Resident Forum
Detection of Oncogenic Human Papillomavirus Genotypes: A Useful Screening Tool for High-Grade Anal Intraepithelial Neoplasia
FR - Detección de genotipos oncogénicos del virus del papiloma humano: una herramienta útil en el cribado de neoplasia intraepitelial anal de alto grado
L. Padilla-España
, J.F. Millán Cayetano, P. García Montero
Autor para correspondencia
Servicio de Dermatología, Hospital Costa del Sol, Marbella, Málaga, Spain
Leído
4527
Vecesse ha leído el artículo
1562
Total PDF
2965
Total HTML
Compartir estadísticas
array:24 [ "pii" => "S157821901500270X" "issn" => "15782190" "doi" => "10.1016/j.adengl.2014.12.015" "estado" => "S300" "fechaPublicacion" => "2015-12-01" "aid" => "1117" "copyright" => "Elsevier España, S.L.U. and AEDV" "copyrightAnyo" => "2014" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Actas Dermosifiliogr. 2015;106:835-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 801 "formatos" => array:3 [ "EPUB" => 53 "HTML" => 554 "PDF" => 194 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731015000149" "issn" => "00017310" "doi" => "10.1016/j.ad.2014.12.014" "estado" => "S300" "fechaPublicacion" => "2015-12-01" "aid" => "1117" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Actas Dermosifiliogr. 2015;106:835-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 576 "formatos" => array:3 [ "EPUB" => 3 "HTML" => 243 "PDF" => 330 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Foro de Residentes</span>" "titulo" => "FR - Detección de genotipos oncogénicos del virus del papiloma humano: una herramienta útil en el cribado de neoplasia intraepitelial anal de alto grado" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "835" "paginaFinal" => "836" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Detection of Oncogenic Human Papillomavirus Genotypes: A Useful Screening Tool for High-Grade Anal Intraepithelial Neoplasia" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2504 "Ancho" => 3330 "Tamanyo" => 235996 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Algoritmo de cribado de la NIA mediante citología anal contemplando la utilidad de la detección de genotipos VPH de alto riesgo.NIA: neoplasia intraepitelial anal; VIH: virus de la inmunodeficiencia humana.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L. Padilla-España, J.F. Millán Cayetano, P. García Montero" "autores" => array:3 [ 0 => array:2 [ "nombre" => "L." "apellidos" => "Padilla-España" ] 1 => array:2 [ "nombre" => "J.F." "apellidos" => "Millán Cayetano" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "García Montero" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S157821901500270X" "doi" => "10.1016/j.adengl.2014.12.015" "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/S157821901500270X?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731015000149?idApp=UINPBA000044" "url" => "/00017310/0000010600000010/v1_201512080105/S0001731015000149/v1_201512080105/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219015002942" "issn" => "15782190" "doi" => "10.1016/j.adengl.2014.12.016" "estado" => "S300" "fechaPublicacion" => "2015-12-01" "aid" => "1130" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Actas Dermosifiliogr. 2015;106:837-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 734 "formatos" => array:3 [ "EPUB" => 45 "HTML" => 519 "PDF" => 170 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Resident's Forum</span>" "titulo" => "Do Sunscreens Eliminate the Risk of Melanoma?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "837" "paginaFinal" => "838" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "FR ¿El uso de fotoprotectores elimina el riesgo de desarrollar melanoma?" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1494 "Ancho" => 3307 "Tamanyo" => 458510 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Schematic representation of the experimental study design used by Viros et al. UVR indicates utraviolet radiation.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "I. Pastushenko, Y. Gilaberte-Calzada" "autores" => array:2 [ 0 => array:2 [ "nombre" => "I." "apellidos" => "Pastushenko" ] 1 => array:2 [ "nombre" => "Y." "apellidos" => "Gilaberte-Calzada" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S000173101500068X" "doi" => "10.1016/j.ad.2014.12.018" "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/S000173101500068X?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219015002942?idApp=UINPBA000044" "url" => "/15782190/0000010600000010/v1_201512060022/S1578219015002942/v1_201512060022/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219015002656" "issn" => "15782190" "doi" => "10.1016/j.adengl.2015.10.005" "estado" => "S300" "fechaPublicacion" => "2015-12-01" "aid" => "1221" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2015;106:833-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 716 "formatos" => array:3 [ "EPUB" => 53 "HTML" => 515 "PDF" => 148 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Videos of Surgical Procedures in Dermatology</span>" "titulo" => "Continuous Suture by Tissue Planes" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "833" "paginaFinal" => "834" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Sutura continua por planos" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "C. Garrido-Colmenero, G. Blasco-Morente, I. Pérez-López, J. Tercedor-Sánchez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Garrido-Colmenero" ] 1 => array:2 [ "nombre" => "G." "apellidos" => "Blasco-Morente" ] 2 => array:2 [ "nombre" => "I." "apellidos" => "Pérez-López" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Tercedor-Sánchez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731015003257" "doi" => "10.1016/j.ad.2015.07.004" "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/S0001731015003257?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219015002656?idApp=UINPBA000044" "url" => "/15782190/0000010600000010/v1_201512060022/S1578219015002656/v1_201512060022/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Resident Forum</span>" "titulo" => "Detection of Oncogenic Human Papillomavirus Genotypes: A Useful Screening Tool for High-Grade Anal Intraepithelial Neoplasia" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "835" "paginaFinal" => "836" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "L. Padilla-España, J.F. Millán Cayetano, P. García Montero" "autores" => array:3 [ 0 => array:4 [ "nombre" => "L." "apellidos" => "Padilla-España" "email" => array:1 [ 0 => "eplaura85@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "J.F." "apellidos" => "Millán Cayetano" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "García Montero" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital Costa del Sol, Marbella, Málaga, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "FR - Detección de genotipos oncogénicos del virus del papiloma humano: una herramienta útil en el cribado de neoplasia intraepitelial anal de alto grado" ] ] "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" => 2504 "Ancho" => 3330 "Tamanyo" => 235186 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Screening algorithm for AIN based on analy cytology and taking into account the usefulness of detection of high-risk HPV genotypes.</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">AIN indicates anal intraepithelial neoplasia; HIV, human immunodeficiency virus.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">High-grade anal intraepithelial neoplasia (AIN) is considered a precursor to anal cancer. Its incidence has increased in specific risk populations, especially persons infected by the human immunodeficiency virus (HIV) and men who have sex with men (MSM).<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Human papillomavirus (HPV) has been shown to play a key pathogenic role in anal cancer (up to 93% of cases). In fact, the frequency of oncogenic genotypes 16 and 18 has increased significantly in both high-grade AIN and anal carcinoma.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Although the natural course of AIN is unknown and recurrence rates of up to 29% have been reported, the condition sometimes progresses to infiltrating forms, especially in older HIV-infected patients with CD4 T-lymphocyte counts <200<span class="elsevierStyleHsp" style=""></span>cells/μL.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">There is no definitive protocol for screening of AIN, in part because of a lack of data on the role of screening in reducing the morbidity and mortality of anal cancer. Most authors base their reports on the program proposed by Chin-Hong and Palefsky,<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> which does not take into account HPV genotyping as an initial screening test.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Screening for AIN is based on the combination of anal cytology and high-resolution anoscopy, as in screening for cervical cancer. However, it is important to remember that anal cytology can lead high-grade AIN to be underdiagnosed, especially in immunodepressed patients (up to 52.7% cases according to Botes et al<span class="elsevierStyleItalic">.</span><a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a>).</p><p id="par0030" class="elsevierStylePara elsevierViewall">Hybrid capture assay and HPV genotyping tests were recently proposed as complementary tools in screening for AIN. Risk genotypes are detected using microplate DNA hybridization assay and subsequent chemiluminescence signal amplification for the qualitative detection of different genotypes of low- and high-risk HPV. This technique is supported by several correlation studies (performed specifically in HIV-infected patients) that compare the findings of both diagnostic methods (anal cytology and detection of HPV), with a strong association between high-grade dysplasia and infection by multiple high-risk HPV genotypes.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Detection of high-risk genotypes could prove to be essential in high-risk populations, such as HIV-infected patients and MSM, in whom anal cytology does not show dysplasia to be present. In these cases, a meticulous examination of the anal canal should be performed using high-resolution anoscopy that enables suspected high-grade AIN lesions to be identified and biopsied (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Therefore, the latest trends point to HPV genotyping as the most sensitive and specific tool when screening for AIN.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> Nevertheless, it is necessary to perform sensitivity and cost-effectiveness studies to compare the various diagnostic procedures used in screening with anoscopy-guided biopsy, which continues to be the definitive confirmatory diagnostic test.</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: Padilla-España L, Millán Cayetano JF, García Montero P. Detection of Oncogenic Human Papillomavirus Genotypes: A Useful Screening Tool for High-Grade Anal Intraepithelial Neoplasia. Actas Dermosifiliogr. 2015;106:835–836.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2504 "Ancho" => 3330 "Tamanyo" => 235186 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Screening algorithm for AIN based on analy cytology and taking into account the usefulness of detection of high-risk HPV genotypes.</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">AIN indicates anal intraepithelial neoplasia; HIV, human immunodeficiency virus.</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" => "Early detection of anal intraepithelial neoplasia in high-risk patients [Article in Spanish]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Sendagorta" 1 => "P. Herranz" 2 => "H. Guadalajara" 3 => "F.X. Zamora" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ad.2011.01.005" "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2011" "volumen" => "102" "paginaInicial" => "757" "paginaFinal" => "765" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21764027" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Progression to and spontaneous regression of high-grade anal squamous intraepithelial lesions in HIV-infected and uninfected men" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W.W. Tong" 1 => "F. Jin" 2 => "L.C. McHugh" 3 => "T. Maher" 4 => "B. Sinclair" 5 => "A.E. Grulich" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/QAD.0b013e3283633111" "Revista" => array:6 [ "tituloSerie" => "AIDS" "fecha" => "2013" "volumen" => "27" "paginaInicial" => "2233" "paginaFinal" => "2243" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24157904" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Natural history and clinical management of anal human papillomavirus disease in men and women infected with human immunodeficiency virus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P.V. Chin-Hong" 1 => "J.M. Palefsky" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1086/344057" "Revista" => array:6 [ "tituloSerie" => "Clin Infect Dis" "fecha" => "2002" "volumen" => "35" "paginaInicial" => "1127" "paginaFinal" => "1134" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12384848" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anal cytological abnormalities are poor predictors of high-grade intraepithelial neoplasia amongst HIV-positive men who have sex with men" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L.P. Botes" 1 => "S. Pett" 2 => "A. Carr" 3 => "D. Marriott" 4 => "D.A. Cooper" 5 => "G. Matthews" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1071/SH11135" "Revista" => array:6 [ "tituloSerie" => "Sex Health" "fecha" => "2013" "volumen" => "10" "paginaInicial" => "9" "paginaFinal" => "17" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23256912" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Usefulness of human papillomavirus testing in anal intraepithelial neoplasia screening in a risk behaviour population [Article in Spanish]" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Padilla-España" 1 => "B. Repiso-Jiménez" 2 => "F. Fernández-Sánchez" 3 => "M. Frieyro-Elicegui" 4 => "T. Fernández-Morano" 5 => "T. Pereda" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.eimc.2014.03.008" "Revista" => array:6 [ "tituloSerie" => "Enferm Infecc Microbiol Clin" "fecha" => "2014" "volumen" => "32" "paginaInicial" => "560" "paginaFinal" => "564" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24908497" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010600000010/v1_201512060022/S157821901500270X/v1_201512060022/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/15782190/0000010600000010/v1_201512060022/S157821901500270X/v1_201512060022/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157821901500270X?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 3 | 8 | 11 |
| 2024 Octubre | 70 | 37 | 107 |
| 2024 Septiembre | 62 | 22 | 84 |
| 2024 Agosto | 86 | 57 | 143 |
| 2024 Julio | 63 | 28 | 91 |
| 2024 Junio | 69 | 31 | 100 |
| 2024 Mayo | 59 | 26 | 85 |
| 2024 Abril | 74 | 24 | 98 |
| 2024 Marzo | 64 | 25 | 89 |
| 2024 Febrero | 62 | 28 | 90 |
| 2024 Enero | 43 | 28 | 71 |
| 2023 Diciembre | 69 | 20 | 89 |
| 2023 Noviembre | 79 | 18 | 97 |
| 2023 Octubre | 61 | 10 | 71 |
| 2023 Septiembre | 59 | 23 | 82 |
| 2023 Agosto | 59 | 18 | 77 |
| 2023 Julio | 61 | 24 | 85 |
| 2023 Junio | 69 | 26 | 95 |
| 2023 Mayo | 57 | 23 | 80 |
| 2023 Abril | 41 | 16 | 57 |
| 2023 Marzo | 46 | 23 | 69 |
| 2023 Febrero | 63 | 24 | 87 |
| 2023 Enero | 32 | 23 | 55 |
| 2022 Diciembre | 57 | 24 | 81 |
| 2022 Noviembre | 32 | 25 | 57 |
| 2022 Octubre | 31 | 23 | 54 |
| 2022 Septiembre | 43 | 29 | 72 |
| 2022 Agosto | 18 | 32 | 50 |
| 2022 Julio | 22 | 28 | 50 |
| 2022 Junio | 14 | 19 | 33 |
| 2022 Mayo | 32 | 23 | 55 |
| 2022 Abril | 33 | 38 | 71 |
| 2022 Marzo | 31 | 44 | 75 |
| 2022 Febrero | 23 | 18 | 41 |
| 2022 Enero | 25 | 35 | 60 |
| 2021 Diciembre | 28 | 35 | 63 |
| 2021 Noviembre | 31 | 34 | 65 |
| 2021 Octubre | 39 | 55 | 94 |
| 2021 Septiembre | 33 | 26 | 59 |
| 2021 Agosto | 12 | 22 | 34 |
| 2021 Julio | 26 | 20 | 46 |
| 2021 Junio | 40 | 18 | 58 |
| 2021 Mayo | 46 | 20 | 66 |
| 2021 Abril | 45 | 42 | 87 |
| 2021 Marzo | 45 | 16 | 61 |
| 2021 Febrero | 40 | 15 | 55 |
| 2021 Enero | 29 | 11 | 40 |
| 2020 Diciembre | 25 | 18 | 43 |
| 2020 Noviembre | 29 | 16 | 45 |
| 2020 Octubre | 20 | 13 | 33 |
| 2020 Septiembre | 24 | 12 | 36 |
| 2020 Agosto | 23 | 18 | 41 |
| 2020 Julio | 18 | 13 | 31 |
| 2020 Junio | 39 | 23 | 62 |
| 2020 Mayo | 27 | 12 | 39 |
| 2020 Abril | 47 | 17 | 64 |
| 2020 Marzo | 28 | 11 | 39 |
| 2020 Febrero | 7 | 2 | 9 |
| 2020 Enero | 0 | 1 | 1 |
| 2019 Diciembre | 4 | 0 | 4 |
| 2019 Noviembre | 0 | 2 | 2 |
| 2019 Septiembre | 4 | 0 | 4 |
| 2019 Agosto | 1 | 0 | 1 |
| 2019 Julio | 0 | 2 | 2 |
| 2019 Junio | 0 | 1 | 1 |
| 2019 Mayo | 3 | 22 | 25 |
| 2019 Abril | 4 | 1 | 5 |
| 2019 Marzo | 4 | 3 | 7 |
| 2019 Febrero | 4 | 0 | 4 |
| 2019 Enero | 9 | 0 | 9 |
| 2018 Diciembre | 12 | 0 | 12 |
| 2018 Noviembre | 3 | 0 | 3 |
| 2018 Octubre | 5 | 0 | 5 |
| 2018 Septiembre | 6 | 0 | 6 |
| 2018 Marzo | 2 | 0 | 2 |
| 2018 Febrero | 45 | 2 | 47 |
| 2018 Enero | 34 | 3 | 37 |
| 2017 Diciembre | 60 | 8 | 68 |
| 2017 Noviembre | 27 | 3 | 30 |
| 2017 Octubre | 27 | 5 | 32 |
| 2017 Septiembre | 22 | 6 | 28 |
| 2017 Agosto | 24 | 7 | 31 |
| 2017 Julio | 19 | 10 | 29 |
| 2017 Junio | 24 | 8 | 32 |
| 2017 Mayo | 25 | 7 | 32 |
| 2017 Abril | 26 | 9 | 35 |
| 2017 Marzo | 16 | 20 | 36 |
| 2017 Febrero | 19 | 9 | 28 |
| 2017 Enero | 17 | 6 | 23 |
| 2016 Diciembre | 30 | 9 | 39 |
| 2016 Noviembre | 40 | 9 | 49 |
| 2016 Octubre | 32 | 16 | 48 |
| 2016 Septiembre | 0 | 1 | 1 |
| 2016 Julio | 0 | 4 | 4 |
| 2016 Junio | 4 | 4 | 8 |
| 2016 Mayo | 0 | 2 | 2 |
| 2016 Abril | 0 | 3 | 3 |
| 2016 Marzo | 0 | 7 | 7 |
| 2016 Febrero | 0 | 2 | 2 |
| 2016 Enero | 0 | 1 | 1 |
Mostrar todo
