Case Report
Effectiveness of 5-Aminolevulinic Acid Photodynamic Therapy in the Treatment of Hidradenitis Suppurativa: A Report of 5 Cases
Efectividad de la terapia fotodinámica con ácido 5-aminolevulínico en el tratamiento de la hidrosadenitis supurativa. Serie de 5 casos
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Serie de 5 casos" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "614" "paginaFinal" => "617" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Effectiveness of 5-Aminolevulinic Acid Photodynamic Therapy in the Treatment of Hidradenitis Suppurativa: A Report of 5 Cases" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 745 "Ancho" => 995 "Tamanyo" => 152186 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Pacientes con compromiso axilar por HAS. Se muestran los resultados de 2 pacientes de la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> con compromiso bilateral de axilas por HAS. A. Fotografías de los pacientes pretratamiento. B. A las 8 semanas de seguimiento. En el paciente 1 se observa respuesta satisfactoria al tratamiento. En el paciente 2 se evidencia importante disminución de lesiones inflamatorias y signos de actividad de la enfermedad.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R. Andino Navarrete, A. Hasson Nisis, J. Parra Cares" "autores" => array:3 [ 0 => array:2 [ "nombre" => "R." "apellidos" => "Andino Navarrete" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Hasson Nisis" ] 2 => array:2 [ "nombre" => "J." 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Romero Aguilera, P. Cortina de la Calle, E. Vera Iglesias, P. Sánchez Caminero, M. García Arpa, J.A. Garrido Martín" "autores" => array:6 [ 0 => array:2 [ "nombre" => "G." "apellidos" => "Romero Aguilera" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "Cortina de la Calle" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Vera Iglesias" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Sánchez Caminero" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "García Arpa" ] 5 => array:2 [ "nombre" => "J.A." 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Andino Navarrete, A. Hasson Nisis, J. Parra Cares" "autores" => array:3 [ 0 => array:3 [ "nombre" => "R." "apellidos" => "Andino Navarrete" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 1 => array:3 [ "nombre" => "A." "apellidos" => "Hasson Nisis" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:4 [ "nombre" => "J." "apellidos" => "Parra Cares" "email" => array:1 [ 0 => "jlparra@puc.cl" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Dermatología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Teledermatología, Centro de Salud Familiar San Fabián, Servicio de Salud Ñuble, San Fabián, Chile" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Efectividad de la terapia fotodinámica con ácido 5-aminolevulínico en el tratamiento de la hidrosadenitis supurativa. Serie de 5 casos" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 770 "Ancho" => 1028 "Tamanyo" => 151068 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Hidradenitis suppurativa: Bilateral axillary involvement. Results for patients 1 (above) and 2 (below) mentioned in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. A, Before treatment. B, At 8 weeks’ follow-up.Treatment response was satisfactory in patient 1. Considerable reduction of inflammatory lesions and decreased signs of disease activity were observed in patient 2.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Hidradenitis suppurativa is traditionally defined as a recurrent and debilitating chronic inflammatory disease that typically presents after puberty with deep and painful inflammatory lesions in apocrine gland–bearing areas, particularly the axillary, inguinal, and anogenital regions.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> However, recent findings emphasize the involvement of the whole hair follicle and pinpoint follicular occlusion and hyperkeratinization as the earliest pathophysiological event in hidradenitis suppurativa.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">While the pathogenesis of hidradenitis suppurativa remains uncertain, genetic factors, hormonal disorders, smoking, and obesity have all been shown to play some role.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The fact that this condition is associated with Crohn disease and has been successfully treated with anti–tumor necrosis factor biologic agents has led to the suggestion that that patients might have an innate immune disorder, and current research focuses on this possibility.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Hidradenitis suppurativa affects 1% of the European population; incidence is highest in the second and third decade of life and is 3 times higher among women than among men.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Because of its severe physical and psychological effects, patients with this condition experience even greater morbidity and quality-of-life impairment than those with other chronic skin conditions, such as psoriasis.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Treatment options are limited despite the high prevalence rate, and few clinical trials have assessed treatment safety or efficacy. Topical and systemic antibiotics, hormone therapy, oral retinoids, immunosuppressants, and surgery have all been tried, with variable outcomes and high recurrence rates.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7,8</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Evidence that photodynamic therapy is effective against acne<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> has led to its use against hidradenitis suppurativa in small case series, with varying results.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7,8,10–17</span></a> Treatment protocols in these series are not comparable due to variation in photosensitizers, light sources, and treatment regimens. The true role of photodynamic therapy against hidradenitis suppurativa is hard to determine based on the limited and mixed evidence currently available.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7,8,10</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Considering the above, and given the few options available for recalcitrant cases, we report our experience using aminolevulinic acid (ALA) and a 635-nm light source to treat 5 patients with moderate to severe hidradenitis suppurativa.Our aim was to evaluate the effectiveness of this treatment by assessing severity, quality of life, and safety.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Patients and Methods</span><p id="par0035" class="elsevierStylePara elsevierViewall">We selected 5 patients, 1 man and 4 women, with a mean (SD) age of 26 (5) years and mean duration of disease of 4 (1) years. Four of the 5 cases involved both armpits (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) and 1 involved the pubic region. Our inclusion criteria were Hurley stage <span class="elsevierStyleSmallCaps">II</span> or <span class="elsevierStyleSmallCaps">III</span> and hidradenitis suppurativa refractory to at least 2 medical treatments. Written informed consent was obtained from all patients.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">A 20% solution of ALA (Oldex, Recalcine) was applied for 1.5 hours followed by exposure to a 635-nm red light source (PDT 1200 L, Herbert Waldmann GmbH & Co.) at a 70 mW/cm<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> fluence rate, with a total dose per session of 37 J/cm.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Each patient had a minimum of 4 sessions at 1- to 2-week intervals, with clinical assessment at 4 and 8 weeks. At baseline and during follow-up visits we determined each patient's modified Hidradenitis Suppurativa Score as described by Sartorius et al., <a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> quality of life in terms of the Dermatology Life Quality Index (DLQI) score,<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> and pain and disease activity rated by the patient according to the following scale: 0, no symptoms or disease activity; 1, mild pain and/or activity; 2, moderate pain and/or activity; 3, severe pain and/or activity.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Directed questioning about treatment adverse effects was included in all sessions.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Results</span><p id="par0050" class="elsevierStylePara elsevierViewall">Results are summarized in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. Patients showed significant improvement in all 3 scores, with effects persisting at 8 weeks’ follow-up. Mean (SD) severity scores dropped from 35 (5) at baseline to 18 (8) after treatment and DLQI decreased by an average 21 points after 4 treatment sessions, with both effects persisting after 8 weeks (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). All patients scored 3 for pain and disease activity at baseline, and all scores were considerably lower (0-1) at 4 and 8 weeks.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Treatment was well tolerated and the only adverse effect was a mild burning sensation during light exposure in 2 of the 5 patients.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Discussion</span><p id="par0060" class="elsevierStylePara elsevierViewall">Photodynamic therapy using 20% ALA was shown to be effective against hidradenitis suppurativa in this study, with significant reduction in severity scores and improved quality of life. This improvement was sustained at 4 and 8 weeks’ follow-up.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Gold et al.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> observed clinical improvement rates of 75% to 100% in 4 patients after 3 or 4 short-contact (15- to 30-minute) treatment sessions using blue light and 20% ALA, and suggested anti-inflammatory activity as the mechanism of action.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Schweiger et al.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a> treated 12 patients for 4 weeks with a weekly application of 20% ALA for 45 minutes followed by exposure to either blue light or intense pulsed light. They observed a 50% reduction in mean lesion count after 4 weeks and a 29% reduction after 8 weeks, with DLQI scores lower than at baseline. Blue light was better tolerated than intense pulsed light.</p><p id="par0075" class="elsevierStylePara elsevierViewall">Less encouraging results were obtained by Strauss et al.,<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> who treated 4 patients with 20% ALA for 3 hours followed by red light exposure. One patient received 3 sessions at weekly intervals and experienced no clinical improvement, another received only 2 sessions and improved significantly at first but without lasting effect, and the remaining 2 patients did not complete the course due to pain during sessions. Sotiriou et al.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a> treated 5 patients for 5 sessions at 2-week intervals using 20% ALA with red light and also found no significant improvement.</p><p id="par0080" class="elsevierStylePara elsevierViewall">Using methyl aminolevulinate, Guglielmetti et al<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> reported 1 case of recalcitrant HS treated with 16% methyl aminolevulinate and red light; inflammation and exudate in the treated areas decreased by 90% to 100% after the second session, with sustained effects at 4 months’ follow-up. In a similar case the patient received 9 treatment sessions at 2-week intervals, itching and discomfort were completely resolved at 6 months’ follow-up, with an 80% remission rate for skin lesions.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Greater absorption of ALA together with higher production of protoporphyrin IX in hair follicles compared to other tissues has been suggested as the mechanism of action of photodynamic therapy for hidradenitis suppurativa.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">20</span></a> The main mechanisms proposed for photodynamic therapy against acne vulgaris, including decreased sebum production, destruction of <span class="elsevierStyleItalic">Propionibacterium acnes</span>, and reduced follicular occlusion,<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">9,11</span></a> may also play a role against hidradenitis suppurativa.</p><p id="par0090" class="elsevierStylePara elsevierViewall">Althought evidence supporting the use of photodynamic therapy for hidradenitis suppurativa is extremely limited, our findings suggest that topical ALA at 20% concentration with a 635-nm light source may be effective in cases refractory to conventional treatment, reducing disease severity and improving quality of life. Controlled clinical studies with larger sample sizes and longer follow-up are needed to assess the effectiveness of photodynamic therapy more conclusively and determine optimal treatment regimens.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Ethical Disclosures</span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Protection of human and animal subjects.</span><p id="par0095" class="elsevierStylePara elsevierViewall">The authors declare that no experiments were performed on humans or animals for this investigation.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Confidentiality of data</span><p id="par0100" class="elsevierStylePara elsevierViewall">The authors declare that they have followed their hospital's protocol on the publication of data concerning patients and that all patients included in the study have received sufficient information and have given their written informed consent to participate in the study.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Right to privacy and informed consent</span><p id="par0105" class="elsevierStylePara elsevierViewall">The authors declare that no private patient data are disclosed in this article.</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Funding</span><p id="par0110" class="elsevierStylePara elsevierViewall">This study was entirely funded by the Department of Dermatology of Pontificia Universidad Católica de Chile.</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Conflicts of Interest</span><p id="par0115" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:2 [ "identificador" => "xres349098" "titulo" => "Abstract" ] 1 => array:2 [ "identificador" => "xpalclavsec330764" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres349097" "titulo" => "Resumen" ] 3 => array:2 [ "identificador" => "xpalclavsec330763" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Patients and Methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:3 [ "identificador" => "sec0025" "titulo" => "Ethical Disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0030" "titulo" => "Protection of human and animal subjects." ] 1 => array:2 [ "identificador" => "sec0035" "titulo" => "Confidentiality of data" ] 2 => array:2 [ "identificador" => "sec0040" "titulo" => "Right to privacy and informed consent" ] ] ] 9 => array:2 [ "identificador" => "sec0045" "titulo" => "Funding" ] 10 => array:2 [ "identificador" => "sec0050" "titulo" => "Conflicts of Interest" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-03-15" "fechaAceptado" => "2013-10-19" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec330764" "palabras" => array:3 [ 0 => "Hidradenitis suppurativa" 1 => "Photodynamic Therapy" 2 => "5-aminolevulinic acid" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec330763" "palabras" => array:3 [ 0 => "Hidrosadenitis supurativa" 1 => "Terapia fotodinámica" 2 => "Ácido 5-aminolevulínico" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Hidradenitis suppurativa has been described as a chronic, recurrent, and disabling inflammatory disease involving the entire hair follicle.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Several treatments, including photodynamic therapy, have been used, but the results have been inconsistent and recurrence is high.</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">In this prospective study, we evaluated disease severity, quality of life, and treatment tolerance in 5 patients with moderate to severe hidradenitis suppurativa treated with photodynamic therapy using 5-aminolevulinic acid and a 635-nm light source. Treatment effectiveness was evaluated using the Sartorius severity score, the Dermatology Life Quality Index, and a visual analog scale for pain and disease activity.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Significant improvements were observed with all 3 instruments and the effects remained visible at 8 weeks. Our results suggest that photodynamic therapy with 5-aminolevulinic acid and a light wavelength of 635 nm could reduce disease severity and improve quality of life in patients with difficult-to-treat hidradenitis suppurativa.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La hidrosadenitis supurativa (HAS) se ha definido como una enfermedad inflamatoria crónica, recurrente y debilitante, que compromete todo el folículo piloso.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Varias alternativas terapéuticas, incluida la terapia fotodinámica, han sido utilizadas, con resultados variables y altas tasas de recurrencia.</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">El presente trabajo muestra la evaluación de severidad, calidad de vida y seguridad de una serie prospectiva de 5 pacientes con HAS moderada o severa, sometidos a terapia fotodinámica, utilizando ácido 5-aminolevulínico (ALA) y luz 635<span class="elsevierStyleHsp" style=""></span>nm. Se evaluó la efectividad del tratamiento con el <span class="elsevierStyleItalic">score</span> de severidad de Sartorious, índice de calidad de vida (DLQI) y una escala visual analógica (EVA) para dolor y actividad de la enfermedad.</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los pacientes mostraron una mejoría significativa en las 3 variables estudiadas, con efectos visibles que se mantenían a las 8 semanas, sugiriendo que esta terapia podría ser efectiva en HAS refractaria a terapias convencionales, disminuyendo la gravedad y mejorando la calidad de vida de los pacientes.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Please cite this article as: Andino Navarrete R, Hasson Nisis A, Parra Cares J. Efectividad de la terapia fotodinámica con ácido 5-aminolevulínico en el tratamiento de la hidrosadenitis supurativa. Serie de 5 casos. Actas Dermosifiliogr. 2014;105:614–617.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 770 "Ancho" => 1028 "Tamanyo" => 151068 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Hidradenitis suppurativa: Bilateral axillary involvement. Results for patients 1 (above) and 2 (below) mentioned in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. A, Before treatment. B, At 8 weeks’ follow-up.Treatment response was satisfactory in patient 1. Considerable reduction of inflammatory lesions and decreased signs of disease activity were observed in patient 2.</p>" ] ] 1 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:3 [ "leyenda" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Abbreviation: DLQI, Dermatology Life Quality Index.</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">Patient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">DLQI Score</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Pain and Activity Scale<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a></td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="3" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Disease Severity<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Baseline \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">Wk 4 \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">Wk 8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Baseline \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">Wk 4 \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">Wk 8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Baseline \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">Wk 4 \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">Wk 8 \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">42 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n 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title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">21 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mean \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">28.80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.49 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.80 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">35.40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18.20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18.20 \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">SD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.68 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.95 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.79 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.55 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.45 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.98 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8.11 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab521003.png" ] ] ] "notaPie" => array:2 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Range of scale: 0-3.</p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">According to Sartorius et al.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a></p>" ] ] 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 8 | 8 | 16 |
| 2024 Octubre | 73 | 48 | 121 |
| 2024 Septiembre | 83 | 32 | 115 |
| 2024 Agosto | 115 | 61 | 176 |
| 2024 Julio | 78 | 37 | 115 |
| 2024 Junio | 84 | 38 | 122 |
| 2024 Mayo | 60 | 37 | 97 |
| 2024 Abril | 76 | 22 | 98 |
| 2024 Marzo | 73 | 26 | 99 |
| 2024 Febrero | 53 | 37 | 90 |
| 2024 Enero | 53 | 28 | 81 |
| 2023 Diciembre | 42 | 16 | 58 |
| 2023 Noviembre | 60 | 25 | 85 |
| 2023 Octubre | 56 | 22 | 78 |
| 2023 Septiembre | 65 | 25 | 90 |
| 2023 Agosto | 49 | 19 | 68 |
| 2023 Julio | 69 | 39 | 108 |
| 2023 Junio | 44 | 21 | 65 |
| 2023 Mayo | 53 | 32 | 85 |
| 2023 Abril | 48 | 19 | 67 |
| 2023 Marzo | 67 | 25 | 92 |
| 2023 Febrero | 54 | 18 | 72 |
| 2023 Enero | 48 | 31 | 79 |
| 2022 Diciembre | 78 | 45 | 123 |
| 2022 Noviembre | 64 | 29 | 93 |
| 2022 Octubre | 22 | 24 | 46 |
| 2022 Septiembre | 19 | 38 | 57 |
| 2022 Agosto | 30 | 27 | 57 |
| 2022 Julio | 24 | 40 | 64 |
| 2022 Junio | 24 | 34 | 58 |
| 2022 Mayo | 35 | 37 | 72 |
| 2022 Abril | 62 | 45 | 107 |
| 2022 Marzo | 69 | 50 | 119 |
| 2022 Febrero | 78 | 44 | 122 |
| 2022 Enero | 56 | 58 | 114 |
| 2021 Diciembre | 62 | 34 | 96 |
| 2021 Noviembre | 44 | 59 | 103 |
| 2021 Octubre | 47 | 52 | 99 |
| 2021 Septiembre | 29 | 34 | 63 |
| 2021 Agosto | 34 | 35 | 69 |
| 2021 Julio | 16 | 35 | 51 |
| 2021 Junio | 24 | 31 | 55 |
| 2021 Mayo | 40 | 25 | 65 |
| 2021 Abril | 62 | 63 | 125 |
| 2021 Marzo | 57 | 24 | 81 |
| 2021 Febrero | 55 | 28 | 83 |
| 2021 Enero | 31 | 21 | 52 |
| 2020 Diciembre | 32 | 10 | 42 |
| 2020 Noviembre | 15 | 16 | 31 |
| 2020 Octubre | 31 | 19 | 50 |
| 2020 Septiembre | 58 | 25 | 83 |
| 2020 Agosto | 28 | 18 | 46 |
| 2020 Julio | 27 | 9 | 36 |
| 2020 Junio | 32 | 25 | 57 |
| 2020 Mayo | 21 | 23 | 44 |
| 2020 Abril | 28 | 25 | 53 |
| 2020 Marzo | 32 | 29 | 61 |
| 2020 Febrero | 3 | 10 | 13 |
| 2020 Enero | 4 | 11 | 15 |
| 2019 Diciembre | 8 | 2 | 10 |
| 2019 Noviembre | 4 | 3 | 7 |
| 2019 Octubre | 0 | 5 | 5 |
| 2019 Septiembre | 4 | 4 | 8 |
| 2019 Agosto | 4 | 6 | 10 |
| 2019 Julio | 8 | 25 | 33 |
| 2019 Junio | 4 | 14 | 18 |
| 2019 Mayo | 6 | 41 | 47 |
| 2019 Abril | 4 | 32 | 36 |
| 2019 Marzo | 4 | 7 | 11 |
| 2019 Febrero | 2 | 4 | 6 |
| 2019 Enero | 2 | 3 | 5 |
| 2018 Diciembre | 2 | 2 | 4 |
| 2018 Noviembre | 2 | 3 | 5 |
| 2018 Octubre | 7 | 0 | 7 |
| 2018 Septiembre | 4 | 2 | 6 |
| 2018 Julio | 0 | 1 | 1 |
| 2018 Junio | 0 | 2 | 2 |
| 2018 Mayo | 0 | 7 | 7 |
| 2018 Marzo | 0 | 1 | 1 |
| 2018 Febrero | 103 | 3 | 106 |
| 2018 Enero | 37 | 5 | 42 |
| 2017 Diciembre | 111 | 6 | 117 |
| 2017 Noviembre | 26 | 5 | 31 |
| 2017 Octubre | 28 | 3 | 31 |
| 2017 Septiembre | 34 | 4 | 38 |
| 2017 Agosto | 61 | 7 | 68 |
| 2017 Julio | 35 | 3 | 38 |
| 2017 Junio | 52 | 7 | 59 |
| 2017 Mayo | 37 | 6 | 43 |
| 2017 Abril | 24 | 6 | 30 |
| 2017 Marzo | 21 | 8 | 29 |
| 2017 Febrero | 24 | 7 | 31 |
| 2017 Enero | 21 | 8 | 29 |
| 2016 Diciembre | 36 | 19 | 55 |
| 2016 Noviembre | 40 | 20 | 60 |
| 2016 Octubre | 41 | 16 | 57 |
| 2016 Septiembre | 37 | 8 | 45 |
| 2016 Agosto | 34 | 11 | 45 |
| 2016 Julio | 26 | 6 | 32 |
| 2016 Junio | 6 | 2 | 8 |
| 2016 Mayo | 5 | 0 | 5 |
| 2016 Abril | 4 | 3 | 7 |
| 2016 Marzo | 4 | 0 | 4 |
| 2016 Febrero | 8 | 1 | 9 |
| 2016 Enero | 18 | 5 | 23 |
| 2015 Diciembre | 15 | 2 | 17 |
| 2015 Noviembre | 14 | 7 | 21 |
| 2015 Octubre | 14 | 8 | 22 |
| 2015 Septiembre | 14 | 2 | 16 |
| 2015 Agosto | 15 | 4 | 19 |
| 2015 Julio | 49 | 4 | 53 |
| 2015 Junio | 23 | 5 | 28 |
| 2015 Mayo | 26 | 14 | 40 |
| 2015 Abril | 14 | 9 | 23 |
| 2015 Marzo | 18 | 6 | 24 |
| 2015 Febrero | 23 | 4 | 27 |
| 2015 Enero | 13 | 3 | 16 |
| 2014 Diciembre | 20 | 6 | 26 |
| 2014 Noviembre | 12 | 1 | 13 |
| 2014 Octubre | 13 | 4 | 17 |
| 2014 Septiembre | 0 | 3 | 3 |
| 2014 Agosto | 2 | 6 | 8 |
| 2014 Julio | 4 | 4 | 8 |
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