Case for Diagnosis
Follicular Papules and Erythematous Plaques on the Back
Pápulas foliculares y placas eritematosas en espalda
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Ruiz-Villaverde, I. Pérez-López, J. Aneiros-Fernández" "autores" => array:3 [ 0 => array:4 [ "nombre" => "R." "apellidos" => "Ruiz-Villaverde" "email" => array:1 [ 0 => "ismenios@hotmail.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" => "I." "apellidos" => "Pérez-López" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "J." "apellidos" => "Aneiros-Fernández" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Unidad de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Virgen de las Nieves, Granada, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Universitario Virgen de las Nieves, Granada, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Pápulas foliculares y placas eritematosas en espalda" ] ] "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" => 401 "Ancho" => 505 "Tamanyo" => 149965 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Hematoxylin and eosin, original magnification<span class="elsevierStyleHsp" style=""></span>x4.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Medical History</span><p id="par0005" class="elsevierStylePara elsevierViewall">A 63-year-old woman with no personal or family background of interest presented a 13-month history of a skin rash formed of papules that coalesced into pruritic plaques affecting the upper third of the back, with no involvement of the limbs or face or of the mucosas. She had previously been treated for 2 months with topical corticosteroids by her family physician, with no response.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Physical Examination</span><p id="par0010" class="elsevierStylePara elsevierViewall">Physical examination revealed a predominantly follicular erythematous papules and more extensive plaques with a moderate degree of infiltration on the upper half of the back (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). There were no palpable locoregional lymph nodes and no hepatosplenomegaly.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Histology</span><p id="par0015" class="elsevierStylePara elsevierViewall">On histopathology, the dermis was infiltrated by a lymphoproliferative process with a perivascular and periadnexal distribution and with minimal epidermal involvement (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The hair follicles presented a lymphoproliferative infiltrate, with the presence of mucin that stained intensely positive with Alcian blue at pH 2.5. Immunohistochemistry was positive for CD3 (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>), CD5, and CD7, with deletion of CD2 and partial deletion of CD4. The proliferating cells were negative for CD30, CD56, TIA-1, perforin, and granzyme B. Molecular study showed clonal rearrangement of the gamma chain of the T-cell receptor.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Additional Tests</span><p id="par0020" class="elsevierStylePara elsevierViewall">The results of the metastatic work-up (complete blood count, general biochemistry, lactate dehydrogenase, β<span class="elsevierStyleInf">2</span>-microglobulin, bone marrow aspiration biopsy, protein electrophoresis, and positron emission tomography-computed tomography) were within normal limits.</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">Follicular mycosis fungoides.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Clinical Course and Treatment</span><p id="par0035" class="elsevierStylePara elsevierViewall">Based on the findings of the histology study and additional tests, we made a diagnosis of stage IB (T2b, N0, M0, B0) mycosis fungoides. The case was presented to the Skin Oncology Committee and it was decided to start treatment with psoralen-UV-A (PUVA) therapy following the standard protocol. Little improvement was achieved at the 3-month follow-up and the patient remains pending further evaluation of other treatment options.</p><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Comment</span><p id="par0040" class="elsevierStylePara elsevierViewall">Follicular mycosis fungoides is a variant of mycosis fungoides characterized by the presence of follicular infiltrates that tend mainly to affect the head and neck. It was first described by Kim in 1985, who reported cases of mycosis fungoides limited to the hair follicles and perifollicular dermis. This variant accounts for 10% of cases of MF.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">From an epidemiologic point of view, there appear to be no differences between the sexes, although there is a slight predominance in adult men. The age at presentation does not differ from that of classic mycosis fungoides.</p><p id="par0050" class="elsevierStylePara elsevierViewall">The etiology and pathogenesis are not fully understood. It has been postulated that the epithelium of the hair follicles may express higher levels of skin-selective lymphocyte receptors (skin-selective homing) and epidermal adhesion molecules.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">2</span></a> Hodak et al.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">3</span></a> described the selective expression of intercellular adhesion molecule 1 on the cell membranes of the follicular epithelium in follicular mycosis fungoides lesions.</p><p id="par0055" class="elsevierStylePara elsevierViewall">The disease presents clinically as follicular papules, plaques with follicular accentuation, or cysts and comedones. Although single lesions have been reported in some patients, it is more common to observe multiple plaques. Presentation in the form of tumors, pseudotumors, or erythroderma is rare. Alopecia is common when the scalp is affected. Pruritus occurs frequently, and in 68% of patients requires specific treatment.</p><p id="par0060" class="elsevierStylePara elsevierViewall">Histopathology usually shows a dermal infiltrate with a perivascular and adnexal distribution, with infiltration of the follicular epithelium by atypical lymphocytes of follicular size and with cerebriform nuclei. There may be associated follicular mucinosis, although this is not a constant finding, and syringotropism and even squamous syringometaplasia. Five different basic patterns are recognized: the classic pattern, with or without associated follicular mucinosis; the eosinophilic folliculitis-like pattern; the cystic pattern; the basaloid pattern; and the granulomatous pattern.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">4</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">On immunohistochemistry, the neoplastic T lymphocytes are CD3<span class="elsevierStyleSup">+</span>, CD4<span class="elsevierStyleSup">+</span>, and CD8<span class="elsevierStyleSup">−</span>, and scattered CD30<span class="elsevierStyleSup">+</span> cells may be observed. The presence of more than 15% of CD30<span class="elsevierStyleSup">+</span> or CD30<span class="elsevierStyleSup">−</span> blast cells is considered a poor prognostic factor. Follicular mycosis fungoides is actually thought to have a poorer prognosis, behaving in a similar or equivalent manner to classic tumor-stage mycosis fungoides (stage IIB).<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">5</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Electron beam radiation is considered to be a more effective treatment than skin-targeting therapies such as PUVA and the topical nitrogen mustards. Some authors propose a more conservative approach using UV-A and bexarotene as the initial option.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">6,7</span></a> Isolated cases have shown a good response to isotretinoin, chlorambucil, radiotherapy, and interferon alfa, although the responses have usually been transitory.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">4</span></a></p></span></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:8 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Medical History" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Physical Examination" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Histology" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Additional Tests" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Diagnosis" ] 5 => array:3 [ "identificador" => "sec0030" "titulo" => "Clinical Course and Treatment" "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0035" "titulo" => "Comment" ] ] ] 6 => array:2 [ "identificador" => "sec0040" "titulo" => "Conflicts of Interest" ] 7 => 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: Ruiz-Villaverde R, Pérez-López I, Aneiros-Fernández J. Pápulas foliculares y placas eritematosas en espalda. Actas Dermosifiliogr. 2016;107:519–520.</p>" ] ] "multimedia" => array:3 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 364 "Ancho" => 980 "Tamanyo" => 68097 ] ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 401 "Ancho" => 505 "Tamanyo" => 149965 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Hematoxylin and eosin, original magnification<span class="elsevierStyleHsp" style=""></span>x4.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 401 "Ancho" => 534 "Tamanyo" => 151174 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Immunohistochemistry positive for CD3. Original magnification<span class="elsevierStyleHsp" style=""></span>×20.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:7 [ 0 => array:3 [ "identificador" => "bib0040" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mycosis fungoides: Disease evolution and prognosis of 309 Dutch patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Van Doorn" 1 => "C.W. van Haselen" 2 => "P.C. van Voorst Vader" 3 => "M.L. Geerts" 4 => "F. Heule" 5 => "M. de Rie" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Dermatol" "fecha" => "2000" "volumen" => "136" "paginaInicial" => "504" "paginaFinal" => "510" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10768649" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0045" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Follicular mycosis fungoides: A clinicohistopathologic study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "N.G. Pereyo" 1 => "L. Requena" 2 => "J. Galloway" 3 => "O.P. Sangüeza" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "1997" "volumen" => "36" "paginaInicial" => "563" "paginaFinal" => "568" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9092742" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0050" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Follicular cutaneous T-cell lymphoma: A clinicopathological study of nine cases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Hodak" 1 => "M. Feinmesser" 2 => "T. Segal" 3 => "G. Yosipovitch" 4 => "M. Lapidoth" 5 => "L. Maron" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "1999" "volumen" => "141" "paginaInicial" => "315" "paginaFinal" => "322" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10468808" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0055" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Folliculotropic mycosis fungoides: Clinicopathological features and outcome in a series of 20 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Muniesa" 1 => "T. Estrach" 2 => "R.M. Pujol" 3 => "F. Gallardo" 4 => "P. García-Muret" 5 => "J. Climent" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2009.03.014" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2010" "volumen" => "62" "paginaInicial" => "418" "paginaFinal" => "426" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20079954" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0060" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The spectrum of histopathologic and immunohistochemical findings in folliculotropic mycosis fungoides" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P. Gerami" 1 => "J. Guitart" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/PAS.0b013e3180439bdc" "Revista" => array:6 [ "tituloSerie" => "Am J Surg Pathol" "fecha" => "2007" "volumen" => "31" "paginaInicial" => "1430" "paginaFinal" => "1438" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17721200" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0065" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical and histopathological features of folliculotropic mycosis fungoides: A Norwegian patient series" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P. Mantaka" 1 => "P. Helsing" 2 => "P. Gjersvik" 3 => "A. Bassarova" 4 => "O.P. Clausen" 5 => "J. Delabie" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2340/00015555-1476" "Revista" => array:6 [ "tituloSerie" => "Acta Derm Venereol" "fecha" => "2013" "volumen" => "93" "paginaInicial" => "325" "paginaFinal" => "329" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23053197" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0070" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Folliculotropic mycosis fungoides. Study of four cases [Article in Spanish]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Gómez-Diez" 1 => "C. Maldonado" 2 => "A. Fueyo" 3 => "F. Vázquez-López" 4 => "M.F. Fresno" 5 => "N. Pérez-Oliva" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2007" "volumen" => "98" "paginaInicial" => "486" "paginaFinal" => "490" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17669304" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010700000006/v2_201704050141/S1578219016300981/v2_201704050141/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/15782190/0000010700000006/v2_201704050141/S1578219016300981/v2_201704050141/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219016300981?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 12 | 9 | 21 |
| 2024 Octubre | 155 | 48 | 203 |
| 2024 Septiembre | 166 | 37 | 203 |
| 2024 Agosto | 189 | 62 | 251 |
| 2024 Julio | 198 | 31 | 229 |
| 2024 Junio | 182 | 37 | 219 |
| 2024 Mayo | 156 | 31 | 187 |
| 2024 Abril | 133 | 29 | 162 |
| 2024 Marzo | 154 | 31 | 185 |
| 2024 Febrero | 147 | 35 | 182 |
| 2024 Enero | 150 | 32 | 182 |
| 2023 Diciembre | 113 | 14 | 127 |
| 2023 Noviembre | 113 | 20 | 133 |
| 2023 Octubre | 136 | 16 | 152 |
| 2023 Septiembre | 109 | 27 | 136 |
| 2023 Agosto | 72 | 18 | 90 |
| 2023 Julio | 118 | 31 | 149 |
| 2023 Junio | 97 | 17 | 114 |
| 2023 Mayo | 116 | 27 | 143 |
| 2023 Abril | 66 | 13 | 79 |
| 2023 Marzo | 64 | 20 | 84 |
| 2023 Febrero | 60 | 21 | 81 |
| 2023 Enero | 54 | 26 | 80 |
| 2022 Diciembre | 69 | 29 | 98 |
| 2022 Noviembre | 36 | 21 | 57 |
| 2022 Octubre | 34 | 17 | 51 |
| 2022 Septiembre | 41 | 25 | 66 |
| 2022 Agosto | 36 | 23 | 59 |
| 2022 Julio | 26 | 35 | 61 |
| 2022 Junio | 22 | 20 | 42 |
| 2022 Mayo | 57 | 27 | 84 |
| 2022 Abril | 79 | 27 | 106 |
| 2022 Marzo | 76 | 50 | 126 |
| 2022 Febrero | 53 | 31 | 84 |
| 2022 Enero | 82 | 31 | 113 |
| 2021 Diciembre | 45 | 37 | 82 |
| 2021 Noviembre | 70 | 42 | 112 |
| 2021 Octubre | 63 | 43 | 106 |
| 2021 Septiembre | 71 | 40 | 111 |
| 2021 Agosto | 75 | 23 | 98 |
| 2021 Julio | 81 | 23 | 104 |
| 2021 Junio | 62 | 26 | 88 |
| 2021 Mayo | 43 | 39 | 82 |
| 2021 Abril | 111 | 37 | 148 |
| 2021 Marzo | 64 | 29 | 93 |
| 2021 Febrero | 60 | 25 | 85 |
| 2021 Enero | 32 | 17 | 49 |
| 2020 Diciembre | 26 | 20 | 46 |
| 2020 Noviembre | 26 | 15 | 41 |
| 2020 Octubre | 19 | 8 | 27 |
| 2020 Septiembre | 21 | 11 | 32 |
| 2020 Agosto | 43 | 20 | 63 |
| 2020 Julio | 20 | 13 | 33 |
| 2020 Junio | 32 | 21 | 53 |
| 2020 Mayo | 21 | 18 | 39 |
| 2020 Abril | 27 | 18 | 45 |
| 2020 Marzo | 28 | 15 | 43 |
| 2020 Febrero | 3 | 0 | 3 |
| 2020 Enero | 2 | 0 | 2 |
| 2019 Diciembre | 4 | 0 | 4 |
| 2019 Noviembre | 4 | 0 | 4 |
| 2019 Septiembre | 4 | 0 | 4 |
| 2019 Agosto | 4 | 0 | 4 |
| 2019 Julio | 4 | 0 | 4 |
| 2019 Junio | 5 | 0 | 5 |
| 2019 Mayo | 4 | 1 | 5 |
| 2019 Abril | 2 | 1 | 3 |
| 2019 Marzo | 0 | 3 | 3 |
| 2019 Febrero | 1 | 0 | 1 |
| 2019 Enero | 3 | 0 | 3 |
| 2018 Diciembre | 2 | 0 | 2 |
| 2018 Noviembre | 2 | 0 | 2 |
| 2018 Octubre | 2 | 0 | 2 |
| 2018 Septiembre | 3 | 0 | 3 |
| 2018 Febrero | 65 | 5 | 70 |
| 2018 Enero | 57 | 10 | 67 |
| 2017 Diciembre | 65 | 7 | 72 |
| 2017 Noviembre | 67 | 6 | 73 |
| 2017 Octubre | 57 | 11 | 68 |
| 2017 Septiembre | 67 | 6 | 73 |
| 2017 Agosto | 55 | 6 | 61 |
| 2017 Julio | 50 | 10 | 60 |
| 2017 Junio | 74 | 9 | 83 |
| 2017 Mayo | 66 | 10 | 76 |
| 2017 Abril | 64 | 10 | 74 |
| 2017 Marzo | 45 | 4 | 49 |
| 2017 Febrero | 21 | 13 | 34 |
| 2017 Enero | 24 | 5 | 29 |
| 2016 Diciembre | 43 | 17 | 60 |
| 2016 Noviembre | 33 | 17 | 50 |
| 2016 Octubre | 35 | 19 | 54 |
| 2016 Julio | 1 | 0 | 1 |
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