array:24 [
  "pii" => "S1578219014003254"
  "issn" => "15782190"
  "doi" => "10.1016/j.adengl.2014.05.022"
  "estado" => "S300"
  "fechaPublicacion" => "2015-01-01"
  "aid" => "1023"
  "copyright" => "Elsevier España, S.L.U. and AEDV"
  "copyrightAnyo" => "2013"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "cor"
  "cita" => "Actas Dermosifiliogr. 2015;106:72-3"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2420
    "formatos" => array:3 [
      "EPUB" => 49
      "HTML" => 912
      "PDF" => 1459
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S0001731014003172"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2014.05.004"
      "estado" => "S300"
      "fechaPublicacion" => "2015-01-01"
      "aid" => "1023"
      "copyright" => "Elsevier España, S.L.U. and AEDV"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "cor"
      "cita" => "Actas Dermosifiliogr. 2015;106:72-3"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 1807
        "formatos" => array:3 [
          "EPUB" => 38
          "HTML" => 1114
          "PDF" => 655
        ]
      ]
      "en" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Case and research letter</span>"
        "titulo" => "Cobblestone mouth&#58; An exuberant oral presentation of pemphigus vegetans"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "72"
            "paginaFinal" => "73"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Una boca en empedrado&#58; una presentaci&#243;n oral exuberante de p&#233;nfigo vegetante"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figure 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1500
                "Ancho" => 602
                "Tamanyo" => 187184
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#44; B&#41; Painful white verrucous papules&#44; fissures&#44; erosions&#44; and crusts on the vermillion border of the lips and the hard palate &#40;cobblestone pattern&#41;&#59; sulci and gyri on the dorsum of the tongue &#40;cerebriform tongue&#41;&#46; &#169; Oozing&#44; raised erythematous plaques with a verrucous surface on the inguinal folds&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "P&#46; Mendes-Bastos, C&#46; Amaro, C&#46; Fernandes"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "P&#46;"
                "apellidos" => "Mendes-Bastos"
              ]
              1 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Amaro"
              ]
              2 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Fernandes"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1578219014003254"
          "doi" => "10.1016/j.adengl.2014.05.022"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219014003254?idApp=UINPBA000044"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731014003172?idApp=UINPBA000044"
      "url" => "/00017310/0000010600000001/v2_201706012025/S0001731014003172/v2_201706012025/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1578219014003266"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2014.05.023"
    "estado" => "S300"
    "fechaPublicacion" => "2015-01-01"
    "aid" => "1024"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Actas Dermosifiliogr. 2015;106:74-5"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1679
      "formatos" => array:3 [
        "EPUB" => 49
        "HTML" => 901
        "PDF" => 729
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case and research letter</span>"
      "titulo" => "Hypertrichosis of the malar areas and poliosis of the eyelashes caused by latanoprost"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "74"
          "paginaFinal" => "75"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Hipertricosis de las Áreas Malares y Poliosis de las Pestañas Causados por Latanoprost"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 751
              "Ancho" => 1001
              "Tamanyo" => 156814
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Poliosis, with affected eyelashes interspersed among normally pigmented eyelashes.</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "S. Özyurt, G. Seyman Çetinkaya"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "S."
              "apellidos" => "Özyurt"
            ]
            1 => array:2 [
              "nombre" => "G. Seyman"
              "apellidos" => "Çetinkaya"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0001731014003184"
        "doi" => "10.1016/j.ad.2014.05.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731014003184?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219014003266?idApp=UINPBA000044"
    "url" => "/15782190/0000010600000001/v2_201502060417/S1578219014003266/v2_201502060417/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1578219014003242"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2014.04.028"
    "estado" => "S300"
    "fechaPublicacion" => "2015-01-01"
    "aid" => "1014"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Actas Dermosifiliogr. 2015;106:70-1"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1410
      "formatos" => array:3 [
        "EPUB" => 57
        "HTML" => 899
        "PDF" => 454
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>"
      "titulo" => "<span class="elsevierStyleItalic">Malassezia</span> Growth on Peritumoral Skin After Routine Methyl-5-Aminolevulinate Photodynamic Therapy for Actinic Keratosis and Nonmelanoma Skin Cancer"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "70"
          "paginaFinal" => "71"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Crecimiento de <span class="elsevierStyleItalic">Malassezia</span> en Piel Peritumoral Tras Terapia Fotodinámica con Metil-5-aminolevulinato para Queratosis Actínica y Cáncer de Piel No Melanoma"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1208
              "Ancho" => 1667
              "Tamanyo" => 119298
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Box plot shows the difference in the number of <span class="elsevierStyleItalic">Malassezia</span> colonies before and after exposure of the peritumoral area and the adjacent control area to MAL-PDT and red light illumination, respectively.</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Y. Gilaberte, C. Aspiroz, C. Alejandre, A. Rezusta"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Y."
              "apellidos" => "Gilaberte"
            ]
            1 => array:2 [
              "nombre" => "C."
              "apellidos" => "Aspiroz"
            ]
            2 => array:2 [
              "nombre" => "C."
              "apellidos" => "Alejandre"
            ]
            3 => array:2 [
              "nombre" => "A."
              "apellidos" => "Rezusta"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0001731014002221"
        "doi" => "10.1016/j.ad.2014.04.010"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731014002221?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219014003242?idApp=UINPBA000044"
    "url" => "/15782190/0000010600000001/v2_201502060417/S1578219014003242/v2_201502060417/en/main.assets"
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case and research letter</span>"
    "titulo" => "Cobblestone mouth: An exuberant oral presentation of pemphigus vegetans"
    "tieneTextoCompleto" => true
    "saludo" => "<span class="elsevierStyleItalic">To the Editor</span>:"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "72"
        "paginaFinal" => "73"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "P. Mendes-Bastos, C. Amaro, C. Fernandes"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "P."
            "apellidos" => "Mendes-Bastos"
            "email" => array:1 [
              0 => "Pmendesbastos@gmail.com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "C."
            "apellidos" => "Amaro"
          ]
          2 => array:2 [
            "nombre" => "C."
            "apellidos" => "Fernandes"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Department of Dermatology and Venereology, Hospital de Curry Cabral, Centro Hospitalar de Lisboa Central, Portugal"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author."
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Una boca en empedrado: una presentación oral exuberante de pénfigo vegetante"
      ]
    ]
    "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" => 1500
            "Ancho" => 602
            "Tamanyo" => 194234
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A, B) Painful white verrucous papules, fissures, erosions, and crusts on the vermillion border of the lips and the hard palate (cobblestone pattern); sulci and gyri on the dorsum of the tongue (cerebriform tongue). &copy; Oozing, raised erythematous plaques with a verrucous surface on the inguinal folds.</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 45-year-old woman presented with a 4-month history of painful erosions on the oral mucosa and lips, and reported a weight loss of 12<span class="elsevierStyleHsp" style=""></span>kg due to difficulties in eating. Over the past 2 months she had noticed painful exudative erosions on the inguinal folds and perineum as well as erythematous conjunctiva and easy tearing. She had been prescribed several systemic and topical medications, but her condition had progressively worsened.</p><p id="par0010" class="elsevierStylePara elsevierViewall">On physical examination, the surfaces of the vermillion border of the lips, the gums, and the hard palate had multiple white verrucous papules, fissures, erosions, and crusts forming a cobblestone pattern. The dorsum of the tongue had sulci and gyri that gave it a cerebriform appearance (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and B). On the perineum, a well-demarcated erosion with a whitish, exudative surface was seen, in addition to painful, oozing, raised erythematous plaques with a verrucous surface on the inguinal folds (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C) and right axilla. The complete skin examination also revealed two small flaccid blisters and an erosion on the back and a superficial erosion on the left lower tarsal conjunctiva.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Histological examination of one of the flaccid blisters on the back revealed an intraepidermal blister and suprabasal acantholysis (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A), as well as a dense epidermal and dermal inflammatory infiltrate, rich in neutrophils and eosinophils (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>B). Histological examination of the left inguinal vegetating plaque showed identical findings, in addition to pseudoepitheliomatous epidermal hyperplasia (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>C). Direct immunofluorescence of perilesional skin showed intercellular staining of the epidermis by immunoglobulin (Ig) G deposits (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>D).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">A diagnosis of pemphigus vegetans was established. The patient was treated with systemic prednisolone 60<span class="elsevierStyleHsp" style=""></span>mg/d (1 mg/kg/day) with a slow taper, azathioprine 150<span class="elsevierStyleHsp" style=""></span>mg/d, and topical tacrolimus 1<span class="elsevierStyleHsp" style=""></span>mg/g ointment on the lips. The cutaneous and mucosal lesions regressed completely in two months and the patient was kept on azathioprine 150<span class="elsevierStyleHsp" style=""></span>mg/d.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Pemphigus vegetans is a rare variant of pemphigus vulgaris, and is thought to represent a reactive response of the skin to the autoimmune insult of pemphigus vulgaris.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> It is characterized by flaccid blisters that erupt into erosions and eventually form papillomatous vegetations, especially in intertriginous areas and on the scalp or face.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> Involvement of the vermilion border of the lips is a clinical hallmark of oral involvement.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The tongue may show cerebriform-like changes.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The exuberant cobblestone pattern of the lips and oral mucosa associated with marked weight loss in the current case highlights the importance of oral manifestations of pemphigus vegetans.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Suprabasal acantholysis is an early histopathological finding in pemphigus vulgaris and pemphigus vegetans. With time, the lesions acquire a verrucous and hyperkeratotic appearance and biopsy samples from pemphigus vegetans may exhibit epidermal hyperplasia, papillomatosis, and intraepidermal eosinophilic abscesses.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,4</span></a> Presence of an eosinophilic response, formation of microabscesses, and extent of vesiculation have been proposed as possible histopathological features for distinguishing pemphigus vegetans from pemphigus vulgaris.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Direct immunofluorescence usually shows deposits of IgG and possibly C3 on the surface of keratinocytes. Circulating intercellular antibodies against desmogleins, generally of the IgG class, are detected in most patients by indirect immunofluorescence.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> The patient described in this report had elevated titers of both anti-desmoglein 3 (&#62;200<span class="elsevierStyleHsp" style=""></span>RU/mL) and anti-desmoglein 1 antibodies (142<span class="elsevierStyleHsp" style=""></span>RU/mL).</p><p id="par0040" class="elsevierStylePara elsevierViewall">The clinical differential diagnosis should include Hayley&#8211;Hayley disease, IgA pemphigus, and paraneoplastic pemphigus,<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> while the histological differential diagnosis should include pemphigus vulgaris, Hayley&#8211;Hayley disease, Darier disease, and Grover disease. Pyodermatitis-pyostomatitis vegetans can clinically and histopathologically resemble pemphigus vegetans and only indirect and direct immunofluorescence studies can accurately distinguish between these two entities.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Mendes-Bastos P, Amaro C, Fernandes C. Una boca en empedrado: una presentaci&oacute;n oral exuberante de p&eacute;nfigo vegetante. Actas Dermosifiliogr. 2015;106:72&#8211;73.</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" => 1500
            "Ancho" => 602
            "Tamanyo" => 194234
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A, B) Painful white verrucous papules, fissures, erosions, and crusts on the vermillion border of the lips and the hard palate (cobblestone pattern); sulci and gyri on the dorsum of the tongue (cerebriform tongue). &copy; Oozing, raised erythematous plaques with a verrucous surface on the inguinal folds.</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" => 1927
            "Ancho" => 750
            "Tamanyo" => 390212
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A) Intraepidermal blister and a dense epidermal and dermal inflammatory infiltrate (hematoxylin&#8211;eosin, original magnification, &times;10). (B) Suprabasal acantholysis and inflammatory infiltrate, rich in neutrophils and eosinophils (hematoxylin&#8211;eosin, original magnification, &times;40). (C) Pseudoepitheliomatous epidermal hyperplasia and dense inflammatory dermal infiltrate (hematoxylin&#8211;eosin, original magnification, &times;10). (D) Direct immunofluorescence showing immunoglobulin G intercellular epidermal deposits.</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:6 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pemphigus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:1 [
                            0 => "M. Amagai"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "titulo" => "Dermatology"
                        "paginaInicial" => "461"
                        "paginaFinal" => "474"
                        "edicion" => "3rd ed."
                        "serieFecha" => "2012"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pemphigus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J. S&aacute;nchez-P&eacute;rez"
                            1 => "A. Garc&iacute;a-D&iacute;ez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2005"
                        "volumen" => "96"
                        "paginaInicial" => "329"
                        "paginaFinal" => "356"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16476253"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pemphigus vegetans associated with verrucous lesions &#8211; expanding a phenotype"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H.L. de Almeida Jr."
                            1 => "M.G.P. Neugebauer"
                            2 => "I.M. Guarenti"
                            3 => "V. Aoki"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clinics (Sao Paulo)"
                        "fecha" => "2006"
                        "volumen" => "61"
                        "paginaInicial" => "279"
                        "paginaFinal" => "282"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Noninfectious vesiculobullous and vesiculopustular diseases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H. Wu"
                            1 => "H.A. Brandling-Benett"
                            2 => "T.J. Harrist"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "titulo" => "Lever&#39;s histopathology of the skin"
                        "paginaInicial" => "149"
                        "paginaFinal" => "152"
                        "edicion" => "10th ed."
                        "serieFecha" => "2009"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Immunobullous Diseases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "F. Wojnarowska"
                            1 => "V.A. Venning"
                            2 => "S.M. Burge"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "titulo" => "Rook&#39;s textbook of dermatology"
                        "paginaInicial" => "41.10"
                        "paginaFinal" => "41.13"
                        "edicion" => "7th ed."
                        "serieFecha" => "2008"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Neumann Type of Pemphigus Vegetans treated with combination of dapsone and steroid"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Y.M. Son"
                            1 => "H.K. Kang"
                            2 => "J.H. Yun"
                            3 => "J.Y. Roh"
                            4 => "J.R. Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5021/ad.2011.23.S3.S310"
                      "Revista" => array:7 [
                        "tituloSerie" => "Ann Dermatol"
                        "fecha" => "2011"
                        "volumen" => "23"
                        "numero" => "Suppl 3"
                        "paginaInicial" => "S310"
                        "paginaFinal" => "S313"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22346265"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000010600000001/v2_201502060417/S1578219014003254/v2_201502060417/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/15782190/0000010600000001/v2_201502060417/S1578219014003254/v2_201502060417/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219014003254?idApp=UINPBA000044"
]
Compartir
Información de la revista

Estadísticas

Siga este enlace para acceder al texto completo del artículo

Case and research letter
Cobblestone mouth: An exuberant oral presentation of pemphigus vegetans
Una boca en empedrado: una presentación oral exuberante de pénfigo vegetante
P. Mendes-Bastos
Autor para correspondencia
Pmendesbastos@gmail.com

Corresponding author.
, C. Amaro, C. Fernandes
Department of Dermatology and Venereology, Hospital de Curry Cabral, Centro Hospitalar de Lisboa Central, Portugal
Leído
16806
Veces
se ha leído el artículo
3350
Total PDF
13456
Total HTML
Compartir estadísticas
 array:24 [
  "pii" => "S1578219014003254"
  "issn" => "15782190"
  "doi" => "10.1016/j.adengl.2014.05.022"
  "estado" => "S300"
  "fechaPublicacion" => "2015-01-01"
  "aid" => "1023"
  "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
  "copyrightAnyo" => "2013"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "cor"
  "cita" => "Actas Dermosifiliogr. 2015;106:72-3"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 2420
    "formatos" => array:3 [
      "EPUB" => 49
      "HTML" => 912
      "PDF" => 1459
    ]
  ]
  "Traduccion" => array:1 [
    "en" => array:19 [
      "pii" => "S0001731014003172"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2014.05.004"
      "estado" => "S300"
      "fechaPublicacion" => "2015-01-01"
      "aid" => "1023"
      "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "cor"
      "cita" => "Actas Dermosifiliogr. 2015;106:72-3"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 1807
        "formatos" => array:3 [
          "EPUB" => 38
          "HTML" => 1114
          "PDF" => 655
        ]
      ]
      "en" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Case and research letter</span>"
        "titulo" => "Cobblestone mouth&#58; An exuberant oral presentation of pemphigus vegetans"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "72"
            "paginaFinal" => "73"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "es" => array:1 [
            "titulo" => "Una boca en empedrado&#58; una presentaci&#243;n oral exuberante de p&#233;nfigo vegetante"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figure 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 1500
                "Ancho" => 602
                "Tamanyo" => 187184
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A&#44; B&#41; Painful white verrucous papules&#44; fissures&#44; erosions&#44; and crusts on the vermillion border of the lips and the hard palate &#40;cobblestone pattern&#41;&#59; sulci and gyri on the dorsum of the tongue &#40;cerebriform tongue&#41;&#46; &#169; Oozing&#44; raised erythematous plaques with a verrucous surface on the inguinal folds&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "P&#46; Mendes-Bastos, C&#46; Amaro, C&#46; Fernandes"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "P&#46;"
                "apellidos" => "Mendes-Bastos"
              ]
              1 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Amaro"
              ]
              2 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Fernandes"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1578219014003254"
          "doi" => "10.1016/j.adengl.2014.05.022"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219014003254?idApp=UINPBA000044"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731014003172?idApp=UINPBA000044"
      "url" => "/00017310/0000010600000001/v2_201706012025/S0001731014003172/v2_201706012025/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1578219014003266"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2014.05.023"
    "estado" => "S300"
    "fechaPublicacion" => "2015-01-01"
    "aid" => "1024"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Actas Dermosifiliogr. 2015;106:74-5"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1679
      "formatos" => array:3 [
        "EPUB" => 49
        "HTML" => 901
        "PDF" => 729
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case and research letter</span>"
      "titulo" => "Hypertrichosis of the malar areas and poliosis of the eyelashes caused by latanoprost"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "74"
          "paginaFinal" => "75"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Hipertricosis de las Áreas Malares y Poliosis de las Pestañas Causados por Latanoprost"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 751
              "Ancho" => 1001
              "Tamanyo" => 156814
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Poliosis, with affected eyelashes interspersed among normally pigmented eyelashes.</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "S. Özyurt, G. Seyman Çetinkaya"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "S."
              "apellidos" => "Özyurt"
            ]
            1 => array:2 [
              "nombre" => "G. Seyman"
              "apellidos" => "Çetinkaya"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0001731014003184"
        "doi" => "10.1016/j.ad.2014.05.005"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731014003184?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219014003266?idApp=UINPBA000044"
    "url" => "/15782190/0000010600000001/v2_201502060417/S1578219014003266/v2_201502060417/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1578219014003242"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2014.04.028"
    "estado" => "S300"
    "fechaPublicacion" => "2015-01-01"
    "aid" => "1014"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "cor"
    "cita" => "Actas Dermosifiliogr. 2015;106:70-1"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 1410
      "formatos" => array:3 [
        "EPUB" => 57
        "HTML" => 899
        "PDF" => 454
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>"
      "titulo" => "<span class="elsevierStyleItalic">Malassezia</span> Growth on Peritumoral Skin After Routine Methyl-5-Aminolevulinate Photodynamic Therapy for Actinic Keratosis and Nonmelanoma Skin Cancer"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "70"
          "paginaFinal" => "71"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Crecimiento de <span class="elsevierStyleItalic">Malassezia</span> en Piel Peritumoral Tras Terapia Fotodinámica con Metil-5-aminolevulinato para Queratosis Actínica y Cáncer de Piel No Melanoma"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1208
              "Ancho" => 1667
              "Tamanyo" => 119298
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Box plot shows the difference in the number of <span class="elsevierStyleItalic">Malassezia</span> colonies before and after exposure of the peritumoral area and the adjacent control area to MAL-PDT and red light illumination, respectively.</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Y. Gilaberte, C. Aspiroz, C. Alejandre, A. Rezusta"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Y."
              "apellidos" => "Gilaberte"
            ]
            1 => array:2 [
              "nombre" => "C."
              "apellidos" => "Aspiroz"
            ]
            2 => array:2 [
              "nombre" => "C."
              "apellidos" => "Alejandre"
            ]
            3 => array:2 [
              "nombre" => "A."
              "apellidos" => "Rezusta"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0001731014002221"
        "doi" => "10.1016/j.ad.2014.04.010"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731014002221?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219014003242?idApp=UINPBA000044"
    "url" => "/15782190/0000010600000001/v2_201502060417/S1578219014003242/v2_201502060417/en/main.assets"
  ]
  "en" => array:15 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case and research letter</span>"
    "titulo" => "Cobblestone mouth: An exuberant oral presentation of pemphigus vegetans"
    "tieneTextoCompleto" => true
    "saludo" => "<span class="elsevierStyleItalic">To the Editor</span>:"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "72"
        "paginaFinal" => "73"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "P. Mendes-Bastos, C. Amaro, C. Fernandes"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "P."
            "apellidos" => "Mendes-Bastos"
            "email" => array:1 [
              0 => "Pmendesbastos@gmail.com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "C."
            "apellidos" => "Amaro"
          ]
          2 => array:2 [
            "nombre" => "C."
            "apellidos" => "Fernandes"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Department of Dermatology and Venereology, Hospital de Curry Cabral, Centro Hospitalar de Lisboa Central, Portugal"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author."
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Una boca en empedrado: una presentación oral exuberante de pénfigo vegetante"
      ]
    ]
    "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" => 1500
            "Ancho" => 602
            "Tamanyo" => 194234
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A, B) Painful white verrucous papules, fissures, erosions, and crusts on the vermillion border of the lips and the hard palate (cobblestone pattern); sulci and gyri on the dorsum of the tongue (cerebriform tongue). &copy; Oozing, raised erythematous plaques with a verrucous surface on the inguinal folds.</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 45-year-old woman presented with a 4-month history of painful erosions on the oral mucosa and lips, and reported a weight loss of 12<span class="elsevierStyleHsp" style=""></span>kg due to difficulties in eating. Over the past 2 months she had noticed painful exudative erosions on the inguinal folds and perineum as well as erythematous conjunctiva and easy tearing. She had been prescribed several systemic and topical medications, but her condition had progressively worsened.</p><p id="par0010" class="elsevierStylePara elsevierViewall">On physical examination, the surfaces of the vermillion border of the lips, the gums, and the hard palate had multiple white verrucous papules, fissures, erosions, and crusts forming a cobblestone pattern. The dorsum of the tongue had sulci and gyri that gave it a cerebriform appearance (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A and B). On the perineum, a well-demarcated erosion with a whitish, exudative surface was seen, in addition to painful, oozing, raised erythematous plaques with a verrucous surface on the inguinal folds (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C) and right axilla. The complete skin examination also revealed two small flaccid blisters and an erosion on the back and a superficial erosion on the left lower tarsal conjunctiva.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Histological examination of one of the flaccid blisters on the back revealed an intraepidermal blister and suprabasal acantholysis (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A), as well as a dense epidermal and dermal inflammatory infiltrate, rich in neutrophils and eosinophils (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>B). Histological examination of the left inguinal vegetating plaque showed identical findings, in addition to pseudoepitheliomatous epidermal hyperplasia (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>C). Direct immunofluorescence of perilesional skin showed intercellular staining of the epidermis by immunoglobulin (Ig) G deposits (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>D).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">A diagnosis of pemphigus vegetans was established. The patient was treated with systemic prednisolone 60<span class="elsevierStyleHsp" style=""></span>mg/d (1 mg/kg/day) with a slow taper, azathioprine 150<span class="elsevierStyleHsp" style=""></span>mg/d, and topical tacrolimus 1<span class="elsevierStyleHsp" style=""></span>mg/g ointment on the lips. The cutaneous and mucosal lesions regressed completely in two months and the patient was kept on azathioprine 150<span class="elsevierStyleHsp" style=""></span>mg/d.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Pemphigus vegetans is a rare variant of pemphigus vulgaris, and is thought to represent a reactive response of the skin to the autoimmune insult of pemphigus vulgaris.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> It is characterized by flaccid blisters that erupt into erosions and eventually form papillomatous vegetations, especially in intertriginous areas and on the scalp or face.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a> Involvement of the vermilion border of the lips is a clinical hallmark of oral involvement.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> The tongue may show cerebriform-like changes.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The exuberant cobblestone pattern of the lips and oral mucosa associated with marked weight loss in the current case highlights the importance of oral manifestations of pemphigus vegetans.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Suprabasal acantholysis is an early histopathological finding in pemphigus vulgaris and pemphigus vegetans. With time, the lesions acquire a verrucous and hyperkeratotic appearance and biopsy samples from pemphigus vegetans may exhibit epidermal hyperplasia, papillomatosis, and intraepidermal eosinophilic abscesses.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,4</span></a> Presence of an eosinophilic response, formation of microabscesses, and extent of vesiculation have been proposed as possible histopathological features for distinguishing pemphigus vegetans from pemphigus vulgaris.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Direct immunofluorescence usually shows deposits of IgG and possibly C3 on the surface of keratinocytes. Circulating intercellular antibodies against desmogleins, generally of the IgG class, are detected in most patients by indirect immunofluorescence.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> The patient described in this report had elevated titers of both anti-desmoglein 3 (&#62;200<span class="elsevierStyleHsp" style=""></span>RU/mL) and anti-desmoglein 1 antibodies (142<span class="elsevierStyleHsp" style=""></span>RU/mL).</p><p id="par0040" class="elsevierStylePara elsevierViewall">The clinical differential diagnosis should include Hayley&#8211;Hayley disease, IgA pemphigus, and paraneoplastic pemphigus,<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> while the histological differential diagnosis should include pemphigus vulgaris, Hayley&#8211;Hayley disease, Darier disease, and Grover disease. Pyodermatitis-pyostomatitis vegetans can clinically and histopathologically resemble pemphigus vegetans and only indirect and direct immunofluorescence studies can accurately distinguish between these two entities.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Mendes-Bastos P, Amaro C, Fernandes C. Una boca en empedrado: una presentaci&oacute;n oral exuberante de p&eacute;nfigo vegetante. Actas Dermosifiliogr. 2015;106:72&#8211;73.</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" => 1500
            "Ancho" => 602
            "Tamanyo" => 194234
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A, B) Painful white verrucous papules, fissures, erosions, and crusts on the vermillion border of the lips and the hard palate (cobblestone pattern); sulci and gyri on the dorsum of the tongue (cerebriform tongue). &copy; Oozing, raised erythematous plaques with a verrucous surface on the inguinal folds.</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" => 1927
            "Ancho" => 750
            "Tamanyo" => 390212
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A) Intraepidermal blister and a dense epidermal and dermal inflammatory infiltrate (hematoxylin&#8211;eosin, original magnification, &times;10). (B) Suprabasal acantholysis and inflammatory infiltrate, rich in neutrophils and eosinophils (hematoxylin&#8211;eosin, original magnification, &times;40). (C) Pseudoepitheliomatous epidermal hyperplasia and dense inflammatory dermal infiltrate (hematoxylin&#8211;eosin, original magnification, &times;10). (D) Direct immunofluorescence showing immunoglobulin G intercellular epidermal deposits.</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:6 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pemphigus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:1 [
                            0 => "M. Amagai"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "titulo" => "Dermatology"
                        "paginaInicial" => "461"
                        "paginaFinal" => "474"
                        "edicion" => "3rd ed."
                        "serieFecha" => "2012"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pemphigus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J. S&aacute;nchez-P&eacute;rez"
                            1 => "A. Garc&iacute;a-D&iacute;ez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2005"
                        "volumen" => "96"
                        "paginaInicial" => "329"
                        "paginaFinal" => "356"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16476253"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pemphigus vegetans associated with verrucous lesions &#8211; expanding a phenotype"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "H.L. de Almeida Jr."
                            1 => "M.G.P. Neugebauer"
                            2 => "I.M. Guarenti"
                            3 => "V. Aoki"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clinics (Sao Paulo)"
                        "fecha" => "2006"
                        "volumen" => "61"
                        "paginaInicial" => "279"
                        "paginaFinal" => "282"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Noninfectious vesiculobullous and vesiculopustular diseases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H. Wu"
                            1 => "H.A. Brandling-Benett"
                            2 => "T.J. Harrist"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "titulo" => "Lever&#39;s histopathology of the skin"
                        "paginaInicial" => "149"
                        "paginaFinal" => "152"
                        "edicion" => "10th ed."
                        "serieFecha" => "2009"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Immunobullous Diseases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "F. Wojnarowska"
                            1 => "V.A. Venning"
                            2 => "S.M. Burge"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "titulo" => "Rook&#39;s textbook of dermatology"
                        "paginaInicial" => "41.10"
                        "paginaFinal" => "41.13"
                        "edicion" => "7th ed."
                        "serieFecha" => "2008"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Neumann Type of Pemphigus Vegetans treated with combination of dapsone and steroid"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "Y.M. Son"
                            1 => "H.K. Kang"
                            2 => "J.H. Yun"
                            3 => "J.Y. Roh"
                            4 => "J.R. Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5021/ad.2011.23.S3.S310"
                      "Revista" => array:7 [
                        "tituloSerie" => "Ann Dermatol"
                        "fecha" => "2011"
                        "volumen" => "23"
                        "numero" => "Suppl 3"
                        "paginaInicial" => "S310"
                        "paginaFinal" => "S313"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22346265"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000010600000001/v2_201502060417/S1578219014003254/v2_201502060417/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/15782190/0000010600000001/v2_201502060417/S1578219014003254/v2_201502060417/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219014003254?idApp=UINPBA000044"
]
Información del artículo
ISSN: 15782190
Idioma original: Inglés
Datos actualizados diariamente
año/Mes Html Pdf Total
2024 Noviembre 46 6 52
2024 Octubre 424 46 470
2024 Septiembre 392 39 431
2024 Agosto 401 71 472
2024 Julio 313 35 348
2024 Junio 254 48 302
2024 Mayo 214 33 247
2024 Abril 204 22 226
2024 Marzo 253 51 304
2024 Febrero 297 32 329
2024 Enero 354 29 383
2023 Diciembre 363 18 381
2023 Noviembre 337 31 368
2023 Octubre 350 16 366
2023 Septiembre 290 28 318
2023 Agosto 265 19 284
2023 Julio 226 36 262
2023 Junio 222 20 242
2023 Mayo 330 27 357
2023 Abril 289 20 309
2023 Marzo 277 28 305
2023 Febrero 216 25 241
2023 Enero 189 25 214
2022 Diciembre 192 38 230
2022 Noviembre 161 38 199
2022 Octubre 180 31 211
2022 Septiembre 135 44 179
2022 Agosto 149 47 196
2022 Julio 161 38 199
2022 Junio 84 33 117
2022 Mayo 210 37 247
2022 Abril 278 54 332
2022 Marzo 283 45 328
2022 Febrero 239 24 263
2022 Enero 308 56 364
2021 Diciembre 247 37 284
2021 Noviembre 269 61 330
2021 Octubre 267 64 331
2021 Septiembre 212 48 260
2021 Agosto 160 35 195
2021 Julio 158 34 192
2021 Junio 246 40 286
2021 Mayo 239 48 287
2021 Abril 552 75 627
2021 Marzo 303 36 339
2021 Febrero 161 28 189
2021 Enero 136 12 148
2020 Diciembre 116 11 127
2020 Noviembre 100 16 116
2020 Octubre 75 16 91
2020 Septiembre 81 11 92
2020 Agosto 67 30 97
2020 Julio 81 11 92
2020 Junio 42 25 67
2020 Mayo 38 24 62
2020 Abril 68 21 89
2020 Marzo 37 18 55
2020 Febrero 3 4 7
2020 Enero 6 7 13
2019 Diciembre 8 6 14
2019 Noviembre 4 4 8
2019 Octubre 0 4 4
2019 Septiembre 1 10 11
2019 Agosto 5 5 10
2019 Julio 10 14 24
2019 Junio 4 25 29
2019 Mayo 10 22 32
2019 Abril 18 39 57
2019 Marzo 3 13 16
2019 Febrero 5 28 33
2019 Enero 9 9 18
2018 Diciembre 5 5 10
2018 Noviembre 9 0 9
2018 Octubre 4 0 4
2018 Septiembre 6 12 18
2018 Agosto 0 26 26
2018 Julio 0 38 38
2018 Junio 0 37 37
2018 Mayo 0 33 33
2018 Abril 0 40 40
2018 Marzo 0 28 28
2018 Febrero 38 36 74
2018 Enero 49 54 103
2017 Diciembre 50 25 75
2017 Noviembre 45 39 84
2017 Octubre 21 36 57
2017 Septiembre 17 57 74
2017 Agosto 40 41 81
2017 Julio 35 66 101
2017 Junio 33 36 69
2017 Mayo 35 38 73
2017 Abril 21 38 59
2017 Marzo 21 64 85
2017 Febrero 28 77 105
2017 Enero 8 42 50
2016 Diciembre 29 27 56
2016 Noviembre 36 29 65
2016 Octubre 18 35 53
2016 Septiembre 0 31 31
2016 Agosto 0 22 22
2016 Julio 9 4 13
2016 Junio 17 22 39
2016 Mayo 13 28 41
2016 Abril 8 39 47
2016 Marzo 8 15 23
2016 Febrero 11 18 29
2016 Enero 15 18 33
2015 Diciembre 11 9 20
2015 Noviembre 14 12 26
2015 Octubre 12 24 36
2015 Septiembre 12 18 30
2015 Agosto 6 3 9
2015 Julio 49 5 54
2015 Junio 28 5 33
2015 Mayo 31 10 41
2015 Abril 23 8 31
2015 Marzo 9 16 25
2015 Febrero 5 3 8
Mostrar todo

Siga este enlace para acceder al texto completo del artículo

Idiomas
Actas Dermo-Sifiliográficas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?