array:23 [
  "pii" => "S157821901830060X"
  "issn" => "15782190"
  "doi" => "10.1016/j.adengl.2017.04.012"
  "estado" => "S300"
  "fechaPublicacion" => "2018-05-01"
  "aid" => "1794"
  "copyrightAnyo" => "2018"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Actas Dermosifiliogr. 2018;109:370-1"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 66
    "formatos" => array:3 [
      "EPUB" => 1
      "HTML" => 64
      "PDF" => 1
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:18 [
      "pii" => "S0001731017305082"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2017.04.028"
      "estado" => "S300"
      "fechaPublicacion" => "2018-05-01"
      "aid" => "1794"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Actas Dermosifiliogr. 2018;109:370-1"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 183
        "formatos" => array:2 [
          "HTML" => 128
          "PDF" => 55
        ]
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fico-cl&#237;nica</span>"
        "titulo" => "Rinotilexoman&#237;a"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "370"
            "paginaFinal" => "371"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Rhinotillexomania"
          ]
        ]
        "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" => 519
                "Ancho" => 1500
                "Tamanyo" => 377172
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Biopsia del septo nasal &#40;tinci&#243;n hematoxilina eosina&#44; amplificaci&#243;n original &#215;10&#41;&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "C&#46; Mart&#237;n-Callizo, M&#46; Sacrist&#224;, Y&#46; Fortu&#241;o, R&#46;M&#46; Pen&#237;n, M&#46;J&#46; Trib&#243;"
            "autores" => array:5 [
              0 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Mart&#237;n-Callizo"
              ]
              1 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Sacrist&#224;"
              ]
              2 => array:2 [
                "nombre" => "Y&#46;"
                "apellidos" => "Fortu&#241;o"
              ]
              3 => array:2 [
                "nombre" => "R&#46;M&#46;"
                "apellidos" => "Pen&#237;n"
              ]
              4 => array:2 [
                "nombre" => "M&#46;J&#46;"
                "apellidos" => "Trib&#243;"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S157821901830060X"
          "doi" => "10.1016/j.adengl.2017.04.012"
          "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/S157821901830060X?idApp=UINPBA000044"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731017305082?idApp=UINPBA000044"
      "url" => "/00017310/0000010900000004/v1_201805050447/S0001731017305082/v1_201805050447/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1578219018300611"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2017.05.025"
    "estado" => "S300"
    "fechaPublicacion" => "2018-05-01"
    "aid" => "1795"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2018;109:372-4"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 64
      "formatos" => array:2 [
        "EPUB" => 1
        "HTML" => 63
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
      "titulo" => "Cutaneous Metastasis in a Patient With Lung Cancer"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "372"
          "paginaFinal" => "374"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Met&#225;stasis cut&#225;nea de carcinoma de pulm&#243;n"
        ]
      ]
      "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" => 611
              "Ancho" => 1500
              "Tamanyo" => 298292
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Infiltration of the dermis by a proliferation of cells forming solid nests of cells &#40;A&#41; &#40;hematoxylin-eosin&#44; original magnification &#215;4&#41; with a squamous growth pattern and marked nuclear pleomorphism&#44; prominent nucleoli&#44; and several mitotic figures &#40;B&#41; &#40;hematoxylin-eosin&#44; original magnification &#215;400&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "C&#46; Mart&#237;nez-Mor&#225;n, B&#46; Echeverr&#237;a-Garc&#237;a, R&#46; Khedaoui, J&#46; Borbujo"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Mart&#237;nez-Mor&#225;n"
            ]
            1 => array:2 [
              "nombre" => "B&#46;"
              "apellidos" => "Echeverr&#237;a-Garc&#237;a"
            ]
            2 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Khedaoui"
            ]
            3 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Borbujo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731017305094"
        "doi" => "10.1016/j.ad.2017.05.019"
        "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/S0001731017305094?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018300611?idApp=UINPBA000044"
    "url" => "/15782190/0000010900000004/v1_201805040442/S1578219018300611/v1_201805040442/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1578219018300593"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2017.03.043"
    "estado" => "S300"
    "fechaPublicacion" => "2018-05-01"
    "aid" => "1793"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2018;109:366-9"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 62
      "HTML" => 62
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
      "titulo" => "Syringocystadenocarcinoma Papilliferum&#58; Case Report and Review of the Literature"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "366"
          "paginaFinal" => "369"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Siringocistadenocarcinoma papil&#237;fero&#44; descripci&#243;n de un caso y revisi&#243;n de la literatura"
        ]
      ]
      "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" => 1309
              "Ancho" => 1500
              "Tamanyo" => 651816
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A&#44; Photograph of syringocystadenocarcinoma papilliferum&#46; B&#44; Panoramic view of the tumor showing a pediculated exophytic and endophytic lesion with a benign&#44; well-delimited&#44; round area at the base &#40;hematoxylin-eosin&#44; original magnification &#215;25&#41;&#46; C&#44; Detail of benign lesion formed by tubular structures partially colonized by atypical cells &#40;arrow&#41; &#40;hematoxylin-eosin&#44; original magnification &#215;100&#41;&#46; D&#44; Area of syringocystadenocarcinoma papilliferum with dermal invasion showing cells with squamous differentiation&#44; mitosis&#44; and pleomorphic nuclei &#40;hematoxylin-eosin &#215;100&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "A&#46;D&#46; Agull&#243; P&#233;rez, B&#46; Bonaut Iriarte, A&#46; C&#243;rdoba Iturriagagoitia, A&#46; Valcayo Pe&#241;alba"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "A&#46;D&#46;"
              "apellidos" => "Agull&#243; P&#233;rez"
            ]
            1 => array:2 [
              "nombre" => "B&#46;"
              "apellidos" => "Bonaut Iriarte"
            ]
            2 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "C&#243;rdoba Iturriagagoitia"
            ]
            3 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Valcayo Pe&#241;alba"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731017305070"
        "doi" => "10.1016/j.ad.2017.03.021"
        "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/S0001731017305070?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018300593?idApp=UINPBA000044"
    "url" => "/15782190/0000010900000004/v1_201805040442/S1578219018300593/v1_201805040442/en/main.assets"
  ]
  "en" => array:16 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
    "titulo" => "Rhinotillexomania"
    "tieneTextoCompleto" => true
    "saludo" => "<span class="elsevierStyleItalic">To the Editor&#58;</span>"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "370"
        "paginaFinal" => "371"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "C&#46; Mart&#237;n-Callizo, M&#46; Sacrist&#224;, Y&#46; Fortu&#241;o, R&#46;M&#46; Pen&#237;n, M&#46;J&#46; Trib&#243;"
        "autores" => array:5 [
          0 => array:4 [
            "nombre" => "C&#46;"
            "apellidos" => "Mart&#237;n-Callizo"
            "email" => array:1 [
              0 => "claramartincallizo&#64;gmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Sacrist&#224;"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Y&#46;"
            "apellidos" => "Fortu&#241;o"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "R&#46;M&#46;"
            "apellidos" => "Pen&#237;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "M&#46;J&#46;"
            "apellidos" => "Trib&#243;"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:4 [
          0 => array:3 [
            "entidad" => "Departamento de Dermatolog&#237;a&#44; Hospital Universitari Joan XXIII&#44; Tarragona&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Departamento de Dermatolog&#237;a&#44; Hospital del Mar&#44; Parc de Salut Mar&#44; Barcelona&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Departamento de Dermatolog&#237;a&#44; Hospital de Viladecans&#44; Viladecans&#44; Barcelona&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Departamento de Anatom&#237;a Patol&#243;gica&#44; Hospital Universitari de Bellvitge&#44; L&#8217;Hospitalet del Llobregat&#44; Barcelona&#44; Spain"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Rinotilexoman&#237;a"
      ]
    ]
    "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" => 648
            "Ancho" => 900
            "Tamanyo" => 96170
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Computed tomography scan showing perforation of the nasal septum but no other alterations&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Rhinotillexomania is a psychiatric compulsive nose-picking disorder&#46; It is more common in children and young adults&#44; and while it rarely has serious consequences&#44; it can result in serious self-inflicted lesions&#44; such as perforation of the nasal septum and destruction of other facial bone structures&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Case Description</span><p id="par0010" class="elsevierStylePara elsevierViewall">A 26-year-old female worker from the health care sector with no history of substance abuse or any other relevant history was evaluated by the dermatology department for nasal septal perforation of 3 years&#8217; duration accompanied by cacosmia&#44; subjective nasal fullness&#44; epistaxis&#44; and frontal-orbital headache associated with instability&#46; She had been seen in the emergency department on multiple occasions&#44; but the physical examination and other tests had always been unremarkable&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Evaluation by the ear&#44; nose&#44; and throat &#40;ENT&#41; department found no anomalies in any of the following tests&#58; blood tests including serology for syphilis&#44; angiotensin-converting enzyme&#44; antinuclear antibodies&#44; anti-DNA&#44; antineutrophil cytoplasmic antibodies &#40;ANCAs&#41; with a cytoplasmic distribution&#44; and ANCAs with a perinuclear distribution&#59; urine toxicology&#59; and bacterial cultures &#40;all negative&#41;&#46; Rhinoscopy showed septal perforation with invasive borders&#46; Computed tomography showed septal perforation but no signs of disease in the sinuses or other bone structures &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Six punch biopsies were performed and histologic examination showed an ulcerated mucosa with fibrosis and inflammation of the chorion&#59; there was no evidence of vasculitis&#44; thrombosis&#44; granulomas&#44; or atypia &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; The patient was prescribed topical and oral antibiotics for 18 months during follow-up at the ENT department but showed little improvement&#46; A septal button was subsequently fitted but was removed 15 days later due to patient intolerance&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">At this point&#44; the patient was referred to the dermatology department as in addition to the unresolved septal perforation&#44; she had linear erosions in the right facial and retroauricular region &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; Histopathologic examination of the lesion behind the ear showed epidermal erosion but no associated alterations&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Considering the findings and the exhaustive differential diagnosis&#44; we established a diagnosis of exclusion of rhinotillexomania with dermatitis artefacta&#46; The patient was started on oral aripiprazole 2&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;d and then 5<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#46; Four months later&#44; the symptoms and facial lesions had disappeared&#44; leaving just the irreparable nasal perforation&#46; At the time of writing&#44; the patient remains asymptomatic&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Discussion</span><p id="par0030" class="elsevierStylePara elsevierViewall">Rhinotillexomania&#44; or compulsive nose picking&#44; was first described in 1995&#44; when it was classified as an impulse control disorder and conceptualized as dermatitis artefacta&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">1</span></a> In the current Diagnostic and Statistical Manual of Mental Disorders &#40;fifth edition&#41;&#44; rhinotillexomania is classified under a new category called <span class="elsevierStyleItalic">obsessive-compulsive disorder and related disorders</span>&#44; which includes body dysmorphic disorder&#44; trichotillomania&#44; and excoriation disorder &#40;skin picking&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">2</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">On rare occasions&#44; rhinotillexomania can lead to complications&#44; such as bacterial infections&#44; serious nose bleeds&#44; septal perforation&#44; and destruction of other facial structures&#44; including the ethmoidal sinuses<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">3&#44;4</span></a> and orbit wall&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">5</span></a> Repeated nose picking has also been associated with other obsessive-compulsive behaviors&#44; such as onychotillomania&#44; onychophagia&#44; and neurotic excoriations&#44; among others&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">6</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The etiology of obsessive-compulsive disorder lies in a complex system in which anomalous brain circuitry and chemical alterations have an important role&#46; Links to alterations in the serotonin&#44; glutamate&#44; and dopamine pathways are also being studied&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">6</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Rhinotillexomania is a diagnosis of exclusion that should be established only after ruling out other causes of septal perforation&#46; The most common cause is cocaine use&#44; but other causes include granulomatous disease &#40;Wegener disease&#44; sarcoidosis&#41;&#44; infectious disease &#40;Leishmania&#44; leprosy&#44; tuberculosis&#44; syphilis&#41;&#44; and malignancy&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">7</span></a> The certainty of the diagnosis is enhanced by a history of psychiatric disease and improvement with treatment&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Antipsychotic drugs are the first-line treatment for dermatitis artefacta&#46; Aripiprazole is classified as an atypical third-generation antipsychotic and it acts as a partial dopamine D<span class="elsevierStyleInf">2</span> receptor agonist&#46; It is as safe if not safer than its predecessors and has antidepressant and anti-anxiolytic properties when used at low doses&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">8</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Patients with rhinotillexomania are frequently evaluated by numerous specialists and often seek a second opinion before a diagnosis is established&#46; In addition&#44; most of them undergo multiple examinations and tests before the absence of organic disease is confirmed&#46; In an analysis of the financial impact of dermatitis artefacta in Ireland&#44; Anwar et al&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a> calculated a cost of at least &#8364;64<span class="elsevierStyleHsp" style=""></span>500 per patient&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of Interest</span><p id="par0060" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:4 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Case Description"
        ]
        1 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Discussion"
        ]
        2 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Conflicts of Interest"
        ]
        3 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Mart&#237;n-Callizo C&#44; Sacrist&#224; M&#44; Fortu&#241;o Y&#44; Pen&#237;n RM&#44; Trib&#243; MJ&#46; Rinotilexoman&#237;a&#46; Actas Dermosifiliogr&#46; 2018&#59;109&#58;370&#8211;371&#46;</p>"
      ]
    ]
    "multimedia" => array:3 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 648
            "Ancho" => 900
            "Tamanyo" => 96170
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Computed tomography scan showing perforation of the nasal septum but no other alterations&#46;</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" => 519
            "Ancho" => 1500
            "Tamanyo" => 377172
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Biopsy of nasal septum &#40;hematoxylin-eosin staining&#44; original magnification &#215;10&#41;&#46;</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" => 694
            "Ancho" => 900
            "Tamanyo" => 93574
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Perforation of nasal septum and excoriations in the right orbital and retroauricular areas&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:9 [
            0 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rhinotillexomania&#58; Psychiatric disorder or habit&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;W&#46; Jefferson"
                            1 => "T&#46;D&#46; Thompson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Psychiatry"
                        "fecha" => "1995"
                        "volumen" => "56"
                        "paginaInicial" => "56"
                        "paginaFinal" => "59"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7852253"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnostic Statistical Manual of Mental Disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "American Psychiatric Association"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "edicion" => "5<span class="elsevierStyleHsp" style=""></span>th ed&#46;"
                        "fecha" => "2013"
                        "editorial" => "American Psychiatric Association"
                        "editorialLocalizacion" => "Arlington VA"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Self-induced ethmoidectomy from rhinotillexomania"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46;D&#46; Caruso"
                            1 => "R&#46;G&#46; Sherry"
                            2 => "A&#46;E&#46; Rosenbaum"
                            3 => "S&#46;E&#46; Joy"
                            4 => "J&#46;K&#46; Chang"
                            5 => "D&#46;M&#46; Sanford"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "AJNR Am J Neuroradiol"
                        "fecha" => "1997"
                        "volumen" => "18"
                        "paginaInicial" => "1949"
                        "paginaFinal" => "1950"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9403460"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Demolition Site&#58; Rhinotillexomania"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46; Giger"
                            1 => "L&#46; Nisa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjmed.2015.08.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Med"
                        "fecha" => "2016"
                        "volumen" => "129"
                        "paginaInicial" => "48"
                        "paginaFinal" => "49"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26299320"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rhinotillexomania&#58; A rare cause of medial orbital wall erosion"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46; Rathore"
                            1 => "S&#46;K&#46; Ahmed"
                            2 => "H&#46;S&#46; Ahluwalia"
                            3 => "P&#46; Mehta"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/IOP.0b013e318281eb40"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ophthal Plast Reconstr Surg"
                        "fecha" => "2013"
                        "volumen" => "29"
                        "paginaInicial" => "e134"
                        "paginaFinal" => "e135"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23446305"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obsessive-compulsive disorder in dermatology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T&#46; Kestenbaum"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Semin Cutan Med Surg"
                        "fecha" => "2013"
                        "volumen" => "32"
                        "paginaInicial" => "83"
                        "paginaFinal" => "87"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24049965"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cocaine-induced midline destructive lesions - an autoimmune disease&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Trimarchi"
                            1 => "M&#46; Bussi"
                            2 => "R&#46;A&#46; Sinico"
                            3 => "P&#46; Meroni"
                            4 => "U&#46; Specks"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.autrev.2012.08.009"
                      "Revista" => array:6 [
                        "tituloSerie" => "Autoimmun Rev"
                        "fecha" => "2013"
                        "volumen" => "12"
                        "paginaInicial" => "496"
                        "paginaFinal" => "500"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22940554"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The current management of delusional parasitosis and dermatitis artefacta"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46;S&#46; Koblenzer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Skin Therapy Lett"
                        "fecha" => "2010"
                        "volumen" => "15"
                        "paginaInicial" => "1"
                        "paginaFinal" => "3"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21076799"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Learning the cost of dermatitis artefacta"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "W&#46; Anwar"
                            1 => "N&#46; Murphy"
                            2 => "F&#46;C&#46; Powell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2230.2004.01621.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Dermatol"
                        "fecha" => "2004"
                        "volumen" => "29"
                        "paginaInicial" => "576"
                        "paginaFinal" => "578"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15347361"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000010900000004/v1_201805040442/S157821901830060X/v1_201805040442/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/15782190/0000010900000004/v1_201805040442/S157821901830060X/v1_201805040442/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157821901830060X?idApp=UINPBA000044"
]
Compartir
Información de la revista

Estadísticas

Siga este enlace para acceder al texto completo del artículo

Case and Research Letters
Rhinotillexomania
Rinotilexomanía
C. Martín-Callizoa,
Autor para correspondencia
claramartincallizo@gmail.com

Corresponding author.
, M. Sacristàb, Y. Fortuñoc, R.M. Penínd, M.J. Tribób
a Departamento de Dermatología, Hospital Universitari Joan XXIII, Tarragona, Spain
b Departamento de Dermatología, Hospital del Mar, Parc de Salut Mar, Barcelona, Spain
c Departamento de Dermatología, Hospital de Viladecans, Viladecans, Barcelona, Spain
d Departamento de Anatomía Patológica, Hospital Universitari de Bellvitge, L’Hospitalet del Llobregat, Barcelona, Spain
Leído
20445
Veces
se ha leído el artículo
2157
Total PDF
18288
Total HTML
Compartir estadísticas
 array:23 [
  "pii" => "S157821901830060X"
  "issn" => "15782190"
  "doi" => "10.1016/j.adengl.2017.04.012"
  "estado" => "S300"
  "fechaPublicacion" => "2018-05-01"
  "aid" => "1794"
  "copyrightAnyo" => "2018"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Actas Dermosifiliogr. 2018;109:370-1"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 66
    "formatos" => array:3 [
      "EPUB" => 1
      "HTML" => 64
      "PDF" => 1
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:18 [
      "pii" => "S0001731017305082"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2017.04.028"
      "estado" => "S300"
      "fechaPublicacion" => "2018-05-01"
      "aid" => "1794"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Actas Dermosifiliogr. 2018;109:370-1"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 183
        "formatos" => array:2 [
          "HTML" => 128
          "PDF" => 55
        ]
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fico-cl&#237;nica</span>"
        "titulo" => "Rinotilexoman&#237;a"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "370"
            "paginaFinal" => "371"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Rhinotillexomania"
          ]
        ]
        "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" => 519
                "Ancho" => 1500
                "Tamanyo" => 377172
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Biopsia del septo nasal &#40;tinci&#243;n hematoxilina eosina&#44; amplificaci&#243;n original &#215;10&#41;&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "C&#46; Mart&#237;n-Callizo, M&#46; Sacrist&#224;, Y&#46; Fortu&#241;o, R&#46;M&#46; Pen&#237;n, M&#46;J&#46; Trib&#243;"
            "autores" => array:5 [
              0 => array:2 [
                "nombre" => "C&#46;"
                "apellidos" => "Mart&#237;n-Callizo"
              ]
              1 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Sacrist&#224;"
              ]
              2 => array:2 [
                "nombre" => "Y&#46;"
                "apellidos" => "Fortu&#241;o"
              ]
              3 => array:2 [
                "nombre" => "R&#46;M&#46;"
                "apellidos" => "Pen&#237;n"
              ]
              4 => array:2 [
                "nombre" => "M&#46;J&#46;"
                "apellidos" => "Trib&#243;"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S157821901830060X"
          "doi" => "10.1016/j.adengl.2017.04.012"
          "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/S157821901830060X?idApp=UINPBA000044"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731017305082?idApp=UINPBA000044"
      "url" => "/00017310/0000010900000004/v1_201805050447/S0001731017305082/v1_201805050447/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1578219018300611"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2017.05.025"
    "estado" => "S300"
    "fechaPublicacion" => "2018-05-01"
    "aid" => "1795"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2018;109:372-4"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 64
      "formatos" => array:2 [
        "EPUB" => 1
        "HTML" => 63
      ]
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
      "titulo" => "Cutaneous Metastasis in a Patient With Lung Cancer"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "372"
          "paginaFinal" => "374"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Met&#225;stasis cut&#225;nea de carcinoma de pulm&#243;n"
        ]
      ]
      "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" => 611
              "Ancho" => 1500
              "Tamanyo" => 298292
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Infiltration of the dermis by a proliferation of cells forming solid nests of cells &#40;A&#41; &#40;hematoxylin-eosin&#44; original magnification &#215;4&#41; with a squamous growth pattern and marked nuclear pleomorphism&#44; prominent nucleoli&#44; and several mitotic figures &#40;B&#41; &#40;hematoxylin-eosin&#44; original magnification &#215;400&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "C&#46; Mart&#237;nez-Mor&#225;n, B&#46; Echeverr&#237;a-Garc&#237;a, R&#46; Khedaoui, J&#46; Borbujo"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Mart&#237;nez-Mor&#225;n"
            ]
            1 => array:2 [
              "nombre" => "B&#46;"
              "apellidos" => "Echeverr&#237;a-Garc&#237;a"
            ]
            2 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Khedaoui"
            ]
            3 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Borbujo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731017305094"
        "doi" => "10.1016/j.ad.2017.05.019"
        "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/S0001731017305094?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018300611?idApp=UINPBA000044"
    "url" => "/15782190/0000010900000004/v1_201805040442/S1578219018300611/v1_201805040442/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1578219018300593"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2017.03.043"
    "estado" => "S300"
    "fechaPublicacion" => "2018-05-01"
    "aid" => "1793"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2018;109:366-9"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 62
      "HTML" => 62
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
      "titulo" => "Syringocystadenocarcinoma Papilliferum&#58; Case Report and Review of the Literature"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "366"
          "paginaFinal" => "369"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Siringocistadenocarcinoma papil&#237;fero&#44; descripci&#243;n de un caso y revisi&#243;n de la literatura"
        ]
      ]
      "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" => 1309
              "Ancho" => 1500
              "Tamanyo" => 651816
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A&#44; Photograph of syringocystadenocarcinoma papilliferum&#46; B&#44; Panoramic view of the tumor showing a pediculated exophytic and endophytic lesion with a benign&#44; well-delimited&#44; round area at the base &#40;hematoxylin-eosin&#44; original magnification &#215;25&#41;&#46; C&#44; Detail of benign lesion formed by tubular structures partially colonized by atypical cells &#40;arrow&#41; &#40;hematoxylin-eosin&#44; original magnification &#215;100&#41;&#46; D&#44; Area of syringocystadenocarcinoma papilliferum with dermal invasion showing cells with squamous differentiation&#44; mitosis&#44; and pleomorphic nuclei &#40;hematoxylin-eosin &#215;100&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "A&#46;D&#46; Agull&#243; P&#233;rez, B&#46; Bonaut Iriarte, A&#46; C&#243;rdoba Iturriagagoitia, A&#46; Valcayo Pe&#241;alba"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "A&#46;D&#46;"
              "apellidos" => "Agull&#243; P&#233;rez"
            ]
            1 => array:2 [
              "nombre" => "B&#46;"
              "apellidos" => "Bonaut Iriarte"
            ]
            2 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "C&#243;rdoba Iturriagagoitia"
            ]
            3 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Valcayo Pe&#241;alba"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731017305070"
        "doi" => "10.1016/j.ad.2017.03.021"
        "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/S0001731017305070?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018300593?idApp=UINPBA000044"
    "url" => "/15782190/0000010900000004/v1_201805040442/S1578219018300593/v1_201805040442/en/main.assets"
  ]
  "en" => array:16 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
    "titulo" => "Rhinotillexomania"
    "tieneTextoCompleto" => true
    "saludo" => "<span class="elsevierStyleItalic">To the Editor&#58;</span>"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "370"
        "paginaFinal" => "371"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "C&#46; Mart&#237;n-Callizo, M&#46; Sacrist&#224;, Y&#46; Fortu&#241;o, R&#46;M&#46; Pen&#237;n, M&#46;J&#46; Trib&#243;"
        "autores" => array:5 [
          0 => array:4 [
            "nombre" => "C&#46;"
            "apellidos" => "Mart&#237;n-Callizo"
            "email" => array:1 [
              0 => "claramartincallizo&#64;gmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "M&#46;"
            "apellidos" => "Sacrist&#224;"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Y&#46;"
            "apellidos" => "Fortu&#241;o"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "R&#46;M&#46;"
            "apellidos" => "Pen&#237;n"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">d</span>"
                "identificador" => "aff0020"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "M&#46;J&#46;"
            "apellidos" => "Trib&#243;"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:4 [
          0 => array:3 [
            "entidad" => "Departamento de Dermatolog&#237;a&#44; Hospital Universitari Joan XXIII&#44; Tarragona&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Departamento de Dermatolog&#237;a&#44; Hospital del Mar&#44; Parc de Salut Mar&#44; Barcelona&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Departamento de Dermatolog&#237;a&#44; Hospital de Viladecans&#44; Viladecans&#44; Barcelona&#44; Spain"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
          3 => array:3 [
            "entidad" => "Departamento de Anatom&#237;a Patol&#243;gica&#44; Hospital Universitari de Bellvitge&#44; L&#8217;Hospitalet del Llobregat&#44; Barcelona&#44; Spain"
            "etiqueta" => "d"
            "identificador" => "aff0020"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Rinotilexoman&#237;a"
      ]
    ]
    "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" => 648
            "Ancho" => 900
            "Tamanyo" => 96170
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Computed tomography scan showing perforation of the nasal septum but no other alterations&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Rhinotillexomania is a psychiatric compulsive nose-picking disorder&#46; It is more common in children and young adults&#44; and while it rarely has serious consequences&#44; it can result in serious self-inflicted lesions&#44; such as perforation of the nasal septum and destruction of other facial bone structures&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Case Description</span><p id="par0010" class="elsevierStylePara elsevierViewall">A 26-year-old female worker from the health care sector with no history of substance abuse or any other relevant history was evaluated by the dermatology department for nasal septal perforation of 3 years&#8217; duration accompanied by cacosmia&#44; subjective nasal fullness&#44; epistaxis&#44; and frontal-orbital headache associated with instability&#46; She had been seen in the emergency department on multiple occasions&#44; but the physical examination and other tests had always been unremarkable&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Evaluation by the ear&#44; nose&#44; and throat &#40;ENT&#41; department found no anomalies in any of the following tests&#58; blood tests including serology for syphilis&#44; angiotensin-converting enzyme&#44; antinuclear antibodies&#44; anti-DNA&#44; antineutrophil cytoplasmic antibodies &#40;ANCAs&#41; with a cytoplasmic distribution&#44; and ANCAs with a perinuclear distribution&#59; urine toxicology&#59; and bacterial cultures &#40;all negative&#41;&#46; Rhinoscopy showed septal perforation with invasive borders&#46; Computed tomography showed septal perforation but no signs of disease in the sinuses or other bone structures &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Six punch biopsies were performed and histologic examination showed an ulcerated mucosa with fibrosis and inflammation of the chorion&#59; there was no evidence of vasculitis&#44; thrombosis&#44; granulomas&#44; or atypia &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; The patient was prescribed topical and oral antibiotics for 18 months during follow-up at the ENT department but showed little improvement&#46; A septal button was subsequently fitted but was removed 15 days later due to patient intolerance&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">At this point&#44; the patient was referred to the dermatology department as in addition to the unresolved septal perforation&#44; she had linear erosions in the right facial and retroauricular region &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; Histopathologic examination of the lesion behind the ear showed epidermal erosion but no associated alterations&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Considering the findings and the exhaustive differential diagnosis&#44; we established a diagnosis of exclusion of rhinotillexomania with dermatitis artefacta&#46; The patient was started on oral aripiprazole 2&#46;5<span class="elsevierStyleHsp" style=""></span>mg&#47;d and then 5<span class="elsevierStyleHsp" style=""></span>mg&#47;d&#46; Four months later&#44; the symptoms and facial lesions had disappeared&#44; leaving just the irreparable nasal perforation&#46; At the time of writing&#44; the patient remains asymptomatic&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Discussion</span><p id="par0030" class="elsevierStylePara elsevierViewall">Rhinotillexomania&#44; or compulsive nose picking&#44; was first described in 1995&#44; when it was classified as an impulse control disorder and conceptualized as dermatitis artefacta&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">1</span></a> In the current Diagnostic and Statistical Manual of Mental Disorders &#40;fifth edition&#41;&#44; rhinotillexomania is classified under a new category called <span class="elsevierStyleItalic">obsessive-compulsive disorder and related disorders</span>&#44; which includes body dysmorphic disorder&#44; trichotillomania&#44; and excoriation disorder &#40;skin picking&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">2</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">On rare occasions&#44; rhinotillexomania can lead to complications&#44; such as bacterial infections&#44; serious nose bleeds&#44; septal perforation&#44; and destruction of other facial structures&#44; including the ethmoidal sinuses<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">3&#44;4</span></a> and orbit wall&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">5</span></a> Repeated nose picking has also been associated with other obsessive-compulsive behaviors&#44; such as onychotillomania&#44; onychophagia&#44; and neurotic excoriations&#44; among others&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">6</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The etiology of obsessive-compulsive disorder lies in a complex system in which anomalous brain circuitry and chemical alterations have an important role&#46; Links to alterations in the serotonin&#44; glutamate&#44; and dopamine pathways are also being studied&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">6</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Rhinotillexomania is a diagnosis of exclusion that should be established only after ruling out other causes of septal perforation&#46; The most common cause is cocaine use&#44; but other causes include granulomatous disease &#40;Wegener disease&#44; sarcoidosis&#41;&#44; infectious disease &#40;Leishmania&#44; leprosy&#44; tuberculosis&#44; syphilis&#41;&#44; and malignancy&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">7</span></a> The certainty of the diagnosis is enhanced by a history of psychiatric disease and improvement with treatment&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Antipsychotic drugs are the first-line treatment for dermatitis artefacta&#46; Aripiprazole is classified as an atypical third-generation antipsychotic and it acts as a partial dopamine D<span class="elsevierStyleInf">2</span> receptor agonist&#46; It is as safe if not safer than its predecessors and has antidepressant and anti-anxiolytic properties when used at low doses&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">8</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Patients with rhinotillexomania are frequently evaluated by numerous specialists and often seek a second opinion before a diagnosis is established&#46; In addition&#44; most of them undergo multiple examinations and tests before the absence of organic disease is confirmed&#46; In an analysis of the financial impact of dermatitis artefacta in Ireland&#44; Anwar et al&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">9</span></a> calculated a cost of at least &#8364;64<span class="elsevierStyleHsp" style=""></span>500 per patient&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of Interest</span><p id="par0060" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:4 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Case Description"
        ]
        1 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Discussion"
        ]
        2 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Conflicts of Interest"
        ]
        3 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Mart&#237;n-Callizo C&#44; Sacrist&#224; M&#44; Fortu&#241;o Y&#44; Pen&#237;n RM&#44; Trib&#243; MJ&#46; Rinotilexoman&#237;a&#46; Actas Dermosifiliogr&#46; 2018&#59;109&#58;370&#8211;371&#46;</p>"
      ]
    ]
    "multimedia" => array:3 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 648
            "Ancho" => 900
            "Tamanyo" => 96170
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Computed tomography scan showing perforation of the nasal septum but no other alterations&#46;</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" => 519
            "Ancho" => 1500
            "Tamanyo" => 377172
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Biopsy of nasal septum &#40;hematoxylin-eosin staining&#44; original magnification &#215;10&#41;&#46;</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" => 694
            "Ancho" => 900
            "Tamanyo" => 93574
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Perforation of nasal septum and excoriations in the right orbital and retroauricular areas&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:9 [
            0 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rhinotillexomania&#58; Psychiatric disorder or habit&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;W&#46; Jefferson"
                            1 => "T&#46;D&#46; Thompson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Clin Psychiatry"
                        "fecha" => "1995"
                        "volumen" => "56"
                        "paginaInicial" => "56"
                        "paginaFinal" => "59"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7852253"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnostic Statistical Manual of Mental Disorders"
                      "autores" => array:1 [
                        0 => array:2 [
                          "colaboracion" => "American Psychiatric Association"
                          "etal" => false
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:4 [
                        "edicion" => "5<span class="elsevierStyleHsp" style=""></span>th ed&#46;"
                        "fecha" => "2013"
                        "editorial" => "American Psychiatric Association"
                        "editorialLocalizacion" => "Arlington VA"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Self-induced ethmoidectomy from rhinotillexomania"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "R&#46;D&#46; Caruso"
                            1 => "R&#46;G&#46; Sherry"
                            2 => "A&#46;E&#46; Rosenbaum"
                            3 => "S&#46;E&#46; Joy"
                            4 => "J&#46;K&#46; Chang"
                            5 => "D&#46;M&#46; Sanford"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "AJNR Am J Neuroradiol"
                        "fecha" => "1997"
                        "volumen" => "18"
                        "paginaInicial" => "1949"
                        "paginaFinal" => "1950"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9403460"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Demolition Site&#58; Rhinotillexomania"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46; Giger"
                            1 => "L&#46; Nisa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.amjmed.2015.08.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Med"
                        "fecha" => "2016"
                        "volumen" => "129"
                        "paginaInicial" => "48"
                        "paginaFinal" => "49"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26299320"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Rhinotillexomania&#58; A rare cause of medial orbital wall erosion"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46; Rathore"
                            1 => "S&#46;K&#46; Ahmed"
                            2 => "H&#46;S&#46; Ahluwalia"
                            3 => "P&#46; Mehta"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/IOP.0b013e318281eb40"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ophthal Plast Reconstr Surg"
                        "fecha" => "2013"
                        "volumen" => "29"
                        "paginaInicial" => "e134"
                        "paginaFinal" => "e135"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23446305"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Obsessive-compulsive disorder in dermatology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T&#46; Kestenbaum"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Semin Cutan Med Surg"
                        "fecha" => "2013"
                        "volumen" => "32"
                        "paginaInicial" => "83"
                        "paginaFinal" => "87"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24049965"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cocaine-induced midline destructive lesions - an autoimmune disease&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Trimarchi"
                            1 => "M&#46; Bussi"
                            2 => "R&#46;A&#46; Sinico"
                            3 => "P&#46; Meroni"
                            4 => "U&#46; Specks"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.autrev.2012.08.009"
                      "Revista" => array:6 [
                        "tituloSerie" => "Autoimmun Rev"
                        "fecha" => "2013"
                        "volumen" => "12"
                        "paginaInicial" => "496"
                        "paginaFinal" => "500"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22940554"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The current management of delusional parasitosis and dermatitis artefacta"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46;S&#46; Koblenzer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Skin Therapy Lett"
                        "fecha" => "2010"
                        "volumen" => "15"
                        "paginaInicial" => "1"
                        "paginaFinal" => "3"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21076799"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Learning the cost of dermatitis artefacta"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "W&#46; Anwar"
                            1 => "N&#46; Murphy"
                            2 => "F&#46;C&#46; Powell"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2230.2004.01621.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Dermatol"
                        "fecha" => "2004"
                        "volumen" => "29"
                        "paginaInicial" => "576"
                        "paginaFinal" => "578"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15347361"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000010900000004/v1_201805040442/S157821901830060X/v1_201805040442/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/15782190/0000010900000004/v1_201805040442/S157821901830060X/v1_201805040442/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157821901830060X?idApp=UINPBA000044"
]
Información del artículo
ISSN: 15782190
Idioma original: Inglés
Datos actualizados diariamente
año/Mes Html Pdf Total
2024 Noviembre 58 12 70
2024 Octubre 650 39 689
2024 Septiembre 905 39 944
2024 Agosto 948 90 1038
2024 Julio 1061 32 1093
2024 Junio 978 48 1026
2024 Mayo 786 58 844
2024 Abril 699 27 726
2024 Marzo 1035 29 1064
2024 Febrero 1726 35 1761
2024 Enero 664 36 700
2023 Diciembre 387 21 408
2023 Noviembre 437 37 474
2023 Octubre 389 35 424
2023 Septiembre 303 35 338
2023 Agosto 302 31 333
2023 Julio 227 46 273
2023 Junio 280 30 310
2023 Mayo 327 45 372
2023 Abril 363 38 401
2023 Marzo 370 37 407
2023 Febrero 281 32 313
2023 Enero 162 46 208
2022 Diciembre 150 53 203
2022 Noviembre 107 29 136
2022 Octubre 119 31 150
2022 Septiembre 65 46 111
2022 Agosto 73 38 111
2022 Julio 77 44 121
2022 Junio 86 31 117
2022 Mayo 167 43 210
2022 Abril 264 40 304
2022 Marzo 262 46 308
2022 Febrero 205 38 243
2022 Enero 218 51 269
2021 Diciembre 153 44 197
2021 Noviembre 133 63 196
2021 Octubre 154 62 216
2021 Septiembre 107 43 150
2021 Agosto 174 38 212
2021 Julio 202 31 233
2021 Junio 191 23 214
2021 Mayo 193 48 241
2021 Abril 579 78 657
2021 Marzo 311 39 350
2021 Febrero 145 41 186
2021 Enero 106 16 122
2020 Diciembre 108 34 142
2020 Noviembre 97 26 123
2020 Octubre 106 21 127
2020 Septiembre 76 28 104
2020 Agosto 65 23 88
2020 Julio 55 21 76
2020 Junio 49 41 90
2020 Mayo 26 18 44
2020 Abril 33 21 54
2020 Marzo 30 28 58
2020 Febrero 1 2 3
2020 Enero 4 0 4
2019 Diciembre 8 0 8
2019 Noviembre 4 0 4
2019 Septiembre 10 0 10
2019 Agosto 4 0 4
2019 Julio 4 0 4
2019 Junio 4 0 4
2019 Mayo 7 0 7
2019 Abril 2 0 2
2019 Marzo 3 0 3
2019 Febrero 3 0 3
2018 Diciembre 4 0 4
2018 Noviembre 2 0 2
2018 Octubre 1 0 1
2018 Septiembre 3 0 3
Mostrar todo

Siga este enlace para acceder al texto completo del artículo

Idiomas
Actas Dermo-Sifiliográficas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?