Case and Research Letters
Intense Local Reaction at the Sites of Injection of Lipolytic Mesotherapy
Reacción Local Intensa en Zonas de Inyección de Mesoterapia Lipolítica
S. Córdoba
, E. Rojas, A. Garrido-Ríos, J. Borbujo
Autor para correspondencia
Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Madrid, Spain
Leído
15934
Vecesse ha leído el artículo
2602
Total PDF
13332
Total HTML
Compartir estadísticas
array:24 [ "pii" => "S1578219017303384" "issn" => "15782190" "doi" => "10.1016/j.adengl.2017.10.020" "estado" => "S300" "fechaPublicacion" => "2017-12-01" "aid" => "1719" "copyright" => "Elsevier España, S.L.U. and AEDV" "copyrightAnyo" => "2017" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2017;108:958-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 520 "formatos" => array:3 [ "EPUB" => 18 "HTML" => 415 "PDF" => 87 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731017303101" "issn" => "00017310" "doi" => "10.1016/j.ad.2017.02.027" "estado" => "S300" "fechaPublicacion" => "2017-12-01" "aid" => "1719" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2017;108:958-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 296 "formatos" => array:3 [ "EPUB" => 2 "HTML" => 252 "PDF" => 42 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta científico-clínica</span>" "titulo" => "Reacción local intensa en zonas de inyección de mesoterapia lipolítica" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "958" "paginaFinal" => "959" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Intense Local Reaction at the Sites of Injection of Lipolytic Mesotherapy" ] ] "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" => 2250 "Ancho" => 1500 "Tamanyo" => 496492 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Placas eritematoedematosas, confluyentes, con vesiculación en puntos de inyección de mesoterapia en el muslo.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S. Córdoba, E. Rojas, A. Garrido-Ríos, J. Borbujo" "autores" => array:4 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Córdoba" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Rojas" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Garrido-Ríos" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Borbujo" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219017303384" "doi" => "10.1016/j.adengl.2017.10.020" "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/S1578219017303384?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731017303101?idApp=UINPBA000044" "url" => "/00017310/0000010800000010/v1_201711300829/S0001731017303101/v1_201711300829/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219017303372" "issn" => "15782190" "doi" => "10.1016/j.adengl.2017.10.019" "estado" => "S300" "fechaPublicacion" => "2017-12-01" "aid" => "1718" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2017;108:960-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 428 "formatos" => array:3 [ "EPUB" => 17 "HTML" => 356 "PDF" => 55 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "First Sonographic Description of Idiopathic Cutaneous Angiosarcoma of the Head and Neck" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "960" "paginaFinal" => "962" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Primera Descripción Ecográfica del Angiosarcoma Cutáneo Idiopático de Cabeza y Cuello" ] ] "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" => 1688 "Ancho" => 1500 "Tamanyo" => 232605 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, Hypoechoic nodule with well-defined borders that are slightly more echogenic than the center of the nodule. B, Color Doppler showed increased vascularity and asymmetrically distributed medium-sized vessels in the base of the nodule. C, Increased vascularity in the non-nodular area of the lesion.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Pedro Vilas Boas, Antonio Ruedas-Martínez, Ofelia Baniandrés-Rodriguez, Cristina Ciudad-Blanco" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Pedro" "apellidos" => "Vilas Boas" ] 1 => array:2 [ "nombre" => "Antonio" "apellidos" => "Ruedas-Martínez" ] 2 => array:2 [ "nombre" => "Ofelia" "apellidos" => "Baniandrés-Rodriguez" ] 3 => array:2 [ "nombre" => "Cristina" "apellidos" => "Ciudad-Blanco" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731017303095" "doi" => "10.1016/j.ad.2017.02.026" "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/S0001731017303095?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017303372?idApp=UINPBA000044" "url" => "/15782190/0000010800000010/v1_201711300824/S1578219017303372/v1_201711300824/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219017303402" "issn" => "15782190" "doi" => "10.1016/j.adengl.2017.10.022" "estado" => "S300" "fechaPublicacion" => "2017-12-01" "aid" => "1720" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2017;108:956-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 384 "formatos" => array:3 [ "EPUB" => 20 "HTML" => 299 "PDF" => 65 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Schnitzler Syndrome With Response to Anakinra Monotherapy: 7 Years of Follow-up" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "956" "paginaFinal" => "958" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Síndrome de Schnitzler con respuesta a anakinra en monoterapia: 7 años de seguimiento" ] ] "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" => 1106 "Ancho" => 2450 "Tamanyo" => 360514 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A and B, Urticarial rash of fleeting pink edematous papules and plaques on the trunk and limbs, with no desquamation.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Y. Hidalgo-García, E. García-Fernández, L. Palacio-Aller, P. Gonzalvo" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Y." "apellidos" => "Hidalgo-García" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "García-Fernández" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Palacio-Aller" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Gonzalvo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731017303113" "doi" => "10.1016/j.ad.2017.03.015" "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/S0001731017303113?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017303402?idApp=UINPBA000044" "url" => "/15782190/0000010800000010/v1_201711300824/S1578219017303402/v1_201711300824/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Intense Local Reaction at the Sites of Injection of Lipolytic Mesotherapy" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor:</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "958" "paginaFinal" => "959" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "S. Córdoba, E. Rojas, A. Garrido-Ríos, J. Borbujo" "autores" => array:4 [ 0 => array:4 [ "nombre" => "S." "apellidos" => "Córdoba" "email" => array:1 [ 0 => "scordoba.hflr@salud.madrid.org" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Rojas" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Garrido-Ríos" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Borbujo" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital Universitario de Fuenlabrada, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Reacción Local Intensa en Zonas de Inyección de Mesoterapia Lipolítica" ] ] "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" => 2250 "Ancho" => 1500 "Tamanyo" => 493292 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Confluent, erythematous edematous plaques with vesicles at the sites of injection of mesotherapy on the thigh.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 45-year-old woman with no past medical history of interest and not on any long-term medication, was seen in the emergency department for the appearance some days earlier of multiple, painful and pruritic, edematous erythematous plaques with purpuric geographic borders. In some areas the lesions were confluent, producing very large plaques (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Some of the lesions had developed superficial vesicles (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) despite oral treatment with hydroxyzine, deflazacort, and cefalexin.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Extensive blood tests, including coagulation studies, were performed and were normal. Histology of the lesions revealed intense superficial edema with a moderate perivascular and interstitial inflammatory infiltrate formed of lymphocytes, histiocytes, and numerous eosinophils, occupying the full thickness of the dermis and infiltrating the subcutaneous adipose tissue. Patchy mild spongiosis and hyperkeratosis with foci of parakeratosis were observed in the epidermis. There were no findings suggestive of vasculitis.</p><p id="par0015" class="elsevierStylePara elsevierViewall">After evaluation of the patient in the emergency department, treatment was started with oral prednisone, 1<span class="elsevierStyleHsp" style=""></span>mg/kg/d, plus amoxicillin-clavulanic acid, bilastine, and topical clobetasol. With this treatment, the lesions improved progressively, with desquamation, until their almost complete disappearance within a week, leaving minimal residual pigmentation.</p><p id="par0020" class="elsevierStylePara elsevierViewall">On further questioning, the patient remembered having undergone lipolytic mesotherapy treatment in the affected areas a week before the onset of symptoms. The mesotherapy treatment involved multiple subcutaneous injections of Dermaheal LL (5% phosphatidylcholine, 1% L-carnitine, and biomimetic peptides; Lab Imex, Valencia, Spain), at the sites of appearance of each one of the lesions. The patient denied having used any cosmetic product exclusively in the affected areas.</p><p id="par0025" class="elsevierStylePara elsevierViewall">After resolution of the lesions, patch testing was performed with the standard battery of the Spanish Contact Dermatitis Research Group (GEIDAC), the Marti-Tor cosmetics battery, and the product itself (Dermaheal LL); the results were negative or not relevant in the readings made at 48 and 96<span class="elsevierStyleHsp" style=""></span>hours and at 7 days. Only weak positivity to mercury and thiomersal was observed at 48 and 96<span class="elsevierStyleHsp" style=""></span>hours. The immediate and delayed readings of the prick test and intradermoreaction test with Dermaheal LL were also negative. The patient was not willing to undergo a subcutaneous provocation test.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Mesotherapy or intradermotherapy is a minimally invasive, nonsurgical procedure that consists of multiple intradermal injections of small quantities of various substances in solution, applied directly to the area to be treated.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> The technique was first described in 1958 by Pistor for the treatment of joint and muscle pain. In recent years it has come to be used in cosmetic medicine as a technique for facial rejuvenation and for the treatment of alopecia or areas of hyperpigmentation.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Lipolytic mesotherapy uses various agents with lipolytic activity (mainly phosphatidylcholine and deoxycholate) for the treatment of localized fat deposits in the neck, eyelids, hips, abdomen, or thighs.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> These substances act as detergents, provoking nonspecific damage to the cell wall, with adipocyte necrosis and subsequent inflammatory infiltrate with a predominance initially of neutrophils and later of T lymphocytes, with granulomas and foam cells.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a> The final stage is secondary fibrosis in the adipose tissue.<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Although mesotherapy is considered a safe procedure as it is minimally invasive and is usually well tolerated, numerous local and systemic side effects have been reported. Nausea, vomiting, and dizziness can develop as nonspecific effects of the treatment. Systemic complications include hypersensitivity reactions to the substances administered, hypertransaminasemia, demyelinating neuropathy, and ischemic colitis.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Mild pain, hematomas, and erythema, and moderate pruritus and edema are often observed locally, at the sites of injection, and tend to resolve untreated within a few days. These manifestations are due to the direct action of the lipolytic substances on the adipocytes. Agents that stimulate the adrenergic receptors, such as isoproterenol or salbutamol, activate cell metabolism, reducing the amount of triglycerides stored in the adipocytes. Mesotherapy with adrenergic stimulants appears to be better tolerated as it does not involve the use of agents with direct toxic effects on the fat cells.<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Granulomas, which may be of infectious<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">7,8</span></a> or noninfectious origin,<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> scars, atrophy, and lipodystrophy are late complications that can appear after mesotherapy treatment and can often resolve leaving marked and permanent cosmetic alterations.</p><p id="par0055" class="elsevierStylePara elsevierViewall">There is only 1 previous report of the appearance of large erythematous edematous plaques in the areas of injection of lipolytic substances, similar to those observed in our patient.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> The injection of excessive quantities of substances with a lipolytic effect, poor circulation, previous scarring in the area treated, or a poor injection technique that leaves the bolus too superficial, are possible causes of the appearance of this complication.</p><p id="par0060" class="elsevierStylePara elsevierViewall">We have presented a patient with an intense local reaction at the sites of injection of lipolytic mesotherapy, probably due to a direct toxic effect of the substances employed. There are very few reports of this complication in the literature and, considering that mesotherapy is a widely used technique, this may suggest that this type of reaction is underdiagnosed.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0065" 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: Córdobascordoba.hflr@salud.madrid.org S, Rojas E, Garrido-Ríos A, Borbujo J. Reacción local intensa en zonas de inyección de mesoterapia lipolítica. Actas Dermosifiliogr. 2017;108:958–959.</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" => 1106 "Ancho" => 1658 "Tamanyo" => 214204 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Geographic erythematous-purpuric plaques at the sites of injection of mesotherapy on the abdomen, hips, and thighs.</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" => 2250 "Ancho" => 1500 "Tamanyo" => 493292 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Confluent, erythematous edematous plaques with vesicles at the sites of injection of mesotherapy on the thigh.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mesotherapy: A bibliographical review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F.O. Camargo" 1 => "P.E. Ferreira" 2 => "A. Machado" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "An Bras Dermatol" "fecha" => "2011" "volumen" => "86" "paginaInicial" => "96" "paginaFinal" => "101" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21437529" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mesotherapy: What is new?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D. Konda" 1 => "D.M. Thappa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/0378-6323.104689" "Revista" => array:6 [ "tituloSerie" => "Indian J Dermatol Venereol Leprol" "fecha" => "2013" "volumen" => "79" "paginaInicial" => "127" "paginaFinal" => "134" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23254749" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lipoplasty of the face and neck" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "T.D. Doerr" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MOO.0b013e32825b0777" "Revista" => array:6 [ "tituloSerie" => "Curr Opin Otolaryngol Head Neck Surg" "fecha" => "2007" "volumen" => "15" "paginaInicial" => "228" "paginaFinal" => "232" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17620895" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Histological changes after treatment for localized fat deposits with phosphatidylcholine and sodium deoxycholate" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E.J. Park" 1 => "H.S. Kim" 2 => "M. Kim" 3 => "H.J. Oh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/jocd.12053" "Revista" => array:6 [ "tituloSerie" => "J Cosmet Dermatol" "fecha" => "2013" "volumen" => "12" "paginaInicial" => "240" "paginaFinal" => "243" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23992167" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fat tissue after lipolysis of lipomas: A histological and immunohistochemical study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F.G. Bechara" 1 => "M. Sand" 2 => "K. Hoffman" 3 => "D. Sand" 4 => "P. Altmeyer" 5 => "M. Stücker" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1600-0560.2006.00651.x" "Revista" => array:6 [ "tituloSerie" => "J Cutan Pathol" "fecha" => "2007" "volumen" => "34" "paginaInicial" => "552" "paginaFinal" => "557" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17576334" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Injectable agents affecting subcutaneous fats" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D.L. Chen" 1 => "J.L. Cohen" 2 => "J.B. Green" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.12788/j.sder.2015.0166" "Revista" => array:6 [ "tituloSerie" => "Semin Cutan Med Surg" "fecha" => "2015" "volumen" => "34" "paginaInicial" => "134" "paginaFinal" => "137" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26566569" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effets cutanés indésirables de la mésothérapie" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D. Tennstedt" 1 => "J.M. Lachapelle" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ann Dermatol Venereol" "fecha" => "1997" "volumen" => "124" "paginaInicial" => "192" "paginaFinal" => "196" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9740838" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nocardia brasiliensis infection: An emergent suppurative granuloma after mesotherapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G. Rodríguez-Gutiérrez" 1 => "S. Toussaint" 2 => "R. Hernández-Castro" 3 => "M.C. Sánchez-León" 4 => "R. Arenas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-4632.2012.05649.x" "Revista" => array:7 [ "tituloSerie" => "Int J Dermatol" "fecha" => "2014" "volumen" => "53" "paginaInicial" => "888" "paginaFinal" => "890" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23829712" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1201971217301212" "estado" => "S300" "issn" => "12019712" ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A complication of mesotherapy: Noninfectious granulomatous panniculitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.D.P. Davis" 1 => "T.I. Wright" 2 => "J.M. Shehan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archderm.144.6.808" "Revista" => array:6 [ "tituloSerie" => "Arch Dermatol" "fecha" => "2008" "volumen" => "144" "paginaInicial" => "808" "paginaFinal" => "809" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18559780" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Severe toxic dermatitis after injection lipolysis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A. Mooch" 1 => "R. Mota" 2 => "P.A. Gerber" 3 => "B. Homey" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Hautzarzt" "fecha" => "2012" "volumen" => "63" "paginaInicial" => "282" "paginaFinal" => "285" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010800000010/v1_201711300824/S1578219017303384/v1_201711300824/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/15782190/0000010800000010/v1_201711300824/S1578219017303384/v1_201711300824/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219017303384?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 22 | 8 | 30 |
| 2024 Octubre | 256 | 54 | 310 |
| 2024 Septiembre | 254 | 42 | 296 |
| 2024 Agosto | 294 | 79 | 373 |
| 2024 Julio | 265 | 59 | 324 |
| 2024 Junio | 257 | 40 | 297 |
| 2024 Mayo | 278 | 33 | 311 |
| 2024 Abril | 220 | 31 | 251 |
| 2024 Marzo | 224 | 32 | 256 |
| 2024 Febrero | 240 | 29 | 269 |
| 2024 Enero | 236 | 40 | 276 |
| 2023 Diciembre | 374 | 33 | 407 |
| 2023 Noviembre | 538 | 60 | 598 |
| 2023 Octubre | 435 | 45 | 480 |
| 2023 Septiembre | 373 | 47 | 420 |
| 2023 Agosto | 262 | 33 | 295 |
| 2023 Julio | 296 | 52 | 348 |
| 2023 Junio | 259 | 40 | 299 |
| 2023 Mayo | 265 | 67 | 332 |
| 2023 Abril | 300 | 49 | 349 |
| 2023 Marzo | 343 | 52 | 395 |
| 2023 Febrero | 264 | 31 | 295 |
| 2023 Enero | 270 | 47 | 317 |
| 2022 Diciembre | 251 | 67 | 318 |
| 2022 Noviembre | 169 | 46 | 215 |
| 2022 Octubre | 154 | 39 | 193 |
| 2022 Septiembre | 131 | 63 | 194 |
| 2022 Agosto | 128 | 52 | 180 |
| 2022 Julio | 103 | 61 | 164 |
| 2022 Junio | 190 | 46 | 236 |
| 2022 Mayo | 387 | 59 | 446 |
| 2022 Abril | 429 | 61 | 490 |
| 2022 Marzo | 357 | 55 | 412 |
| 2022 Febrero | 317 | 45 | 362 |
| 2022 Enero | 369 | 56 | 425 |
| 2021 Diciembre | 230 | 52 | 282 |
| 2021 Noviembre | 224 | 58 | 282 |
| 2021 Octubre | 224 | 61 | 285 |
| 2021 Septiembre | 180 | 57 | 237 |
| 2021 Agosto | 197 | 45 | 242 |
| 2021 Julio | 227 | 30 | 257 |
| 2021 Junio | 186 | 41 | 227 |
| 2021 Mayo | 208 | 38 | 246 |
| 2021 Abril | 571 | 106 | 677 |
| 2021 Marzo | 216 | 46 | 262 |
| 2021 Febrero | 126 | 42 | 168 |
| 2021 Enero | 104 | 28 | 132 |
| 2020 Diciembre | 104 | 31 | 135 |
| 2020 Noviembre | 82 | 28 | 110 |
| 2020 Octubre | 84 | 22 | 106 |
| 2020 Septiembre | 75 | 16 | 91 |
| 2020 Agosto | 61 | 29 | 90 |
| 2020 Julio | 100 | 26 | 126 |
| 2020 Junio | 75 | 44 | 119 |
| 2020 Mayo | 51 | 33 | 84 |
| 2020 Abril | 39 | 17 | 56 |
| 2020 Marzo | 39 | 12 | 51 |
| 2020 Febrero | 4 | 0 | 4 |
| 2020 Enero | 4 | 0 | 4 |
| 2019 Diciembre | 4 | 0 | 4 |
| 2019 Noviembre | 6 | 0 | 6 |
| 2019 Septiembre | 6 | 0 | 6 |
| 2019 Agosto | 4 | 0 | 4 |
| 2019 Julio | 4 | 0 | 4 |
| 2019 Junio | 4 | 0 | 4 |
| 2019 Mayo | 6 | 0 | 6 |
| 2019 Abril | 3 | 2 | 5 |
| 2019 Marzo | 3 | 0 | 3 |
| 2019 Enero | 3 | 0 | 3 |
| 2018 Diciembre | 7 | 0 | 7 |
| 2018 Noviembre | 10 | 0 | 10 |
| 2018 Octubre | 10 | 0 | 10 |
| 2018 Septiembre | 3 | 0 | 3 |
| 2018 Febrero | 45 | 17 | 62 |
| 2018 Enero | 93 | 13 | 106 |
| 2017 Diciembre | 189 | 43 | 232 |
| 2017 Noviembre | 11 | 12 | 23 |
Mostrar todo
