Case and Research Letters
Periarticular Thenar Erythema and Onycholysis Syndrome: A Manifestation of Taxane-Induced Cutaneous Toxicity
Síndrome de eritema tenar periarticular y onicolisis: una manifestación de toxicidad cutánea por taxanos
E. Rodríguez-Lomba
, I. Molina-López, R. Suárez-Fernández, O. Baniandrés-Rodríguez
Autor para correspondencia
Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain
Leído
7958
Vecesse ha leído el artículo
2473
Total PDF
5485
Total HTML
Compartir estadísticas
array:24 [ "pii" => "S1578219017301439" "issn" => "15782190" "doi" => "10.1016/j.adengl.2017.05.002" "estado" => "S300" "fechaPublicacion" => "2017-07-01" "aid" => "1575" "copyright" => "Elsevier España, S.L.U. and AEDV" "copyrightAnyo" => "2016" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2017;108:595-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 691 "formatos" => array:3 [ "EPUB" => 40 "HTML" => 555 "PDF" => 96 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731016304446" "issn" => "00017310" "doi" => "10.1016/j.ad.2016.11.014" "estado" => "S300" "fechaPublicacion" => "2017-07-01" "aid" => "1575" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2017;108:595-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 318 "formatos" => array:3 [ "EPUB" => 3 "HTML" => 261 "PDF" => 54 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científico-clínica</span>" "titulo" => "Síndrome de eritema tenar periarticular y onicolisis: una manifestación de toxicidad cutánea por taxanos" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "595" "paginaFinal" => "597" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Periarticular Thenar Erythema and Onycholysis Syndrome: A Manifestation of Taxane-Induced Cutaneous Toxicity" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1266 "Ancho" => 950 "Tamanyo" => 369100 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio histológico de la lesión en el dorso de la mano del caso n.° 2: A. Epidermis hiperqueratósica con paraqueratosis, focos de degeneración vacuolar de la basal e infiltrado perivascular y en banda con escasos eosinófilos (hematoxilina-eosina, ×20). B. Mayor aumento (×40) evidenciando queratinocitos necróticos en epidermis.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "E. Rodríguez-Lomba, I. Molina-López, R. Suárez-Fernández, O. Baniandrés-Rodríguez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "E." "apellidos" => "Rodríguez-Lomba" ] 1 => array:2 [ "nombre" => "I." "apellidos" => "Molina-López" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Suárez-Fernández" ] 3 => array:2 [ "nombre" => "O." "apellidos" => "Baniandrés-Rodríguez" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219017301439" "doi" => "10.1016/j.adengl.2017.05.002" "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/S1578219017301439?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731016304446?idApp=UINPBA000044" "url" => "/00017310/0000010800000006/v3_201707250313/S0001731016304446/v3_201707250313/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219017301427" "issn" => "15782190" "doi" => "10.1016/j.adengl.2017.05.001" "estado" => "S300" "fechaPublicacion" => "2017-07-01" "aid" => "1574" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2017;108:597-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 593 "formatos" => array:3 [ "EPUB" => 33 "HTML" => 438 "PDF" => 122 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>" "titulo" => "Oral Oxybutynin for Local and Multifocal Hyperhidrosis: A Multicenter Study" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "597" "paginaFinal" => "599" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Estudio multicéntrico sobre el uso de oxibutinina oral en hiperhidrosis local y multifocal" ] ] "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" => 2031 "Ancho" => 2663 "Tamanyo" => 124725 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Numbers of patients with given Hyperhidrosis Disease Severity Scale (HDSS) scores before (left) and after (right) treatment.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "T. Toledo-Pastrana, J. Márquez-Enríquez, J.F. Millán-Cayetano" "autores" => array:3 [ 0 => array:2 [ "nombre" => "T." "apellidos" => "Toledo-Pastrana" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Márquez-Enríquez" ] 2 => array:2 [ "nombre" => "J.F." "apellidos" => "Millán-Cayetano" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731016304434" "doi" => "10.1016/j.ad.2016.11.013" "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/S0001731016304434?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017301427?idApp=UINPBA000044" "url" => "/15782190/0000010800000006/v1_201706300050/S1578219017301427/v1_201706300050/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S157821901730207X" "issn" => "15782190" "doi" => "10.1016/j.adengl.2016.11.020" "estado" => "S300" "fechaPublicacion" => "2017-07-01" "aid" => "1579" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2017;108:593-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 385 "formatos" => array:3 [ "EPUB" => 28 "HTML" => 260 "PDF" => 97 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>" "titulo" => "Refractory solar urticaria successfully treated with omalizumab with normalization of phototest" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "593" "paginaFinal" => "594" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Urticaria solar refractaria tratada satisfactoriamente con omalizumab y normalización del fototest" ] ] "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" => 996 "Ancho" => 990 "Tamanyo" => 67385 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A) Phototest before omalizumab (Waldman® UV 181 UVA) was positive for UVA, minimal urticarial dose 7<span class="elsevierStyleHsp" style=""></span>J/cm<span class="elsevierStyleSup">2</span>. (B) Phototest after omalizumab (Waldman® UV 181 UVA): no reaction occurred to UVA after 6 months of treatment.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "A. Combalia, C. Fernández-Sartorio, P. Aguilera" "autores" => array:3 [ 0 => array:2 [ "nombre" => "A." "apellidos" => "Combalia" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Fernández-Sartorio" ] 2 => array:2 [ "nombre" => "P." "apellidos" => "Aguilera" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0001731017300133" "doi" => "10.1016/j.ad.2016.11.015" "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/S0001731017300133?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157821901730207X?idApp=UINPBA000044" "url" => "/15782190/0000010800000006/v1_201706300050/S157821901730207X/v1_201706300050/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Periarticular Thenar Erythema and Onycholysis Syndrome: A Manifestation of Taxane-Induced Cutaneous Toxicity" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor</span>:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "595" "paginaFinal" => "597" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "E. Rodríguez-Lomba, I. Molina-López, R. Suárez-Fernández, O. Baniandrés-Rodríguez" "autores" => array:4 [ 0 => array:4 [ "nombre" => "E." "apellidos" => "Rodríguez-Lomba" "email" => array:1 [ 0 => "enriquerlomba@outlook.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "I." "apellidos" => "Molina-López" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Suárez-Fernández" ] 3 => array:2 [ "nombre" => "O." "apellidos" => "Baniandrés-Rodríguez" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Síndrome de eritema tenar periarticular y onicolisis: una manifestación de toxicidad cutánea por taxanos" ] ] "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" => 1266 "Ancho" => 950 "Tamanyo" => 369100 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Histology of the lesion on the dorsum of the hand of patient<span class="elsevierStyleHsp" style=""></span>2. A, Hyperkeratotic epidermis with parakeratosis, foci of vacuolar degeneration of the basal layer, and a band-like perivascular infiltrate with occasional eosinophils. Hematoxylin and eosin, original magnification ×10. B, At higher power, evidence of necrotic keratinocytes in the epidermis. Hematoxylin and eosin, original magnification<span class="elsevierStyleHsp" style=""></span>×40.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In recent years, the widespread use of taxane-based chemotherapy regimens for the management of malignant tumors of various origins has evidenced the high frequency of cutaneous toxicity induced by this pharmacological group.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> In 2003, among its possible manifestations, Childress and Lokich<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> defined periarticular thenar erythema and onycholysis (PATEO) syndrome as a rare subtype of hand-foot syndrome associated with nail changes in patients treated with paclitaxel and docetaxel. In contrast to typical palmar-plantar erythrodysesthesia, or classic hand-foot syndrome, skin involvement in this syndrome is characterized by an absence of involvement of the palms and soles and by the presence of alterations predominantly affecting the dorsum of the hands (particularly around the base of the thumb and fifth finger), the area of the Achilles tendon, and the perimaleolar skin.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We present 3 patients on chemotherapy with taxanes who developed clinical manifestations similar to those described in this syndrome.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The 3 patients were women aged 35, 56, and 68 years, with infiltrating ductal adenocarcinoma of the breast on adjuvant treatment with docetaxel and cyclophosphamide (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). They sought dermatologic evaluation for the appearance of painful erythematous-violaceous plaques with fine superficial desquamation on the dorsum of both hands (Fig. 1A). The lesions interfered with their activities of daily living. The lesions had arisen 3 to 12 days after the administration of chemotherapy, and showed a clearly progressive deterioration with each cycle, despite the use of topical corticosteroids. Associated nail involvement in the 3 cases varied from fine parallel Beau lines and subungual splinter hemorrhages to frank distal onycholysis of the nail plate (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> B). Physical examination revealed no lesions on the rest of the skin, and the patients presented an otherwise good general state of health. Histology of a 4-mm punch biopsy from the dorsum of the hand of patient number 2 revealed a hyperkeratotic epidermis with parakeratosis, necrotic keratinocytes, focal vacuolar degeneration of the basal layer, and a band-like perivascular lymphocytic inflammatory infiltrate with occasional eosinophils (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>,<span class="elsevierStyleHsp" style=""></span>A and<span class="elsevierStyleHsp" style=""></span>B). These findings were consistent with a clinical suspicion of taxane-induced toxicity. Dose adjustment of the chemotherapy, together with the application of topical corticosteroid therapy under occlusion controlled the lesions and significantly improved symptoms in all 3 patients. Only 1 patient required a single course of a tapered regimen of oral corticosteroids for a severe deterioration of the lesions on the dorsum of the hands that interfered with her activities of daily living.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">PATEO syndrome is a manifestation of taxane-induced cutaneous toxicity predominantly affecting acral areas and with associated nail alterations. The frequency of this complication has been reported as 10% and 5%, respectively, in patients treated with paclitaxel and docetaxel, and its intensity appears to increase with the cumulative dose and with weekly regimens.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,3</span></a> Skin involvement is characterized by the presence of painful erythematous-violaceous plaques on the dorsum of the hands, on the feet, and in the area of the Achilles tendon; these lesions can subsequently develop vesicles and flaking. Severity is very variable, from asymptomatic forms to ones that have a marked impact on the basic activities of daily living. Some classifications, such as those of the World Health Organization and the National Cancer Institute, have established criteria of severity to evaluate acral skin involvement.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4,7</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Nail changes in these patients are due to the cytotoxic effect of taxanes and their presence is characteristic of this condition, in contrast to other hand-foot syndromes secondary to anthracyclines or multikinase inhibitors.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a> The cytotoxicity of these agents is due to their inhibition of microtubule function in cell division, and is most intense in those epithelia with high rates of cell proliferation, such as the nail matrix. The most common changes described after the administration of these drugs are Beau lines, onychomadesis, onycholysis, subungual splinter hemorrhages, subungual hematomas, leukonychia, paronychia, and nail hyperpigmentation.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4,5</span></a> Although the clinical manifestations are not usually severe, some manifestations, such as subungual hematomas, abscesses, and distal onycholysis can cause significant morbidity in oncologic patients and must be taken into consideration.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Histology of the skin lesions reveals changes similar to those observed in typical palmar-plantar erythrodysesthesia induced by other chemotherapeutic agents. It is characterized by the presence of a hyperkeratotic and acanthotic epidermis, with necrotic keratinocytes, focal vacuolar degeneration of the basal layer, blood-vessel dilatation, and a lichenoid inflammatory infiltrate with few lymphocytes, neutrophils, or eosinophils.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3,7</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">In clinical practice, the impact of PATEO syndrome on the quality of life of oncology patients is a frequent cause of dose reduction of the chemotherapy regimen, as occurred in our patient number 2. In the most severe and disabling cases, discontinuation of treatment may even be indicated.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> Preventive measures are an essential strategy to reduce the morbidity associated with these treatments in debilitated patients. Local hypothermia using socks or gloves during infusions of the drug can be effective, though this cannot be extended to other chemotherapy regimens with oral administration.<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">9,10</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Given the high frequency of dermatologic consultations related to the side effects of chemotherapy in oncology patients, we consider it important to be aware of this atypical form of acral erythema and of its management as, in disabling cases, it can require dose reduction or a temporary interruption of the chemotherapy treatment. It is notable that all 3 of our patients were on combined treatment with cyclophosphamide and docetaxel for adenocarcinoma of the breast, and the possibility that the combination may have increased the cutaneous morbidity compared with the administration of docetaxel in monotherapy cannot therefore be excluded.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of Interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Please cite this article as: Rodríguez-Lomba E, Molina-López I, Suárez-Fernández R, Baniandrés-Rodríguez O. Síndrome de eritema tenar periarticular y onicolisis: una manifestación de toxicidad cutánea por taxanos. Actas Dermosifiliogr. 2017;108:595–597.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1219 "Ancho" => 900 "Tamanyo" => 177042 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Periarticular thenar erythema and onycholysis syndrome: Docetaxel-induced skin and nail changes. A, Patient<span class="elsevierStyleHsp" style=""></span>1. Erythematous-violaceous plaques on the dorsum of the hands and over the proximal phalanx. B, Nail changes in patient 3: parallel Beau lines and onycholysis of the distal third of the nail plate.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1266 "Ancho" => 950 "Tamanyo" => 369100 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Histology of the lesion on the dorsum of the hand of patient<span class="elsevierStyleHsp" style=""></span>2. A, Hyperkeratotic epidermis with parakeratosis, foci of vacuolar degeneration of the basal layer, and a band-like perivascular infiltrate with occasional eosinophils. Hematoxylin and eosin, original magnification ×10. B, At higher power, evidence of necrotic keratinocytes in the epidermis. Hematoxylin and eosin, original magnification<span class="elsevierStyleHsp" style=""></span>×40.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:3 [ "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Abbreviations: G-CSF, granulocyte colony stimulating factor; NCI, National Cancer Institute.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sex \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age, y \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tumor \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Adjuvant Chemotherapy \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Latency<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Cumulative Dose<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">NCI Grade<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Treatment \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">56 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Infiltrating ductal adenocarcinoma of the right breast, T2N1M0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Docetaxel<span class="elsevierStyleHsp" style=""></span>+ cyclophosphamide \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12 d \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Third cycle \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Topical corticosteroid<br>Oral pyridoxine \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">35 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Infiltrating ductal adenocarcinoma of the left breast, T2N0M0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Docetaxel<span class="elsevierStyleHsp" style=""></span>+ cyclophosphamide<span class="elsevierStyleHsp" style=""></span>+ G-CSF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 d \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Second cycle \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Topical corticosteroid<br>Tapering regimen of prednisone \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">68 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Infiltrating ductal adenocarcinoma of the left breast, T2N0M0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Docetaxel<span class="elsevierStyleHsp" style=""></span>+ cyclophosphamide<span class="elsevierStyleHsp" style=""></span>+ G-CSF \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 d \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Second cycle \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Topical corticosteroid \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1450901.png" ] ] ] "notaPie" => array:3 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Time to onset of symptoms after the most recent administration of chemotherapy.</p>" ] 1 => array:3 [ "identificador" => "tblfn0010" "etiqueta" => "b" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Chemotherapy cycle being administered when symptoms first arose.</p>" ] 2 => array:3 [ "identificador" => "tblfn0015" "etiqueta" => "c" "nota" => "<p class="elsevierStyleNotepara" id="npar0015">National Cancer Institute classification of the severity of acral erythema.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4,7</span></a></p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Epidemiologic, Clinical, and Therapeutic Details of 3 Cases of Periarticular Thenar Erythema and Onycholysis Syndrome.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "203.e1-203e12" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cutaneous reactions to chemotherapeutic drugs and targeted therapies for cancer: Part I. Conventional chemotherapeutic drugs" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.M. Reyes-Habito" 1 => "E.K. Roh" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2014" "volumen" => "71" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cutaneous hand and foot toxicity associated with cancer chemotherapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Childress" 1 => "J. Lokich" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.coc.0000026486.56886.18" "Revista" => array:6 [ "tituloSerie" => "Am J Clin Oncol" "fecha" => "2003" "volumen" => "26" "paginaInicial" => "435" "paginaFinal" => "436" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14528066" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antimicrotubule agents" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "C. Garbe" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:5 [ "titulo" => "Dermatologic principles and practice in oncology: Conditions of the skin, hair and nails in cancer patients" "paginaInicial" => "208" "paginaFinal" => "214" "edicion" => "1st ed" "serieFecha" => "2014" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chemotherapy-induced hand-foot syndrome and nail changes: A review of clinical presentation, etiology, pathogenesis, and management" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K.K. Miller" 1 => "L. Gorcey" 2 => "B.N. McLellan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2014.03.019" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2014" "volumen" => "71" "paginaInicial" => "787" "paginaFinal" => "794" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24795111" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Taxane-induced nail changes: Incidence, clinical presentation and outcome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A.M. Minisini" 1 => "A. Tosti" 2 => "A.F. Sobrero" 3 => "M. Mansutti" 4 => "B.M. Piraccini" 5 => "C. Sacco" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Oncol" "fecha" => "2003" "volumen" => "14" "paginaInicial" => "333" "paginaFinal" => "337" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12562663" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nail changes due to docetaxel–a neglected side effect and nuisance for the patient" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D. Winther" 1 => "D.M. Saunte" 2 => "M. Knap" 3 => "V. Haahr" 4 => "A.B. Jensen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00520-007-0232-0" "Revista" => array:6 [ "tituloSerie" => "Support Care Cancer" "fecha" => "2007" "volumen" => "15" "paginaInicial" => "1191" "paginaFinal" => "1197" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17318589" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Chemotherapy-induced acral erythema: A clinical and histopathologic study of 44 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Hueso" 1 => "O. Sanmartín" 2 => "E. Nagore" 3 => "R. Botella-Estrada" 4 => "C. Requena" 5 => "B. Llombart" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2008" "volumen" => "99" "paginaInicial" => "281" "paginaFinal" => "290" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18394404" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Palmar-plantar erythrodysesthesia associated with chemotherapy and its treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K.P. Farr" 1 => "A. Safwat" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000327767" "Revista" => array:6 [ "tituloSerie" => "Case Rep Oncol" "fecha" => "2011" "volumen" => "4" "paginaInicial" => "229" "paginaFinal" => "235" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21537373" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Matched case-control phase 2 study to evaluate the use of a frozen sock to prevent docetaxel-induced onycholysis and cutaneous toxicity of the foot" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Scotte" 1 => "E. Banu" 2 => "J. Medioni" 3 => "E. Levy" 4 => "C. Ebenezer" 5 => "S. Marsan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/cncr.23333" "Revista" => array:6 [ "tituloSerie" => "Cancer" "fecha" => "2008" "volumen" => "112" "paginaInicial" => "1625" "paginaFinal" => "1631" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18286527" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multicenter study of a frozen glove to prevent docetaxel-induced onycholysis and cutaneous toxicity of the hand" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Scotte" 1 => "J.M. Tourani" 2 => "E. Banu" 3 => "M. Peyromaure" 4 => "E. Levy" 5 => "S. Marsan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1200/JCO.2005.15.651" "Revista" => array:6 [ "tituloSerie" => "J Clin Oncol" "fecha" => "2005" "volumen" => "23" "paginaInicial" => "4424" "paginaFinal" => "4429" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15994152" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010800000006/v1_201706300050/S1578219017301439/v1_201706300050/en/main.assets" "Apartado" => array:4 [ "identificador" => "6157" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case and Research Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010800000006/v1_201706300050/S1578219017301439/v1_201706300050/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017301439?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 7 | 13 | 20 |
| 2024 Octubre | 113 | 70 | 183 |
| 2024 Septiembre | 110 | 64 | 174 |
| 2024 Agosto | 128 | 84 | 212 |
| 2024 Julio | 209 | 105 | 314 |
| 2024 Junio | 104 | 47 | 151 |
| 2024 Mayo | 93 | 44 | 137 |
| 2024 Abril | 88 | 25 | 113 |
| 2024 Marzo | 106 | 35 | 141 |
| 2024 Febrero | 78 | 39 | 117 |
| 2024 Enero | 92 | 38 | 130 |
| 2023 Diciembre | 72 | 23 | 95 |
| 2023 Noviembre | 90 | 32 | 122 |
| 2023 Octubre | 88 | 32 | 120 |
| 2023 Septiembre | 96 | 37 | 133 |
| 2023 Agosto | 74 | 28 | 102 |
| 2023 Julio | 91 | 59 | 150 |
| 2023 Junio | 95 | 39 | 134 |
| 2023 Mayo | 97 | 68 | 165 |
| 2023 Abril | 101 | 31 | 132 |
| 2023 Marzo | 89 | 47 | 136 |
| 2023 Febrero | 78 | 36 | 114 |
| 2023 Enero | 66 | 48 | 114 |
| 2022 Diciembre | 90 | 41 | 131 |
| 2022 Noviembre | 51 | 35 | 86 |
| 2022 Octubre | 65 | 30 | 95 |
| 2022 Septiembre | 30 | 37 | 67 |
| 2022 Agosto | 27 | 55 | 82 |
| 2022 Julio | 22 | 49 | 71 |
| 2022 Junio | 33 | 22 | 55 |
| 2022 Mayo | 121 | 56 | 177 |
| 2022 Abril | 141 | 43 | 184 |
| 2022 Marzo | 130 | 49 | 179 |
| 2022 Febrero | 111 | 34 | 145 |
| 2022 Enero | 120 | 54 | 174 |
| 2021 Diciembre | 96 | 39 | 135 |
| 2021 Noviembre | 83 | 51 | 134 |
| 2021 Octubre | 79 | 64 | 143 |
| 2021 Septiembre | 92 | 49 | 141 |
| 2021 Agosto | 136 | 37 | 173 |
| 2021 Julio | 95 | 36 | 131 |
| 2021 Junio | 65 | 44 | 109 |
| 2021 Mayo | 90 | 56 | 146 |
| 2021 Abril | 216 | 95 | 311 |
| 2021 Marzo | 126 | 50 | 176 |
| 2021 Febrero | 104 | 47 | 151 |
| 2021 Enero | 73 | 33 | 106 |
| 2020 Diciembre | 67 | 26 | 93 |
| 2020 Noviembre | 54 | 25 | 79 |
| 2020 Octubre | 97 | 21 | 118 |
| 2020 Septiembre | 81 | 27 | 108 |
| 2020 Agosto | 54 | 28 | 82 |
| 2020 Julio | 59 | 18 | 77 |
| 2020 Junio | 83 | 43 | 126 |
| 2020 Mayo | 26 | 14 | 40 |
| 2020 Abril | 24 | 14 | 38 |
| 2020 Marzo | 20 | 11 | 31 |
| 2020 Febrero | 6 | 0 | 6 |
| 2020 Enero | 4 | 0 | 4 |
| 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 | 4 | 0 | 4 |
| 2019 Mayo | 4 | 0 | 4 |
| 2019 Abril | 3 | 0 | 3 |
| 2019 Febrero | 2 | 0 | 2 |
| 2019 Enero | 4 | 0 | 4 |
| 2018 Diciembre | 3 | 0 | 3 |
| 2018 Octubre | 1 | 0 | 1 |
| 2018 Septiembre | 8 | 0 | 8 |
| 2018 Febrero | 51 | 4 | 55 |
| 2018 Enero | 69 | 6 | 75 |
| 2017 Diciembre | 67 | 8 | 75 |
| 2017 Noviembre | 53 | 4 | 57 |
| 2017 Octubre | 54 | 7 | 61 |
| 2017 Septiembre | 40 | 10 | 50 |
| 2017 Agosto | 65 | 19 | 84 |
| 2017 Julio | 75 | 22 | 97 |
| 2017 Junio | 26 | 16 | 42 |
Mostrar todo
