Case for Diagnosis
Pedunculated Papule and Fissure in the Anterior Midline of the Neck
Pápula pediculada y fisura en línea cervical anterior de recién nacido
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Serie de 14 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" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1113 "Ancho" => 1500 "Tamanyo" => 587938 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Patient #4: A 63-year-old man with a pigmented lesion on the scapula. A, A 13-mm pigmented macule on the left scapula. B, Dermoscopic image showing asymmetric follicular pigmentation, rhomboidal structures, and some obliterated follicular openings. 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Arjona-Aguilera, G. Blasco-Morente, J. Tercedor-Sánchez" "autores" => array:3 [ 0 => array:4 [ "nombre" => "C." "apellidos" => "Arjona-Aguilera" "email" => array:1 [ 0 => "cintiaarjona@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" => "G." "apellidos" => "Blasco-Morente" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "J." "apellidos" => "Tercedor-Sánchez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Unidad de Gestión Clínica de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Puerta del Mar, Cádiz, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Unidad de Gestión Clínica de Dermatología Médico-Quirúrgica y Venereología, Hospital Universitario Virgen de las Nieves, Granada, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Pápula pediculada y fisura en línea cervical anterior de recién nacido" ] ] "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" => 300 "Ancho" => 444 "Tamanyo" => 25749 ] ] ] ] "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 3-month-old boy was seen for an exudative lesion in the anterior cervical region that had been present since birth. The gestation period had been normal and the child had been born at full term. The patient had no other medical or surgical history of interest.</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 skin-colored pedunculated papule on the anterior midline of the neck. At the caudal end of the lesion, there was an orifice that connected to a small mucosal fistula measuring barely 2<span class="elsevierStyleHsp" style=""></span>mm in length (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The lesion was not adhered to deeper tissues and showed no mobility when the patient swallowed or moved his tongue. A catheter was inserted into the orifice and reached a dead end after penetrating about 3-4<span class="elsevierStyleHsp" style=""></span>mm.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Additional Tests</span><p id="par0015" class="elsevierStylePara elsevierViewall">Dermoscopic examination revealed a pink pedunculated papule measuring 0.3<span class="elsevierStyleHsp" style=""></span>cm in diameter, at the inferior end of which was a fissure (barely visible to the naked eye) measuring 0.1<span class="elsevierStyleHsp" style=""></span>cm with a mild transparent exudate (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Soft-tissue ultrasound examination revealed a round, well-defined hypoechoic superficial lesion that showed no evidence of a fistulous tract as well as a thyroid with a typical morphology and location. Complete blood count, biochemistry, and hormone panel were normal. An electrocardiogram (ECG) was carried out as a first step to rule out cardiac abnormalities.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">What Is Your Diagnosis?</span></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Diagnosis</span><p id="par0030" class="elsevierStylePara elsevierViewall">Midline cervical cleft (MCC).</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Clinical Course</span><p id="par0035" class="elsevierStylePara elsevierViewall">The patient was assessed by the pediatric surgery department and an initial attitude of watchful waiting was adopted. Curative surgical treatment will be scheduled for when the boy is around 1 year of age.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Comment</span><p id="par0040" class="elsevierStylePara elsevierViewall">MCC is a rare congenital anomaly that causes a visible defect at the midline of the neck. Around 200 cases have been described in the international literature,<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> mostly in plastic surgery or otorhinolaryngology journals. MCC appears sporadically and is slightly more common in girls.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1,2</span></a> The clinical presentation is characterized by a linear vertical deepithelized plaque with a fibroepithelial papule at the cranial end that extends towards the caudal end, terminating in a blind sinus.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1,2</span></a> The entity has no relationship to the thyroid or to the hyoid bone.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> The lesion is generally limited to the skin, but there have been cases in which it extends to the subcutaneous tissue and underlying muscle.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2,3</span></a> The size of the lesion can be highly variable and it can be located anywhere along the anterior midline from the lower lip to the suprasternal region.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> The condition is generally detected at birth, but mild forms can go undetected or can be mistaken for remnants of the thyroglossal duct or branchial anomalies.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> The differential diagnosis should include fistulas, sinus cysts of branchial origin, and bronchogenic cysts.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1,2</span></a> Branchial disease typically appears in the region anterior to the sternocleidomastoid muscle, and bronchogenic cysts tend to be located in the suprasternal notch.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2,4</span></a> In case of doubt, ultrasound and computed tomography can be very useful in establishing a diagnosis.</p><p id="par0045" class="elsevierStylePara elsevierViewall">The embryopathogenesis of MCC is not yet fully understood, and most authors consider it to be a mild form on the spectrum of congenital branchial anomalies.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1,2,5</span></a> This would explain the occasional association of MCC with other anomalies such as thyroglossal duct cysts, dermoid cysts, bronchogenic cysts, cleft lip, and congenital cardiac anomalies.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1,6</span></a> A full hormone panel and an ECG are also recommended as a first step to rule out associated comorbidities.</p><p id="par0050" class="elsevierStylePara elsevierViewall">The clinical course of MCC is benign with spontaneous scarring and the formation of a fibrous cord.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1,5,6</span></a> However, because there is considerable risk of infection, cervical contracture, and limitation of mobility, MCC should be managed with surgery around the age of 1 year and no later than 2 years.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2,3</span></a> The preferred technique is complete excision followed by Z-plasty closure<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">4–6</span></a> to prevent the recurrence of fibrosis, which can occur following direct closure.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> Finally, periodic follow-up of the patient throughout infancy is recommended because of the risk of retraction and hypertrophic scarring.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">4,6</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">In conclusion, we have described a case of mild <span class="elsevierStyleGrantSponsor" id="gs1">MCC</span> in which the typical atrophic plaque was not evident and the diagnosis was supported by physical examination, dermoscopy, and ultrasound. Other congenital anomalies are rarely associated with <span class="elsevierStyleGrantSponsor" id="gs2">MCC</span> and should be ruled out during the diagnostic process. Treatment of the condition should be mainly surgical.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conflicts of Interest</span><p id="par0060" 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" => "Additional Tests" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Diagnosis" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Clinical Course" ] 5 => array:2 [ "identificador" => "sec0030" "titulo" => "Comment" ] 6 => array:2 [ "identificador" => "sec0035" "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: Arjona-Aguilera C, Blasco-Morente G, Tercedor-Sánchez J. Pápula pediculada y fisura en línea cervical anterior de recién nacido. Actas Dermosifiliogr. 2016;107:681–682.</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" => 300 "Ancho" => 444 "Tamanyo" => 25749 ] ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 450 "Ancho" => 366 "Tamanyo" => 26157 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Polarized light, original magnification ×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" => "Midline cervical cleft: Review of an uncommon entity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L. Puscas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1155/2015/209418" "Revista" => array:5 [ "tituloSerie" => "Int J Pediatr" "fecha" => "2015" "volumen" => "2015" "paginaInicial" => "209418" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25983756" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fisura cervical media: Reporte de un caso" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C.E. Remolcois" 1 => "Q.P. Larraguibel" 2 => "V.G. López" 3 => "C.J.A. Sepúlveda" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Chil Pediatr" "fecha" => "2013" "volumen" => "84" "paginaInicial" => "80" "paginaFinal" => "82" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hendidura cervical media congénita" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "N. Martí Fajardo" 1 => "C. Ortega Monzó" 2 => "R. Tamarit Ortí" 3 => "R. Ibáñez Ramón" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Piel" "fecha" => "2013" "volumen" => "28" "paginaInicial" => "122" "paginaFinal" => "123" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0050" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fente cervicale médiane congénitale" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.P. Sannajust" 1 => "I. Barthelemy" 2 => "C. Emering" 3 => "I. Mandará" 4 => "J.M. Mondie" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Stomatol Chir Maxillofac" "fecha" => "2004" "volumen" => "105" "paginaInicial" => "338" "paginaFinal" => "341" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15671956" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Congenital midline cervical cleft: A practical approach to Z-plasty closure" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C.S. Cochran" 1 => "R.J. DeFatta" 2 => "A.C. Brenski" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ijporl.2005.07.024" "Revista" => array:6 [ "tituloSerie" => "Int J Pediatr Otorhinolaryngol" "fecha" => "2006" "volumen" => "70" "paginaInicial" => "553" "paginaFinal" => "560" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16414126" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A case of congenital midline cervical cleft with congenital heart disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Hirokawa" 1 => "H. Uotani" 2 => "H. Okami" 3 => "K. Tsukada" 4 => "T. Futatani" 5 => "I. Hashimoto" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Pediatr Surg" "fecha" => "2003" "volumen" => "38" "paginaInicial" => "1099" "paginaFinal" => "1101" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12861550" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010700000008/v2_201704100057/S1578219016301548/v2_201704100057/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/15782190/0000010700000008/v2_201704100057/S1578219016301548/v2_201704100057/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219016301548?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 6 | 6 | 12 |
| 2024 Octubre | 84 | 31 | 115 |
| 2024 Septiembre | 109 | 25 | 134 |
| 2024 Agosto | 117 | 54 | 171 |
| 2024 Julio | 98 | 27 | 125 |
| 2024 Junio | 92 | 36 | 128 |
| 2024 Mayo | 74 | 35 | 109 |
| 2024 Abril | 99 | 26 | 125 |
| 2024 Marzo | 76 | 29 | 105 |
| 2024 Febrero | 75 | 33 | 108 |
| 2024 Enero | 58 | 35 | 93 |
| 2023 Diciembre | 61 | 16 | 77 |
| 2023 Noviembre | 67 | 46 | 113 |
| 2023 Octubre | 66 | 60 | 126 |
| 2023 Septiembre | 57 | 40 | 97 |
| 2023 Agosto | 46 | 24 | 70 |
| 2023 Julio | 57 | 40 | 97 |
| 2023 Junio | 62 | 25 | 87 |
| 2023 Mayo | 75 | 29 | 104 |
| 2023 Abril | 50 | 22 | 72 |
| 2023 Marzo | 65 | 22 | 87 |
| 2023 Febrero | 67 | 19 | 86 |
| 2023 Enero | 56 | 30 | 86 |
| 2022 Diciembre | 68 | 55 | 123 |
| 2022 Noviembre | 32 | 27 | 59 |
| 2022 Octubre | 31 | 19 | 50 |
| 2022 Septiembre | 30 | 32 | 62 |
| 2022 Agosto | 25 | 39 | 64 |
| 2022 Julio | 46 | 38 | 84 |
| 2022 Junio | 36 | 27 | 63 |
| 2022 Mayo | 47 | 34 | 81 |
| 2022 Abril | 49 | 27 | 76 |
| 2022 Marzo | 40 | 48 | 88 |
| 2022 Febrero | 35 | 29 | 64 |
| 2022 Enero | 47 | 42 | 89 |
| 2021 Diciembre | 49 | 34 | 83 |
| 2021 Noviembre | 47 | 40 | 87 |
| 2021 Octubre | 44 | 41 | 85 |
| 2021 Septiembre | 27 | 37 | 64 |
| 2021 Agosto | 43 | 31 | 74 |
| 2021 Julio | 30 | 21 | 51 |
| 2021 Junio | 43 | 18 | 61 |
| 2021 Mayo | 55 | 42 | 97 |
| 2021 Abril | 152 | 41 | 193 |
| 2021 Marzo | 65 | 19 | 84 |
| 2021 Febrero | 47 | 25 | 72 |
| 2021 Enero | 31 | 21 | 52 |
| 2020 Diciembre | 28 | 11 | 39 |
| 2020 Noviembre | 35 | 22 | 57 |
| 2020 Octubre | 30 | 17 | 47 |
| 2020 Septiembre | 38 | 12 | 50 |
| 2020 Agosto | 36 | 13 | 49 |
| 2020 Julio | 21 | 9 | 30 |
| 2020 Junio | 26 | 26 | 52 |
| 2020 Mayo | 20 | 12 | 32 |
| 2020 Abril | 21 | 15 | 36 |
| 2020 Marzo | 31 | 16 | 47 |
| 2020 Febrero | 5 | 1 | 6 |
| 2019 Diciembre | 4 | 0 | 4 |
| 2019 Septiembre | 4 | 0 | 4 |
| 2019 Junio | 2 | 0 | 2 |
| 2019 Mayo | 1 | 1 | 2 |
| 2019 Abril | 2 | 4 | 6 |
| 2019 Marzo | 2 | 0 | 2 |
| 2019 Enero | 1 | 0 | 1 |
| 2018 Diciembre | 5 | 0 | 5 |
| 2018 Noviembre | 2 | 0 | 2 |
| 2018 Octubre | 2 | 0 | 2 |
| 2018 Septiembre | 3 | 0 | 3 |
| 2018 Febrero | 28 | 3 | 31 |
| 2018 Enero | 31 | 7 | 38 |
| 2017 Diciembre | 56 | 6 | 62 |
| 2017 Noviembre | 31 | 7 | 38 |
| 2017 Octubre | 26 | 4 | 30 |
| 2017 Septiembre | 27 | 7 | 34 |
| 2017 Agosto | 27 | 10 | 37 |
| 2017 Julio | 26 | 4 | 30 |
| 2017 Junio | 32 | 13 | 45 |
| 2017 Mayo | 35 | 7 | 42 |
| 2017 Abril | 33 | 7 | 40 |
| 2017 Marzo | 19 | 9 | 28 |
| 2017 Febrero | 24 | 9 | 33 |
| 2017 Enero | 17 | 11 | 28 |
| 2016 Diciembre | 35 | 19 | 54 |
| 2016 Noviembre | 28 | 20 | 48 |
| 2016 Octubre | 124 | 27 | 151 |
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