Original Article
Prescribing Habits for Androgenic Alopecia Among Dermatologists in Spain in 2017: A Cross-Sectional Study
Estudio transversal acerca de los hábitos de prescripción en alopecia androgénica de los dermatólogos en España en 2017
C. Pindado-Ortega
, D. Saceda-Corralo, D. Buendía-Castaño, P. Fernández-González, Ó.M. Moreno-Arrones, P. Fonda-Pascual, A. Alegre-Sánchez, A.R. Rodrigues-Barata, S. Vañó-Galván
Autor para correspondencia
Servicio de Dermatología, Hospital Ramón y Cajal, Madrid, Spain
Leído
6565
Vecesse ha leído el artículo
2821
Total PDF
3744
Total HTML
Compartir estadísticas
array:25 [ "pii" => "S1578219018301793" "issn" => "15782190" "doi" => "10.1016/j.adengl.2018.05.020" "estado" => "S300" "fechaPublicacion" => "2018-07-01" "aid" => "1919" "copyright" => "Elsevier España, S.L.U. and AEDV" "copyrightAnyo" => "2018" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2018;109:536-42" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4 "formatos" => array:2 [ "HTML" => 1 "PDF" => 3 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731018300814" "issn" => "00017310" "doi" => "10.1016/j.ad.2018.02.006" "estado" => "S300" "fechaPublicacion" => "2018-07-01" "aid" => "1919" "copyright" => "AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2018;109:536-42" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 533 "formatos" => array:2 [ "HTML" => 442 "PDF" => 91 ] ] "es" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original</span>" "titulo" => "Estudio transversal acerca de los hábitos de prescripción en alopecia androgénica de los dermatólogos en España en 2017" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:3 [ 0 => "es" 1 => "es" 2 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "536" "paginaFinal" => "542" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Prescribing Habits for Androgenic Alopecia Among Dermatologists in Spain in 2017: A Cross-Sectional Study" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 1 "multimedia" => array:5 [ "identificador" => "201808010429440601" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 580 "Ancho" => 1333 "Tamanyo" => 95434 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "C. Pindado-Ortega, D. Saceda-Corralo, D. Buendía-Castaño, P. Fernández-González, Ó.M. Moreno-Arrones, P. Fonda-Pascual, A. Alegre-Sánchez, A.R. Rodrigues-Barata, S. Vañó-Galván" "autores" => array:9 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Pindado-Ortega" ] 1 => array:2 [ "nombre" => "D." "apellidos" => "Saceda-Corralo" ] 2 => array:2 [ "nombre" => "D." "apellidos" => "Buendía-Castaño" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Fernández-González" ] 4 => array:2 [ "nombre" => "Ó.M." "apellidos" => "Moreno-Arrones" ] 5 => array:2 [ "nombre" => "P." "apellidos" => "Fonda-Pascual" ] 6 => array:2 [ "nombre" => "A." "apellidos" => "Alegre-Sánchez" ] 7 => array:2 [ "nombre" => "A.R." "apellidos" => "Rodrigues-Barata" ] 8 => array:2 [ "nombre" => "S." "apellidos" => "Vañó-Galván" ] ] ] ] "resumen" => array:1 [ 0 => array:3 [ "titulo" => "Graphical abstract" "clase" => "graphical" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Varón de 28 años con MAGA y tratamiento con dutasterida 0,5 mg al día y minoxidil 5% en aplicación nocturna. A. Pre- tratamiento. B. 12 meses post-tratamiento. <elsevierMultimedia ident="201808010429440601"></elsevierMultimedia></p></span>" ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219018301793" "doi" => "10.1016/j.adengl.2018.05.020" "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/S1578219018301793?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731018300814?idApp=UINPBA000044" "url" => "/00017310/0000010900000006/v1_201808010427/S0001731018300814/v1_201808010427/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219018301823" "issn" => "15782190" "doi" => "10.1016/j.adengl.2018.05.022" "estado" => "S300" "fechaPublicacion" => "2018-07-01" "aid" => "1814" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2018;109:e37-41" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3 "formatos" => array:2 [ "HTML" => 1 "PDF" => 2 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">e- Case Report</span>" "titulo" => "Reflectance Confocal Microscopy: A Promising Tool to Identify Malignancy in Melanocytic Lesions Exhibiting a Dermoscopic Island" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e37" "paginaFinal" => "e41" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Microscopia confocal de reflectancia: una herramienta útil para diagnosticar malignidad en lesiones melanocíticas que presenten el signo de la isla" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "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" => 1891 "Ancho" => 2167 "Tamanyo" => 552888 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Clinical, dermoscopy, reflectance confocal microscopy (RCM), and histology findings. A, Light brown nevus (4<span class="elsevierStyleHsp" style=""></span>mm) in the lumbar region with asymmetry and a hyperpigmented area. B, Dermoscopic island: dermoscopy reveals a homogenous reticular pattern within which lies an area of eccentric hyperpigmention with a distinct, atypical reticular pattern. C, RCM image showing isolated atypical round cells (arrows), atypical cells forming nests (circles), and papillae with poorly defined contours (asterisks). D, Proliferation of large atypical melanocytes with prominent, hyperchromatic nucleoli corresponding to the dermoscopic island (hematoxylin-eosin, original magnification ×100).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Elosua-González, R. Gamo-Villegas, U. Floristán-Muruzábal, F. Pinedo-Moraleda, J.L. López-Estebaranz" "autores" => array:5 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Elosua-González" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Gamo-Villegas" ] 2 => array:2 [ "nombre" => "U." "apellidos" => "Floristán-Muruzábal" ] 3 => array:2 [ "nombre" => "F." "apellidos" => "Pinedo-Moraleda" ] 4 => array:2 [ "nombre" => "J.L." "apellidos" => "López-Estebaranz" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731017305483" "doi" => "10.1016/j.ad.2017.06.018" "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/S0001731017305483?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018301823?idApp=UINPBA000044" "url" => "/15782190/0000010900000006/v1_201808010420/S1578219018301823/v1_201808010420/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219018301732" "issn" => "15782190" "doi" => "10.1016/j.adengl.2018.05.015" "estado" => "S300" "fechaPublicacion" => "2018-07-01" "aid" => "1922" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Actas Dermosifiliogr. 2018;109:529-35" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5 "formatos" => array:2 [ "HTML" => 2 "PDF" => 3 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Papulopustular Rosacea: Response to Treatment with Oral Azithromycin" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "529" "paginaFinal" => "535" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Rosácea papulopustulosa: respuesta al tratamiento con azitromicina oral" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "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" => 1099 "Ancho" => 1733 "Tamanyo" => 228744 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">A, Clinical deterioration after treatment with oral doxycycline. B, Complete resolution of inflammatory lesions, with just residual erythema, after treatment with oral azithromycin.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Lova Navarro, P. Sánchez-Pedreño Guillen, A.M. Victoria Martínez, T. Martínez Menchón, R. Corbalán Vélez, J. Frías Iniesta" "autores" => array:6 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Lova Navarro" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "Sánchez-Pedreño Guillen" ] 2 => array:2 [ "nombre" => "A.M." "apellidos" => "Victoria Martínez" ] 3 => array:2 [ "nombre" => "T." "apellidos" => "Martínez Menchón" ] 4 => array:2 [ "nombre" => "R." "apellidos" => "Corbalán Vélez" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Frías Iniesta" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S000173101830084X" "doi" => "10.1016/j.ad.2018.02.009" "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/S000173101830084X?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018301732?idApp=UINPBA000044" "url" => "/15782190/0000010900000006/v1_201808010420/S1578219018301732/v1_201808010420/en/main.assets" ] "asociados" => array:1 [ 0 => array:19 [ "pii" => "S1578219018301951" "issn" => "15782190" "doi" => "10.1016/j.adengl.2018.04.021" "estado" => "S300" "fechaPublicacion" => "2018-07-01" "aid" => "1956" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2018;109:470" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4 "formatos" => array:2 [ "HTML" => 2 "PDF" => 2 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Commentaries</span>" "titulo" => "New Perspectives on the Treatment of Androgenetic Alopecia" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "470" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Nuevas perspectivas en el tratamiento de la alopecia androgenética" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Ferrando" "autores" => array:1 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Ferrando" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731018301819" "doi" => "10.1016/j.ad.2018.04.001" "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/S0001731018301819?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018301951?idApp=UINPBA000044" "url" => "/15782190/0000010900000006/v1_201808010420/S1578219018301951/v1_201808010420/en/main.assets" ] ] "en" => array:22 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original Article</span>" "titulo" => "Prescribing Habits for Androgenic Alopecia Among Dermatologists in Spain in 2017: A Cross-Sectional Study" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "536" "paginaFinal" => "542" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "C. Pindado-Ortega, D. Saceda-Corralo, D. Buendía-Castaño, P. Fernández-González, Ó.M. Moreno-Arrones, P. Fonda-Pascual, A. Alegre-Sánchez, A.R. Rodrigues-Barata, S. Vañó-Galván" "autores" => array:9 [ 0 => array:4 [ "nombre" => "C." "apellidos" => "Pindado-Ortega" "email" => array:1 [ 0 => "cpindadoortega@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "D." "apellidos" => "Saceda-Corralo" ] 2 => array:2 [ "nombre" => "D." "apellidos" => "Buendía-Castaño" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Fernández-González" ] 4 => array:2 [ "nombre" => "Ó.M." "apellidos" => "Moreno-Arrones" ] 5 => array:2 [ "nombre" => "P." "apellidos" => "Fonda-Pascual" ] 6 => array:2 [ "nombre" => "A." "apellidos" => "Alegre-Sánchez" ] 7 => array:2 [ "nombre" => "A.R." "apellidos" => "Rodrigues-Barata" ] 8 => array:2 [ "nombre" => "S." "apellidos" => "Vañó-Galván" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital Ramón y Cajal, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Estudio transversal acerca de los hábitos de prescripción en alopecia androgénica de los dermatólogos en España en 2017" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figure 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1281 "Ancho" => 2170 "Tamanyo" => 196734 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Frequency of prescription for each treatment in women with post-menopausal androgenetic alopecia (lilac bar, public sector; orange bar, private sector; green line, mean). Cyproterone A, cyproterone acetate; LLLT, low-level laser therapy; PRP, platelet-rich plasma.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Androgenetic alopecia (AGA) is a condition characterized by progressive hair follicle miniaturization under certain hormonal conditions in genetically predisposed individuals.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">1</span></a> It is the most prevalent form of alopecia in both men and women, although its prevalence and the hair loss pattern differ between the sexes. AGA is an age-dependent disorder estimated to affect 70% of Caucasian men in their lifetime.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">2</span></a> In women, prevalence varies from 30% to 50% depending on the study.<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">2–4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Untreated, AGA leads to progressive hair loss, with an annual rate of decrease in hair density of 6%.<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">5</span></a> Despite this, there are only 2 drugs approved for the treatment of male AGA in Spain: topical minoxidil and oral finasteride. In the case of female AGA, the only approved treatment is topical minoxidil. However, many other therapies are commonly prescribed off label, a practice that has given rise to considerable variation in the management of these patients.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The primary objective of this study was to describe the prescribing habits of dermatologists in Spain for male and female AGA. The secondary objectives were to describe the relative frequency of AGA compared to other types of alopecia in the dermatology office in Spain and to evaluate the differences between the public and private sector in prescribing habits.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Patients and Methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">We designed a cross-sectional, descriptive study based on a questionnaire. The questionnaire was completed by dermatologists working in Spain using Google Forms (see <a class="elsevierStyleCrossRef" href="#sec0040">supplementary material</a>). Respondents were asked to provide the following information: consultation setting for their patients with alopecia, distribution by population group of patients with AGA (men, premenopausal women, or postmenopausal women), and the treatments prescribed for each group. They were asked specifically about topical minoxidil, oral finisteride, topical finisteride, oral dutasteride, platelet-rich plasma (PRP), low-level laser therapy (LLLT), nutricosmetics, and hair transplantation, as well as oral contraceptives, cyproterone acetate and other oral antiandrogens in women (flutamide, spironolactone, finisteride, and dutasteride). The specific question asked relating to hair transplantation was whether the dermatologists performed hair transplantation procedures themselves. Statistical analysis was carried out using the SPSS statistical package v.24. The Chi-square test with Yate's correction when necessary was used for the comparison of proportions between different groups. Statistical significance was set at a value of <span class="elsevierStyleItalic">P</span> less than .05.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0025" class="elsevierStylePara elsevierViewall">In total, 241 questionnaires were included in the study. Of the respondents, 209 were staff physicians (86.7%) and 32 were residents (13.7%). Of the staff physicians, 18 (12%) treated patients in a specialized trichology unit, and the rest worked in a general office.</p><p id="par0030" class="elsevierStylePara elsevierViewall">With respect to the sector in which the dermatologists saw patients with AGA, 58 (24%) worked in the public sector, 51 (21%) in private practice, and 132 (55%) in both sectors. The geographical distribution of the respondents by autonomous community was as follows: Madrid (24%), Andalusia (19%), Galicia (10%), Murcia (9.1%), the Balearic Islands (9%), Catalonia (5%), and others (< 5%), including Cantabria, Castile-La Mancha, Castile-Leon, Ceuta, the Valencian Community, Extremadura, the Canary Islands, La Rioja, Navarre, the Basque Country, and Asturias.</p><p id="par0035" class="elsevierStylePara elsevierViewall">AGA was the most frequent motive for consultation (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) in both the public and private sectors, accounting for 38% of all visits. The next most common was telogen effluvium (24%), followed by alopecia areata (14%), frontal fibrosing alopecia (10%), lichen planopilaris (3%), folliculitis decalvans (3%), lupus alopecia (2%), and other types of hair loss (5%). Statistically significant differences were found between the public and private sectors in the most frequent motive for consultation: AGA (31% vs 42%; <span class="elsevierStyleItalic">P =</span> .026), alopecia areata (18% vs 10%; <span class="elsevierStyleItalic">P =</span> .002) and fibrosing frontal alopecia (13% vs 7%; <span class="elsevierStyleItalic">P <</span> .001).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Of the patients who consulted a dermatologist because of AGA, 57% were women and 43% men. Of the women, 31% were postmenopausal and 26% were premenopausal (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). No statistically significant differences were found between the public and private sectors in this distribution.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">In men with AGA (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>), the most frequently prescribed treatments were as follows: topical minoxidil (98%), oral finasteride (96%), nutricosmetics (44%), topical finasteride (37%), oral dutasteride (33%), PRP (14%), and LLLT (8%). Statistically significant differences were found between the public and private sectors in the prescription of certain treatments: topical finasteride (29% vs 59%; <span class="elsevierStyleItalic">P =</span> .001), oral dutasteride (19% vs 39%; <span class="elsevierStyleItalic">P <</span> .034), LLLT (5% vs 12%; <span class="elsevierStyleItalic">P =</span> .012), and PRP (2% vs 25%; <span class="elsevierStyleItalic">P <</span> .001).</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">In premenopausal women with AGA (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>), the most frequently prescribed treatments were as follows: topical minoxidil (98%), oral contraceptives (81%), nutricosmetics (72%), cyproterone acetate (58%), oral finasteride (39%), topical finasteride (39%), spironolactone (27%), PRP (20%), oral dutasteride (20%), oral flutamide (18%), and LLLT (7%). Statistically significant differences were found between public vs private prescription for topical finasteride (29% vs 47%; <span class="elsevierStyleItalic">P =</span> .002), oral flutamide (9% vs 24%; <span class="elsevierStyleItalic">P <</span> .001), oral finasteride (26% vs 45%; <span class="elsevierStyleItalic">P <</span> .001), oral dutasteride (3% vs 16%; <span class="elsevierStyleItalic">P <</span> .001), LLLT (3% vs 14%; <span class="elsevierStyleItalic">P <</span> .001), PRP (3% vs 37%; <span class="elsevierStyleItalic">P <</span> .001), and nutricosmetics (66% vs 80%; <span class="elsevierStyleItalic">P =</span> .034).</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">In postmenopausal women with AGA (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>), the most frequently prescribed treatments were as follows: topical minoxidil (98%), oral finasteride (84%), nutricosmetics (68%), topical finasteride (50%), oral dutasteride (35%), PRP (21%), spironolactone (16%) cyproterone acetate (16%), oral flutamide (9%), and LLLT (9%). Significant differences were found between public and private prescription for the following drugs: oral finasteride (67% vs 86%; <span class="elsevierStyleItalic">P <</span> .001, oral dutasteride (22% vs 41%; <span class="elsevierStyleItalic">P <</span> .001), LLLT (5% vs 16%; <span class="elsevierStyleItalic">P <</span> .001), PRP (5% vs 33%; <span class="elsevierStyleItalic">P <</span> .001), and nutricosmetics (60% vs 80%; <span class="elsevierStyleItalic">P <</span> .001).</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Of the dermatologists who responded to the survey, only 3.7% reported that they performed surgical procedures involving hair transplantation whereas 96.3% referred their patients to another specialist for this intervention.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0065" class="elsevierStylePara elsevierViewall">The present study provides an up-to-date overview of the prescribing habits of Spanish dermatologists in patients with AGA. First, the findings confirm that AGA continues to be the most common motive for consultation in trichology, followed by telogen effluvium, alopecia areata, and frontal fibrosing alopecia. The most common scarring alopecia in our study was frontal fibrosing alopecia, confirming the dramatic increase in the incidence of this disorder suggested by earlier studies.<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">6</span></a> Patients diagnosed with AGA reported a significant decline in quality of life. Hair loss can affect the individual's self-esteem and lead to depression.<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">7</span></a> The high incidence of AGA and its impact on patients’ quality of life have made it the most frequent cause of consultation in trichology.</p><p id="par0070" class="elsevierStylePara elsevierViewall">We found a similar gender distribution in patients with AGA as that reported by earlier studies: 43% men, 31% postmenopausal women, and 26% premenopausal women.<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">2</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Despite the high prevalence of AGA, there are very few approved treatments. Topical minoxidil and oral finasteride are the most studied treatments for male AGA. Both of these drugs have been shown to be effective and have good tolerability in placebo-controlled RCTs,<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">8,9</span></a> supporting their position as first-line treatment options. In fact, most of the dermatologists surveyed cited topical minoxidil as the most commonly prescribed drug for both male AGA and pre- and postmenopausal female AGA (<a class="elsevierStyleCrossRef" href="#fig0030">Fig. 6</a>).</p><elsevierMultimedia ident="fig0030"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">With respect to antiandrogens, the use of oral finasteride as a first-line treatment in male AGA is confirmed. However, despite the greater effectiveness reported for oral dutasteride,<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">10–14</span></a> this drug is not at the top of the list of drugs prescribed in this setting. The belief that dutasteride is more likely to have an adverse effect on the patient's sex life—a supposition ruled out by a meta-analysis<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">15</span></a>—is probably a factor in the low prescription rate of oral dutasteride in patients who could benefit from its greater efficacy.</p><p id="par0085" class="elsevierStylePara elsevierViewall">To date, only 1 published study has compared the efficacy of antiandrogen drugs in the treatment of female AGA in premenopausal women and it has been criticized for having a high risk of bias.<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">16</span></a> Flutamide at a dose of 250<span class="elsevierStyleHsp" style=""></span>mg daily for one year achieved a slight improvement in patients with alopecia, while cyproterone acetate 50<span class="elsevierStyleHsp" style=""></span>mg and finasteride 5<span class="elsevierStyleHsp" style=""></span>mg were considered ineffective. In our study, however, we found that cyproterone acetate was the oral antiandrogen most often prescribed in premenopausal female AGA, followed by finasteride, spironolactone, dutasteride, and oral flutamide. It should be noted that shortly after the data in the present study were collected, the Spanish Agency of Medicines and Medical Devices published an informative note on serious cases of hepatotoxicity associated with the off-label use of oral flutamide in which it advised against such use.<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">17</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">Also striking is the high frequency of the prescription of nutricosmetics in both male and female AGA. Although the therapeutic effectiveness of these treatments is doubtful,<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">18</span></a> they are used in monotherapy or as adjuvants to increase patient adherence to the medical treatments.</p><p id="par0095" class="elsevierStylePara elsevierViewall">We also observed an increase in the prescription of 2 new therapies for AGA in both sexes: topical finasteride and LLLT.<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">10</span></a> LLLT is an emerging light therapy. A recent review of 21 studies on the effectiveness of LLLT in male and female AGA, alopecia areata, and chemotherapy-induced alopecia showed it to be a treatment option in both male and female patients with AGA who have not responded to or were not candidates for the first-line treatments.<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">19</span></a> While its effectiveness is supported by several scientific studies, the optimum treatment protocol and intensity or duration of treatment for LLLT has not yet been defined.<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">20–22</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">We also found significant differences in prescribing habits between the public and private sectors. In general terms, topical finasteride, oral dutasteride, PRP, and LLLT were particularly used in the private sector. This difference is very likely due to the higher cost to the patient of these new treatments. In the case of PRP, a recent meta-analysis showed positive results in patients with AGA, above all in mild cases or cases with a short history, irrespective of the age or sex of the patient.<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">23</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">Finally, it is striking that only 3.7% of dermatologists perform hair transplantation procedures. This may be due to a variety of reasons, including the lack of knowledge and skill in these techniques when the dermatologist was in training and the growing number of clinics run by other specialists that offer hair transplantation interventions. The added value to the patient when a dermatologist performs a hair transplantation intervention has been discussed in an earlier article.<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">24</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">Our study reveals considerable variation in the clinical management of AGA in Spain. Prescription guidelines for the treatment of AGA could help to improve the situation and ensure that patients benefit from the therapies supported by the most scientific evidence.</p><p id="par0115" class="elsevierStylePara elsevierViewall">Our study had certain limitations: no questions were included about some new treatments for AGA, including oral minoxidil (Sinclair, personal communication), and micro-injections of dutasteride.<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">25</span></a> Furthermore, we did not calculate the optimum sample size before carrying out the study and we did not monitor the distribution of the survey; as a result it was impossible to determine the percentage of response. Since the results of the study are based on the responses of the dermatologists who completed the survey, they could be affected by memory bias.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusions</span><p id="par0120" class="elsevierStylePara elsevierViewall">The treatments most prescribed by dermatologists in Spain for male AGA and female AGA in postmenopausal women were topical minoxidil, oral finasteride, and nutricosmetics. In premenopausal women, the most common treatments were topical minoxidil, oral contraceptives, and nutricosmetics. AGA was the most common motive for consultation among patients with hair loss, followed by telogen effluvium, alopecia areata, and frontal fibrosing alopecia. Treatment with topical finasteride, oral dutasteride, PRP, and LLLT were more often prescribed in the private sector.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflicts of Interest</span><p id="par0125" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:12 [ 0 => array:3 [ "identificador" => "xres1066787" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1014548" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1066788" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1014547" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Patients and Methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflicts of Interest" ] 10 => array:2 [ "identificador" => "xack361069" "titulo" => "Acknowledgments" ] 11 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2017-09-24" "fechaAceptado" => "2018-02-07" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1014548" "palabras" => array:6 [ 0 => "Androgenetic alopecia" 1 => "Finasteride" 2 => "Dutasteride" 3 => "Low-level laser therapy" 4 => "Minoxidil" 5 => "Nutricosmetics" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1014547" "palabras" => array:6 [ 0 => "Alopecia androgénica" 1 => "Finasterida" 2 => "Dutasterida" 3 => "Láser de baja potencia" 4 => "Minoxidil" 5 => "Nutricosméticos" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Background</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Topical minoxidil and oral finasteride are the only drugs approved for the treatment of androgenetic alopecia (AGA) in Spain. However, the management of this condition is highly variable because numerous treatments are used off-label. The main aim of this study was to describe the prescribing habits of dermatologists in Spain for male AGA (MAGA) and female AGA (FAGA).</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Descriptive cross-sectional study using online questionnaires completed by dermatologists working in Spain.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The responses of 241 dermatologists were analyzed. The most common treatments prescribed for MAGA were minoxidil (98%), oral finasteride (96%), nutricosmetics (44%), topical finasteride (37%), oral dutasteride (33%), platelet-rich plasma (14%), and low-level laser therapy (8%). For premenopausal FAGA, the most common treatments were topical minoxidil (98%), oral contraceptives (81%), nutricosmetics (72%), cyproterone acetate (58%), oral finasteride (39%), topical finasteride (39%), spironolactone (27%), platelet-rich plasma (20%), oral dutasteride (20%), oral flutamide (18%), and low-level laser therapy (7%). Finally, for postmenopausal FAGA, the most common treatments prescribed were topical minoxidil (98%), oral finasteride (84%), nutricosmetics (68%), topical finasteride (50%), oral dutasteride (35%), platelet-rich plasma (21%), spironolactone (16%), cyproterone acetate (16%), oral flutamide (9%), and low-level laser therapy (9%).</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A limitation of our study is that we did not analyze novel AGA treatments such as oral minoxidil and dutasteride mesotherapy.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The most common treatments prescribed for AGA by dermatologists in Spain are topical minoxidil, oral finasteride, and nutricosmetics for MAGA and postmenopausal FAGA and topical minoxidil, oral contraceptives, and nutricosmetics for premenopausal FAGA.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Background" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducción</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">A pesar de que los únicos fármacos con indicación aprobada en nuestro país para la alopecia androgénica (AGA) son minoxidil tópico y finasterida oral, es común la utilización de numerosas terapias fuera de indicación, provocando una gran variabilidad en el manejo de estos pacientes. El objetivo principal de este trabajo fue describir los hábitos de prescripción de los dermatólogos en España en AGA masculina (MAGA) y AGA femenina (FAGA).</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y métodos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo transversal mediante cuestionarios digitales autocumplimentados por dermatólogos que ejercen en territorio español.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron las respuestas de un total de 241 dermatólogos. En MAGA los tratamientos más utilizados fueron en este orden: minoxidil tópico (98%), finasterida oral (96%), nutricosméticos (44%), finasterida tópica (37%), dutasterida oral (33%), plasma rico en plaquetas (14%) y láser de baja potencia (8%). En FAGA premenopáusica: minoxidil tópico (98%), anticonceptivos orales (81%), nutricosméticos (72%), acetato de ciproterona (58%), finasterida oral (39%), finasterida tópica (39%), espironolactona (27%), plasma rico en plaquetas (20%), dutasterida oral (20%), flutamida oral (18%) y láser de baja potencia (7%). En FAGA posmenopáusica: minoxidil tópico (98%), finasterida oral (84%), nutricosméticos (68%), finasterida tópica (50%), dutasterida oral (35%), plasma rico en plaquetas (21%), espironolactona (16%), acetato de ciproterona (16%), flutamida oral (9%) y láser de baja potencia (9%). Como limitaciones de nuestro estudio, no se incluyeron terapias novedosas para AGA como minoxidil oral o microinyecciones de dutasterida.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Los agentes terapéuticos más utilizados en MAGA y FAGA posmenopáusica por los dermatólogos en España fueron minoxidil tópico, finasterida oral y nutricosméticos, mientras que en FAGA premenopáusica fueron minoxidil tópico, anticonceptivos orales y nutricosméticos.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Pindado-Ortega C, Saceda-Corralo D, Buendía-Castaño D, Fernández-González P, Moreno-Arrones ÓM, Fonda-Pascual P, et al. Estudio transversal acerca de los hábitos de prescripción en alopecia androgénica de los dermatólogos en España en 2017. Actas Dermosifiliogr. 2018;109:536–542.</p>" ] ] "apendice" => array:1 [ 0 => array:1 [ "seccion" => array:1 [ 0 => array:4 [ "apendice" => "<p id="par0140" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="upi0005"></elsevierMultimedia></p>" "etiqueta" => "Appendix A" "titulo" => "Supplementary data" "identificador" => "sec0040" ] ] ] ] "multimedia" => array:7 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1534 "Ancho" => 1420 "Tamanyo" => 83127 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Frequency of consultation in the dermatology office for different types of alopecia. AGA, androgenic alopecia: FD, folliculitis decalvans; FFA, frontal fibrosing alopecia: LPP, lichen planopilaris.</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" => 1420 "Ancho" => 1420 "Tamanyo" => 52499 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Frequency of male androgenetic alopecia (MAGA), premenopausal female androgenetic alopecia (FAGA-Pre), and postmenopausal androgenetic alopecia (FAGA-Post) in the dermatology office.</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" => 1258 "Ancho" => 2170 "Tamanyo" => 159211 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Frequency of prescription for each treatment in male androgenetic alopecia (lilac bar, public sector; orange bar, private sector; green line, mean). LLLT, low-level laser therapy; PRP, platelet-rich plasma.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1269 "Ancho" => 2174 "Tamanyo" => 194064 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Frequency of prescription for each treatment in women with pre-menopausal androgenetic alopecia (lilac bar, public sector; orange bar, private sector; green line, mean). Cyproterone A, cyproterone acetate; LLLT, low-level laser therapy; PRP, platelet-rich plasma.</p>" ] ] 4 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figure 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1281 "Ancho" => 2170 "Tamanyo" => 196734 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Frequency of prescription for each treatment in women with post-menopausal androgenetic alopecia (lilac bar, public sector; orange bar, private sector; green line, mean). Cyproterone A, cyproterone acetate; LLLT, low-level laser therapy; PRP, platelet-rich plasma.</p>" ] ] 5 => array:7 [ "identificador" => "fig0030" "etiqueta" => "Figure 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 945 "Ancho" => 2167 "Tamanyo" => 203205 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Man aged 28 years with androgenetic alopecia treated with dutasteride 0.5<span class="elsevierStyleHsp" style=""></span>mg/d and minoxidil 5% applied nightly. A, Pretreatment. B, 12 months after start of treatment.</p>" ] ] 6 => array:5 [ "identificador" => "upi0005" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "Ecomponente" => array:2 [ "fichero" => "mmc1.pdf" "ficheroTamanyo" => 184483 ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:25 [ 0 => array:3 [ "identificador" => "bib0130" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Androgenetic alopecia: Pathogenesis and potential for therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.A. Ellis" 1 => "R. Sinclair" 2 => "S.B. Harrap" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "doi:10.1017/S1462399402004453" "Revista" => array:6 [ "tituloSerie" => "Expert Rev Mol Med." "fecha" => "2002" "volumen" => "4" "paginaInicial" => "1" "paginaFinal" => "11" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14987393" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0135" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incidence of female androgenetic alopecia (female pattern alopecia)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "O.T. Norwood" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Dermatol Surg." "fecha" => "2001" "volumen" => "27" "paginaInicial" => "53" "paginaFinal" => "54" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11231244" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0140" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of androgenetic alopecia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Tosti" 1 => "F. Camacho-Martinez" 2 => "R. Dawber" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol." "fecha" => "1999" "volumen" => "12" "paginaInicial" => "205" "paginaFinal" => "214" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10461639" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0145" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of hair loss" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "V.H. Price" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJM199909233411307" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med." "fecha" => "1999" "volumen" => "341" "paginaInicial" => "964" "paginaFinal" => "973" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10498493" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0150" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Natural progression of male pattern baldness in young men" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D.H. Rushton" 1 => "I.D. Ramsay" 2 => "M.J. Norris" 3 => "J.J. Gilkes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Exp Dermatol." "fecha" => "1991" "volumen" => "16" "paginaInicial" => "188" "paginaFinal" => "192" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1934570" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0155" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Frontal fibrosing alopecia: A multicenter review of 355 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Vañó-Galván" 1 => "A.M. Molina-Ruiz" 2 => "C. Serrano-Falcón" 3 => "S. Arias-Santiago" 4 => "A.R. Rodrigues-Barata" 5 => "G. Garnacho-Saucedo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2013.12.003" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol." "fecha" => "2014" "volumen" => "70" "paginaInicial" => "670" "paginaFinal" => "678" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24508293" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0160" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The psychological impact of alopecia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "N. Hunt" 1 => "S. McHale" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1136/bmj.331.7522.951" "Revista" => array:6 [ "tituloSerie" => "BMJ." "fecha" => "2005" "volumen" => "331" "paginaInicial" => "951" "paginaFinal" => "953" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16239692" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0165" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Topical minoxidil: Systematic review and meta-analysis of its efficacy in androgenetic alopecia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.K. Gupta" 1 => "A. Charrette" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Skinmed." "fecha" => "2015" "volumen" => "13" "paginaInicial" => "185" "paginaFinal" => "189" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26380504" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0170" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy and safety of finasteride therapy for androgenetic alopecia: A systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.M. Mella" 1 => "M.C. Perret" 2 => "M. Manzotti" 3 => "H.N. Catalano" 4 => "G. Guyatt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archdermatol.2010.256" "Revista" => array:6 [ "tituloSerie" => "Arch Dermatol." "fecha" => "2010" "volumen" => "146" "paginaInicial" => "1141" "paginaFinal" => "1150" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20956649" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0175" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Novedades terapéuticas en tricología" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S. Vañó-Galván" 1 => "F. Camacho" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ad.2016.11.010" "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr." "fecha" => "2017" "volumen" => "108" "paginaInicial" => "221" "paginaFinal" => "228" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28061966" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0180" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Superiority of dutasteride over finasteride in hair regrowth and reversal of miniaturization in men with androgenetic alopecia: A randomized controlled open-label, evaluator-blinded study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "S.J.S. Shanshanwal" 1 => "R.S. Dhurat" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/0378-6323.188652" "Revista" => array:6 [ "tituloSerie" => "Indian J Dermatol Venereol Leprol." "fecha" => "2017" "volumen" => "83" "paginaInicial" => "47" "paginaFinal" => "54" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27549867" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0185" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of dutasteride 0.5<span class="elsevierStyleHsp" style=""></span>mg/d in men with androgenetic alopecia recalcitrant to finasteride" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.Y. Jung" 1 => "J.H. Yeon" 2 => "J.W. Choi" 3 => "S.H. Kwon" 4 => "B.J. Kim" 5 => "S.W. Youn" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ijd.12060" "Revista" => array:6 [ "tituloSerie" => "Int J Dermatol." "fecha" => "2014" "volumen" => "53" "paginaInicial" => "1351" "paginaFinal" => "1357" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24898559" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0190" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "e3" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A randomized, active- and placebo-controlled study of the efficacy and safety of different doses of dutasteride versus placebo and finasteride in the treatment of male subjects with androgenetic alopecia" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "W. Gubelin Harcha" 1 => "J. Barboza Martínez" 2 => "T.F. Tsai" 3 => "K. Katsuoka" 4 => "M. Kawashima" 5 => "R. Tsuboi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2013.10.049" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol." "fecha" => "2014" "volumen" => "70" "paginaInicial" => "489" "paginaFinal" => "498" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24411083" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0195" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term safety and efficacy of dutasteride in the treatment of male patients with androgenetic alopecia" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "ARI114264 Study Group" "etal" => true "autores" => array:6 [ 0 => "Y. Tsunemi" 1 => "R. Irisawa" 2 => "H. Yoshiie" 3 => "B. Brotherton" 4 => "H. Ito" 5 => "R. Tsuboi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/1346-8138.13310" "Revista" => array:6 [ "tituloSerie" => "J Dermatol." "fecha" => "2016" "volumen" => "43" "paginaInicial" => "1051" "paginaFinal" => "1058" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26893187" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0200" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effect of 5α-reductase inhibitors on sexual function: A meta-analysis and systematic review of randomized controlled trials" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Liu" 1 => "S. Zhao" 2 => "F. Li" 3 => "E. Li" 4 => "R. Kang" 5 => "L. Luo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jsxm.2016.07.006" "Revista" => array:6 [ "tituloSerie" => "J Sex Med." "fecha" => "2016" "volumen" => "13" "paginaInicial" => "1297" "paginaFinal" => "1310" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27475241" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0205" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "CD007628" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Interventions for female pattern hair loss" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E.J. Van Zuuren" 1 => "Z. Fedorowicz" 2 => "J. Schoones" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:2 [ "tituloSerie" => "Cochrane Database Syst Rev." "fecha" => "2016" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0210" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "NI-MUH_FV_03-2017-flutamida.pdf [Internet]. [cited 2017 Sep 20]. Available from: <a id="intr0015" class="elsevierStyleInterRef" href="https://www.aemps.gob.es/informa/notasInformativas/medicamentosUsoHumano/seguridad/2017/docs/NI-MUH_FV_03-2017-flutamida.pdf">https://www.aemps.gob.es/informa/notasInformativas/medicamentosUsoHumano/seguridad/2017/docs/NI-MUH_FV_03-2017-flutamida.pdf</a>" ] ] ] 17 => array:3 [ "identificador" => "bib0215" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Blumeyer" 1 => "A. Tosti" 2 => "A. Messenger" 3 => "P. Reygagne" 4 => "V. Del Marmol" 5 => "P.I. Spuls" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Dtsch Dermatol Ges J Ger Soc Dermatol JDDG." "fecha" => "2011" "volumen" => "9 Suppl 6" "paginaInicial" => "S1" "paginaFinal" => "S57" ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0220" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Low level laser therapy and hair regrowth: An evidence-based review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Zarei" 1 => "T.C. Wikramanayake" 2 => "L. Falto-Aizpurua" 3 => "L.A. Schachner" 4 => "J.J. Jimenez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10103-015-1818-2" "Revista" => array:6 [ "tituloSerie" => "Lasers Med Sci." "fecha" => "2016" "volumen" => "31" "paginaInicial" => "363" "paginaFinal" => "371" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26690359" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0225" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Efficacy and safety of a low-level laser device in the treatment of male and female pattern hair loss: A multicenter, randomized, sham device-controlled double-blind study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.J. Jimenez" 1 => "T.C. Wikramanayake" 2 => "W. Bergfeld" 3 => "M. Hordinsky" 4 => "J.G. Hickman" 5 => "M.R. Hamblin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s40257-013-0060-6" "Revista" => array:6 [ "tituloSerie" => "Am J Clin Dermatol." "fecha" => "2014" "volumen" => "15" "paginaInicial" => "115" "paginaFinal" => "127" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24474647" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0230" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Low-level laser (light) therapy (LLLT) for treatment of hair loss" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P. Avci" 1 => "G.K. Gupta" 2 => "J. Clark" 3 => "N. Wikonkal" 4 => "M.R. Hamblin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/lsm.22170" "Revista" => array:6 [ "tituloSerie" => "Lasers Surg Med." "fecha" => "2014" "volumen" => "46" "paginaInicial" => "144" "paginaFinal" => "151" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23970445" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0235" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Low-level light therapy for androgenetic alopecia: A 24-week, randomized, double-blind, sham device-controlled multicenter trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "H. Kim" 1 => "J.W. Choi" 2 => "J.Y. Kim" 3 => "J.W. Shin" 4 => "S.-J. Lee" 5 => "C.-H. Huh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/dsu.12200" "Revista" => array:6 [ "tituloSerie" => "Dermatol Surg." "fecha" => "2013" "volumen" => "39" "paginaInicial" => "1177" "paginaFinal" => "1183" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23551662" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0240" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Meta-analysis of efficacy of platelet-rich plasma therapy for androgenetic alopecia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.K. Gupta" 1 => "J.L. Carviel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Dermatol Treat." "fecha" => "2017" "volumen" => "28" "paginaInicial" => "55" "paginaFinal" => "58" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0245" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hair transplant: Added value when performed by a dermatologist" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "S. Vañó Galván" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ad.2017.06.001" "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr." "fecha" => "2017" "volumen" => "108" "paginaInicial" => "495" "paginaFinal" => "497" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28668139" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0250" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mesotherapy with dutasteride in the treatment of androgenetic alopecia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D. Saceda-Corralo" 1 => "A.R. Rodrigues-Barata" 2 => "S. Vano-Galvan" 3 => "P. Jaen-Olasolo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/ijt.ijt_73_16" "Revista" => array:5 [ "tituloSerie" => "Int J Trichology." "fecha" => "2017" "volumen" => "9" "paginaInicial" => "143" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28932074" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack361069" "titulo" => "Acknowledgments" "texto" => "<p id="par0130" class="elsevierStylePara elsevierViewall">We would like to thank the members of the Dermachat working group for their collaboration in this study.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010900000006/v1_201808010420/S1578219018301793/v1_201808010420/en/main.assets" "Apartado" => array:4 [ "identificador" => "6256" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original article" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010900000006/v1_201808010420/S1578219018301793/v1_201808010420/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018301793?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 12 | 9 | 21 |
| 2024 Octubre | 106 | 52 | 158 |
| 2024 Septiembre | 75 | 35 | 110 |
| 2024 Agosto | 125 | 56 | 181 |
| 2024 Julio | 75 | 41 | 116 |
| 2024 Junio | 92 | 29 | 121 |
| 2024 Mayo | 67 | 41 | 108 |
| 2024 Abril | 85 | 33 | 118 |
| 2024 Marzo | 62 | 42 | 104 |
| 2024 Febrero | 85 | 32 | 117 |
| 2024 Enero | 79 | 44 | 123 |
| 2023 Diciembre | 60 | 25 | 85 |
| 2023 Noviembre | 86 | 45 | 131 |
| 2023 Octubre | 62 | 33 | 95 |
| 2023 Septiembre | 61 | 44 | 105 |
| 2023 Agosto | 31 | 25 | 56 |
| 2023 Julio | 68 | 46 | 114 |
| 2023 Junio | 43 | 49 | 92 |
| 2023 Mayo | 70 | 47 | 117 |
| 2023 Abril | 46 | 56 | 102 |
| 2023 Marzo | 82 | 52 | 134 |
| 2023 Febrero | 65 | 43 | 108 |
| 2023 Enero | 55 | 46 | 101 |
| 2022 Diciembre | 65 | 52 | 117 |
| 2022 Noviembre | 43 | 43 | 86 |
| 2022 Octubre | 29 | 44 | 73 |
| 2022 Septiembre | 30 | 44 | 74 |
| 2022 Agosto | 28 | 58 | 86 |
| 2022 Julio | 42 | 48 | 90 |
| 2022 Junio | 42 | 45 | 87 |
| 2022 Mayo | 70 | 57 | 127 |
| 2022 Abril | 66 | 59 | 125 |
| 2022 Marzo | 87 | 79 | 166 |
| 2022 Febrero | 70 | 56 | 126 |
| 2022 Enero | 82 | 90 | 172 |
| 2021 Diciembre | 74 | 51 | 125 |
| 2021 Noviembre | 69 | 58 | 127 |
| 2021 Octubre | 88 | 78 | 166 |
| 2021 Septiembre | 72 | 69 | 141 |
| 2021 Agosto | 71 | 85 | 156 |
| 2021 Julio | 49 | 40 | 89 |
| 2021 Junio | 48 | 46 | 94 |
| 2021 Mayo | 65 | 86 | 151 |
| 2021 Abril | 118 | 131 | 249 |
| 2021 Marzo | 111 | 70 | 181 |
| 2021 Febrero | 123 | 70 | 193 |
| 2021 Enero | 98 | 65 | 163 |
| 2020 Diciembre | 88 | 66 | 154 |
| 2020 Noviembre | 74 | 51 | 125 |
| 2020 Octubre | 59 | 29 | 88 |
| 2020 Septiembre | 67 | 36 | 103 |
| 2020 Agosto | 45 | 40 | 85 |
| 2020 Julio | 44 | 45 | 89 |
| 2020 Junio | 52 | 46 | 98 |
| 2020 Mayo | 32 | 23 | 55 |
| 2020 Abril | 25 | 15 | 40 |
| 2020 Marzo | 25 | 18 | 43 |
| 2019 Mayo | 0 | 1 | 1 |
| 2018 Septiembre | 1 | 2 | 3 |
Mostrar todo
