E-CASE REPORT
The Usefulness of Ultrasound Imaging in Digital and Extradigital Glomus Tumors
Tumores glómicos digitales y extradigitales. Utilidad de la ecografía cutánea
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En la exploración se aprecia distrofia ungueal en la cara medial del primer dedo de la mano derecha. B. En modo B se aprecia una lesión sólida hipoecoica de forma ovalada, bien delimitada, de bordes regulares. C. En el modo doppler color se aprecia la abundante vascularización en el lecho ungueal. D. El análisis espectral demuestra un flujo sistólico arterial de bajo grado dentro de la lesión.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.E. Gómez-Sánchez, F. Alfageme-Roldán, G. Roustán-Gullón, M.A. Segurado-Rodríguez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M.E." "apellidos" => "Gómez-Sánchez" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Alfageme-Roldán" ] 2 => array:2 [ "nombre" => "G." 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Hernández-Núñez, L. Nájera Botello, A. Romero Maté, C. Martínez-Sánchez, M. Utrera Busquets, A. Calderón Komáromy, J. Borbujo Martínez" "autores" => array:7 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Hernández-Núñez" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Nájera Botello" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Romero Maté" ] 3 => array:2 [ "nombre" => "C." "apellidos" => "Martínez-Sánchez" ] 4 => array:2 [ "nombre" => "M." "apellidos" => "Utrera Busquets" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Calderón Komáromy" ] 6 => array:2 [ "nombre" => "J." 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Gómez-Sánchez, F. Alfageme-Roldán, G. Roustán-Gullón, M.A. Segurado-Rodríguez" "autores" => array:4 [ 0 => array:4 [ "nombre" => "M.E." "apellidos" => "Gómez-Sánchez" "email" => array:1 [ 0 => "m_gomsanchez@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "F." "apellidos" => "Alfageme-Roldán" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "G." "apellidos" => "Roustán-Gullón" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "M.A." "apellidos" => "Segurado-Rodríguez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Complejo Hospitalario Universitario de Albacete, Albacete, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Puerta de Hierro Majadahonda, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital del Sureste, Arganda del Rey, Madrid, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tumores glómicos digitales y extradigitales. Utilidad de la ecografía cutánea" ] ] "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" => 1432 "Ancho" => 1800 "Tamanyo" => 236336 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A, Clinical examination of the left thigh shows a scar-like macule with poorly defined borders. B, B mode Doppler ultrasound shows a solid, hypoechoic, spherical lesion with a regular border at the dermal-hypodermal interface. A hypoechoic prolongation in the form of a stalk is seen in the upper part of the lesion. C, Color Doppler mode shows increased vascularization.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Glomus tumors are an uncommon type of benign neoplasm derived from a structure known as the neuromyoarterial glomus, which contributes to regulation of body temperature.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–5</span></a> These structures are most often found in the skin, in particular in the subungual region.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Subungual glomus tumors are suspected when a lesion is found at this typical site,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> accompanied by a clinical presentation of sensitivity to cold and severe pain that can be spontaneous or arise after minimal contact. In contrast, diagnosis of extradigital glomus tumors is often mistaken or delayed given the low incidence of such lesions.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,5</span></a> In this study, we aimed to assess the correlation between clinical, histopathologic, and ultrasound findings for extradigital glomus tumors, and compare these findings with the characteristics of digital glomus tumors. We also aimed to describe the usefulness of ultrasound and color Doppler imaging in the diagnosis, surgical treatment, and follow-up of these tumors.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Care Report</span><p id="par0010" class="elsevierStylePara elsevierViewall">We present a total of 5 patients (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>), attended in our dermatology department. Three were men and 2 were women, and ages ranged from 42 to 65 years. All patients were seen for longstanding lesions present for several years on the limbs; all were painful with local sensitivity. With clinical suspicion of glomus tumor, each patient underwent a preoperative ultrasound study with a device equipped with a high frequency probe. Images were taken in B mode and color Doppler mode. Pulsed Doppler techniques were also used to characterize blood flow in intratumoral and peritumoral vessels. All patients had similar ultrasound findings, consistent with a vascularized tumor embedded in soft tissue. Once the extent of the lesion had been defined with the help of ultrasound, it was excised and the surgical defect was directly closed. In the case of the subungual lesion, the tumor was fully excised with access achieved by raising the proximal nail bed. After excision, the surgical defect was closed (<a class="elsevierStyleCrossRefs" href="#fig0005">Figures 1 and 2</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The histologic findings were consistent with glomus tumor, with well-defined solid nodules surrounded by compact fibrotic tissue and no encapsulation. These nodules were comprised of monomorphous polygonal groups of glomus cells. Small vascular spaces could be discerned among these cell groups, surrounded by a fascicle of endothelial cells. In the immunohistochemical study, smooth muscle stained positive for actin and negative for desmin.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Subsequently, all patients underwent regular clinical and ultrasound follow-up and remained free of signs of recurrence. In the patient with a subungual glomus tumor, substantial nail dystrophy was present after surgery as a sequelae.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Discussion</span><p id="par0025" class="elsevierStylePara elsevierViewall">It is estimated that glomic tumors comprise 1.6% of all soft tissue tumors<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5,7</span></a> and 4.5% of all tumors on the hand. They are classified into 2 variants: solitary glomus tumors and multiple glomus tumors, with clinical and anatomopathologic differences.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Solitary tumors are the most common and are the subject of the discussion in this article.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> They can manifest in the form of erythematous-violaceous nodule, red-pink or blue tipped macule, or increased curvature or deformity of the nail plate.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> Glomus tumors are classified according to their site as digital and extradigital. Extradigital tumors are less common. The typical clinical presentation is one of localized pain and sensitivity and hypersensitivity to cold (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–8</span></a></p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Our patients were aged between 60 and 70 years in the case of extradigital sites and all were men, whereas the patient with the digital tumor was a woman in her forties. This is all consistent with what is reported in the literature, even though the sample was not particularly representative given the low number of patients. This difference between sites could be either because the tumor occurs in elderly patients or because often the atypical site of these tumors hinders diagnosis<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and they are confused with hemangiomas, neuromas, or neurofibromas,<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,5</span></a> with subsequent delay in definitive diagnosis. According to some authors, the mean time to definitive diagnosis of extradigital glomus tumors can vary between 5 and 20 years.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In fact, in 1 of the cases presented as an extradigital glomus tumor, correct diagnosis was delayed 35 years due to erroneous initial diagnosis and the fact that use of cryotherapy masked the clinical picture.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Ultrasound has only recently been used as an additional study for diagnosis and follow-up of cutaneous lesions. Applications include a range of inflammatory diseases, benign and malignant tumors, and even esthetics.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> In the ultrasound images captured in B mode, glomus tumors are seen as small solid, hypoechoic, well-defined nodules, more or less homogenous, with a regular border, most often located in the superficial dermis, with no involvement of the deep layers.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,4,6,10</span></a> In our patients, all tumors were in the dermis except 2 (patients 2 and 4) at the dermal-hypodermal interface. These did not however penetrate the hypodermis. The color Doppler study shows extensive vascularization inside the tumor, as would be expected with a vascular type tumor such as a glomus tumor.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,4,10,11</span></a> In addition, the pulsed Doppler study usually shows a low-grade systolic murmur. Both characteristics help us to differentiate such tumors, in the first instance, from other nonvascularized soft tissue tumors.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,12</span></a> However, an intense vascular signal in the Doppler study can also be seen in hemangiomas or arteriovenous malformations. Some B-mode ultrasound findings can assist in the differential diagnosis (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). In hemangiomas, grey-scale images do not show such homogenous echogenicity and the margins are less well defined. In addition, vascular flow is diminished as blood pools are present. Malformations are usually more poorly defined lesions compared to surrounding tissue, with no mass effect, and they show the typical arteriovenous shunt.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Three of our patients had the typical stalk sign. This sign corresponds to a hypoechoic prolongation of the lesion by the stalk, which in Doppler mode reveals an intense vascularization characteristic of vascular lesions such as glomus tumors.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Nevertheless, images obtained by ultrasound are not specific to any particular lesion, and diagnosis of glomus tumor is clinical, with confirmation from histopathologic study. However, cutaneous ultrasound can guide diagnosis, providing significant information in a simple skin examination.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Study of ultrasound images is also very useful for exactly, simply, quickly, and painlessly locating the lesion prior to excision. The technique can reveal the relationship with surrounding tissue to enable complete excision with minimal trauma and so avoid subsequent recurrence.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,6,13</span></a> Ultrasound has been able to detect tumors as small as 1<span class="elsevierStyleHsp" style=""></span>mm,<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> reflecting its usefulness in the early diagnosis of lesions. The limitations of ultrasound are seen with flat lesions less than 3<span class="elsevierStyleHsp" style=""></span>mm across<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> and with sites where artifacts may appear, such as subungual if the nail is very thick.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">The use of supplementary magnetic resonance imaging is a useful, noninvasive method, but it is more costly and so its use in everyday clinical practice does not appear to be justified.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,6,8</span></a> Radiography is inexpensive and quick, but it is only useful in large tumors and in subungual tumors to differentiate them from subungual exostosis.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">In conclusion, we highlight the usefulness of ultrasound for early diagnosis, detailed information on location, and guidance for complex excision of glomus tumors, as observed in our patients.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflicts of Interest</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:2 [ "identificador" => "xres365529" "titulo" => "Abstract" ] 1 => array:2 [ "identificador" => "xpalclavsec345130" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres365530" "titulo" => "Resumen" ] 3 => array:2 [ "identificador" => "xpalclavsec345129" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Care Report" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflicts of Interest" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-06-01" "fechaAceptado" => "2014-02-14" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec345130" "palabras" => array:5 [ 0 => "Extradigital glomus tumor" 1 => "Subungual glomus tumor" 2 => "Ultrasound" 3 => "Diagnosis" 4 => "Doppler" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec345129" "palabras" => array:5 [ 0 => "Tumor glómico extradigital" 1 => "Tumor glómico subungueal" 2 => "Ultrasonidos" 3 => "Diagnóstico" 4 => "Doppler" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Recent years have witnessed an increase in the use of ultrasound imaging of the skin in the field of dermatology, as the technique reveals details of vessels and other structures that cannot be detected on physical examination. Extradigital glomus tumors are rarely seen in clinical practice and can pose a diagnostic challenge for dermatologists. We report on 4 patients with a clinical suspicion of extradigital glomus tumor and on 1 patient with a clinical suspicion of subungual glomus tumor. All 5 patients underwent ultrasound examination in B mode and color and pulsed-wave Doppler prior to surgical excision of the tumor and histologic examination, which confirmed the diagnosis in each case. Ultrasound imaging of the skin, combined with clinical findings, provided a simple, noninvasive way of making a prompt diagnosis and identifying the exact location of the lesion for surgical removal.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">En los últimos años se ha observado un aumento del uso de la ecografía cutánea en el campo de la dermatología, al proporcionar detalles estructurales y/o vasculares que con la simple exploración física no se pueden apreciar. Los tumores glómicos extradigitales son lesiones poco frecuentes en la práctica clínica y pueden suponer un reto diagnóstico para el dermatólogo. Presentamos 4 pacientes con sospecha clínica de tumor glómico extradigital y un paciente con sospecha de tumor glómico subungueal. A cada paciente se le realizó exploración ecográfica en modo B, doppler color y doppler pulsado, exéresis quirúrgica y análisis histológico que confirmó el diagnóstico sospechado. El uso de la ecografía cutánea añadida a los datos clínicos permitió de una manera sencilla e inocua evitar retrasos diagnósticos y determinar la localización exacta para una adecuada exéresis quirúrgica.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Gómez-Sánchez ME, Alfageme-Roldán F, Roustán-Gullón G, Segurado-Rodríguez MA. Tumores glómicos digitales y extradigitales. Utilidad de la ecografía cutánea. Actas Dermosifiliogr. 2014;105:e45–e49.</p>" ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1432 "Ancho" => 1800 "Tamanyo" => 236336 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A, Clinical examination of the left thigh shows a scar-like macule with poorly defined borders. B, B mode Doppler ultrasound shows a solid, hypoechoic, spherical lesion with a regular border at the dermal-hypodermal interface. A hypoechoic prolongation in the form of a stalk is seen in the upper part of the lesion. C, Color Doppler mode shows increased vascularization.</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" => 1362 "Ancho" => 1790 "Tamanyo" => 362467 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A, The examination shows nail dystrophy on the medial face of the first finger of the right hand. B, B mode Doppler image showing a well-defined, solid hypoechoic lesion with an oval form and regular borders. C, In Color Doppler mode, extensive vascularization can be seen in the nail bed. D, Spectral analysis shows low grade systolic arterial flow within the lesion.</p>" ] ] 2 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Source: Amitay-Laish et al.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a></p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Case 1 \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">Case 2 \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">Case 3 \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">Case 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">Case 5 \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="elsevierStyleBold">Age</span> \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">65 \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">60 \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">46 \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">67 \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">46 \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="elsevierStyleBold">Sex</span> \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">Male \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">Male \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">Female \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">Male \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">Female \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="elsevierStyleBold">Site</span> \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">Lateral face of the elbow \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">Thigh \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">Thigh \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">Lateral face of the elbow \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">Nail \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="elsevierStyleBold">Clinical Characteristics</span> \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">Pink macule of 0.5<span class="elsevierStyleHsp" style=""></span>cm, with a punctiform, erythematous-violaceous papule with central elevationVery painful on palpation \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">Scar-like macule with poorly defined borders Nodule or underlying tumor not palpablePainful on application of pressure \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">Two violaceous papules of 0.5<span class="elsevierStyleHsp" style=""></span>cm with a smooth surface on an erythematous-violaceous basePainful on application of pressure \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">Palpable nodule with overlying skin of erythematous-blue color, with irregular border, measuring 0.8<span class="elsevierStyleHsp" style=""></span>cm approximatelyPainful to touch \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">Nail dystrophy on the medial face of the first finger of the right handVery painful to touch and sensitive to the cold at this site \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="elsevierStyleBold">Lesion duration</span> \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">5 years \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">35 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 year \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 years \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="elsevierStyleBold">Prior Treatment</span> \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">No \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">Electrocoagulation \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">Electrocoagulation \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">No \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">No \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="elsevierStyleBold">Relapse after excision</span> \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">No \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">No \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">No \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">No \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">No \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 " colspan="6" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="6" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleBold">Ultrasound study</span></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="6" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">B Mode</span></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><span class="elsevierStyleHsp" style=""></span>Site \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">Dermis \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">Dermis-hypodermis \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">Dermis \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">Dermis-hypodermis \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">Dermis \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><span class="elsevierStyleHsp" style=""></span>Echostructure \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">Solid lesion \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">Solid lesion \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">Solid lesion, form of use \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">Solid lesion \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">Ovaluated lesion \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><span class="elsevierStyleHsp" style=""></span>Borders or forms \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">Regular form \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">Regular border \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">Well-defined borders \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">Well-defined \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">Well-defined, regular border \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><span class="elsevierStyleHsp" style=""></span>Echogenicity \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">Hypoechoic, homogeneous \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">Hypoechoic, heterogeneous \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">Hypoechoic, heterogeneous \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">Hypoechoic, heterogeneous \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">Isoechoic \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><span class="elsevierStyleHsp" style=""></span>Stalk sign \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">+ \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">+ \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">– \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">+ \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">– \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 " colspan="6" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Color Doppler</span></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><span class="elsevierStyleHsp" style=""></span>Flow<span class="elsevierStyleHsp" style=""></span>± \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">+ \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">+ \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">+ \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">+ \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">+ \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><span class="elsevierStyleHsp" style=""></span>Site: intralesional/perilesional/both \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">Intralesional \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">Intralesional \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">Intralesional \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">Intralesional \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">Intralesional \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 " colspan="6" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Spectral Doppler</span></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><span class="elsevierStyleHsp" style=""></span>Type of flow: arterial/venous/both \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">Arterial \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">Both \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">Arterial \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">Arterial \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">Arterial \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab549030.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Clinical Cases: Clinical and Ultrasound Characteristics of the Glomic Tumors.</p>" ] ] 3 => array:7 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Source: Schiefer et al.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>; Lee et al.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></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">Clinical Characteristics \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">Subungual Glomus Tumor \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">Extradigital Glomus Tumor \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">Sex \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">Female 2:1 \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="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Male 4:1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age on diagnosis \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">Twenties and fifties \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">Forties and sixties \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">Clinical characteristics \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">Pain, localized sensitivity and hypersensitivity to cold \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">Pain \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">Correct initial diagnosis \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">Often \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">Less often \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab549029.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Clinical Differences Between Subungual and Extradigital Glomus Tumors.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tumores glómicos" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L. Requena" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "titulo" => "Tumores cutáneos de partes blandas" "paginaInicial" => "597" "paginaFinal" => "603" "edicion" => "1.ª ed." "serieFecha" => "2012" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Role of high-variable frequency ultrasound in preoperative diagnosis of glomus tumors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "X. Wortsman" 1 => "G.B. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 3 | 0 | 3 |
| 2024 Octubre | 80 | 43 | 123 |
| 2024 Septiembre | 89 | 30 | 119 |
| 2024 Agosto | 110 | 55 | 165 |
| 2024 Julio | 83 | 36 | 119 |
| 2024 Junio | 85 | 57 | 142 |
| 2024 Mayo | 65 | 35 | 100 |
| 2024 Abril | 60 | 25 | 85 |
| 2024 Marzo | 62 | 25 | 87 |
| 2024 Febrero | 53 | 34 | 87 |
| 2024 Enero | 50 | 30 | 80 |
| 2023 Diciembre | 55 | 23 | 78 |
| 2023 Noviembre | 63 | 24 | 87 |
| 2023 Octubre | 67 | 34 | 101 |
| 2023 Septiembre | 83 | 32 | 115 |
| 2023 Agosto | 55 | 18 | 73 |
| 2023 Julio | 49 | 31 | 80 |
| 2023 Junio | 62 | 23 | 85 |
| 2023 Mayo | 71 | 24 | 95 |
| 2023 Abril | 47 | 31 | 78 |
| 2023 Marzo | 79 | 30 | 109 |
| 2023 Febrero | 59 | 20 | 79 |
| 2023 Enero | 50 | 26 | 76 |
| 2022 Diciembre | 45 | 39 | 84 |
| 2022 Noviembre | 40 | 33 | 73 |
| 2022 Octubre | 28 | 21 | 49 |
| 2022 Septiembre | 32 | 39 | 71 |
| 2022 Agosto | 26 | 42 | 68 |
| 2022 Julio | 20 | 40 | 60 |
| 2022 Junio | 23 | 21 | 44 |
| 2022 Mayo | 26 | 48 | 74 |
| 2022 Abril | 49 | 31 | 80 |
| 2022 Marzo | 31 | 41 | 72 |
| 2022 Febrero | 35 | 36 | 71 |
| 2022 Enero | 43 | 37 | 80 |
| 2021 Diciembre | 23 | 26 | 49 |
| 2021 Noviembre | 49 | 57 | 106 |
| 2021 Octubre | 36 | 47 | 83 |
| 2021 Septiembre | 26 | 38 | 64 |
| 2021 Agosto | 27 | 33 | 60 |
| 2021 Julio | 23 | 29 | 52 |
| 2021 Junio | 19 | 37 | 56 |
| 2021 Mayo | 28 | 30 | 58 |
| 2021 Abril | 58 | 53 | 111 |
| 2021 Marzo | 42 | 18 | 60 |
| 2021 Febrero | 57 | 27 | 84 |
| 2021 Enero | 26 | 14 | 40 |
| 2020 Diciembre | 32 | 18 | 50 |
| 2020 Noviembre | 23 | 9 | 32 |
| 2020 Octubre | 33 | 10 | 43 |
| 2020 Septiembre | 37 | 11 | 48 |
| 2020 Agosto | 26 | 16 | 42 |
| 2020 Julio | 37 | 12 | 49 |
| 2020 Junio | 44 | 22 | 66 |
| 2020 Mayo | 30 | 21 | 51 |
| 2020 Abril | 28 | 11 | 39 |
| 2020 Marzo | 36 | 19 | 55 |
| 2020 Febrero | 3 | 0 | 3 |
| 2020 Enero | 4 | 3 | 7 |
| 2019 Diciembre | 8 | 5 | 13 |
| 2019 Noviembre | 4 | 2 | 6 |
| 2019 Octubre | 0 | 2 | 2 |
| 2019 Septiembre | 8 | 7 | 15 |
| 2019 Agosto | 4 | 3 | 7 |
| 2019 Julio | 2 | 2 | 4 |
| 2019 Junio | 6 | 7 | 13 |
| 2019 Mayo | 2 | 27 | 29 |
| 2019 Abril | 1 | 3 | 4 |
| 2019 Marzo | 2 | 8 | 10 |
| 2019 Enero | 2 | 0 | 2 |
| 2018 Diciembre | 2 | 0 | 2 |
| 2018 Noviembre | 1 | 0 | 1 |
| 2018 Octubre | 5 | 0 | 5 |
| 2018 Septiembre | 3 | 0 | 3 |
| 2018 Mayo | 0 | 5 | 5 |
| 2018 Abril | 0 | 3 | 3 |
| 2018 Marzo | 2 | 2 | 4 |
| 2018 Febrero | 26 | 4 | 30 |
| 2018 Enero | 30 | 10 | 40 |
| 2017 Diciembre | 40 | 7 | 47 |
| 2017 Noviembre | 31 | 5 | 36 |
| 2017 Octubre | 38 | 8 | 46 |
| 2017 Septiembre | 35 | 8 | 43 |
| 2017 Agosto | 53 | 14 | 67 |
| 2017 Julio | 39 | 6 | 45 |
| 2017 Junio | 67 | 23 | 90 |
| 2017 Mayo | 58 | 15 | 73 |
| 2017 Abril | 75 | 11 | 86 |
| 2017 Marzo | 36 | 41 | 77 |
| 2017 Febrero | 32 | 15 | 47 |
| 2017 Enero | 23 | 16 | 39 |
| 2016 Diciembre | 34 | 18 | 52 |
| 2016 Noviembre | 55 | 31 | 86 |
| 2016 Octubre | 76 | 16 | 92 |
| 2016 Septiembre | 49 | 8 | 57 |
| 2016 Agosto | 1 | 10 | 11 |
| 2016 Julio | 10 | 0 | 10 |
| 2016 Junio | 9 | 2 | 11 |
| 2016 Mayo | 4 | 4 | 8 |
| 2016 Abril | 7 | 2 | 9 |
| 2016 Marzo | 8 | 9 | 17 |
| 2016 Febrero | 16 | 3 | 19 |
| 2016 Enero | 7 | 1 | 8 |
| 2015 Diciembre | 20 | 1 | 21 |
| 2015 Noviembre | 13 | 2 | 15 |
| 2015 Octubre | 16 | 0 | 16 |
| 2015 Septiembre | 9 | 2 | 11 |
| 2015 Agosto | 10 | 1 | 11 |
| 2015 Julio | 28 | 1 | 29 |
| 2015 Junio | 36 | 11 | 47 |
| 2015 Mayo | 31 | 16 | 47 |
| 2015 Abril | 26 | 7 | 33 |
| 2015 Marzo | 39 | 4 | 43 |
| 2015 Febrero | 30 | 7 | 37 |
| 2015 Enero | 24 | 6 | 30 |
| 2014 Diciembre | 20 | 6 | 26 |
| 2014 Noviembre | 20 | 3 | 23 |
| 2014 Octubre | 19 | 3 | 22 |
| 2014 Septiembre | 8 | 4 | 12 |
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