Case and Research Letter
Ultrasound Appearance of Juvenile Xanthogranuloma
Imagen ecográfica de xantogranuloma juvenil
Leído
7619
Vecesse ha leído el artículo
2175
Total PDF
5444
Total HTML
Compartir estadísticas
array:24 [ "pii" => "S157821901730197X" "issn" => "15782190" "doi" => "10.1016/j.adengl.2017.06.009" "estado" => "S300" "fechaPublicacion" => "2017-09-01" "aid" => "1632" "copyright" => "Elsevier España, S.L.U. and AEDV" "copyrightAnyo" => "2017" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2017;108:683-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 676 "formatos" => array:3 [ "EPUB" => 33 "HTML" => 561 "PDF" => 82 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731017301199" "issn" => "00017310" "doi" => "10.1016/j.ad.2016.11.021" "estado" => "S300" "fechaPublicacion" => "2017-09-01" "aid" => "1632" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2017;108:683-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 246 "formatos" => array:3 [ "EPUB" => 4 "HTML" => 206 "PDF" => 36 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científico-clínica</span>" "titulo" => "Imagen ecográfica de xantogranuloma juvenil" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "683" "paginaFinal" => "685" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Ultrasound Appearance of Juvenile Xanthogranuloma" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figura 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1304 "Ancho" => 1625 "Tamanyo" => 445758 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A. H-E ×<span class="elsevierStyleHsp" style=""></span>20. Se observa una proliferación histiocítica difusa, que ocupa la totalidad de la dermis. B. (H-E ×<span class="elsevierStyleHsp" style=""></span>400. A mayor aumento la proliferación se encuentra constituida por células de núcleos ovalados isomorfos y citoplasma eosinófilo, mezcladas con células espumosas, algunas multinucleadas, entre las que se identifican ocasionales células de tipo Touton.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "C. Martínez-Morán, B. Echeverría-García, J.C. Tardío, J. Borbujo" "autores" => array:4 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Martínez-Morán" ] 1 => array:2 [ "nombre" => "B." "apellidos" => "Echeverría-García" ] 2 => array:2 [ "nombre" => "J.C." "apellidos" => "Tardío" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Borbujo" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S157821901730197X" "doi" => "10.1016/j.adengl.2017.06.009" "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/S157821901730197X?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731017301199?idApp=UINPBA000044" "url" => "/00017310/0000010800000007/v2_201708291352/S0001731017301199/v2_201708291352/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219017301944" "issn" => "15782190" "doi" => "10.1016/j.adengl.2017.06.007" "estado" => "S300" "fechaPublicacion" => "2017-09-01" "aid" => "1613" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2017;108:685-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1340 "formatos" => array:3 [ "EPUB" => 37 "HTML" => 1165 "PDF" => 138 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>" "titulo" => "Oral Ivermectin to Treat Papulopustular Rosacea in an Immunocompetent Patient" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "685" "paginaFinal" => "686" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento con ivermectina oral en un paciente inmunocompetente con rosácea pápulo-pustulosa" ] ] "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" => 656 "Ancho" => 1500 "Tamanyo" => 187285 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, Clinical appearance of the lesions before treatment with a single dose of oral ivermectin (250<span class="elsevierStyleHsp" style=""></span>μg/kg). B, Clinical appearance 6 months later.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Á. Hernández-Martín" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Á." "apellidos" => "Hernández-Martín" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731017300698" "doi" => "10.1016/j.ad.2017.01.011" "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/S0001731017300698?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017301944?idApp=UINPBA000044" "url" => "/15782190/0000010800000007/v2_201708291348/S1578219017301944/v2_201708291348/en/main.assets" ] "itemAnterior" => 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" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letter</span>" "titulo" => "Ultrasound Appearance of Juvenile Xanthogranuloma" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">Dear Editor:</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "683" "paginaFinal" => "685" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "C. Martínez-Morán, B. Echeverría-García, J.C. Tardío, J. Borbujo" "autores" => array:4 [ 0 => array:4 [ "nombre" => "C." "apellidos" => "Martínez-Morán" "email" => array:1 [ 0 => "cmmoran@salud.madrid.org" ] "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" => "B." "apellidos" => "Echeverría-García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "J.C." "apellidos" => "Tardío" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "J." "apellidos" => "Borbujo" "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 de Fuenlabrada, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital Universitario de Fuenlabrada, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Imagen ecográfica de xantogranuloma juvenil" ] ] "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" => 1304 "Ancho" => 1625 "Tamanyo" => 445758 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A, A diffuse histiocytic proliferation occupies the full thickness of the dermis. Hematoxylin and eosin, original magnification<span class="elsevierStyleHsp" style=""></span>×20. B, At higher power, the proliferation is seen to be formed of cells with isomorphic oval nuclei and eosinophilic cytoplasm, together with foam cells, some of which are multinucleated, including occasional Touton-type cells. Hematoxylin and eosin, original magnification<span class="elsevierStyleHsp" style=""></span>×400.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We present a 7-year-old girl with no past history of interest, who was seen for an asymptomatic lesion that had arisen in the right axilla 3 months earlier and had grown progressively, but that had remained stable after a cycle of cryotherapy in her health center 2 months earlier. Examination revealed a well-defined oval papule in the right axilla. The papule was of yellowish color centrally and more erythematous peripherally. No drainage orifice was present and no material was emitted when pressure was placed on the lesion (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Color Doppler ultrasound (Esaote MyLabClass C with an 18<span class="elsevierStyleHsp" style=""></span>MHz transducer) was performed, showing a well-defined, homogeneous, hypoechoic lesion in the dermis, measuring 6.5<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3.5<span class="elsevierStyleHsp" style=""></span>mm, and that depressed the subcutaneous cellular tissue (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). No posterior enhancement or lateral shadow was observed. Color Doppler showed no flow within the lesion.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">We performed complete excision of the lesion. Histopathology study revealed a diffuse histiocytic proliferation that occupied the full thickness of the dermis (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>A). The lesion was formed of cells with isomorphic oval nuclei and eosinophilic cytoplasm and foam cells, some of which were multinucleated, including occasional Touton-type cells (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>B). These cells were accompanied by numerous lymphocytes. No epidermotropism was observed. The diagnosis was xanthogranuloma.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Juvenile xanthogranuloma (JXG) is a benign histiocytic tumor characterized by being most common in the first 2 decades of life. Various classifications place this lesion in the non-Langerhans cell histiocytoses, together with other diseases such as disseminated xanthoma, diffuse eruptive histiocytosis, benign cephalic histiocytosis, and sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease).</p><p id="par0025" class="elsevierStylePara elsevierViewall">JXG is the most common histiocytic disease of childhood,<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> though its incidence may be underestimated due to the indolent, asymptomatic nature of these solitary lesions and their tendency to resolve spontaneously.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Clinically, it presents as yellowish papulonodular lesions in the skin and other organs, but it is not associated with metabolic disorders. It is the most common form of non-X histiocytosis and shows no racial or sex differences. Two clinical forms are recognized, both typically asymptomatic. The papular form with firm reddish or yellowish lesions of 2 to 5<span class="elsevierStyleHsp" style=""></span>mm in diameter, located in the skin or rarely in the mucosas; and the less common, nodular form, which develops as an isolated or small number of round, brownish-red or yellowish lesions of 1 to 2<span class="elsevierStyleHsp" style=""></span>cm in diameter. The 2 forms can coexist and can arise at any of the sites affected by this disease: lung, heart, gastrointestinal tract, central nervous system, adrenal glands, pituitary gland, bone, bone marrow, kidney, eyes.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The differential diagnosis of JXG when it presents as a solitary lesion, as in our patient, should include Spitz nevus, cystic lesions, and certain adnexal tumors, such as pilomatrixoma.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The definitive diagnosis of JXG is made on histopathology, which, in early lesions, shows a monomorphic infiltrate of histiocytes that contain no lipids and that can occupy the full thickness of the dermis, or at least the upper half of the dermis. Mature lesions contain foam cells and Touton-type giant cells, located particularly in the superficial dermis and at the border of the infiltrate, and fibrosis may be observed. Lymphocytes, neutrophils, and eosinophils may sometimes also be seen. Immunohistochemistry shows that the histiocytes in the infiltrate usually express CD68, CD163, Factor XIIIa, and CD4 and are negative for protein S-100,<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3,4</span></a> which facilitates their differentiation from Langerhans cell histiocytosis and Rosai-Dorfman disease.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Although the definitive diagnosis of JXG is histological, we consider that ultrasound can be a useful noninvasive diagnostic tool. The ultrasound findings in our patient were very similar to those of an earlier description of the ultrasound image of JXG in an adult, which showed a lesion in the dermis with no posterior enhancement or lateral shadow.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">The sonographic differential diagnosis of JXG should include other vascular lesions such as infantile hemangioma, in which greater vascularity is usually observed on Doppler and more marked epidermal alterations are present, induced by the underlying lesion.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">The ultrasound image of JXG can be differentiated from epidermal and other cysts because those cystic lesions are usually anechoic or hypoechoic with anechoic bands.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> Tumors that arise from the hair matrix, such as pilomatrixomas, present sonographically as hypoechoic lesions with different degrees of internal echogenicity, producing a posterior acoustic shadow.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Solivetti et al.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> described 5 ultrasound images of pilomatrixomas that varied from a completely calcified lesion, in which only the posterior acoustic shadow was observed (type<span class="elsevierStyleHsp" style=""></span>1) to one with a pseudoneoplastic, hypoechoic appearance, with increased vascularity on Doppler (type<span class="elsevierStyleHsp" style=""></span>5). The ultrasound features of basal cell carcinoma (BCC) differ from those of JXG in that BCC is a hypoechoic lesion that contains hyperechoic spots within its substance.<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">8,9</span></a><a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> summarizes the ultrasound characteristics of other tumors and lesions that are common in childhood.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">We have presented a patient with JXG that was excised surgically and we have correlated the clinical and histopathological features with the ultrasound findings on 3 images of the lesion.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0070" 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="npar0005">Please cite this article as: Martínez-Morán C, Echeverría-García B, Tardío JC, Borbujo J. Imagen ecográfica de xantogranuloma juvenil. Actas Dermosifiliogr. 2017;108:683–685.</p>" ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1083 "Ancho" => 1625 "Tamanyo" => 153133 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A solid yellowish-erythematous papule of 7<span class="elsevierStyleHsp" style=""></span>mm diameter in the right axilla.</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" => 734 "Ancho" => 975 "Tamanyo" => 129276 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">High-frequency (18<span class="elsevierStyleHsp" style=""></span>MHz) Doppler ultrasound image showing a well-defined, homogeneous, hypoechoic lesion measuring 6.5<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>3.5<span class="elsevierStyleHsp" style=""></span>mm in the dermis, with no blood flow internally.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1304 "Ancho" => 1625 "Tamanyo" => 445758 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">A, A diffuse histiocytic proliferation occupies the full thickness of the dermis. Hematoxylin and eosin, original magnification<span class="elsevierStyleHsp" style=""></span>×20. B, At higher power, the proliferation is seen to be formed of cells with isomorphic oval nuclei and eosinophilic cytoplasm, together with foam cells, some of which are multinucleated, including occasional Touton-type cells. Hematoxylin and eosin, original magnification<span class="elsevierStyleHsp" style=""></span>×400.</p>" ] ] 3 => 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:1 [ "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">Juvenile Xanthogranuloma \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">Pilomatrixoma \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">Infantile Hemangioma \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">Dermoid Cyst \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">Dermatofibroma \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">Gray scale \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Homogeneous, hypoechoic, dermal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Five types described.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a><br>Hyperechoic areas.<br>Posterior acoustic shadow \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Hypoechoic, formed of a more or less homogeneous stroma (more stroma than channels) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Deep hypoechoic lesion with linear hyperechoic images internally \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Homogeneous, with poorly defined borders, dermal \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">Color Doppler \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No vascularity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No vascularity except type 5<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Abundant vascularity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No vascularity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Occasionally vascular \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1501064.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Ultrasound Features of Lesions Common in Childhood.</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" => "Juvenile xanthogranulomas in the first two decades of life: A clinicopathologic study of 174 cases with cutaneous and extracutaneous manifestations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L.P. Dehner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Surg Pathol" "fecha" => "2003" "volumen" => "27" "paginaInicial" => "579" "paginaFinal" => "593" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12717244" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epithelioma of Malherbe: New ultrasound patterns" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F.M. Solivetti" 1 => "F. Elia" 2 => "A. Drusco" 3 => "C. Panetta" 4 => "A. Amantea" 5 => "A. Di Carlo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1756-9966-29-42" "Revista" => array:5 [ "tituloSerie" => "J Exp Clin Cancer Res" "fecha" => "2010" "volumen" => "29" "paginaInicial" => "42" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20444298" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "“Juvenile” xanthogranuloma: An immunophenotypic study with a reappraisal of histogenesis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "M.D. Kraus" 1 => "J.C. Haley" 2 => "R. Ruiz" 3 => "L. Essary" 4 => "C.A. Moran" 5 => "C.D. Fletcher" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Dermatopathol" "fecha" => "2001" "volumen" => "23" "paginaInicial" => "104" "paginaFinal" => "111" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11285404" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Solitary (juvenile) xanthogranuloma: A comprehensive immunohistochemical study emphasizing recently developed markers of histiocytic lineage" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R.F. Sandell" 1 => "J.M. Carter" 2 => "A.L. Folpe" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.humpath.2015.05.025" "Revista" => array:6 [ "tituloSerie" => "Hum Pathol" "fecha" => "2015" "volumen" => "46" "paginaInicial" => "1390" "paginaFinal" => "1397" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26220162" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Color doppler sonography of cutaneous juvenile xanthogranuloma with clinical and histologic correlations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Niklitschek" 1 => "I. Niklitschek" 2 => "S. González" 3 => "X. Wortsman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.7863/ultra.15.04007" "Revista" => array:6 [ "tituloSerie" => "J Ultrasound Med" "fecha" => "2016" "volumen" => "35" "paginaInicial" => "212" "paginaFinal" => "215" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26635254" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Epidermal cysts in the superficial soft tissue: Sonographic features with an emphasis on the pseudotestis pattern" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.C. Huang" 1 => "S.F. Ko" 2 => "H.Y. Huang" 3 => "S.H. Ng" 4 => "T.Y. Lee" 5 => "Y.W. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Ultrasound Med" "fecha" => "2011" "volumen" => "30" "paginaInicial" => "11" "paginaFinal" => "17" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21193700" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pilomatricomas: The diagnostic value of ultrasound" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.J. Choo" 1 => "S.J. Lee" 2 => "Y.H. Lee" 3 => "J.H. Lee" 4 => "M. Oh" 5 => "M.H. Kim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00256-009-0678-x" "Revista" => array:6 [ "tituloSerie" => "Skeletal Radiol" "fecha" => "2010" "volumen" => "39" "paginaInicial" => "243" "paginaFinal" => "250" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19296101" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sonography of facial cutaneous basal cell carcinoma: A first-line imaging technique" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "X. Wortsman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Ultrasound Med" "fecha" => "2013" "volumen" => "32" "paginaInicial" => "567" "paginaFinal" => "572" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23525381" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ultrasound as predictor of histologic subtypes linked to recurrence in basal cell carcinoma of the skin" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "X. Wortsman" 1 => "P. Vergara" 2 => "A. Castro" 3 => "D. Saavedra" 4 => "F. Bobadilla" 5 => "I. Sazunic" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/jdv.12660" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2015" "volumen" => "29" "paginaInicial" => "702" "paginaFinal" => "707" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25200424" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ecografía cutánea en el paciente pediátrico" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B. Echeverriìa-Garciìa" 1 => "A. Hernández-NunÞez" 2 => "J. Borbujo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actual Med" "fecha" => "2014" "volumen" => "99" "numero" => "Supl" "paginaInicial" => "52" "paginaFinal" => "68" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010800000007/v2_201708291348/S157821901730197X/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/S157821901730197X/v2_201708291348/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157821901730197X?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 20 | 11 | 31 |
| 2024 Octubre | 138 | 41 | 179 |
| 2024 Septiembre | 146 | 34 | 180 |
| 2024 Agosto | 165 | 54 | 219 |
| 2024 Julio | 146 | 44 | 190 |
| 2024 Junio | 139 | 40 | 179 |
| 2024 Mayo | 95 | 40 | 135 |
| 2024 Abril | 100 | 34 | 134 |
| 2024 Marzo | 95 | 28 | 123 |
| 2024 Febrero | 90 | 38 | 128 |
| 2024 Enero | 96 | 37 | 133 |
| 2023 Diciembre | 100 | 27 | 127 |
| 2023 Noviembre | 107 | 41 | 148 |
| 2023 Octubre | 93 | 27 | 120 |
| 2023 Septiembre | 121 | 32 | 153 |
| 2023 Agosto | 105 | 23 | 128 |
| 2023 Julio | 116 | 61 | 177 |
| 2023 Junio | 90 | 26 | 116 |
| 2023 Mayo | 100 | 31 | 131 |
| 2023 Abril | 93 | 25 | 118 |
| 2023 Marzo | 96 | 36 | 132 |
| 2023 Febrero | 113 | 24 | 137 |
| 2023 Enero | 79 | 27 | 106 |
| 2022 Diciembre | 69 | 40 | 109 |
| 2022 Noviembre | 55 | 30 | 85 |
| 2022 Octubre | 30 | 37 | 67 |
| 2022 Septiembre | 42 | 40 | 82 |
| 2022 Agosto | 38 | 50 | 88 |
| 2022 Julio | 37 | 47 | 84 |
| 2022 Junio | 32 | 31 | 63 |
| 2022 Mayo | 79 | 58 | 137 |
| 2022 Abril | 74 | 39 | 113 |
| 2022 Marzo | 64 | 67 | 131 |
| 2022 Febrero | 71 | 43 | 114 |
| 2022 Enero | 95 | 45 | 140 |
| 2021 Diciembre | 68 | 48 | 116 |
| 2021 Noviembre | 70 | 52 | 122 |
| 2021 Octubre | 68 | 53 | 121 |
| 2021 Septiembre | 70 | 48 | 118 |
| 2021 Agosto | 81 | 45 | 126 |
| 2021 Julio | 73 | 27 | 100 |
| 2021 Junio | 70 | 41 | 111 |
| 2021 Mayo | 85 | 61 | 146 |
| 2021 Abril | 259 | 114 | 373 |
| 2021 Marzo | 197 | 42 | 239 |
| 2021 Febrero | 88 | 33 | 121 |
| 2021 Enero | 89 | 27 | 116 |
| 2020 Diciembre | 67 | 27 | 94 |
| 2020 Noviembre | 77 | 16 | 93 |
| 2020 Octubre | 72 | 18 | 90 |
| 2020 Septiembre | 63 | 13 | 76 |
| 2020 Agosto | 60 | 28 | 88 |
| 2020 Julio | 52 | 14 | 66 |
| 2020 Junio | 45 | 35 | 80 |
| 2020 Mayo | 38 | 13 | 51 |
| 2020 Abril | 27 | 14 | 41 |
| 2020 Marzo | 33 | 16 | 49 |
| 2020 Febrero | 3 | 0 | 3 |
| 2020 Enero | 4 | 0 | 4 |
| 2019 Diciembre | 8 | 0 | 8 |
| 2019 Noviembre | 4 | 0 | 4 |
| 2019 Septiembre | 13 | 0 | 13 |
| 2019 Agosto | 4 | 0 | 4 |
| 2019 Julio | 4 | 0 | 4 |
| 2019 Junio | 6 | 0 | 6 |
| 2019 Mayo | 5 | 0 | 5 |
| 2019 Abril | 2 | 0 | 2 |
| 2019 Marzo | 2 | 0 | 2 |
| 2019 Febrero | 3 | 0 | 3 |
| 2019 Enero | 1 | 0 | 1 |
| 2018 Diciembre | 2 | 0 | 2 |
| 2018 Noviembre | 1 | 0 | 1 |
| 2018 Octubre | 6 | 0 | 6 |
| 2018 Septiembre | 4 | 0 | 4 |
| 2018 Febrero | 55 | 8 | 63 |
| 2018 Enero | 47 | 5 | 52 |
| 2017 Diciembre | 102 | 10 | 112 |
| 2017 Noviembre | 30 | 6 | 36 |
| 2017 Octubre | 44 | 15 | 59 |
| 2017 Septiembre | 187 | 21 | 208 |
| 2017 Agosto | 16 | 10 | 26 |
| 2017 Julio | 10 | 7 | 17 |
Mostrar todo
