Case and Research Letter
Melanomas Arising on Tattoos: A Casual Association with Practical Implications
Melanomas sobre tatuajes: una asociación casual con implicaciones prácticas
Leído
6284
Vecesse ha leído el artículo
2345
Total PDF
3939
Total HTML
Compartir estadísticas
array:24 [ "pii" => "S1578219017301932" "issn" => "15782190" "doi" => "10.1016/j.adengl.2017.06.006" "estado" => "S300" "fechaPublicacion" => "2017-09-01" "aid" => "1635" "copyright" => "Elsevier España, S.L.U. and AEDV" "copyrightAnyo" => "2017" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2017;108:678-80" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 635 "formatos" => array:3 [ "EPUB" => 28 "HTML" => 495 "PDF" => 112 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731017301229" "issn" => "00017310" "doi" => "10.1016/j.ad.2016.11.023" "estado" => "S300" "fechaPublicacion" => "2017-09-01" "aid" => "1635" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2017;108:678-80" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 191 "formatos" => array:3 [ "EPUB" => 4 "HTML" => 136 "PDF" => 51 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">CARTA CIENTÍFICO-CLÍNICA</span>" "titulo" => "Melanomas sobre tatuajes: una asociación casual con implicaciones prácticas" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "678" "paginaFinal" => "680" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Melanomas Arising on Tattoos: A Casual Association with Practical Implications" ] ] "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" => 780 "Ancho" => 1500 "Tamanyo" => 315252 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A) Melanoma en el miembro superior izquierdo sobre tatuaje de más de 60 años de antigüedad. B) Imagen histológica del melanoma en la que se puede apreciar la presencia de pigmento del tatuaje (H&E, ×4. Detalle inferior derecho, ×40).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Armengot-Carbó, N. Barrado-Solís, C. Martínez-Lahuerta, E. Gimeno-Carpio" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Armengot-Carbó" ] 1 => array:2 [ "nombre" => "N." "apellidos" => "Barrado-Solís" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Martínez-Lahuerta" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Gimeno-Carpio" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219017301932" "doi" => "10.1016/j.adengl.2017.06.006" "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/S1578219017301932?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731017301229?idApp=UINPBA000044" "url" => "/00017310/0000010800000007/v2_201708291352/S0001731017301229/v2_201708291352/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219017302135" "issn" => "15782190" "doi" => "10.1016/j.adengl.2017.06.016" "estado" => "S300" "fechaPublicacion" => "2017-09-01" "aid" => "1634" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2017;108:680-3" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 583 "formatos" => array:3 [ "EPUB" => 32 "HTML" => 428 "PDF" => 123 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>" "titulo" => "Cerebral Cavernous Malformation: When the Key to Diagnosis Is on the Skin" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "680" "paginaFinal" => "683" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cavernomatosis cerebral múltiple: cuando la clave del diagnóstico está en la piel" ] ] "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" => 1535 "Ancho" => 1521 "Tamanyo" => 414530 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, Angiokeratoma on the knee. B, Dermoscopic image with vascular lacunae and a superficial scab. C, Histology showing vessels with fibrin thrombi in the dermis and epidermal hyperplasia. Hematoxylin and eosin, original magnification<span class="elsevierStyleHsp" style=""></span>×4. D, Axial T2-weighted cerebral magnetic resonance image: cerebral cavernous malformation.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.M. Escudero-Góngora, A. Bauzá, A. Giacaman, A. Martín-Santiago" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M.M." "apellidos" => "Escudero-Góngora" ] 1 => array:2 [ "nombre" => "A." "apellidos" => "Bauzá" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Giacaman" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Martín-Santiago" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731017301217" "doi" => "10.1016/j.ad.2016.12.019" "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/S0001731017301217?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017302135?idApp=UINPBA000044" "url" => "/15782190/0000010800000007/v2_201708291348/S1578219017302135/v2_201708291348/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219017302159" "issn" => "15782190" "doi" => "10.1016/j.adengl.2017.06.018" "estado" => "S300" "fechaPublicacion" => "2017-09-01" "aid" => "1636" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2017;108:675-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 659 "formatos" => array:3 [ "EPUB" => 29 "HTML" => 523 "PDF" => 107 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>" "titulo" => "Reticulate Acropigmentation of Kitamura and Nevus of Ito" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "675" "paginaFinal" => "677" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Acropigmentación reticulada de Kitamura y nevus de Ito" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 827 "Ancho" => 2133 "Tamanyo" => 453436 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A, Findings from a biopsy specimen taken from the wrist. Note the lentiginous epidermal hyperplasia with hyperpigmented bulbous projections of the epidermal rete ridges and increased basal melanocytes (hematoxylin-eosin [H-E], original magnification ×10; detail (inset), original magnification ×40). B, Findings from a biopsy specimen taken from the back. Notice the dendritic melanocytes in the reticular and papillary dermis and hyperpigmentation of the basal layer of the epidermis (H-E, original magnification ×20).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. García-Arpa, M. Franco-Muñoz, M.A. Flores-Terry, C. Ramos-Rodríguez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "García-Arpa" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Franco-Muñoz" ] 2 => array:2 [ "nombre" => "M.A." "apellidos" => "Flores-Terry" ] 3 => array:2 [ "nombre" => "C." "apellidos" => "Ramos-Rodríguez" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731017301230" "doi" => "10.1016/j.ad.2016.11.024" "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/S0001731017301230?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017302159?idApp=UINPBA000044" "url" => "/15782190/0000010800000007/v2_201708291348/S1578219017302159/v2_201708291348/en/main.assets" ] "en" => array:17 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>" "titulo" => "Melanomas Arising on Tattoos: A Casual Association with Practical Implications" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor:</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "678" "paginaFinal" => "680" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M. Armengot-Carbó, N. Barrado-Solís, C. Martínez-Lahuerta, E. Gimeno-Carpio" "autores" => array:4 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "Armengot-Carbó" "email" => array:1 [ 0 => "miquelarmengot@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" => "N." "apellidos" => "Barrado-Solís" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "C." "apellidos" => "Martínez-Lahuerta" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "E." "apellidos" => "Gimeno-Carpio" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital General Universitario de Castellón, Castellón de la Plana, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital General Universitario de Castellón, Castellón de la Plana, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Arnau de Vilanova, Valencia, Spain" "etiqueta" => "c" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Melanomas sobre tatuajes: una asociación casual con implicaciones prácticas" ] ] "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" => 780 "Ancho" => 1500 "Tamanyo" => 315252 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, Melanoma on the left arm over a tattoo that is more than 60 years old. B, Histopathology of the melanoma, in which tattoo ink is visible (hematoxylin-eosin, original magnification ×4). The inset shows a more detailed image (original magnification ×40).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 35-year-old man came to the clinic after noticing changes in a pigmented lesion on his right arm, where he had had a tattoo some 2 years previously. When the tattoo was placed, the tattooist avoided a pre-existing nevus, although during recent months this had grown until it reached the tattoo and came to the patient's attention (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> A and B). Clinical suspicion led us to remove the lesion. Histopathology showed it to be a superficial melanoma (Breslow depth, 0.35<span class="elsevierStyleHsp" style=""></span>mm) that had developed from a dysplastic nevus (Fig 1 C and D).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Another patient (82 years) was referred by his family doctor with a suspected melanoma, which took the form of a pigmented lesion on a tattoo on the left arm that was observed during an examination for other reasons. The tattoo was more than 60 years old and the patient had not noticed the lesion for which he was referred, namely, an asymmetrical pigmented macule with irregular borders and various colors, with areas suggestive of regression (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a> A). Histopathology confirmed the lesion to be a superficial, partially regressing melanoma (Breslow depth, 0.4<span class="elsevierStyleHsp" style=""></span>mm) with no associated lesions.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">A possible pathogenic association between tattoos and melanoma has been the subject of speculation in the literature, with potential causes including local trauma, the carcinogenic potential of the ink, and even a possible increase in absorption of ultraviolet radiation.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> However, this finding is now considered a mere coincidence.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1–3</span></a> In recent years, we have seen a marked increase in the popularity of permanent tattoos in Spain, especially among young people. The estimated prevalence of tattoos in Europe is 10%, which increases to 25% in adults aged 20-35 years.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> However, cases of melanoma on tattoos are still rare,<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> as demonstrated by the fact that only 28 cases have been reported in the literature to date (30 counting the 2 cases reported here).<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1–10</span></a> Together with the lack of cases of multiple melanoma over a single tattoo, this supports the notion that the association between tattoos and melanoma is merely casual.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1–3</span></a> Nevertheless, the finding of melanoma on a tattoo has several relevant implications.</p><p id="par0020" class="elsevierStylePara elsevierViewall">On the one hand, the presence of a tattoo usually masks pigmented lesions and hampers early diagnosis of a potential melanoma on the part of both the patient and the dermatologist, thus leading to a delay in diagnosis.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1–8</span></a> It is essential to raise awareness among the population in general and among tattooists in particular that a tattoo should never be placed over pre-existing pigmented lesions.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1,6</span></a> Similarly, when examining a patient with tattoos, the dermatologist should pay special attention to tattooed skin in order to avoid overlooking a hidden suspicious lesion.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,8</span></a> Of note, in the first patient we report and in 2 cases in the literature,<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">9,10</span></a> the cosmetic alteration in the tattooed image caused by the melanoma made it easy for the patient to notice it, thus making for earlier detection than if the lesion had appeared at another site. Although these cases are exceptions to what we report above, there is no doubt that if tattooists adopted the practice of leaving an area of healthy skin around pre-existing nevi, any changes these could subsequently undergo would be more easily detected.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">On the other hand, there is a risk that if a tattoo is placed on a pigmented lesion, this may already be a melanoma, and multiple metastatic deposits could be seeded during placement, as occurred in a recently published case,<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> thus highlighting the importance of avoiding previously pigmented lesions. Therefore, in specific cases with a risk of melanoma (patients with atypical nevus syndrome, multiple nevi, or a family history of melanoma), the individual should undergo a dermatological assessment before having the tattoo.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Finally, before a tattoo is eliminated by laser, the tattooed skin should be carefully examined—both clinically and dermoscopically<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a>—to detect potentially hidden pigmented lesions and avoid applying laser therapy over the areas affected (since this can alter their characteristics and lead to subsequent diagnostic errors). Alternatively, the lesions should be removed before laser therapy if they are suspected of being melanomas. Therefore, laser removal of tattoos should only be performed by dermatologists.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">In conclusion, we present 2 new cases of melanoma on a tattoo. Although the association appears to be casual, it has several implications: the need for close attention during examination of the tattooed skin, the importance of raising awareness among tattooists and users that pigmented lesions should not be tattooed, and the importance of the fact that laser removal of a tattoo should always be performed by a dermatologist.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of Interest" ] 1 => array:2 [ "identificador" => "xack297048" "titulo" => "Acknowledgments" ] 2 => 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: Armengot-Carbó M, Barrado-Solís N, Martínez-Lahuerta C, Gimeno-Carpio E. Melanomas sobre tatuajes: una asociación casual con implicaciones prácticas. Actas Dermosifiliogr. 2017;108:678–680.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1130 "Ancho" => 1500 "Tamanyo" => 389623 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, Melanoma over a recent tattoo on the right arm. B, Dermoscopic image showing striking asymmetry of colors and structures and highlighting the presence of an atypical pigment network, pseudopods, and irregularly distributed globules and spots. C, Histopathology based on HMB45-Ki67 immunohistochemistry showing the presence of nests of neoplastic cells in the dermis (red), as well as black granules of tattoo ink inside macrophages and free in the dermis (HMB45-Ki67, original magnification ×4). D, Detail of the black granules of tattoo ink (HMB45-Ki67, original magnification ×40).</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" => 780 "Ancho" => 1500 "Tamanyo" => 315252 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, Melanoma on the left arm over a tattoo that is more than 60 years old. B, Histopathology of the melanoma, in which tattoo ink is visible (hematoxylin-eosin, original magnification ×4). The inset shows a more detailed image (original magnification ×40).</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:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Melanoma arising in a tattoo: Case report and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "K.A. Nolan" 1 => "M. Kling" 2 => "M. Birge" 3 => "A. Kling" 4 => "S. Fishman" 5 => "R. Phelps" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Cutis" "fecha" => "2013" "volumen" => "92" "paginaInicial" => "227" "paginaFinal" => "230" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24343207" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Melanoma on a tattoo" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "N. Kluger" 1 => "K. Saarinen" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.lpm.2014.10.016" "Revista" => array:6 [ "tituloSerie" => "Presse Med" "fecha" => "2015" "volumen" => "44" "paginaInicial" => "473" "paginaFinal" => "475" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25707574" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Melanoma on tattoos: Two Finnish cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "N. Kluger" 1 => "S. Koskenmies" 2 => "L. Jeskanen" 3 => "M. Övermark" 4 => "O. Saksela" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2340/00015555-1705" "Revista" => array:6 [ "tituloSerie" => "Acta Derm Venereol" "fecha" => "2014" "volumen" => "94" "paginaInicial" => "325" "paginaFinal" => "326" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24096729" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pitfalls and recommendations in cases of laser removal of decorative tattoos with pigmented lesions: Case report and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Pohl" 1 => "K. Kaiser" 2 => "C. Raulin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamadermatol.2013.4901" "Revista" => array:6 [ "tituloSerie" => "JAMA Dermatol" "fecha" => "2013" "volumen" => "149" "paginaInicial" => "1087" "paginaFinal" => "1089" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23903803" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Melanoma and melanocytic nevi in decorative tattoos: Three case reports" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E. Varga" 1 => "I. Korom" 2 => "J. Varga" 3 => "J. Kohán" 4 => "L. Kemény" 5 => "J. Oláh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1600-0560.2011.01788.x" "Revista" => array:6 [ "tituloSerie" => "J Cutan Pathol" "fecha" => "2011" "volumen" => "38" "paginaInicial" => "994" "paginaFinal" => "998" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21883372" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Malignant melanoma disguised in a tattoo" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E.P. Anthony" 1 => "A. Godbolt" 2 => "F. Tang" 3 => "E.K. McMeniman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ajd.12219" "Revista" => array:6 [ "tituloSerie" => "Australas J Dermatol" "fecha" => "2015" "volumen" => "56" "paginaInicial" => "232" "paginaFinal" => "233" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26201372" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Malignant melanoma arising in red tattoo ink" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C.W. Joyce" 1 => "G. Duff" 2 => "D. McKenna" 3 => "P.J. Regan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5999/aps.2015.42.4.475" "Revista" => array:6 [ "tituloSerie" => "Arch Plast Surg" "fecha" => "2015" "volumen" => "42" "paginaInicial" => "475" "paginaFinal" => "477" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26217569" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Melanoma in a Chinese dragon tattoo" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G. Tchernev" 1 => "A.A. Chokoeva" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0140-6736(15)01038-7" "Revista" => array:3 [ "tituloSerie" => "Lancet" "fecha" => "2015" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26313074" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "When a melanoma is uncovered by a tattoo" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Caccavale" 1 => "E. Moscarella" 2 => "G. de Fata Salvatores" 3 => "V. Piccolo" 4 => "T. Russo" 5 => "G. Argenziano" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ijd.13124" "Revista" => array:6 [ "tituloSerie" => "Int J Dermatol" "fecha" => "2016" "volumen" => "55" "paginaInicial" => "79" "paginaFinal" => "80" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26518737" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A dangerous fruit of Belladonna" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "T. Deinlein" 1 => "E. Arzberger" 2 => "F. Scarfi" 3 => "R. Fink Puches" 4 => "R. Hofmann-Wellenhof" 5 => "I. Zalaudek" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2016.01.007" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2016" "volumen" => "75" "paginaInicial" => "e93" "paginaFinal" => "e94" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27543242" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack297048" "titulo" => "Acknowledgments" "texto" => "<p id="par0045" class="elsevierStylePara elsevierViewall">We are grateful to Dr. Josefa San Juan and to Dr. José Ferrando from the Histopathology Department of Hospital Arnau de Vilanova, Valencia, Spain for providing us with access to the sections in the second case.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010800000007/v2_201708291348/S1578219017301932/v2_201708291348/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/15782190/0000010800000007/v2_201708291348/S1578219017301932/v2_201708291348/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017301932?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 13 | 13 | 26 |
| 2024 Octubre | 90 | 57 | 147 |
| 2024 Septiembre | 111 | 26 | 137 |
| 2024 Agosto | 130 | 100 | 230 |
| 2024 Julio | 92 | 36 | 128 |
| 2024 Junio | 105 | 47 | 152 |
| 2024 Mayo | 106 | 34 | 140 |
| 2024 Abril | 92 | 25 | 117 |
| 2024 Marzo | 101 | 32 | 133 |
| 2024 Febrero | 90 | 36 | 126 |
| 2024 Enero | 74 | 28 | 102 |
| 2023 Diciembre | 71 | 28 | 99 |
| 2023 Noviembre | 89 | 28 | 117 |
| 2023 Octubre | 65 | 40 | 105 |
| 2023 Septiembre | 62 | 31 | 93 |
| 2023 Agosto | 38 | 26 | 64 |
| 2023 Julio | 73 | 50 | 123 |
| 2023 Junio | 65 | 36 | 101 |
| 2023 Mayo | 63 | 36 | 99 |
| 2023 Abril | 69 | 31 | 100 |
| 2023 Marzo | 69 | 40 | 109 |
| 2023 Febrero | 70 | 26 | 96 |
| 2023 Enero | 56 | 40 | 96 |
| 2022 Diciembre | 70 | 51 | 121 |
| 2022 Noviembre | 38 | 23 | 61 |
| 2022 Octubre | 27 | 14 | 41 |
| 2022 Septiembre | 37 | 42 | 79 |
| 2022 Agosto | 41 | 35 | 76 |
| 2022 Julio | 21 | 42 | 63 |
| 2022 Junio | 16 | 36 | 52 |
| 2022 Mayo | 84 | 53 | 137 |
| 2022 Abril | 62 | 40 | 102 |
| 2022 Marzo | 53 | 53 | 106 |
| 2022 Febrero | 59 | 47 | 106 |
| 2022 Enero | 55 | 63 | 118 |
| 2021 Diciembre | 50 | 53 | 103 |
| 2021 Noviembre | 50 | 67 | 117 |
| 2021 Octubre | 69 | 61 | 130 |
| 2021 Septiembre | 34 | 48 | 82 |
| 2021 Agosto | 57 | 39 | 96 |
| 2021 Julio | 47 | 37 | 84 |
| 2021 Junio | 47 | 39 | 86 |
| 2021 Mayo | 56 | 59 | 115 |
| 2021 Abril | 110 | 110 | 220 |
| 2021 Marzo | 94 | 36 | 130 |
| 2021 Febrero | 79 | 47 | 126 |
| 2021 Enero | 54 | 48 | 102 |
| 2020 Diciembre | 65 | 34 | 99 |
| 2020 Noviembre | 43 | 28 | 71 |
| 2020 Octubre | 23 | 21 | 44 |
| 2020 Septiembre | 39 | 22 | 61 |
| 2020 Agosto | 34 | 25 | 59 |
| 2020 Julio | 30 | 21 | 51 |
| 2020 Junio | 39 | 42 | 81 |
| 2020 Mayo | 24 | 22 | 46 |
| 2020 Abril | 21 | 16 | 37 |
| 2020 Marzo | 21 | 13 | 34 |
| 2020 Febrero | 8 | 0 | 8 |
| 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 | 2 | 0 | 2 |
| 2019 Febrero | 5 | 0 | 5 |
| 2019 Enero | 1 | 0 | 1 |
| 2018 Diciembre | 4 | 2 | 6 |
| 2018 Noviembre | 1 | 0 | 1 |
| 2018 Octubre | 3 | 0 | 3 |
| 2018 Septiembre | 1 | 0 | 1 |
| 2018 Abril | 0 | 1 | 1 |
| 2018 Marzo | 0 | 1 | 1 |
| 2018 Febrero | 19 | 9 | 28 |
| 2018 Enero | 40 | 13 | 53 |
| 2017 Diciembre | 46 | 12 | 58 |
| 2017 Noviembre | 34 | 6 | 40 |
| 2017 Octubre | 50 | 10 | 60 |
| 2017 Septiembre | 191 | 25 | 216 |
| 2017 Agosto | 60 | 23 | 83 |
| 2017 Julio | 3 | 10 | 13 |
Mostrar todo
