Case and Research Letters
Usefulness of High-Frequency Ultrasound in the Diagnosis of Piezogenic Pedal Papules
Utilidad de la ecografía de alta frecuencia en el diagnóstico de las pápulas piezogénicas
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Imagen clínica de pápulas piezogénicas de una mujer de 52 años, evidentes incluso sin apoyo plantar. Se observan pequeñas pápulas/nódulos color piel, redondeadas, en la cara interna del talón. B. Imagen ecográfica de una pápula piezogénica: se observa área isoecoica con el tejido celular subcutáneo subyacente rodeado por la dermis reticular. Se objetiva un ligero engrosamiento de la dermis.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A.I. Rodríguez-Bandera, F. Alfageme Roldán, M. Hospital-Gil, R. de Lucas Laguna" "autores" => array:4 [ 0 => array:2 [ "nombre" => "A.I." "apellidos" => "Rodríguez-Bandera" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Alfageme Roldán" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Hospital-Gil" ] 3 => array:2 [ "nombre" => "R." "apellidos" => "de Lucas Laguna" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219015001833" "doi" => "10.1016/j.adengl.2015.06.017" "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/S1578219015001833?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731015000113?idApp=UINPBA000044" "url" => "/00017310/0000010600000007/v1_201509041239/S0001731015000113/v1_201509041239/es/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S1578219015001845" "issn" => "15782190" "doi" => "10.1016/j.adengl.2015.06.018" "estado" => "S300" "fechaPublicacion" => "2015-09-01" "aid" => "1115" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2015;106:593-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1188 "formatos" => array:3 [ "EPUB" => 48 "HTML" => 584 "PDF" => 556 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Dermoscopic Features of Pigmented Fungiform Papillae of the Tongue" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "593" "paginaFinal" => "594" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Características dermatoscópicas de las papilas fungiformes pigmentadas de la lengua" ] ] "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" => 833 "Ancho" => 851 "Tamanyo" => 118835 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Multiple brown fungiform papillae located on the tip and lateral aspects of the tongue.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "V. Pinos-León" "autores" => array:1 [ 0 => array:2 [ "nombre" => "V." "apellidos" => "Pinos-León" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731015000125" "doi" => "10.1016/j.ad.2014.12.012" "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/S0001731015000125?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219015001845?idApp=UINPBA000044" "url" => "/15782190/0000010600000007/v1_201508271313/S1578219015001845/v1_201508271313/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S1578219015001808" "issn" => "15782190" "doi" => "10.1016/j.adengl.2015.06.015" "estado" => "S300" "fechaPublicacion" => "2015-09-01" "aid" => "1113" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2015;106:588-90" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1422 "formatos" => array:3 [ "EPUB" => 52 "HTML" => 713 "PDF" => 657 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Granulomatous Reactions to Red Tattoo Pigments: A Description of 5 Cases" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "588" "paginaFinal" => "590" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Reacciones granulomatosas a los tatuajes rojos: presentación de 5 lesiones" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 911 "Ancho" => 1299 "Tamanyo" => 266673 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, Lesion No. 2: The image shows erosions and release of material to the red areas of a multicolored tattoo on the dorsum of the right foot (B). C, Granuloma annulare lesions can be observed on the dorsum of the left foot.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "C. Martín-Callizo, J. Marcoval, R.M. Penín" "autores" => array:3 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Martín-Callizo" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Marcoval" ] 2 => array:2 [ "nombre" => "R.M." "apellidos" => "Penín" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731015000101" "doi" => "10.1016/j.ad.2014.12.010" "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/S0001731015000101?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219015001808?idApp=UINPBA000044" "url" => "/15782190/0000010600000007/v1_201508271313/S1578219015001808/v1_201508271313/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Usefulness of High-Frequency Ultrasound in the Diagnosis of Piezogenic Pedal Papules" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "591" "paginaFinal" => "593" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A.I. Rodríguez-Bandera, F. Alfageme Roldán, M. Hospital-Gil, R. de Lucas Laguna" "autores" => array:4 [ 0 => array:4 [ "nombre" => "A.I." "apellidos" => "Rodríguez-Bandera" "email" => array:1 [ 0 => "anarb85@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "F." "apellidos" => "Alfageme Roldán" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "M." "apellidos" => "Hospital-Gil" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "R." "apellidos" => "de Lucas Laguna" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Universitario La Paz, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Universitario Puerta de Hierro, 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" => "Utilidad de la ecografía de alta frecuencia en el diagnóstico de las pápulas piezogénicas" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 634 "Ancho" => 1400 "Tamanyo" => 95348 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, Clinical photograph of piezogenic papules in a 13-year-old girl. Small, round, skin-colored papules/nodules are visible on the medial surface of the heel. B, Ultrasound image of a piezogenic papule. A round hypoechoic area is observed in the dermis. This corresponds to a fat lobule surrounded by the reticular dermis.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Piezogenic papules are produced by the herniation of adipose tissue through the dermal connective tissue. They develop in up to 60% of the general population<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">1</span></a> and are caused by persistent excessive pressure; they are therefore most common in athletes (runners, jumpers, etc.), obese persons, and those who frequently carry heavy weights.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">2</span></a> A high incidence has also been reported in patients with Ehlers-Danlos syndrome due to the disease-related weakness of the collagen.<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">3,4</span></a> Presentation is usually as skin-colored papules or nodules on the lateral or posterior surfaces of the heels, although they have been described at less typical sites such as the wrists.<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">5,6</span></a> Piezogenic papules are usually asymptomatic and are therefore an uncommon cause of consultation, leading to underestimation of their true prevalence. However, they may occasionally give rise to pain, typically due to the continuous friction with footwear.<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">2,3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The diagnosis of piezogenic papules is above all clinical, though atypical presentations may lead to a need to perform biopsy for histologic confirmation of the suspected diagnosis.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">1</span></a> High-frequency ultrasound, ever more widely employed in dermatology,<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">7,8</span></a> can be used to support the clinical diagnosis.</p><p id="par0015" class="elsevierStylePara elsevierViewall">We present 2 cases, one of an obese 52-year-old woman with no other history of interest (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A) and the other of a child aged 13 years who regularly practiced aikido (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A). These cases help to illustrate the potential usefulness of ultrasound as a diagnostic tool for this condition. Both patients presented asymptomatic skin-colored papules of soft consistency on the medial surface of both heels. The papules measured 0.5<span class="elsevierStyleHsp" style=""></span>cm in diameter and became more prominent when the patients stood up. Despite the characteristic clinical presentation, ultrasound was performed to characterize the lesions sonographically. The ultrasound device (Esaote, MyLabClass C, Genoa, Italy) had a variable-frequency linear array transducer; the frequency for the test was 18<span class="elsevierStyleHsp" style=""></span>MHz, with a lateral resolution of 240<span class="elsevierStyleHsp" style=""></span>μm. The patients were examined in a sitting position, with the knees flexed and the soles of their feet resting on the examination couch, rocking the body weight onto the feet to make the alteration more evident. In both cases, an area was observed that was isoechoic with the subcutaneous cellular tissue but was surrounded by the reticular dermis, producing posterior acoustic enhancement (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1B and 2B</a>). No abnormal vascularization was observed in color Doppler mode. The ultrasound findings helped to confirm the suspected diagnosis of piezogenic papules. No further diagnostic tests or treatment were considered necessary.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">These examples illustrate the possibility of using high-frequency ultrasound as an additional test for the diagnosis of piezogenic papules.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Cho et al.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">9</span></a> described similar ultrasound findings in 4 patients. As in the cases described by those authors, ultrasound study of the regions with a clinical suspicion of piezogenic papules in our patients revealed areas within the reticular dermis that were isoechoic with the subcutaneous cellular tissue. Cho et al. explained that the ultrasound image may represent rupture of the interlobular septa adjacent to the reticular dermis and the coalescence of the most superficial fat lobules. In our patients, in contrast to the description by Cho et al., we observed posterior enhancement that could have been due to different ultrasound transmission by this area of subcutaneous cellular tissue compared with adjacent areas of the dermis. It should be noted that the device used by Cho et al. operated at a variable frequency of 5-12<span class="elsevierStyleHsp" style=""></span>MHz whereas, in our patients, we used a device with a linear array with a variable frequency of 16 to 22<span class="elsevierStyleHsp" style=""></span>MHz.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The clear delimitation of the lesion and the absence of abnormal vascularization within the lesions support their benign nature.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">10</span></a> The differential diagnosis should include other benign dermal or subdermal lesions such as lipoma, neurofibroma, and even benign vascular tumors such as a glomus tumor at an atypical site. On ultrasound, lipoma appears as a well-defined, elongated, hypo- or isoechoic area in the hypodermis, with its long axis parallel to the skin surface; it may contain hyperechoic striate lines, which represent the septa.<a class="elsevierStyleCrossRefs" href="#bib0125"><span class="elsevierStyleSup">11,12</span></a> Neurofibroma is described sonographically as a well or ill-defined nodular or pseudonodular lesion that is homogeneously hypoechoic or that may contain hyperechoic areas within a hypo- or anechoic mass, with a variable degree of vascularization.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">13</span></a> Plexiform neurofibromas, however, appear as hypoechoic and hypovascular tracts that follow the paths of nerves.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">13</span></a> Glomus tumor is seen as a small, solid, well-defined, hypoechoic nodule in the dermis, with abundant blood vessels visible on color Doppler mode.<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">14</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Apart from the study by Cho et al., we have found no other articles in the literature that have characterized piezogenic papules using high-frequency ultrasound. We therefore consider that studies with a larger number of patients could be of interest to validate the ultrasound patterns and thus enable us to improve the sensitivity and specificity of the ultrasound diagnosis of dermal and subdermal lesions.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Rodríguez-Bandera AI, Alfageme Roldán F, Hospital-Gil M, de Lucas Laguna R. Utilidad de la ecografía de alta frecuencia en el diagnóstico de las pápulas piezogénicas. Actas Dermosifiliogr. 2015;106:591–593.</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" => 868 "Ancho" => 1500 "Tamanyo" => 148242 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, Clinical photograph of piezogenic papules in a 52-year-old woman, visible even without weightbearing. Small, round, skin-colored papules/nodules are present on the medial surface of the heel. B, Ultrasound image of a piezogenic papule. An area isoechoic with the underlying subcutaneous cellular tissue is observed within the reticular dermis. There is slight thickening of the dermis.</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" => 634 "Ancho" => 1400 "Tamanyo" => 95348 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, Clinical photograph of piezogenic papules in a 13-year-old girl. Small, round, skin-colored papules/nodules are visible on the medial surface of the heel. B, Ultrasound image of a piezogenic papule. A round hypoechoic area is observed in the dermis. This corresponds to a fat lobule surrounded by the reticular dermis.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:14 [ 0 => array:3 [ "identificador" => "bib0075" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Piezogenic pedal papules" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D.L. Ma" 1 => "S. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 15 | 7 | 22 |
| 2024 Octubre | 128 | 66 | 194 |
| 2024 Septiembre | 171 | 49 | 220 |
| 2024 Agosto | 168 | 70 | 238 |
| 2024 Julio | 138 | 51 | 189 |
| 2024 Junio | 131 | 50 | 181 |
| 2024 Mayo | 118 | 40 | 158 |
| 2024 Abril | 124 | 23 | 147 |
| 2024 Marzo | 129 | 31 | 160 |
| 2024 Febrero | 93 | 32 | 125 |
| 2024 Enero | 96 | 30 | 126 |
| 2023 Diciembre | 93 | 23 | 116 |
| 2023 Noviembre | 105 | 34 | 139 |
| 2023 Octubre | 107 | 60 | 167 |
| 2023 Septiembre | 99 | 41 | 140 |
| 2023 Agosto | 122 | 33 | 155 |
| 2023 Julio | 96 | 54 | 150 |
| 2023 Junio | 81 | 34 | 115 |
| 2023 Mayo | 100 | 43 | 143 |
| 2023 Abril | 94 | 40 | 134 |
| 2023 Marzo | 77 | 45 | 122 |
| 2023 Febrero | 87 | 55 | 142 |
| 2023 Enero | 70 | 44 | 114 |
| 2022 Diciembre | 61 | 45 | 106 |
| 2022 Noviembre | 51 | 52 | 103 |
| 2022 Octubre | 46 | 39 | 85 |
| 2022 Septiembre | 44 | 68 | 112 |
| 2022 Agosto | 40 | 43 | 83 |
| 2022 Julio | 36 | 64 | 100 |
| 2022 Junio | 26 | 41 | 67 |
| 2022 Mayo | 53 | 44 | 97 |
| 2022 Abril | 73 | 49 | 122 |
| 2022 Marzo | 94 | 62 | 156 |
| 2022 Febrero | 67 | 45 | 112 |
| 2022 Enero | 117 | 49 | 166 |
| 2021 Diciembre | 106 | 37 | 143 |
| 2021 Noviembre | 89 | 65 | 154 |
| 2021 Octubre | 73 | 64 | 137 |
| 2021 Septiembre | 62 | 56 | 118 |
| 2021 Agosto | 67 | 49 | 116 |
| 2021 Julio | 60 | 46 | 106 |
| 2021 Junio | 82 | 39 | 121 |
| 2021 Mayo | 74 | 52 | 126 |
| 2021 Abril | 169 | 84 | 253 |
| 2021 Marzo | 103 | 33 | 136 |
| 2021 Febrero | 99 | 30 | 129 |
| 2021 Enero | 85 | 25 | 110 |
| 2020 Diciembre | 62 | 29 | 91 |
| 2020 Noviembre | 60 | 25 | 85 |
| 2020 Octubre | 48 | 19 | 67 |
| 2020 Septiembre | 54 | 18 | 72 |
| 2020 Agosto | 51 | 19 | 70 |
| 2020 Julio | 55 | 24 | 79 |
| 2020 Junio | 62 | 53 | 115 |
| 2020 Mayo | 37 | 16 | 53 |
| 2020 Abril | 29 | 29 | 58 |
| 2020 Marzo | 43 | 43 | 86 |
| 2020 Febrero | 5 | 21 | 26 |
| 2020 Enero | 0 | 12 | 12 |
| 2019 Diciembre | 4 | 12 | 16 |
| 2019 Noviembre | 0 | 14 | 14 |
| 2019 Octubre | 0 | 15 | 15 |
| 2019 Septiembre | 8 | 26 | 34 |
| 2019 Agosto | 0 | 32 | 32 |
| 2019 Julio | 1 | 40 | 41 |
| 2019 Junio | 2 | 35 | 37 |
| 2019 Mayo | 2 | 75 | 77 |
| 2019 Abril | 19 | 72 | 91 |
| 2019 Marzo | 4 | 32 | 36 |
| 2019 Febrero | 2 | 20 | 22 |
| 2019 Enero | 6 | 8 | 14 |
| 2018 Diciembre | 2 | 11 | 13 |
| 2018 Noviembre | 1 | 0 | 1 |
| 2018 Octubre | 17 | 0 | 17 |
| 2018 Septiembre | 7 | 3 | 10 |
| 2018 Agosto | 0 | 15 | 15 |
| 2018 Julio | 0 | 17 | 17 |
| 2018 Junio | 0 | 13 | 13 |
| 2018 Mayo | 0 | 9 | 9 |
| 2018 Abril | 0 | 6 | 6 |
| 2018 Marzo | 2 | 4 | 6 |
| 2018 Febrero | 22 | 7 | 29 |
| 2018 Enero | 33 | 10 | 43 |
| 2017 Diciembre | 48 | 14 | 62 |
| 2017 Noviembre | 36 | 16 | 52 |
| 2017 Octubre | 46 | 5 | 51 |
| 2017 Septiembre | 26 | 10 | 36 |
| 2017 Agosto | 35 | 19 | 54 |
| 2017 Julio | 22 | 13 | 35 |
| 2017 Junio | 26 | 33 | 59 |
| 2017 Mayo | 23 | 21 | 44 |
| 2017 Abril | 24 | 14 | 38 |
| 2017 Marzo | 8 | 39 | 47 |
| 2017 Febrero | 17 | 12 | 29 |
| 2017 Enero | 11 | 20 | 31 |
| 2016 Diciembre | 17 | 24 | 41 |
| 2016 Noviembre | 26 | 33 | 59 |
| 2016 Octubre | 18 | 37 | 55 |
| 2016 Septiembre | 0 | 4 | 4 |
| 2016 Agosto | 0 | 5 | 5 |
| 2016 Julio | 6 | 7 | 13 |
| 2016 Junio | 9 | 1 | 10 |
| 2016 Mayo | 13 | 4 | 17 |
| 2016 Abril | 4 | 1 | 5 |
| 2016 Marzo | 7 | 4 | 11 |
| 2016 Febrero | 1 | 3 | 4 |
| 2016 Enero | 0 | 12 | 12 |
| 2015 Diciembre | 0 | 2 | 2 |
| 2015 Noviembre | 0 | 8 | 8 |
| 2015 Octubre | 0 | 3 | 3 |
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