Case for Diagnosis
Hyperpigmented Macules on a Young Man's Arms
Máculas hiperpigmentadas bilaterales en brazos de un varón joven
Leído
8290
Vecesse ha leído el artículo
2904
Total PDF
5386
Total HTML
Compartir estadísticas
array:24 [ "pii" => "S1578219016301561" "issn" => "15782190" "doi" => "10.1016/j.adengl.2016.07.004" "estado" => "S300" "fechaPublicacion" => "2016-10-01" "aid" => "1368" "copyright" => "Elsevier España, S.L.U. and AEDV" "copyrightAnyo" => "2016" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2016;107:683-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 923 "formatos" => array:3 [ "EPUB" => 54 "HTML" => 665 "PDF" => 204 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731016000880" "issn" => "00017310" "doi" => "10.1016/j.ad.2015.06.021" "estado" => "S300" "fechaPublicacion" => "2016-10-01" "aid" => "1368" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2016;107:683-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 537 "formatos" => array:3 [ "EPUB" => 3 "HTML" => 435 "PDF" => 99 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Casos para el diagnóstico</span>" "titulo" => "Máculas hiperpigmentadas bilaterales en brazos de un varón joven" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "683" "paginaFinal" => "684" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Hyperpigmented Macules on a Young Man's Arms" ] ] "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" => 375 "Ancho" => 500 "Tamanyo" => 26640 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S. de Asís-Cuestas, E. Martí-Ibor, A. Mateu-Puchades" "autores" => array:3 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "de Asís-Cuestas" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Martí-Ibor" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Mateu-Puchades" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219016301561" "doi" => "10.1016/j.adengl.2016.07.004" "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/S1578219016301561?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731016000880?idApp=UINPBA000044" "url" => "/00017310/0000010700000008/v1_201609280244/S0001731016000880/v1_201609280244/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S157821901630155X" "issn" => "15782190" "doi" => "10.1016/j.adengl.2016.07.003" "estado" => "S300" "fechaPublicacion" => "2016-10-01" "aid" => "1365" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Actas Dermosifiliogr. 2016;107:685" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1536 "formatos" => array:3 [ "EPUB" => 67 "HTML" => 1275 "PDF" => 194 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Dermatology</span>" "titulo" => "Long-standing Plaque of Alopecia on the Scalp" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "685" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Placa alopécica en cuero cabelludo de larga evolución" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "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" => 675 "Ancho" => 900 "Tamanyo" => 190170 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "C. Garrido-Colmenero, J. Aneiros-Fernandez, R. Ruiz-Villaverde" "autores" => array:3 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Garrido-Colmenero" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Aneiros-Fernandez" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Ruiz-Villaverde" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731016000855" "doi" => "10.1016/j.ad.2015.04.030" "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/S0001731016000855?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157821901630155X?idApp=UINPBA000044" "url" => "/15782190/0000010700000008/v2_201704100057/S157821901630155X/v2_201704100057/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219016301548" "issn" => "15782190" "doi" => "10.1016/j.adengl.2016.07.002" "estado" => "S300" "fechaPublicacion" => "2016-10-01" "aid" => "1358" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2016;107:681-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 869 "formatos" => array:3 [ "EPUB" => 66 "HTML" => 628 "PDF" => 175 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case for Diagnosis</span>" "titulo" => "Pedunculated Papule and Fissure in the Anterior Midline of the Neck" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "681" "paginaFinal" => "682" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Pápula pediculada y fisura en línea cervical anterior de recién nacido" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "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 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "C. Arjona-Aguilera, G. Blasco-Morente, J. Tercedor-Sánchez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Arjona-Aguilera" ] 1 => array:2 [ "nombre" => "G." "apellidos" => "Blasco-Morente" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Tercedor-Sánchez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731016000715" "doi" => "10.1016/j.ad.2015.06.019" "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/S0001731016000715?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219016301548?idApp=UINPBA000044" "url" => "/15782190/0000010700000008/v2_201704100057/S1578219016301548/v2_201704100057/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case for Diagnosis</span>" "titulo" => "Hyperpigmented Macules on a Young Man's Arms" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "683" "paginaFinal" => "684" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "S. de Asís-Cuestas, E. Martí-Ibor, A. Mateu-Puchades" "autores" => array:3 [ 0 => array:4 [ "nombre" => "S." "apellidos" => "de Asís-Cuestas" "email" => array:1 [ 0 => "aifosofia00@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" => "E." "apellidos" => "Martí-Ibor" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "A." "apellidos" => "Mateu-Puchades" "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 Doctor Peset, Valencia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Universitario Doctor Peset, Valencia, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Máculas hiperpigmentadas bilaterales en brazos de un varón joven" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 374 "Ancho" => 500 "Tamanyo" => 43650 ] ] ] ] "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 40-year-old man was referred by the oncology department for assessment of pigmented lesions on the upper limbs that had appeared progressively over the previous 5 years. The patient's medical history included a cholangiocarcinoma diagnosed 2 years earlier, which was treated with surgery, radiation therapy, chemotherapy, and oral capecitabine. The patient was disease-free at the time of the visit.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient reported that the lesions had been stable and asymptomatic since they appeared, that they did not change in appearance when exposed to high temperatures or physical exercise, and that they did not change after treatment with topical antifungal agents prescribed by a primary care physician.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Physical Examination</span><p id="par0015" class="elsevierStylePara elsevierViewall">Physical examination revealed multiple well-defined brownish macules with fine superficial telangiectasias, distributed in a bilateral symmetric pattern on the external aspect of both arms (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a>). The lesions were negative for the Darier sign. No similar lesions were observed elsewhere on the body.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Additional Tests</span><p id="par0020" class="elsevierStylePara elsevierViewall">Biopsy of a lesion revealed basal layer hyperpigmentation and no other findings of interest (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). No increase in the number of mast cells or melanocytes was observed with hematoxylin-eosin staining or with immunostaining for c-kit.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0025" 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">Acquired bilateral telangiectatic macules.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Clinical Course</span><p id="par0035" class="elsevierStylePara elsevierViewall">The lesions have remained stable after 1 year of follow-up.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Comment</span><p id="par0040" class="elsevierStylePara elsevierViewall">Acquired bilateral telangiectatic macules are a recently described entity.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> The lesions have certain constant clinical and pathological characteristics that allow them to be differentiated from similar entities.</p><p id="par0045" class="elsevierStylePara elsevierViewall">The lesions typically occur in middle-aged men with skin phototype <span class="elsevierStyleSmallCaps">III-IV</span><a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> and follow an insidious clinical course. Patients present with symmetrically distributed brownish erythematous macules with fine superficial telangiectasias on the extensor surface of the arms. The lesions are asymptomatic and negative for the Darier sign.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Histologic examination of the lesions reveals basal layer hyperpigmentation and capillary proliferation in the dermis, sometimes accompanied by a subtle perivascular inflammatory infiltrate.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> No epidermal alterations are present and the number of mast cells and melanocytes is normal (as can be confirmed by immunohistochemistry for c-kit and Fontana-Masson staining, respectively).</p><p id="par0055" class="elsevierStylePara elsevierViewall">In the case series described by Park et al., the lesions did not improve spontaneously in any of the patients after a mean follow-up period of 4 years. In the case of our patient, we did not prescribe treatment because the lesions were asymptomatic and stable. No significant changes were observed during 14 months of follow-up.</p><p id="par0060" class="elsevierStylePara elsevierViewall">The differential diagnosis includes the following:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">−</span><p id="par0065" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Telangiectasia macularis eruptiva perstans</span><a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2,3</span></a><span class="elsevierStyleItalic">:</span> Indolent cutaneous mastocytosis characterized by brownish erythematous macules that are generally asymptomatic. The lesions tend to be negative for the Darier sign. Unlike acquired bilateral telangiectatic macules, this entity also tends to affect the trunk. Histologically, it is characterized by an increase in the number of mast cells.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">−</span><p id="par0070" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Acquired brachial cutaneous dyschromatosis</span><a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a><span class="elsevierStyleItalic">:</span> This recently described entity affects postmenopausal women and is characterized by greyish-brown asymptomatic macules on the extensor surface of the arms. Histologically, it is characterized by epidermal atrophy, basal layer hyperpigmentation, and solar elastosis. Its appearance has been associated with UV radiation and the ingestion of angiotensin-converting enzyme inhibitors.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">−</span><p id="par0075" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Generalized essential telangiectasia</span><a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a><span class="elsevierStyleItalic">:</span> This entity typically occurs in women 40 to 50 years of age. It manifests as asymptomatic telangiectasias on the lower limbs that subsequently become generalized and is not associated with systemic diseases.</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">−</span><p id="par0080" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Hereditary benign telangiectasia</span><a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a><span class="elsevierStyleItalic">:</span> This rare entity is more frequent in women and children and is characterized by punctate telangiectasias surrounded by a pale halo on the upper third of the trunk, the arms, and the head. The lesions are asymptomatic and are not associated with systemic disease.</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">−</span><p id="par0085" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Drug-induced hyperpigmentation:</span> Various drugs—including antimalarial agents, chemotherapeutic agents, antibiotics, amiodarone, phenytoin, and heavy metals—have been associated with pigmentary alterations. In order to diagnose this entity, a good medical history must be taken and a temporal relationship must be established between the administration of the drug and the appearance of the lesions.</p></li></ul></p><p id="par0090" class="elsevierStylePara elsevierViewall">Therefore, differences in sex and age at onset, the absence of systemic symptoms, the site of the lesions, and histologic findings allow us to rule out other diseases and confirm the diagnosis of acquired bilateral telangiectatic macules.</p><p id="par0095" class="elsevierStylePara elsevierViewall">In conclusion, we have presented a new case of acquired bilateral telangiectatic macules, a recently described entity characterized by asymptomatic pigmented lesions on the arms that occurs in grown men and follows a chronic indolent clinical course.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conflicts of Interest</span><p id="par0100" 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: de Asís-Cuestas S. Máculas hiperpigmentadas bilaterales en brazos de un varón joven. Actas Dermosifiliogr. 2016;107:683–684.</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" => 375 "Ancho" => 500 "Tamanyo" => 32535 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 374 "Ancho" => 500 "Tamanyo" => 43650 ] ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 375 "Ancho" => 500 "Tamanyo" => 110827 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Hematoxylin-eosin, original magnification ×10. Inset at lower right, hematoxylin-eosin, original magnification ×20.</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" => "Acquired bilateral telangiectatic macules: A distinct clinical entity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J.H. Park" 1 => "D.J. Lee" 2 => "Y.J. Lee" 3 => "Y.H. Jang" 4 => "H.Y. Kang" 5 => "Y.C. Kim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamadermatol.2013.10238" "Revista" => array:7 [ "tituloSerie" => "JAMA Dermatol" "fecha" => "2014" "volumen" => "150" "paginaInicial" => "974" "paginaFinal" => "977" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24806791" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0302283812002400" "estado" => "S300" "issn" => "03022838" ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Telangiectasia macularis eruptiva perstans: More than skin deep" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C.E. Watkins" 1 => "W.B. Bokor" 2 => "S. Leicht" 3 => "G. Youngberg" 4 => "G. Krishnaswamy" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4081/dr.2011.e12" "Revista" => array:5 [ "tituloSerie" => "Dermatol Reports" "fecha" => "2011" "volumen" => "3" "paginaInicial" => "e12" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25386256" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Telangiectasia macularis eruptiva perstans" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "N.Q. Nguyen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Dermatol Online J" "fecha" => "2004" "volumen" => "10" "paginaInicial" => "3" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15748573" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0302283811000303" "estado" => "S300" "issn" => "03022838" ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0050" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acquired brachial cutaneous dyschromatosis: A common pigmentary disorder of the arm in middle-aged women" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "F. Rongioletti" 1 => "A. Rebora" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2000" "volumen" => "42" "paginaInicial" => "680" "paginaFinal" => "684" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10727320" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Generalized essential telangiectasia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.K. Karen" 1 => "S.J. Mengden" 2 => "H. Kamino" 3 => "J.L. Shupack" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Dermatol Online J" "fecha" => "2008" "volumen" => "14" "paginaInicial" => "9" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19094847" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hereditary benign telangiectasia: Two families with punctate telangiectasias surrounded by anemic halos" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "H. Ujiie" 1 => "K. Kodama" 2 => "M. Akiyama" 3 => "H. Shimizu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archdermatol.2009.342" "Revista" => array:6 [ "tituloSerie" => "Arch Dermatol" "fecha" => "2010" "volumen" => "146" "paginaInicial" => "98" "paginaFinal" => "99" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20083709" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010700000008/v2_201704100057/S1578219016301561/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/S1578219016301561/v2_201704100057/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219016301561?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 24 | 10 | 34 |
| 2024 Octubre | 165 | 56 | 221 |
| 2024 Septiembre | 181 | 33 | 214 |
| 2024 Agosto | 218 | 70 | 288 |
| 2024 Julio | 141 | 59 | 200 |
| 2024 Junio | 142 | 66 | 208 |
| 2024 Mayo | 123 | 52 | 175 |
| 2024 Abril | 111 | 30 | 141 |
| 2024 Marzo | 97 | 37 | 134 |
| 2024 Febrero | 91 | 37 | 128 |
| 2024 Enero | 78 | 47 | 125 |
| 2023 Diciembre | 99 | 47 | 146 |
| 2023 Noviembre | 97 | 47 | 144 |
| 2023 Octubre | 114 | 45 | 159 |
| 2023 Septiembre | 99 | 81 | 180 |
| 2023 Agosto | 70 | 90 | 160 |
| 2023 Julio | 114 | 116 | 230 |
| 2023 Junio | 97 | 59 | 156 |
| 2023 Mayo | 96 | 51 | 147 |
| 2023 Abril | 82 | 64 | 146 |
| 2023 Marzo | 123 | 39 | 162 |
| 2023 Febrero | 88 | 51 | 139 |
| 2023 Enero | 105 | 85 | 190 |
| 2022 Diciembre | 99 | 76 | 175 |
| 2022 Noviembre | 57 | 80 | 137 |
| 2022 Octubre | 39 | 62 | 101 |
| 2022 Septiembre | 53 | 64 | 117 |
| 2022 Agosto | 26 | 63 | 89 |
| 2022 Julio | 35 | 43 | 78 |
| 2022 Junio | 49 | 39 | 88 |
| 2022 Mayo | 114 | 85 | 199 |
| 2022 Abril | 99 | 61 | 160 |
| 2022 Marzo | 71 | 67 | 138 |
| 2022 Febrero | 67 | 27 | 94 |
| 2022 Enero | 91 | 46 | 137 |
| 2021 Diciembre | 58 | 61 | 119 |
| 2021 Noviembre | 72 | 62 | 134 |
| 2021 Octubre | 95 | 52 | 147 |
| 2021 Septiembre | 76 | 53 | 129 |
| 2021 Agosto | 67 | 55 | 122 |
| 2021 Julio | 59 | 29 | 88 |
| 2021 Junio | 82 | 37 | 119 |
| 2021 Mayo | 67 | 47 | 114 |
| 2021 Abril | 168 | 64 | 232 |
| 2021 Marzo | 101 | 33 | 134 |
| 2021 Febrero | 88 | 31 | 119 |
| 2021 Enero | 39 | 19 | 58 |
| 2020 Diciembre | 53 | 17 | 70 |
| 2020 Noviembre | 47 | 19 | 66 |
| 2020 Octubre | 44 | 12 | 56 |
| 2020 Septiembre | 43 | 15 | 58 |
| 2020 Agosto | 30 | 12 | 42 |
| 2020 Julio | 30 | 15 | 45 |
| 2020 Junio | 56 | 27 | 83 |
| 2020 Mayo | 28 | 18 | 46 |
| 2020 Abril | 31 | 19 | 50 |
| 2020 Marzo | 31 | 18 | 49 |
| 2020 Febrero | 3 | 0 | 3 |
| 2020 Enero | 4 | 0 | 4 |
| 2019 Diciembre | 4 | 0 | 4 |
| 2019 Noviembre | 4 | 0 | 4 |
| 2019 Agosto | 4 | 0 | 4 |
| 2019 Julio | 4 | 0 | 4 |
| 2019 Junio | 4 | 0 | 4 |
| 2019 Mayo | 6 | 1 | 7 |
| 2019 Abril | 5 | 3 | 8 |
| 2019 Marzo | 2 | 0 | 2 |
| 2019 Febrero | 2 | 0 | 2 |
| 2019 Enero | 4 | 0 | 4 |
| 2018 Diciembre | 1 | 0 | 1 |
| 2018 Noviembre | 2 | 0 | 2 |
| 2018 Octubre | 13 | 0 | 13 |
| 2018 Septiembre | 1 | 0 | 1 |
| 2018 Febrero | 17 | 4 | 21 |
| 2018 Enero | 37 | 9 | 46 |
| 2017 Diciembre | 50 | 9 | 59 |
| 2017 Noviembre | 44 | 8 | 52 |
| 2017 Octubre | 42 | 7 | 49 |
| 2017 Septiembre | 25 | 9 | 34 |
| 2017 Agosto | 29 | 7 | 36 |
| 2017 Julio | 28 | 8 | 36 |
| 2017 Junio | 45 | 13 | 58 |
| 2017 Mayo | 53 | 10 | 63 |
| 2017 Abril | 39 | 14 | 53 |
| 2017 Marzo | 25 | 8 | 33 |
| 2017 Febrero | 21 | 11 | 32 |
| 2017 Enero | 22 | 9 | 31 |
| 2016 Diciembre | 31 | 18 | 49 |
| 2016 Noviembre | 34 | 22 | 56 |
| 2016 Octubre | 59 | 34 | 93 |
| 2016 Septiembre | 2 | 0 | 2 |
Mostrar todo
