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Facial Erythema: Keys to the Differential Diagnosis
RR - Eritema facial: claves para el diagnóstico diferencial
N. Lamas-Doménech
, H. Collgros
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Servicio de Dermatología, Hospital Universitario Sagrat Cor, Barcelona, Spain
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Lamas-Doménech, H. Collgros" "autores" => array:2 [ 0 => array:4 [ "nombre" => "N." "apellidos" => "Lamas-Doménech" "email" => array:1 [ 0 => "n.lamas.domenech@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "H." "apellidos" => "Collgros" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital Universitario Sagrat Cor, Barcelona, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "RR - Eritema facial: claves para el diagnóstico diferencial" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Facial erythema is a very common reason for consulting a dermatologist. While often a manifestation of a benign condition, in some cases it may be the first sign of a more serious disorder and specific diagnostic tests are needed to rule out these diseases. Flushing can be produced by agents acting on the vascular smooth muscle receptors or by signals sent by the vasomotor nerves. It can be episodic or persistent. Episodic flushing is usually caused by endogenous vasoactive mediators or medication. Persistent flushing is caused by successive episodes over long periods, which eventually lead to the appearance of telangiectasias and enlarged vessels with slow-flowing deoxygenated blood.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the most common benign causes of flushing as well as other less common and potentially serious causes.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> The first step is to determine whether the patient's clinical history and a careful physical examination provide sufficient information to guide the diagnosis. If they do, we only have to decide whether or not additional tests are required to confirm the suspected diagnosis. Once the diagnosis is confirmed and the cause established, we can decide on an appropriate treatment. In more complex cases, the patient should keep a diary for 2 weeks and record when flushing occurs, the symptoms, any association with other symptoms (diarrhea, bronchospasm, headache, low blood pressure, tachycardia, abdominal pain, urticaria, or pruritus), and any external triggers (food, beverages, drugs, alcohol, exercise, emotions, stress, or occupational exposure). The data collected may provide the key to a suspected diagnosis, which can then be confirmed by the appropriate diagnostic studies. When the results obtained do not point to a possible cause or when the investigations undertaken do not support the suspected diagnosis, a more comprehensive battery of tests must be ordered to rule out the more common serious causes of flushing (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). The recommended first step is to measure plasma levels of serotonin, tryptase, chromogranin A, and histamine and 24h-urine levels of 5-hydroxyindoleacetic, vanillylmandelic acid, norepinephrine, metanephrines, and prostaglandin D2. In the presence of elevated values, the suspected diagnosis would be carcinoid syndrome, pheochromocytoma, or mastocytosis.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> If the results are within normal limits, we would then check for the presence of the following: hematuria, which would be indicative of renal cell carcinoma; elevated vasoactive intestinal peptide, which would suggest pancreatic carcinoma; elevated calcitonin, which would point to a possible medullary thyroid carcinoma. If an anaphylactic reaction is suspected, we would measure immunoglobulin E or perform a skin prick test for a specific substance. If the findings do not clearly support a particular diagnosis, the next step should be to investigate the less common causes, such as anxiety, psychiatric disorders, idiopathic flushing, and mast cell activation syndrome.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">We currently have symptomatic treatment at our disposal: brimonidine tartrate 0.5% gel. This topical treatment, which has been shown to be safe and effective in controlled clinical trials and has recently become available in Spain, can help to control flushing and improve the patient's quality of life.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The dermatologist plays a key role in the diagnosis of patients with flushing, since correct management may have implications for the morbidity and mortality of the condition.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-07-26" "fechaAceptado" => "2014-10-02" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec540940" "palabras" => array:3 [ 0 => "Facial erythema" 1 => "Flushing" 2 => "Differential diagnosis" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Lamas-Doménech N, Collgros H. RR - Eritema facial: claves para el diagnóstico diferencial. Actas Dermosifiliogr. 2015;106:427–429.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Source: Izikson et al.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a>; Lafont et al.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</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"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tests Required \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleBold">Common Causes</span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Benign causes</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Emotions \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Temperature \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Food and drinks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Rosacea</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Menopause</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Follicle-stimulating hormone (plasma) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Fever</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Alcohol</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleBold">Less Common, Serious Causes</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Carcinoid tumor</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5-Hydroxyindoleacetic acid (24-h urine) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Pheochromocytoma</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Metanephrines, norepinephrine, epinephrine, dopamine, and vanillylmandelic acid (24-h urine) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Mastocytosis</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Plasma tryptase (persistently elevation), n-methyl histamine, prostaglandin D2 (24-h urine) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Anaphylaxis</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Specific immunoglobulin E, skin prick test, elevated plasma tryptase during episode \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleBold">Other causes</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Medullary thyroid carcinoma</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Plasma calcitonin \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Pancreatic Tumor (VIPoma)</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Plasma vasoactive intestinal peptide (VIP) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Renal cell carcinoma</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Hematuria and radiologic evidence \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Psychiatric disorders</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Idiopathic flushing</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Neurologic</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Parkinson \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Migraine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Multiple sclerosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Trigeminal disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Horner syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Frey syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Autonomic epilepsy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Autonomic hyperreflexia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Orthostatic hypotension \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>Streeten syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Mast cell activation syndrome</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Medication</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="2" align="left" valign="top"><span class="elsevierStyleBold">Rare causes</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">Sarcoidosis, mitral stenosis, gastric dumping syndrome, arsenic poisoning, ciguatera poisoning, POEMS syndrome, bronchogenic carcinoma, malignant histiocytoma, malignant neuroblastoma, malignant ganglioneuroma, preaortic surgery, Leigh syndrome, Rovsing syndrome</span> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab840235.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Flushing: Causes and the Diagnostic Tests Required.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Advances in understanding and managing rosacea: Part 1: Connecting the dots between pathophysiological mechanisms and common clinical features of rosacea with emphasis on 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Zirwas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2005.07.057" "Revista" => array:7 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2006" "volumen" => "55" "paginaInicial" => "193" "paginaFinal" => "208" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16844500" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0015028209007778" "estado" => "S300" "issn" => "00150282" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Alertas cutáneas en malignidades sistémicas (parte I)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Yuste-Chaves" 1 => "P. Unamuno-Pérez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.adengl.2012.03.027" "Revista" => array:7 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2013" "volumen" => "104" "paginaInicial" => "285" "paginaFinal" => "298" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23578547" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1472648312000880" "estado" => "S300" "issn" => "14726483" ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Étiologies et orientation diagnostique devant un flush" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Lafont" 1 => "H. Sokol" 2 => "M.E. Sarre-Annweiler" 3 => "E. Lecornet-Sokol" 4 => "S. Barete" 5 => "O. Hermine" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.revmed.2013.08.015" "Revista" => array:7 [ "tituloSerie" => "Rev Med Interne" "fecha" => "2014" "volumen" => "35" "paginaInicial" => "303" "paginaFinal" => "309" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24080240" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0015028207034681" "estado" => "S300" "issn" => "00150282" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy and safety of once-daily topical brimonidine tartrate gel 0.5% for the treatment of moderate to severe facial erythema of rosacea: Results of two randomized, double-blind, and vehicle-controlled pivotal studies" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Fowler Jr." 1 => "M. Jackson" 2 => "A. Moore" 3 => "M. Jarratt" 4 => "T. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 32 | 10 | 42 |
| 2024 Octubre | 533 | 62 | 595 |
| 2024 Septiembre | 570 | 54 | 624 |
| 2024 Agosto | 681 | 82 | 763 |
| 2024 Julio | 764 | 63 | 827 |
| 2024 Junio | 547 | 50 | 597 |
| 2024 Mayo | 650 | 63 | 713 |
| 2024 Abril | 681 | 46 | 727 |
| 2024 Marzo | 615 | 52 | 667 |
| 2024 Febrero | 606 | 48 | 654 |
| 2024 Enero | 718 | 49 | 767 |
| 2023 Diciembre | 431 | 49 | 480 |
| 2023 Noviembre | 360 | 54 | 414 |
| 2023 Octubre | 309 | 62 | 371 |
| 2023 Septiembre | 329 | 63 | 392 |
| 2023 Agosto | 247 | 42 | 289 |
| 2023 Julio | 234 | 72 | 306 |
| 2023 Junio | 215 | 40 | 255 |
| 2023 Mayo | 273 | 49 | 322 |
| 2023 Abril | 247 | 39 | 286 |
| 2023 Marzo | 222 | 61 | 283 |
| 2023 Febrero | 187 | 28 | 215 |
| 2023 Enero | 167 | 48 | 215 |
| 2022 Diciembre | 151 | 63 | 214 |
| 2022 Noviembre | 76 | 33 | 109 |
| 2022 Octubre | 47 | 26 | 73 |
| 2022 Septiembre | 41 | 69 | 110 |
| 2022 Agosto | 33 | 38 | 71 |
| 2022 Julio | 34 | 39 | 73 |
| 2022 Junio | 28 | 31 | 59 |
| 2022 Mayo | 258 | 60 | 318 |
| 2022 Abril | 304 | 59 | 363 |
| 2022 Marzo | 373 | 65 | 438 |
| 2022 Febrero | 256 | 46 | 302 |
| 2022 Enero | 332 | 63 | 395 |
| 2021 Diciembre | 239 | 43 | 282 |
| 2021 Noviembre | 250 | 82 | 332 |
| 2021 Octubre | 256 | 86 | 342 |
| 2021 Septiembre | 290 | 80 | 370 |
| 2021 Agosto | 236 | 71 | 307 |
| 2021 Julio | 313 | 52 | 365 |
| 2021 Junio | 401 | 88 | 489 |
| 2021 Mayo | 358 | 113 | 471 |
| 2021 Abril | 748 | 306 | 1054 |
| 2021 Marzo | 482 | 170 | 652 |
| 2021 Febrero | 288 | 124 | 412 |
| 2021 Enero | 250 | 164 | 414 |
| 2020 Diciembre | 137 | 125 | 262 |
| 2020 Noviembre | 100 | 97 | 197 |
| 2020 Octubre | 75 | 84 | 159 |
| 2020 Septiembre | 122 | 99 | 221 |
| 2020 Agosto | 76 | 123 | 199 |
| 2020 Julio | 75 | 128 | 203 |
| 2020 Junio | 63 | 109 | 172 |
| 2020 Mayo | 64 | 147 | 211 |
| 2020 Abril | 67 | 122 | 189 |
| 2020 Marzo | 82 | 108 | 190 |
| 2020 Febrero | 5 | 36 | 41 |
| 2020 Enero | 5 | 47 | 52 |
| 2019 Diciembre | 6 | 25 | 31 |
| 2019 Noviembre | 4 | 68 | 72 |
| 2019 Octubre | 1 | 59 | 60 |
| 2019 Septiembre | 4 | 79 | 83 |
| 2019 Agosto | 6 | 70 | 76 |
| 2019 Julio | 5 | 61 | 66 |
| 2019 Junio | 4 | 49 | 53 |
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| 2019 Abril | 2 | 129 | 131 |
| 2019 Marzo | 2 | 70 | 72 |
| 2019 Febrero | 1 | 51 | 52 |
| 2019 Enero | 4 | 37 | 41 |
| 2018 Diciembre | 1 | 7 | 8 |
| 2018 Noviembre | 1 | 0 | 1 |
| 2018 Octubre | 5 | 0 | 5 |
| 2018 Septiembre | 6 | 33 | 39 |
| 2018 Agosto | 0 | 68 | 68 |
| 2018 Julio | 0 | 71 | 71 |
| 2018 Junio | 0 | 63 | 63 |
| 2018 Mayo | 1 | 82 | 83 |
| 2018 Abril | 0 | 88 | 88 |
| 2018 Marzo | 112 | 123 | 235 |
| 2018 Febrero | 655 | 135 | 790 |
| 2018 Enero | 570 | 97 | 667 |
| 2017 Diciembre | 414 | 76 | 490 |
| 2017 Noviembre | 389 | 99 | 488 |
| 2017 Octubre | 325 | 61 | 386 |
| 2017 Septiembre | 224 | 54 | 278 |
| 2017 Agosto | 191 | 58 | 249 |
| 2017 Julio | 119 | 62 | 181 |
| 2017 Junio | 117 | 51 | 168 |
| 2017 Mayo | 116 | 81 | 197 |
| 2017 Abril | 88 | 44 | 132 |
| 2017 Marzo | 82 | 71 | 153 |
| 2017 Febrero | 73 | 29 | 102 |
| 2017 Enero | 65 | 27 | 92 |
| 2016 Diciembre | 42 | 23 | 65 |
| 2016 Noviembre | 47 | 52 | 99 |
| 2016 Octubre | 37 | 75 | 112 |
| 2016 Septiembre | 0 | 46 | 46 |
| 2016 Agosto | 0 | 34 | 34 |
| 2016 Julio | 9 | 5 | 14 |
| 2016 Junio | 13 | 1 | 14 |
| 2016 Mayo | 10 | 33 | 43 |
| 2016 Abril | 7 | 45 | 52 |
| 2016 Marzo | 6 | 3 | 9 |
| 2016 Febrero | 5 | 2 | 7 |
| 2016 Enero | 9 | 1 | 10 |
| 2015 Diciembre | 4 | 1 | 5 |
| 2015 Noviembre | 0 | 1 | 1 |
| 2015 Octubre | 0 | 3 | 3 |
| 2015 Septiembre | 0 | 2 | 2 |
| 2015 Agosto | 0 | 3 | 3 |
| 2015 Julio | 12 | 9 | 21 |
| 2015 Junio | 16 | 6 | 22 |
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