Resident's Forum
Psychotropic Drugs in Dermatology
FR-Utilización de psicofármacos en dermatología
A.M. Rodríguez Martín
, M. González Padilla
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Servicio de Dermatología, Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain
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Rodríguez Martín, M. González Padilla" "autores" => array:2 [ 0 => array:4 [ "nombre" => "A.M." "apellidos" => "Rodríguez Martín" "email" => array:1 [ 0 => "rodriguezmartinanamaria@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "M." "apellidos" => "González Padilla" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital Universitario Reina Sofía de Córdoba, Córdoba, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding Author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "FR-Utilización de psicofármacos en dermatología" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In daily dermatology practice it is not uncommon to encounter psychiatric disturbances that can present as psychodermatoses or as psychological complications of chronic diseases. Delusional parasitosis, psychogenic pruritus, dermatitis artefacta, trichotillomania, and the somatoform disorders belong to the first group, while the archetypal diseases in the second group are psoriasis, atopy, and acne. These patients are usually unwilling to be referred to a psychiatrist and, if referral is achieved, the therapeutic alliance achieved in the clinical interview is lost in many cases. It is therefore necessary for the dermatologist to have a basic understanding of the psychotropic drugs in order to initiate appropriate treatment.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The psychotropic drugs most frequently prescribed in daily clinical practice are the antidepressants, the benzodiazepines, and the antipsychotics (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Of these 3 groups, the antidepressants—specifically, the serotonin reuptake inhibitors—are the drugs most commonly employed in dermatology consultations. These drugs are safe and have few side effects, the most important of which are gastrointestinal disturbances, insomnia, and sexual dysfunction. They are used particularly in cases of neurotic excoriation, dysmorphophobia, trichotillomania, and chronic pruritus. They must be administered for a minimum of 4 to 6 weeks before the effects become evident, and treatment must be continued for several months. Drug withdrawal must be gradual to avoid recurrence or withdrawal symptoms (anxiety, nausea, diaphoresis, and others).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Other antidepressants used in dermatology are the tricyclic (doxepine and amitriptyline) and the tetracyclic (mirtazapine) antidepressants. Both types block serotonin, norepinephrine, and dopamine reuptake, whilst also acting as histaminergic, cholinergic, and α-adrenergic receptor antagonists. These drugs are useful in neurotic excoriation, generalized pruritus, and chronic urticaria. Amitriptyline is used in the treatment of postherpetic neuralgia. The main side effects are sedation, blurred vision, dryness of the mouth, urinary retention, constipation, and increased intraocular pressure. Amitriptyline can produce cardiovascular effects, including arrhythmias and prolongation of the QT interval.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The benzodiazepines act mainly as anxiolytics and sedatives and, in dermatology, they are therefore mainly employed to minimize anxiety secondary to a dermatologic disease. They should only be used for short periods as they can induce tolerance and dependence.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The antipsychotics are a group of drugs that are difficult for dermatologists to manage. The most widely used is pimozide, employed as first-line treatment in delusional parasitosis. Remission is achieved in 50% of cases with doses of 2 to 4<span class="elsevierStyleHsp" style=""></span>mg/d.<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">2–4</span></a> Pimozide is a dopamine receptor antagonist, and its side effects include extrapyramidal symptoms, blurred vision, orthostatic hypotension, constipation, and urinary retention. It is important to remember that pimozide can stimulate prolactin secretion and prolong the QT interval.</p><p id="par0030" class="elsevierStylePara elsevierViewall">In conclusion, the management of the psychocutaneous disorders requires a multidisciplinary approach in the emerging psychosomatic medicine units. Collaboration between dermatologists, psychologists, and psychiatrists will provide integral treatment for the patient. It is important to perform an adequate psychological evaluation and be prepared to initiate treatment with psychotropic drugs when necessary. The dermatologist should therefore be aware of the main psychotropic drugs.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of Interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "xpalclavsec547593" "titulo" => "Palabras clave" ] 1 => array:2 [ "identificador" => "xpalclavsec547594" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of Interest" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec547594" "palabras" => array:3 [ 0 => "Psychotropic drugs" 1 => "Psychodermatoses" 2 => "Therapeutic" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Rodríguez Martín AM, González Padilla M. FR-Utilización de psicofármacos en dermatología. Actas Dermosifiliogr. 2015;106:507–509.</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">Abbreviations: BZ, benzodiazepine; EBD, eating behavior disorder; FDA, Food and Drug Administration of the United States; GAD, generalized anxiety disorder; IOP, intraocular pressure; MD, major depression; OCD, obsessive-compulsive disorder; PTSD, posttraumatic stress disorder; SSRI, selective serotonin reuptake inhibitor; TCA, Tricyclic antidepressant; TeCA, Tetracyclic antidepressant.</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="left" valign="top" scope="col" style="border-bottom: 2px solid black">Drug \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">Classification \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">FDA Indications \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">Dermatologic Indication \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">Side Effects \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">Starting Dose \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">Maintenance Dose \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="7" align="left" valign="top"><span class="elsevierStyleItalic">Antidepressants</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Fluoxetine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SSRI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">OCD, MD, EBD, agoraphobia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Neurotic excoriationDysmorphophobiaTrichotillomaniaChronic pruritus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Gastrointestinal effectsInsomniaSexual dysfunctionNo weight gain, except with paroxetine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20<span class="elsevierStyleHsp" style=""></span>mg/d \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20-60<span class="elsevierStyleHsp" style=""></span>mg/d \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>Paroxetine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SSRI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">OCD, MD, GAD, PTSD, agoraphobia, social phobia \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><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20<span class="elsevierStyleHsp" style=""></span>mg/d \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20-50<span class="elsevierStyleHsp" style=""></span>mg/d \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>Sertraline \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SSRI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">OCD, MD, PTSD, agoraphobia, social phobia \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><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">50<span class="elsevierStyleHsp" style=""></span>mg/d \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">50-200<span class="elsevierStyleHsp" style=""></span>mg/d \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>Citalopram \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SSRI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MD \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><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20<span class="elsevierStyleHsp" style=""></span>mg/d \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20-60<span class="elsevierStyleHsp" style=""></span>mg/d \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>Escitalopram \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SSRI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MD, GAD \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><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10<span class="elsevierStyleHsp" style=""></span>mg/d \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10-20<span class="elsevierStyleHsp" style=""></span>mg/d \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>Fluvoxamine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">SSRI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">OCD, social phobia \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><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">50<span class="elsevierStyleHsp" style=""></span>mg at night \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">100-300<span class="elsevierStyleHsp" style=""></span>mg at night \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>Amitriptyline \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">TCA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Neurotic excoriationGeneralized pruritusChronic urticariaPostherpetic neuralgia with amitriptyline \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Anticholinergic effectsSedationIncreased IOPProlongation QT intervalWeight gain \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25<span class="elsevierStyleHsp" style=""></span>mg at night \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25-75<span class="elsevierStyleHsp" style=""></span>mg at night \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>Doxepine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">TCA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MD, GAD, insomnia, chronic pruritus \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><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25<span class="elsevierStyleHsp" style=""></span>mg at night \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">25-100<span class="elsevierStyleHsp" style=""></span>mg \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>Mirtazapine \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">TeCA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MD \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><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15<span class="elsevierStyleHsp" style=""></span>mg at night \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">15-45<span class="elsevierStyleHsp" style=""></span>mg \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="7" 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="7" align="left" valign="top"><span class="elsevierStyleItalic">Anxiolytics</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Alprazolam \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Short-acting BZ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">GAD, agoraphobia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Anxiety states related to chronic diseaseShort-term use(7-10 d) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ToleranceDependenceSedationAnterograde amnesiaParadoxical reactions \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.125-0.250<span class="elsevierStyleHsp" style=""></span>mg up to 4 times/d \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.25-0.5<span class="elsevierStyleHsp" style=""></span>mg up to 3 times/d \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>Lorazepam \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Intermediate acting BZ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Anxiety, insomnia \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><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1-2<span class="elsevierStyleHsp" style=""></span>mg up to 2-3 times/d \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1-2<span class="elsevierStyleHsp" style=""></span>mg up to 2-3 times/d, maximum dose 4<span class="elsevierStyleHsp" style=""></span>mg/d \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>Clorazepate dipotassium \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Long-acting BZ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">GAD, anxiety \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><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10-45<span class="elsevierStyleHsp" style=""></span>mg up to2-3 times/d \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10-45<span class="elsevierStyleHsp" style=""></span>mg up to2-3 times/d, Maximum dose 90<span class="elsevierStyleHsp" style=""></span>mg/d \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="7" 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="7" align="left" valign="top"><span class="elsevierStyleItalic">Antipsychotics</span></td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Pimozide \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1st generation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Gilles de la Tourette syndrome \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Delusional parasitosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Extrapyramidal symptomsAnticholinergic effectsIncreased PRLProlongation QT interval \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.5-1<span class="elsevierStyleHsp" style=""></span>mg/d \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1-6<span class="elsevierStyleHsp" style=""></span>mg/d \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab849493.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Main Psychotropic Drugs Used in Dermatology.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0025" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Tratamientos con psicofármacos de los trastornos psicodermatológicos" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J. Escalas" 1 => "A. Guerra" 2 => "M.C. Rodríguez-Cerdeira" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2010" "volumen" => "101" "paginaInicial" => "485" "paginaFinal" => "494" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20738967" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0030" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of psychotropic drugs in dermatology: Unique perspectives of a dermatologist and psychiatrist" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K.K. Park" 1 => "J. 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Muskin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clindermatol.2011.11.001" "Revista" => array:6 [ "tituloSerie" => "Clin Dermatol" "fecha" => "2013" "volumen" => "31" "paginaInicial" => "3" "paginaFinal" => "10" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23245968" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0040" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Psychiatric medications: Adverse cutaneous drug reactions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.A. Bliss" 1 => "J.K. Warnock" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clindermatol.2011.11.014" "Revista" => array:6 [ "tituloSerie" => "Clin Dermatol" "fecha" => "2013" "volumen" => "31" "paginaInicial" => "101" "paginaFinal" => "109" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23245981" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010600000006/v1_201506260207/S1578219015001304/v1_201506260207/en/main.assets" "Apartado" => array:4 [ "identificador" => "34945" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Resident's Forum" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010600000006/v1_201506260207/S1578219015001304/v1_201506260207/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219015001304?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 6 | 6 | 12 |
| 2024 Octubre | 110 | 57 | 167 |
| 2024 Septiembre | 98 | 41 | 139 |
| 2024 Agosto | 141 | 64 | 205 |
| 2024 Julio | 126 | 45 | 171 |
| 2024 Junio | 95 | 45 | 140 |
| 2024 Mayo | 118 | 55 | 173 |
| 2024 Abril | 94 | 27 | 121 |
| 2024 Marzo | 71 | 46 | 117 |
| 2024 Febrero | 91 | 43 | 134 |
| 2024 Enero | 86 | 47 | 133 |
| 2023 Diciembre | 81 | 35 | 116 |
| 2023 Noviembre | 65 | 55 | 120 |
| 2023 Octubre | 74 | 53 | 127 |
| 2023 Septiembre | 55 | 47 | 102 |
| 2023 Agosto | 28 | 38 | 66 |
| 2023 Julio | 42 | 59 | 101 |
| 2023 Junio | 9 | 21 | 30 |
| 2023 Mayo | 51 | 65 | 116 |
| 2023 Abril | 40 | 47 | 87 |
| 2023 Marzo | 50 | 57 | 107 |
| 2023 Febrero | 41 | 35 | 76 |
| 2023 Enero | 34 | 43 | 77 |
| 2022 Diciembre | 52 | 76 | 128 |
| 2022 Noviembre | 22 | 51 | 73 |
| 2022 Octubre | 31 | 41 | 72 |
| 2022 Septiembre | 27 | 64 | 91 |
| 2022 Agosto | 37 | 49 | 86 |
| 2022 Julio | 19 | 53 | 72 |
| 2022 Junio | 35 | 49 | 84 |
| 2022 Mayo | 36 | 78 | 114 |
| 2022 Abril | 55 | 57 | 112 |
| 2022 Marzo | 45 | 49 | 94 |
| 2022 Febrero | 48 | 35 | 83 |
| 2022 Enero | 46 | 50 | 96 |
| 2021 Diciembre | 52 | 46 | 98 |
| 2021 Noviembre | 43 | 45 | 88 |
| 2021 Octubre | 64 | 51 | 115 |
| 2021 Septiembre | 35 | 41 | 76 |
| 2021 Agosto | 29 | 40 | 69 |
| 2021 Julio | 34 | 38 | 72 |
| 2021 Junio | 49 | 36 | 85 |
| 2021 Mayo | 48 | 33 | 81 |
| 2021 Abril | 90 | 47 | 137 |
| 2021 Marzo | 59 | 29 | 88 |
| 2021 Febrero | 69 | 29 | 98 |
| 2021 Enero | 42 | 19 | 61 |
| 2020 Diciembre | 47 | 20 | 67 |
| 2020 Noviembre | 14 | 12 | 26 |
| 2020 Octubre | 16 | 11 | 27 |
| 2020 Septiembre | 31 | 17 | 48 |
| 2020 Agosto | 25 | 11 | 36 |
| 2020 Julio | 18 | 23 | 41 |
| 2020 Junio | 34 | 32 | 66 |
| 2020 Mayo | 27 | 21 | 48 |
| 2020 Abril | 27 | 20 | 47 |
| 2020 Marzo | 25 | 23 | 48 |
| 2020 Febrero | 4 | 7 | 11 |
| 2020 Enero | 0 | 10 | 10 |
| 2019 Diciembre | 2 | 5 | 7 |
| 2019 Noviembre | 0 | 3 | 3 |
| 2019 Octubre | 0 | 4 | 4 |
| 2019 Septiembre | 4 | 7 | 11 |
| 2019 Agosto | 0 | 7 | 7 |
| 2019 Julio | 0 | 14 | 14 |
| 2019 Junio | 2 | 20 | 22 |
| 2019 Mayo | 0 | 24 | 24 |
| 2019 Abril | 0 | 24 | 24 |
| 2019 Marzo | 2 | 11 | 13 |
| 2019 Febrero | 0 | 8 | 8 |
| 2019 Enero | 2 | 7 | 9 |
| 2018 Diciembre | 3 | 6 | 9 |
| 2018 Noviembre | 0 | 6 | 6 |
| 2018 Octubre | 4 | 0 | 4 |
| 2018 Septiembre | 3 | 5 | 8 |
| 2018 Agosto | 0 | 13 | 13 |
| 2018 Julio | 0 | 4 | 4 |
| 2018 Junio | 0 | 4 | 4 |
| 2018 Mayo | 0 | 5 | 5 |
| 2018 Abril | 0 | 6 | 6 |
| 2018 Marzo | 2 | 8 | 10 |
| 2018 Febrero | 26 | 12 | 38 |
| 2018 Enero | 27 | 9 | 36 |
| 2017 Diciembre | 39 | 10 | 49 |
| 2017 Noviembre | 27 | 10 | 37 |
| 2017 Octubre | 24 | 11 | 35 |
| 2017 Septiembre | 24 | 6 | 30 |
| 2017 Agosto | 23 | 11 | 34 |
| 2017 Julio | 19 | 11 | 30 |
| 2017 Junio | 35 | 24 | 59 |
| 2017 Mayo | 28 | 9 | 37 |
| 2017 Abril | 28 | 16 | 44 |
| 2017 Marzo | 24 | 35 | 59 |
| 2017 Febrero | 15 | 12 | 27 |
| 2017 Enero | 15 | 5 | 20 |
| 2016 Diciembre | 27 | 12 | 39 |
| 2016 Noviembre | 34 | 9 | 43 |
| 2016 Octubre | 30 | 13 | 43 |
| 2016 Septiembre | 0 | 4 | 4 |
| 2016 Agosto | 0 | 1 | 1 |
| 2016 Julio | 6 | 2 | 8 |
| 2016 Junio | 7 | 1 | 8 |
| 2016 Mayo | 8 | 2 | 10 |
| 2016 Abril | 3 | 1 | 4 |
| 2016 Marzo | 7 | 1 | 8 |
| 2016 Febrero | 8 | 2 | 10 |
| 2016 Enero | 1 | 1 | 2 |
| 2015 Diciembre | 0 | 1 | 1 |
| 2015 Noviembre | 0 | 1 | 1 |
| 2015 Octubre | 0 | 3 | 3 |
| 2015 Agosto | 0 | 1 | 1 |
| 2015 Julio | 0 | 1 | 1 |
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