungoides: a new case expanding the expectrum of phenotipical and clinical findings" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "I. Neri" 1 => "C. D’acunto" 2 => "A. Pileri" 3 => "C. Reggiani" 4 => "A. Patrizi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "G Ital Dermatol Venereol" "fecha" => "2011" "volumen" => "146" "paginaInicial" => "505" "paginaFinal" => "507" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22095185" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lymphomatoid papulosis vs mycosis fungoides plaque stage" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.B. Ackerman" 1 => "J. Niven" 2 => "J.M. Grant-Kels" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Differential diagnosis in dermatopathology" "paginaInicial" => "158" "paginaFinal" => "165" "serieFecha" => "1982" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Micosis fungoide folicular. Estudio de cuatro casos" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Gómez-Diez" 1 => "C. Maldonado" 2 => "A. Fueyo" 3 => "F. Vázquez-López" 4 => "M.F. Fresno" 5 => "N. Pérez-Oliva" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2007" "volumen" => "98" "paginaInicial" => "486" "paginaFinal" => "490" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17669304" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Actualización terapéutica en los linfomas cutáneos" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.M. Izu-Belloso" 1 => "J.C. García-Ruiz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ad.2012.01.011" "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2012" "volumen" => "103" "paginaInicial" => "694" "paginaFinal" => "707" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22575363" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010500000001/v1_201401220123/S1578219013002746/v1_201401220123/en/main.assets" "Apartado" => array:4 [ "identificador" => "6157" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case and Research Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010500000001/v1_201401220123/S1578219013002746/v1_201401220123/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219013002746?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 12 | 14 | 26 |
| 2024 Octubre | 103 | 38 | 141 |
| 2024 Septiembre | 105 | 34 | 139 |
| 2024 Agosto | 144 | 53 | 197 |
| 2024 Julio | 107 | 50 | 157 |
| 2024 Junio | 113 | 42 | 155 |
| 2024 Mayo | 115 | 35 | 150 |
| 2024 Abril | 81 | 31 | 112 |
| 2024 Marzo | 116 | 36 | 152 |
| 2024 Febrero | 115 | 37 | 152 |
| 2024 Enero | 90 | 33 | 123 |
| 2023 Diciembre | 194 | 23 | 217 |
| 2023 Noviembre | 259 | 31 | 290 |
| 2023 Octubre | 236 | 40 | 276 |
| 2023 Septiembre | 305 | 31 | 336 |
| 2023 Agosto | 190 | 24 | 214 |
| 2023 Julio | 232 | 44 | 276 |
| 2023 Junio | 234 | 33 | 267 |
| 2023 Mayo | 233 | 35 | 268 |
| 2023 Abril | 168 | 22 | 190 |
| 2023 Marzo | 178 | 27 | 205 |
| 2023 Febrero | 148 | 24 | 172 |
| 2023 Enero | 190 | 25 | 215 |
| 2022 Diciembre | 186 | 56 | 242 |
| 2022 Noviembre | 120 | 38 | 158 |
| 2022 Octubre | 155 | 31 | 186 |
| 2022 Septiembre | 123 | 48 | 171 |
| 2022 Agosto | 176 | 35 | 211 |
| 2022 Julio | 126 | 31 | 157 |
| 2022 Junio | 131 | 36 | 167 |
| 2022 Mayo | 160 | 41 | 201 |
| 2022 Abril | 157 | 58 | 215 |
| 2022 Marzo | 123 | 50 | 173 |
| 2022 Febrero | 140 | 35 | 175 |
| 2022 Enero | 171 | 42 | 213 |
| 2021 Diciembre | 128 | 31 | 159 |
| 2021 Noviembre | 134 | 46 | 180 |
| 2021 Octubre | 163 | 51 | 214 |
| 2021 Septiembre | 115 | 42 | 157 |
| 2021 Agosto | 151 | 35 | 186 |
| 2021 Julio | 133 | 35 | 168 |
| 2021 Junio | 137 | 43 | 180 |
| 2021 Mayo | 90 | 36 | 126 |
| 2021 Abril | 125 | 51 | 176 |
| 2021 Marzo | 49 | 25 | 74 |
| 2021 Febrero | 45 | 22 | 67 |
| 2021 Enero | 37 | 23 | 60 |
| 2020 Diciembre | 52 | 21 | 73 |
| 2020 Noviembre | 25 | 21 | 46 |
| 2020 Octubre | 24 | 14 | 38 |
| 2020 Septiembre | 28 | 14 | 42 |
| 2020 Agosto | 19 | 26 | 45 |
| 2020 Julio | 34 | 11 | 45 |
| 2020 Junio | 42 | 21 | 63 |
| 2020 Mayo | 24 | 25 | 49 |
| 2020 Abril | 31 | 26 | 57 |
| 2020 Marzo | 22 | 24 | 46 |
| 2020 Febrero | 4 | 8 | 12 |
| 2020 Enero | 4 | 1 | 5 |
| 2019 Diciembre | 8 | 5 | 13 |
| 2019 Noviembre | 4 | 2 | 6 |
| 2019 Octubre | 0 | 2 | 2 |
| 2019 Septiembre | 4 | 4 | 8 |
| 2019 Agosto | 4 | 8 | 12 |
| 2019 Julio | 10 | 16 | 26 |
| 2019 Junio | 4 | 38 | 42 |
| 2019 Mayo | 6 | 30 | 36 |
| 2019 Abril | 2 | 22 | 24 |
| 2019 Marzo | 0 | 9 | 9 |
| 2019 Febrero | 4 | 4 | 8 |
| 2019 Enero | 0 | 5 | 5 |
| 2018 Diciembre | 1 | 5 | 6 |
| 2018 Noviembre | 2 | 0 | 2 |
| 2018 Octubre | 2 | 0 | 2 |
| 2018 Septiembre | 3 | 0 | 3 |
| 2018 Mayo | 0 | 6 | 6 |
| 2018 Abril | 0 | 5 | 5 |
| 2018 Marzo | 6 | 2 | 8 |
| 2018 Febrero | 113 | 5 | 118 |
| 2018 Enero | 82 | 12 | 94 |
| 2017 Diciembre | 125 | 12 | 137 |
| 2017 Noviembre | 78 | 14 | 92 |
| 2017 Octubre | 91 | 9 | 100 |
| 2017 Septiembre | 54 | 14 | 68 |
| 2017 Agosto | 55 | 19 | 74 |
| 2017 Julio | 88 | 14 | 102 |
| 2017 Junio | 92 | 22 | 114 |
| 2017 Mayo | 66 | 18 | 84 |
| 2017 Abril | 63 | 12 | 75 |
| 2017 Marzo | 59 | 31 | 90 |
| 2017 Febrero | 133 | 19 | 152 |
| 2017 Enero | 103 | 16 | 119 |
| 2016 Diciembre | 95 | 7 | 102 |
| 2016 Noviembre | 126 | 31 | 157 |
| 2016 Octubre | 202 | 29 | 231 |
| 2016 Septiembre | 234 | 9 | 243 |
| 2016 Agosto | 219 | 9 | 228 |
| 2016 Julio | 97 | 5 | 102 |
| 2016 Junio | 7 | 9 | 16 |
| 2016 Mayo | 12 | 4 | 16 |
| 2016 Abril | 8 | 15 | 23 |
| 2016 Marzo | 9 | 28 | 37 |
| 2016 Febrero | 8 | 26 | 34 |
| 2016 Enero | 3 | 19 | 22 |
| 2015 Diciembre | 6 | 24 | 30 |
| 2015 Noviembre | 6 | 16 | 22 |
| 2015 Octubre | 6 | 1 | 7 |
| 2015 Septiembre | 10 | 9 | 19 |
| 2015 Agosto | 7 | 2 | 9 |
| 2015 Julio | 149 | 19 | 168 |
| 2015 Junio | 82 | 1 | 83 |
| 2015 Mayo | 107 | 7 | 114 |
| 2015 Abril | 85 | 15 | 100 |
| 2015 Marzo | 86 | 13 | 99 |
| 2015 Febrero | 77 | 4 | 81 |
| 2015 Enero | 54 | 7 | 61 |
| 2014 Diciembre | 51 | 5 | 56 |
| 2014 Noviembre | 40 | 3 | 43 |
| 2014 Octubre | 32 | 6 | 38 |
| 2014 Septiembre | 44 | 1 | 45 |
| 2014 Agosto | 31 | 3 | 34 |
| 2014 Julio | 31 | 5 | 36 |
| 2014 Junio | 32 | 6 | 38 |
| 2014 Mayo | 43 | 6 | 49 |
| 2014 Abril | 34 | 6 | 40 |
| 2014 Marzo | 29 | 5 | 34 |
| 2014 Febrero | 9 | 6 | 15 |
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