Cases for Diagnosis
Nodules on the Forehead Associated With Generalized Lymphadenopathy
Nódulos frontales asociados a adenopatías generalizadas
Leído
23285
Vecesse ha leído el artículo
2788
Total PDF
20497
Total HTML
Compartir estadísticas
array:23 [ "pii" => "S1578219015001729" "issn" => "15782190" "doi" => "10.1016/j.adengl.2015.06.007" "estado" => "S300" "fechaPublicacion" => "2015-09-01" "aid" => "1141" "copyright" => "Elsevier España, S.L.U. and AEDV" "copyrightAnyo" => "2014" "documento" => "simple-article" "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2015;106:579-80" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1657 "formatos" => array:3 [ "EPUB" => 50 "HTML" => 594 "PDF" => 1013 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731015001258" "issn" => "00017310" "doi" => "10.1016/j.ad.2015.01.013" "estado" => "S300" "fechaPublicacion" => "2015-09-01" "aid" => "1141" "copyright" => "Elsevier España, S.L.U. y AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2015;106:579-80" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 695 "formatos" => array:3 [ "EPUB" => 3 "HTML" => 377 "PDF" => 315 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Casos para el diagnóstico</span>" "titulo" => "Nódulos frontales asociados a adenopatías generalizadas" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "579" "paginaFinal" => "580" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Nodules on the Forehead Associated With Generalized Lymphadenopathy" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 921 "Ancho" => 950 "Tamanyo" => 184550 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Lobato-Berezo, F. Burgos-Lázaro, M.Á. Gallego-Valdés" "autores" => array:3 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Lobato-Berezo" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Burgos-Lázaro" ] 2 => array:2 [ "nombre" => "M.Á." "apellidos" => "Gallego-Valdés" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219015001729" "doi" => "10.1016/j.adengl.2015.06.007" "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/S1578219015001729?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731015001258?idApp=UINPBA000044" "url" => "/00017310/0000010600000007/v1_201509041239/S0001731015001258/v1_201509041239/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S1578219015001742" "issn" => "15782190" "doi" => "10.1016/j.adengl.2015.06.009" "estado" => "S300" "fechaPublicacion" => "2015-09-01" "aid" => "1144" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2015;106:581-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1121 "formatos" => array:3 [ "EPUB" => 58 "HTML" => 700 "PDF" => 363 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case for Diagnosis</span>" "titulo" => "Cutaneous Nodules in Multiple Myeloma" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "581" "paginaFinal" => "582" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Nódulos cutáneos asociados a mieloma múltiple" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 732 "Ancho" => 976 "Tamanyo" => 254244 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Immunohistochemistry of IgG κ (A) and λ (B), original magnification, ×20.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S. Gómez-Armayones, F. Climent, O. Servitje" "autores" => array:3 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Gómez-Armayones" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Climent" ] 2 => array:2 [ "nombre" => "O." "apellidos" => "Servitje" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731015001283" "doi" => "10.1016/j.ad.2014.12.021" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731015001283?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219015001742?idApp=UINPBA000044" "url" => "/15782190/0000010600000007/v1_201508271313/S1578219015001742/v1_201508271313/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S1578219015001705" "issn" => "15782190" "doi" => "10.1016/j.adengl.2015.06.005" "estado" => "S300" "fechaPublicacion" => "2015-09-01" "aid" => "1153" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2015;106:e33-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 956 "formatos" => array:3 [ "EPUB" => 54 "HTML" => 578 "PDF" => 324 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">e-Case Report</span>" "titulo" => "Treatment of Sézary Syndrome With Alemtuzumab: A Series of 5 Cases and a Review of the Literature" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e33" "paginaFinal" => "e39" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento del síndrome de Sézary con alemtuzumab: serie de 5 casos y revisión de la literatura" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "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" => 538 "Ancho" => 1500 "Tamanyo" => 162726 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A, Erythematous lesions on the abdomen of a patient with SS before starting treatment with alemtuzumab (case<span class="elsevierStyleHsp" style=""></span>3). B, In the same patient, resolution of the erythema 4 weeks after starting treatment with alemtuzumab.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "E. del Alcázar-Viladomiu, A. Tuneu-Valls, A. López-Pestaña, M.J. Vidal-Manceñido" "autores" => array:4 [ 0 => array:2 [ "nombre" => "E." "apellidos" => "del Alcázar-Viladomiu" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Tuneu-Valls" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "López-Pestaña" ] 3 => array:2 [ "nombre" => "M.J." "apellidos" => "Vidal-Manceñido" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731015001477" "doi" => "10.1016/j.ad.2015.02.008" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731015001477?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219015001705?idApp=UINPBA000044" "url" => "/15782190/0000010600000007/v1_201508271313/S1578219015001705/v1_201508271313/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Cases for Diagnosis</span>" "titulo" => "Nodules on the Forehead Associated With Generalized Lymphadenopathy" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "579" "paginaFinal" => "580" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A. Lobato-Berezo, F. Burgos-Lázaro, M.Á. Gallego-Valdés" "autores" => array:3 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Lobato-Berezo" "email" => array:1 [ 0 => "allobe@hotmail.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "F." "apellidos" => "Burgos-Lázaro" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "M.Á." "apellidos" => "Gallego-Valdés" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Departamento de Dermatología y Venereología, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Departamento de Anatomía Patológica, Hospital Universitario Severo Ochoa, Leganés, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Nódulos frontales asociados a adenopatías generalizadas" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 921 "Ancho" => 950 "Tamanyo" => 199783 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Medical History</span><p id="par0005" class="elsevierStylePara elsevierViewall">The patient was a Moroccan man aged 27 years. He had no known drug allergies and no past history of interest. He was being investigated in internal medicine for a widespread lymphadenopathy that had developed several months earlier. Two months before consultation in dermatology, he developed slightly tender lesions on the forehead that had progressively increased in size.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Physical Examination</span><p id="par0010" class="elsevierStylePara elsevierViewall">Three nodular lesions measuring between 10 and 20<span class="elsevierStyleHsp" style=""></span>mm in diameter were observed in the left frontal region. There were no changes in the overlying skin (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Histopathology</span><p id="par0015" class="elsevierStylePara elsevierViewall">Biopsy of a lesion revealed epithelioid granulomas in the hypodermis with a low-grade lymphocytic response and foreign body material, with no central necrosis. Birefringence for foreign bodies was negative (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Additional Tests</span><p id="par0020" class="elsevierStylePara elsevierViewall">General biochemistry, C-reactive protein, angiotensin converting enzyme, complete blood count, and erythrocyte sedimentation rate were within normal limits. Serology for human immunodeficiency virus, hepatitis A, B, and C viruses, Epstein-Barr virus, cytomegalovirus, toxoplasma, and parvovirus B19 was negative. The Mantoux test was negative. Sputum and urine cultures for mycobacteria were negative. Culture and the polymerase chain reaction for mycobacteria in the skin biopsy were negative. Thoracic and abdominal computed tomography revealed pathological axillary, mediastinal, paratracheal, para-aortic, hilar, subcarinal, cardiophrenic, retroperitoneal, and mesenteric lymph nodes. Fine needle aspiration biopsy of an axillary lymph node showed no signs of malignancy.</p><p id="par0025" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">What is Your Diagnosis?</span></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Diagnosis</span><p id="par0030" class="elsevierStylePara elsevierViewall">Subcutaneous sarcoidosis associated with systemic sarcoidosis.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Clinical Course and Treatment</span><p id="par0035" class="elsevierStylePara elsevierViewall">Treatment was started with prednisone, 1<span class="elsevierStyleHsp" style=""></span>mg/kg/d, by mouth in a tapering regimen, and the patient was administered 3 monthly intralesional injections with triamcinolone acetonide diluted 1-in-3 in normal saline. This produced a slight improvement, with no increase in the number of lesions at subsequent follow-up visits.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Comment</span><p id="par0040" class="elsevierStylePara elsevierViewall">Sarcoidosis is a chronic granulomatous disease of unknown origin, characterized by the formation of noncaseating granulomas in different organs and tissues. Around 25% of patients develop skin lesions, which can be specific or nonspecific depending on the presence or absence of granulomas on histology. The specific lesions include macules, papules, plaques, lupus pernio, subcutaneous sarcoidosis, and cicatricial sarcoidosis, while the nonspecific lesions are erythema nodosum, plaques of alopecia, calcifications, and pruritic lesions, among others.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Subcutaneous sarcoidosis, also known as Darier-Roussy sarcoid, is the least common specific form (12%) and only affects the hypodermis. It is most common in white women aged between 40 and 60 years. Clinically it presents as multiple firm, slightly painful, mobile, round, skin-colored nodules that typically arise on the limbs bilaterally but asymmetrically. They have also been reported on the trunk, face, buttocks, and head and neck.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Ahmed and Harshad<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> reported a strong association between subcutaneous sarcoidosis and moderate systemic involvement by sarcoidosis. Lesions of subcutaneous sarcoidosis are observed in up to 2% of cases of systemic sarcoidosis. Although the lesions may be the first sign of the systemic sarcoidosis, it is more common for them to develop during the course of the disease; they are rarely an isolated finding.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The diagnosis is based on the clinical manifestations and histology, which reveals a predominantly lobular panniculitis with noncaseating epithelioid granulomas, with no peripheral lymphocytic corona, but with a large number of multinucleated giant cells. Schaumann (conchoidal) bodies and asteroid bodies may be seen; although these lesions are characteristic, they are not pathognomic of sarcoidosis.</p><p id="par0060" class="elsevierStylePara elsevierViewall">The differential diagnosis should include erythema nodosum, tuberculosis, and other granulomatous diseases, such as fungal or atypical mycobacterial infections, birefringent foreign bodies, and autoimmune diseases such as rheumatoid arthritis or lupus erythematosus.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Some authors have reported spontaneous resolution of the nodules. However, when associated systemic disease is present, the oral corticosteroids, hydroxychloroquine, tetracyclines, methotrexate, dapsone, clofazimine, and nonsteroidal anti-inflammatory drugs have been found to be effective.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Our case is interesting because the appearance and easy accessibility of lesions in the frontal region enabled us to make a diagnosis of systemic sarcoidosis associated with subcutaneous sarcoidosis (Darier-Roussy sarcoid). It should be noted that sarcoid nodules are very rare on the forehead.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Conflicts of Interest</span><p id="par0075" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Medical History" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Physical Examination" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Histopathology" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Additional Tests" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Diagnosis" ] 5 => array:2 [ "identificador" => "sec0030" "titulo" => "Clinical Course and Treatment" ] 6 => array:2 [ "identificador" => "sec0035" "titulo" => "Comment" ] 7 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflicts of Interest" ] 8 => array:2 [ "identificador" => "xack183945" "titulo" => "Acknowledgments" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Lobato-Berezo A, Burgos-Lázaro F, Gallego-Valdés MÁ. Nódulos frontales asociados a adenopatías generalizadas. Actas Dermosifiliogr. 2015;106:579–580.</p>" ] ] "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 921 "Ancho" => 950 "Tamanyo" => 199783 ] ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 732 "Ancho" => 976 "Tamanyo" => 397690 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Hematoxylin-eosin, original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>10.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sarcoidosis cicatricial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "B. Pérez-Tato" 1 => "A. Cuenca" 2 => "L. Barco" 3 => "C. Iglesias" 4 => "P. Ruiz" 5 => "F. Sánchez de Paz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2003" "volumen" => "94" "paginaInicial" => "327" "paginaFinal" => "329" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Subcutaneous sarcoidosis of the face" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D. Bosniæ" 1 => "M. Baresiæ" 2 => "D. Bagatin" 3 => "I. Iliæ" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Intern Med" "fecha" => "2010" "volumen" => "49" "paginaInicial" => "589" "paginaFinal" => "592" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20228597" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Subcutaneous sarcoidosis: Is it a specific subset of cutaneous sarcoidosis frequently associated with systemic disease?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "I. Ahmed" 1 => "S.R. Harshad" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2005.10.001" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2006" "volumen" => "54" "paginaInicial" => "55" "paginaFinal" => "60" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16384755" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0050" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sarcoidosis subcutánea como primera manifestación de enfermedad sistémica" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Calzado" 1 => "C.M. Galera" 2 => "I. Arrue" 3 => "J.L. Rodríguez-Peralto" 4 => "S. López" 5 => "A. Guerra" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2005" "volumen" => "96" "paginaInicial" => "379" "paginaFinal" => "381" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16476258" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Subcutaneous sarcoidosis as the inicial manifestation of systemic sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C. Ramírez" 1 => "E. Faúndez" 2 => "M.P. Valdés" 3 => "R. de la Fuente" 4 => "L. Carreño" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Piel" "fecha" => "2013" "volumen" => "28" "paginaInicial" => "387" "paginaFinal" => "390" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Subcutaneous sarcoidosis in a melanoma scar" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Singh" 1 => "S. Aboutalebi" 2 => "J. Smith" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Cutis" "fecha" => "2011" "volumen" => "87" "paginaInicial" => "234" "paginaFinal" => "236" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21699125" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack183945" "titulo" => "Acknowledgments" "texto" => "<p id="par0080" class="elsevierStylePara elsevierViewall">We would like to thank Dr. Antonio Aguilar Martínez for his help in making the diagnosis.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010600000007/v1_201508271313/S1578219015001729/v1_201508271313/en/main.assets" "Apartado" => array:4 [ "identificador" => "6154" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case for Diagnosis" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010600000007/v1_201508271313/S1578219015001729/v1_201508271313/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219015001729?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 89 | 10 | 99 |
| 2024 Octubre | 662 | 63 | 725 |
| 2024 Septiembre | 589 | 41 | 630 |
| 2024 Agosto | 660 | 65 | 725 |
| 2024 Julio | 394 | 52 | 446 |
| 2024 Junio | 371 | 51 | 422 |
| 2024 Mayo | 415 | 38 | 453 |
| 2024 Abril | 323 | 30 | 353 |
| 2024 Marzo | 560 | 34 | 594 |
| 2024 Febrero | 664 | 41 | 705 |
| 2024 Enero | 580 | 24 | 604 |
| 2023 Diciembre | 573 | 29 | 602 |
| 2023 Noviembre | 844 | 38 | 882 |
| 2023 Octubre | 726 | 27 | 753 |
| 2023 Septiembre | 626 | 33 | 659 |
| 2023 Agosto | 612 | 21 | 633 |
| 2023 Julio | 632 | 46 | 678 |
| 2023 Junio | 568 | 31 | 599 |
| 2023 Mayo | 546 | 31 | 577 |
| 2023 Abril | 470 | 12 | 482 |
| 2023 Marzo | 539 | 19 | 558 |
| 2023 Febrero | 501 | 21 | 522 |
| 2023 Enero | 557 | 23 | 580 |
| 2022 Diciembre | 518 | 36 | 554 |
| 2022 Noviembre | 248 | 25 | 273 |
| 2022 Octubre | 198 | 26 | 224 |
| 2022 Septiembre | 205 | 33 | 238 |
| 2022 Agosto | 180 | 30 | 210 |
| 2022 Julio | 235 | 33 | 268 |
| 2022 Junio | 116 | 27 | 143 |
| 2022 Mayo | 372 | 39 | 411 |
| 2022 Abril | 464 | 33 | 497 |
| 2022 Marzo | 333 | 41 | 374 |
| 2022 Febrero | 452 | 24 | 476 |
| 2022 Enero | 607 | 38 | 645 |
| 2021 Diciembre | 438 | 35 | 473 |
| 2021 Noviembre | 368 | 41 | 409 |
| 2021 Octubre | 322 | 55 | 377 |
| 2021 Septiembre | 239 | 40 | 279 |
| 2021 Agosto | 241 | 26 | 267 |
| 2021 Julio | 231 | 29 | 260 |
| 2021 Junio | 234 | 34 | 268 |
| 2021 Mayo | 179 | 18 | 197 |
| 2021 Abril | 476 | 59 | 535 |
| 2021 Marzo | 210 | 18 | 228 |
| 2021 Febrero | 101 | 30 | 131 |
| 2021 Enero | 66 | 20 | 86 |
| 2020 Diciembre | 69 | 18 | 87 |
| 2020 Noviembre | 45 | 9 | 54 |
| 2020 Octubre | 29 | 14 | 43 |
| 2020 Septiembre | 36 | 10 | 46 |
| 2020 Agosto | 22 | 10 | 32 |
| 2020 Julio | 27 | 26 | 53 |
| 2020 Junio | 34 | 39 | 73 |
| 2020 Mayo | 25 | 22 | 47 |
| 2020 Abril | 40 | 16 | 56 |
| 2020 Marzo | 35 | 36 | 71 |
| 2020 Febrero | 8 | 17 | 25 |
| 2020 Enero | 4 | 4 | 8 |
| 2019 Diciembre | 8 | 5 | 13 |
| 2019 Noviembre | 4 | 12 | 16 |
| 2019 Octubre | 0 | 11 | 11 |
| 2019 Septiembre | 4 | 9 | 13 |
| 2019 Agosto | 4 | 4 | 8 |
| 2019 Julio | 4 | 12 | 16 |
| 2019 Junio | 6 | 20 | 26 |
| 2019 Mayo | 4 | 30 | 34 |
| 2019 Abril | 3 | 29 | 32 |
| 2019 Marzo | 4 | 6 | 10 |
| 2019 Febrero | 1 | 7 | 8 |
| 2019 Enero | 3 | 4 | 7 |
| 2018 Diciembre | 1 | 8 | 9 |
| 2018 Octubre | 6 | 0 | 6 |
| 2018 Septiembre | 4 | 0 | 4 |
| 2018 Mayo | 0 | 12 | 12 |
| 2018 Abril | 0 | 2 | 2 |
| 2018 Marzo | 9 | 4 | 13 |
| 2018 Febrero | 71 | 19 | 90 |
| 2018 Enero | 48 | 35 | 83 |
| 2017 Diciembre | 63 | 36 | 99 |
| 2017 Noviembre | 25 | 42 | 67 |
| 2017 Octubre | 36 | 94 | 130 |
| 2017 Septiembre | 20 | 61 | 81 |
| 2017 Agosto | 25 | 50 | 75 |
| 2017 Julio | 16 | 44 | 60 |
| 2017 Junio | 24 | 53 | 77 |
| 2017 Mayo | 32 | 66 | 98 |
| 2017 Abril | 29 | 77 | 106 |
| 2017 Marzo | 9 | 93 | 102 |
| 2017 Febrero | 11 | 46 | 57 |
| 2017 Enero | 15 | 8 | 23 |
| 2016 Diciembre | 19 | 18 | 37 |
| 2016 Noviembre | 25 | 14 | 39 |
| 2016 Octubre | 26 | 26 | 52 |
| 2016 Septiembre | 0 | 4 | 4 |
| 2016 Julio | 4 | 1 | 5 |
| 2016 Junio | 9 | 3 | 12 |
| 2016 Mayo | 9 | 1 | 10 |
| 2016 Abril | 6 | 2 | 8 |
| 2016 Marzo | 2 | 9 | 11 |
| 2016 Febrero | 0 | 9 | 9 |
| 2016 Enero | 0 | 5 | 5 |
| 2015 Diciembre | 0 | 3 | 3 |
| 2015 Noviembre | 0 | 2 | 2 |
| 2015 Octubre | 0 | 1 | 1 |
Mostrar todo
