Reverse Isotopic Phenomenon in Drug Reaction with Eosinophilia and Systemic Symptoms

array:24 ["pii" => "S1578219018303275" "issn" => "15782190" "doi" => "10.1016/j.adengl.2018.09.013" "estado" => "S300" "fechaPublicacion" => "2019-09-01" "aid" => "2045" "copyright" => "Elsevier España, S.L.U. and AEDV" "copyrightAnyo" => "2018" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2019;110:613-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1 "HTML" => 1 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731018303855" "issn" => "00017310" "doi" => "10.1016/j.ad.2018.02.026" "estado" => "S300" "fechaPublicacion" => "2019-09-01" "aid" => "2045" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2019;110:613-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 175 "formatos" => array:2 [ "HTML" => 121 "PDF" => 54 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "Carta científico-clínica" "titulo" => "Fenómeno isotópico inverso en el síndrome de reacción por drogas con eosinofilia y síntomas sistémicos" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "613" "paginaFinal" => "615" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Reverse Isotopic Phenomenon in Drug Reaction with Eosinophilia and Systemic Symptoms" ] ] "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" => 851 "Ancho" => 800 "Tamanyo" => 115318 ] ] "descripcion" => array:1 [ "es" => "A más aumentos, la zona preservada muestra hiperpigmentación y cicatrices del herpes zóster curado quedando preservado el dermatoma T9 de la erupción cutánea." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Adil, Syed Suhail Amin, R. Dinesh Raj, Hera Tabassum" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Adil" ] 1 => array:2 [ "nombre" => "Syed Suhail" "apellidos" => "Amin" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Dinesh Raj" ] 3 => array:2 [ "nombre" => "Hera" "apellidos" => "Tabassum" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219018303275" "doi" => "10.1016/j.adengl.2018.09.013" "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/S1578219018303275?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731018303855?idApp=UINPBA000044" "url" => "/00017310/0000011000000007/v1_201909021023/S0001731018303855/v1_201909021023/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219019302410" "issn" => "15782190" "doi" => "10.1016/j.adengl.2019.07.013" "estado" => "S300" "fechaPublicacion" => "2019-09-01" "aid" => "2168" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2019;110:615-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "Case and Research Letters" "titulo" => "Molluscum Contagiosum on the Palms: An Uncommon Location" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "615" "paginaFinal" => "617" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Molusco contagioso palmar, una localización excepcional" ] ] "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" => 1079 "Ancho" => 905 "Tamanyo" => 131294 ] ] "descripcion" => array:1 [ "en" => "Two erythematous papules with diameters of 2 and 4mm, respectively. The larger papule shows central hyperkeratosis and a perilesional erythematous halo." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "P. García-Montero, R. Serrano-Pardo, R. Ruiz-Rodríguez, I. Sánchez-Carpintero" "autores" => array:4 [ 0 => array:2 [ "nombre" => "P." "apellidos" => "García-Montero" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Serrano-Pardo" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Ruiz-Rodríguez" ] 3 => array:2 [ "nombre" => "I." "apellidos" => "Sánchez-Carpintero" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731019300997" "doi" => "10.1016/j.ad.2018.02.043" "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/S0001731019300997?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019302410?idApp=UINPBA000044" "url" => "/15782190/0000011000000007/v1_201909021030/S1578219019302410/v1_201909021030/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219019302380" "issn" => "15782190" "doi" => "10.1016/j.adengl.2018.01.006" "estado" => "S300" "fechaPublicacion" => "2019-09-01" "aid" => "1927" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2019;110:610-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "Case and Research Letters" "titulo" => "Green, yellow and red hours to go to the beach" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "610" "paginaFinal" => "612" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Horas de color verde, amarillo y rojo para ir a la playa" ] ] "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" => 1160 "Ancho" => 1733 "Tamanyo" => 431163 ] ] "descripcion" => array:1 [ "en" => "Sun clock." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "O. Correia, A.F. Duarte, A. Picoto" "autores" => array:3 [ 0 => array:2 [ "nombre" => "O." "apellidos" => "Correia" ] 1 => array:2 [ "nombre" => "A.F." "apellidos" => "Duarte" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Picoto" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731018300899" "doi" => "10.1016/j.ad.2018.01.008" "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/S0001731018300899?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019302380?idApp=UINPBA000044" "url" => "/15782190/0000011000000007/v1_201909021030/S1578219019302380/v1_201909021030/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "Case and Research Letters" "titulo" => "Reverse Isotopic Phenomenon in Drug Reaction with Eosinophilia and Systemic Symptoms" "tieneTextoCompleto" => true "saludo" => "To the Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "613" "paginaFinal" => "615" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "M. Adil, Syed Suhail Amin, R. Dinesh Raj, Hera Tabassum" "autores" => array:4 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "Adil" "email" => array:1 [ 0 => "dr.mohd.adil@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Syed Suhail" "apellidos" => "Amin" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Dinesh Raj" ] 3 => array:2 [ "nombre" => "Hera" "apellidos" => "Tabassum" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Departamento de Dermatología, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Fenómeno isotópico inverso en el síndrome de reacción por drogas con eosinofilia y síntomas sistémicos" ] ] "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" => 851 "Ancho" => 800 "Tamanyo" => 117178 ] ] "descripcion" => array:1 [ "en" => "A closer view of the spared site shows hyperpigmentation and scars of healed herpes zoster with sparing of the T9 dermatome by the rash." ] ] ] "textoCompleto" => "Reverse isotopic phenomenon, or isotopic non-response, is an extremely rare phenomenon characterised by the absence of a skin disease at the site of another unrelated skin disease which is already healed.<a class="elsevierStyleCrossRef" href="#bib0060">1</a> Sparing occurs at the healed site of an inflammatory disease. Most reports of reverse isotopic phenomenon show the sparing of the skin previously involved in herpes zoster.<a class="elsevierStyleCrossRef" href="#bib0065">2</a>We describe a case of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome due to carbamazepine with isotopic non-response at the site of healed herpes zoster.A 60 year male presented to us with complaints of fever, breathlessness and red itchy rash over body since 7 days. The patient had developed herpes zoster on the lower part of the right chest around two months back, and was prescribed Tab Carbamazepine by a local physician for the residual pain.On examination, the patient was found to have generalised swelling, particularly prominent over the periocular areas. He was febrile (100.6 F) and had tachycardia (heart rate-110/min) and tachypnea (respiratory rate-22/min). The abdomen was distended and bowels sounds were not heard. There was mildly tender lymphadenopathy in inguinal and axillary areas. Cutaneous examination revealed erythematous maculopapular lesions predominantly distributed over the face, trunk and proximal extremities with tendency to coalesce such that the whole of the trunk was involved except the right T9 dermatome which was characteristically spared. [<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>] The skin of the right T9 dermatome showed hyperpigmented scars of the healed herpes zoster. [<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>] The rest of the cutaneous and systemic examination was normal.<elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia>Investigations revealed leucocytosis (TLC- 15500/ cu mm; normal- 4000-11000/ cu mm) with eosinophilia (AEC- 1580/ cu mm; normal- 40-440/ cu mm). There was elevation of liver enzymes (SGOT- 660 IU; normal- 7-40 IU, SGPT- 590 IU; normal- 7-56 IU) and increased blood urea (120mg/dl; normal- 10-40mg/dl) and serum creatinine (1.9mg/dl; normal- 0.3-1.2mg/dl). The patient had a normal chest radiograph and a gas filled distended bowel suggestive of paralytic ileus. The patient had hyperamylesemia (260 U/l; normal- 40-140 U/l) suggestive of pancreatitis. He subsequently developed fatal acute respiratory distress syndrome. A diagnosis of DRESS syndrome was made based on the RegiSCAR criteria.<a class="elsevierStyleCrossRef" href="#bib0070">3</a>DRESS syndrome is a rare idiosyncratic reaction reaction to a drug characterised by skin rash, fever, lymphadenopathy, eosinophilia and multiorgan involvement. It is commonly caused by anticonvulsant medications, allopurinol, minocycline and antiretroviral agents like abacavir. Pathogenesis is unclear but it is believed to occur in patients who metabolise the drugs and its active metabolites slowly. A genetic predisposition exists and Human Herpesviruses has been associated. The cross reaction of antiviral T cells with the culprit drug has been proposed to mediate this syndrome.<a class="elsevierStyleCrossRef" href="#bib0075">4</a> However, the sparing of the healed herpes zoster site casts doubt regarding this theory.The possible reason for the sparing of a skin lesion to a secondary insult is unclear. The rash of DRESS may result from alteration of the local immune response by a virus itself or by production of Th1 cytokines like TNF-alpha, IFN-gamma, IL-2 and IL-5.<a class="elsevierStyleCrossRef" href="#bib0065">2</a> The loss or hypoactivity of Langerhans cells at the site of herpes zoster has been demonstrated and may play a role in this sparing phenomenon.<a class="elsevierStyleCrossRef" href="#bib0080">5</a> Also, herpesvirus infected keratinocytes have decreased expression of MHC and ICAM-1, hindering their function as antigen presenting cells and inhibiting T cell response, thereby leading to the skin rash of DRESS.<a class="elsevierStyleCrossRef" href="#bib0085">6</a>Isotopic non-response needs to be differentiated from isomorphic non-response or Renbök phenomenon. The site of another unrelated skin disease is spared in both of the above phenomenon. This disease is still active in Renbök phenomenon while it is healed in the isotopic non-response.<a class="elsevierStyleCrossRef" href="#bib0060">1</a>Very few cases of reverse isotopic phenomenon have been reported in literature. There reports have shown the sparing of the sites of vaccination,<a class="elsevierStyleCrossRef" href="#bib0090">7</a> herpes zoster<a class="elsevierStyleCrossRefs" href="#bib0065">2,5,6,8,9</a> and burn scar<a class="elsevierStyleCrossRef" href="#bib0105">10</a> that have occurred in diverse conditions like epidermal necrolysis,<a class="elsevierStyleCrossRef" href="#bib0065">2</a> erythema multiformae,<a class="elsevierStyleCrossRef" href="#bib0095">8</a> cutaneous lymphomas,<a class="elsevierStyleCrossRef" href="#bib0080">5</a> leprosy<a class="elsevierStyleCrossRef" href="#bib0100">9</a> and annular elastolytic giant cell granuloma.<a class="elsevierStyleCrossRef" href="#bib0105">10</a> [<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>] Ours is probably the first case of reverse isotopic phenomenon in DRESS syndrome.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Conflicts of InterestThe authors declare that they have no conflicts of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of Interest" ] 1 => array:1 [ "titulo" => "Bibliografía" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Adil M, Amin SS, Dinesh Raj R, Tabassum H. Reverse Isotopic Phenomenon in Drug Reaction with Eosinophilia and Systemic Symptoms. Actas Dermosifiliogr. 2019;110:613–615." ] ] "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" => 1410 "Ancho" => 800 "Tamanyo" => 125202 ] ] "descripcion" => array:1 [ "en" => "Confluent erythematous maculopapular lesions over the chest and abdomen with sparing of the right T9 dermatome." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 851 "Ancho" => 800 "Tamanyo" => 117178 ] ] "descripcion" => array:1 [ "en" => "A closer view of the spared site shows hyperpigmentation and scars of healed herpes zoster with sparing of the T9 dermatome by the rash." ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "DRESS: drug reaction with eosinophilia and systemic symptoms; ND: no disponible; Rx: rayos X; SJS-TEN: Stevens-Johnson syndrome-toxic epidermal necrolysis." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N.° de caso \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Estudio \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Edad/sexo \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Enfermedad secundaria \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sitio de la preservación \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Enfermedad primaria \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nuestro caso \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 años/varón \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Síndrome DRESS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Tronco (dermatoma T9 derecho) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Herpes zóster \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Tenea D<a class="elsevierStyleCrossRef" href="#bib0065">2</a> (2010) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">39 años/mujer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Síndrome Stevens-Johnson \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lado derecho del tronco \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Herpes zóster \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Kannangara AP et al.<a class="elsevierStyleCrossRef" href="#bib0085">6</a> (2008) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53 años/mujer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Síndrome sobreposición SJS-TEN \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nervio craneal V1 izquierda \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Herpes zóster \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Kannangara AP et al.<a class="elsevierStyleCrossRef" href="#bib0085">6</a> (2008) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">62 años/varón \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Eritrodermia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">C3-C4 izquierda \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Herpes zóster \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Park H et al.<a class="elsevierStyleCrossRef" href="#bib0090">7</a> (2008) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">67 años/mujer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Eritema multiforme \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Tronco (dermatoma T3) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Herpes zóster \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Twersky JM et al.<a class="elsevierStyleCrossRef" href="#bib0080">5</a> (2004) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">58 años/varón \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Linfoma cutáneo células T \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Tronco (dermatoma T8 izquierdo) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Herpes zóster \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Jain R et al.<a class="elsevierStyleCrossRef" href="#bib0095">8</a> (2003) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lepra «borderline» \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Herpes zóster \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Jain R et al.<a class="elsevierStyleCrossRef" href="#bib0095">8</a> (2003) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lepra «borderline» \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ND \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Herpes zóster \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Okaya-Bayazit E et al.<a class="elsevierStyleCrossRef" href="#bib0100">9</a> (1999) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">72 años/mujer \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Granuloma elastolítico anular de células gigantes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Antebrazo izquierdo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cicatriz quemadura \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nasca MR et al.<a class="elsevierStyleCrossRef" href="#bib0105">10</a> (1995) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">53 años/varón \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Acné esteroideo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Espalda \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sitio irradiación Rx \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Huilgol SC et al.<a class="elsevierStyleCrossRef" href="#bib0110">11</a> (1995) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">74 años/varón \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Granuloma anulargeneralizado \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Brazo izquierdo \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Punto de vacunación \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2114540.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Details of cases of isotopic non-response reported in literature." ] ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bib0060" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Wolf's isotopic response" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Wolf" 1 => "D. Wolf" 2 => "E. Ruocco" 3 => "G. Brunetti" 4 => "V. Ruocco" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clindermatol.2010.09.015" "Revista" => array:6 [ "tituloSerie" => "Clin Dermatol" "fecha" => "2011" "volumen" => "29" "paginaInicial" => "237" "paginaFinal" => "240" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21396564" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0065" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Carbamazepine-induced Stevens-Johnson syndrome sparing the skin previously affected by herpes zoster infection in a patient with systemic lupus erythematosus: A reverse isotopic phenomenon" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D. Tenea" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000319628" "Revista" => array:6 [ "tituloSerie" => "Case Rep Dermatol" "fecha" => "2010" "volumen" => "2" "paginaInicial" => "140" "paginaFinal" => "145" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21076686" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0070" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Choudhary" 1 => "M. McLeod" 2 => "D. Torchia" 3 => "P. Romanelli" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Clin Aesthetic Dermatol" "fecha" => "2013" "volumen" => "6" "paginaInicial" => "31" "paginaFinal" => "37" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0075" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A complex interaction between drug allergy and viral infection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "T. Shiohara" 1 => "Y. Kano" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Rev Allergol Immunol" "fecha" => "2007" "volumen" => "33" "paginaInicial" => "124" "paginaFinal" => "133" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0080" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cutaneous T-cell lymphoma sparing resolving dermatomal herpes zoster lesions: An unusual phenomenon and implications for pathophysiology" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.M. Twersky" 1 => "J.J. Nordlund" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2003.12.027" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2004" "volumen" => "51" "paginaInicial" => "123" "paginaFinal" => "126" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15243537" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0085" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Herpes zoster virus associated “sparing phenomenon”: Is it an innate possess of HZV or keratinocyte cytokine(s) mediated or combination?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.P. Kannangara" 1 => "A.B.JJr. Fleischer" 2 => "G. Yosipovitch" 3 => "R.W. Ragunathan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1468-3083.2008.02627.x" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2008" "volumen" => "22" "paginaInicial" => "1373" "paginaFinal" => "1375" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18422536" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0090" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Erythema multiforme sparing regressing herpes zoster lesion: “Reverse isotopic phenomenon?”" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H. Park" 1 => "Y. Kang" 2 => "U. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2008" "volumen" => "58" "numero" => "Suppl 2" "paginaInicial" => "AB40" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0095" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Leprosy and herpes zoster: An association or dissociation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R. Jain" 1 => "S. Dogra" 2 => "I. Kaur" 3 => "B. Kumar" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Indian J Lepr" "fecha" => "2003" "volumen" => "75" "paginaInicial" => "263" "paginaFinal" => "264" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15267196" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0100" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Annular elastolytic giant cell granuloma: Sparing of a burn scar and successful treatment with chloroquine" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E. Ozkaya-Bayazit" 1 => "N. Büyükbabani" 2 => "C. Baykal" 3 => "A. Ozturk" 4 => "M. Okcu" 5 => "H.P. Soyer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1365-2133.1999.02723.x" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "1999" "volumen" => "140" "paginaInicial" => "525" "paginaFinal" => "530" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10233280" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0105" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Nasca MR, Micali G, Ferrau F. Steroid acne sparing an area of previous irradiated skin. Acta Derm Venereol. 1995;75:495." ] ] ] 10 => array:3 [ "identificador" => "bib0110" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Generalized granuloma annular sparing vaccination sites" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S.C. Huilgol" 1 => "K. Liddell" 2 => "M.M. Black" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2230.1995.tb01283.x" "Revista" => array:6 [ "tituloSerie" => "Clin Exp Dermatol" "fecha" => "1995" "volumen" => "20" "paginaInicial" => "51" "paginaFinal" => "53" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7671397" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011000000007/v1_201909021030/S1578219018303275/v1_201909021030/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/15782190/0000011000000007/v1_201909021030/S1578219018303275/v1_201909021030/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018303275?idApp=UINPBA000044"]

Estadísticas

Case and Research Letters

Reverse Isotopic Phenomenon in Drug Reaction with Eosinophilia and Systemic Symptoms

Fenómeno isotópico inverso en el síndrome de reacción por drogas con eosinofilia y síntomas sistémicos

M. Adil

Autor para correspondencia

dr.mohd.adil@gmail.com

Corresponding author.

, Syed Suhail Amin, R. Dinesh Raj, Hera Tabassum

Departamento de Dermatología, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, India

Leído

5564

Veces
se ha leído el artículo

2190

Total PDF

3374

Total HTML

Compartir estadísticas

 array:24 [
  "pii" => "S1578219018303275"
  "issn" => "15782190"
  "doi" => "10.1016/j.adengl.2018.09.013"
  "estado" => "S300"
  "fechaPublicacion" => "2019-09-01"
  "aid" => "2045"
  "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
  "copyrightAnyo" => "2018"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Actas Dermosifiliogr. 2019;110:613-5"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 1
    "HTML" => 1
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0001731018303855"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2018.02.026"
      "estado" => "S300"
      "fechaPublicacion" => "2019-09-01"
      "aid" => "2045"
      "copyright" => "AEDV"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Actas Dermosifiliogr. 2019;110:613-5"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 175
        "formatos" => array:2 [
          "HTML" => 121
          "PDF" => 54
        ]
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fico-cl&#237;nica</span>"
        "titulo" => "Fen&#243;meno isot&#243;pico inverso en el s&#237;ndrome de reacci&#243;n por drogas con eosinofilia y s&#237;ntomas sist&#233;micos"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "613"
            "paginaFinal" => "615"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Reverse Isotopic Phenomenon in Drug Reaction with Eosinophilia and Systemic Symptoms"
          ]
        ]
        "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" => 851
                "Ancho" => 800
                "Tamanyo" => 115318
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A m&#225;s aumentos&#44; la zona preservada muestra hiperpigmentaci&#243;n y cicatrices del herpes z&#243;ster curado quedando preservado el dermatoma T9 de la erupci&#243;n cut&#225;nea&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "M&#46; Adil, Syed Suhail Amin, R&#46; Dinesh Raj, Hera Tabassum"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "M&#46;"
                "apellidos" => "Adil"
              ]
              1 => array:2 [
                "nombre" => "Syed Suhail"
                "apellidos" => "Amin"
              ]
              2 => array:2 [
                "nombre" => "R&#46;"
                "apellidos" => "Dinesh Raj"
              ]
              3 => array:2 [
                "nombre" => "Hera"
                "apellidos" => "Tabassum"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1578219018303275"
          "doi" => "10.1016/j.adengl.2018.09.013"
          "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/S1578219018303275?idApp=UINPBA000044"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731018303855?idApp=UINPBA000044"
      "url" => "/00017310/0000011000000007/v1_201909021023/S0001731018303855/v1_201909021023/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1578219019302410"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2019.07.013"
    "estado" => "S300"
    "fechaPublicacion" => "2019-09-01"
    "aid" => "2168"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2019;110:615-7"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
      "titulo" => "Molluscum Contagiosum on the Palms&#58; An Uncommon Location"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "615"
          "paginaFinal" => "617"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Molusco contagioso palmar&#44; una localizaci&#243;n excepcional"
        ]
      ]
      "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" => 1079
              "Ancho" => 905
              "Tamanyo" => 131294
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Two erythematous papules with diameters of 2 and 4<span class="elsevierStyleHsp" style=""></span>mm&#44; respectively&#46; The larger papule shows central hyperkeratosis and a perilesional erythematous halo&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "P&#46; Garc&#237;a-Montero, R&#46; Serrano-Pardo, R&#46; Ruiz-Rodr&#237;guez, I&#46; S&#225;nchez-Carpintero"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Garc&#237;a-Montero"
            ]
            1 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Serrano-Pardo"
            ]
            2 => array:2 [
              "nombre" => "R&#46;"
              "apellidos" => "Ruiz-Rodr&#237;guez"
            ]
            3 => array:2 [
              "nombre" => "I&#46;"
              "apellidos" => "S&#225;nchez-Carpintero"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731019300997"
        "doi" => "10.1016/j.ad.2018.02.043"
        "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/S0001731019300997?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019302410?idApp=UINPBA000044"
    "url" => "/15782190/0000011000000007/v1_201909021030/S1578219019302410/v1_201909021030/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1578219019302380"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2018.01.006"
    "estado" => "S300"
    "fechaPublicacion" => "2019-09-01"
    "aid" => "1927"
    "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2019;110:610-2"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
      "titulo" => "Green&#44; yellow and red hours to go to the beach"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "610"
          "paginaFinal" => "612"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Horas de color verde&#44; amarillo y rojo para ir a la playa"
        ]
      ]
      "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" => 1160
              "Ancho" => 1733
              "Tamanyo" => 431163
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Sun clock&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "O&#46; Correia, A&#46;F&#46; Duarte, A&#46; Picoto"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "O&#46;"
              "apellidos" => "Correia"
            ]
            1 => array:2 [
              "nombre" => "A&#46;F&#46;"
              "apellidos" => "Duarte"
            ]
            2 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Picoto"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731018300899"
        "doi" => "10.1016/j.ad.2018.01.008"
        "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/S0001731018300899?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019302380?idApp=UINPBA000044"
    "url" => "/15782190/0000011000000007/v1_201909021030/S1578219019302380/v1_201909021030/en/main.assets"
  ]
  "en" => array:16 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
    "titulo" => "Reverse Isotopic Phenomenon in Drug Reaction with Eosinophilia and Systemic Symptoms"
    "tieneTextoCompleto" => true
    "saludo" => "<span class="elsevierStyleItalic">To the Editor&#58;</span>"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "613"
        "paginaFinal" => "615"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "M&#46; Adil, Syed Suhail Amin, R&#46; Dinesh Raj, Hera Tabassum"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "M&#46;"
            "apellidos" => "Adil"
            "email" => array:1 [
              0 => "dr.mohd.adil@gmail.com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "Syed Suhail"
            "apellidos" => "Amin"
          ]
          2 => array:2 [
            "nombre" => "R&#46;"
            "apellidos" => "Dinesh Raj"
          ]
          3 => array:2 [
            "nombre" => "Hera"
            "apellidos" => "Tabassum"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Departamento de Dermatolog&#237;a&#44; Jawaharlal Nehru Medical College&#44; Aligarh Muslim University&#44; Aligarh&#44; India"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Fen&#243;meno isot&#243;pico inverso en el s&#237;ndrome de reacci&#243;n por drogas con eosinofilia y s&#237;ntomas sist&#233;micos"
      ]
    ]
    "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" => 851
            "Ancho" => 800
            "Tamanyo" => 117178
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A closer view of the spared site shows hyperpigmentation and scars of healed herpes zoster with sparing of the T9 dermatome by the rash&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Reverse isotopic phenomenon&#44; or isotopic non-response&#44; is an extremely rare phenomenon characterised by the absence of a skin disease at the site of another unrelated skin disease which is already healed&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a> Sparing occurs at the healed site of an inflammatory disease&#46; Most reports of reverse isotopic phenomenon show the sparing of the skin previously involved in herpes zoster&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">We describe a case of Drug Reaction with Eosinophilia and Systemic Symptoms &#40;DRESS&#41; syndrome due to carbamazepine with isotopic non-response at the site of healed herpes zoster&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">A 60 year male presented to us with complaints of fever&#44; breathlessness and red itchy rash over body since 7 days&#46; The patient had developed herpes zoster on the lower part of the right chest around two months back&#44; and was prescribed Tab Carbamazepine by a local physician for the residual pain&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">On examination&#44; the patient was found to have generalised swelling&#44; particularly prominent over the periocular areas&#46; He was febrile &#40;100&#46;6 F&#41; and had tachycardia &#40;heart rate-110&#47;min&#41; and tachypnea &#40;respiratory rate-22&#47;min&#41;&#46; The abdomen was distended and bowels sounds were not heard&#46; There was mildly tender lymphadenopathy in inguinal and axillary areas&#46; Cutaneous examination revealed erythematous maculopapular lesions predominantly distributed over the face&#44; trunk and proximal extremities with tendency to coalesce such that the whole of the trunk was involved except the right T9 dermatome which was characteristically spared&#46; &#91;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#93; The skin of the right T9 dermatome showed hyperpigmented scars of the healed herpes zoster&#46; &#91;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#93; The rest of the cutaneous and systemic examination was normal&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Investigations revealed leucocytosis &#40;TLC- 15500&#47; cu mm&#59; normal- 4000-11000&#47; cu mm&#41; with eosinophilia &#40;AEC- 1580&#47; cu mm&#59; normal- 40-440&#47; cu mm&#41;&#46; There was elevation of liver enzymes &#40;SGOT- 660 IU&#59; normal- 7-40 IU&#44; SGPT- 590 IU&#59; normal- 7-56 IU&#41; and increased blood urea &#40;120<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#59; normal- 10-40<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41; and serum creatinine &#40;1&#46;9<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#59; normal- 0&#46;3-1&#46;2<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#41;&#46; The patient had a normal chest radiograph and a gas filled distended bowel suggestive of paralytic ileus&#46; The patient had hyperamylesemia &#40;260 U&#47;l&#59; normal- 40-140 U&#47;l&#41; suggestive of pancreatitis&#46; He subsequently developed fatal acute respiratory distress syndrome&#46; A diagnosis of DRESS syndrome was made based on the RegiSCAR criteria&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">3</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">DRESS syndrome is a rare idiosyncratic reaction reaction to a drug characterised by skin rash&#44; fever&#44; lymphadenopathy&#44; eosinophilia and multiorgan involvement&#46; It is commonly caused by anticonvulsant medications&#44; allopurinol&#44; minocycline and antiretroviral agents like abacavir&#46; Pathogenesis is unclear but it is believed to occur in patients who metabolise the drugs and its active metabolites slowly&#46; A genetic predisposition exists and Human Herpesviruses has been associated&#46; The cross reaction of antiviral T cells with the culprit drug has been proposed to mediate this syndrome&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">4</span></a> However&#44; the sparing of the healed herpes zoster site casts doubt regarding this theory&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The possible reason for the sparing of a skin lesion to a secondary insult is unclear&#46; The rash of DRESS may result from alteration of the local immune response by a virus itself or by production of Th1 cytokines like TNF-alpha&#44; IFN-gamma&#44; IL-2 and IL-5&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">2</span></a> The loss or hypoactivity of Langerhans cells at the site of herpes zoster has been demonstrated and may play a role in this sparing phenomenon&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a> Also&#44; herpesvirus infected keratinocytes have decreased expression of MHC and ICAM-1&#44; hindering their function as antigen presenting cells and inhibiting T cell response&#44; thereby leading to the skin rash of DRESS&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">6</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Isotopic non-response needs to be differentiated from isomorphic non-response or Renb&#246;k phenomenon&#46; The site of another unrelated skin disease is spared in both of the above phenomenon&#46; This disease is still active in Renb&#246;k phenomenon while it is healed in the isotopic non-response&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Very few cases of reverse isotopic phenomenon have been reported in literature&#46; There reports have shown the sparing of the sites of vaccination&#44;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a> herpes zoster<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">2&#44;5&#44;6&#44;8&#44;9</span></a> and burn scar<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> that have occurred in diverse conditions like epidermal necrolysis&#44;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">2</span></a> erythema multiformae&#44;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a> cutaneous lymphomas&#44;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a> leprosy<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a> and annular elastolytic giant cell granuloma&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> &#91;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#93; Ours is probably the first case of reverse isotopic phenomenon in DRESS syndrome&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0050" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:2 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Conflicts of Interest"
        ]
        1 => array:1 [
          "titulo" => "Bibliograf&#237;a"
        ]
      ]
    ]
    "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; Adil M&#44; Amin SS&#44; Dinesh Raj R&#44; Tabassum H&#46; Reverse Isotopic Phenomenon in Drug Reaction with Eosinophilia and Systemic Symptoms&#46; Actas Dermosifiliogr&#46; 2019&#59;110&#58;613&#8211;615&#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" => 1410
            "Ancho" => 800
            "Tamanyo" => 125202
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Confluent erythematous maculopapular lesions over the chest and abdomen with sparing of the right T9 dermatome&#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" => 851
            "Ancho" => 800
            "Tamanyo" => 117178
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A closer view of the spared site shows hyperpigmentation and scars of healed herpes zoster with sparing of the T9 dermatome by the rash&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">DRESS&#58; drug reaction with eosinophilia and systemic symptoms&#59; ND&#58; no disponible&#59; Rx&#58; rayos X<span class="elsevierStyleSmallCaps">&#59; SJS-TEN&#58;</span> Stevens-Johnson syndrome-toxic epidermal necrolysis&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&#46;&#176; de caso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Estudio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Edad&#47;sexo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Enfermedad secundaria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sitio de la preservaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Enfermedad primaria&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nuestro caso&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60 a&#241;os&#47;var&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237;ndrome DRESS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tronco &#40;dermatoma T9 derecho&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Herpes z&#243;ster&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tenea D<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">2</span></a> &#40;2010&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">39 a&#241;os&#47;mujer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237;ndrome Stevens-Johnson&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lado derecho del tronco&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Herpes z&#243;ster&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Kannangara AP et al&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">6</span></a> &#40;2008&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53 a&#241;os&#47;mujer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237;ndrome sobreposici&#243;n SJS-TEN&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nervio craneal V1 izquierda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Herpes z&#243;ster&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Kannangara AP et al&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">6</span></a> &#40;2008&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62 a&#241;os&#47;var&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eritrodermia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">C3-C4 izquierda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Herpes z&#243;ster&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Park H et al&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a> &#40;2008&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">67 a&#241;os&#47;mujer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eritema multiforme&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tronco &#40;dermatoma T3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Herpes z&#243;ster&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Twersky JM et al&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">5</span></a> &#40;2004&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58 a&#241;os&#47;var&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Linfoma cut&#225;neo c&#233;lulas T&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tronco &#40;dermatoma T8 izquierdo&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Herpes z&#243;ster&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Jain R et al&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a> &#40;2003&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ND&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lepra &#171;borderline&#187;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ND&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Herpes z&#243;ster&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Jain R et al&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">8</span></a> &#40;2003&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ND&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lepra &#171;borderline&#187;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">ND&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Herpes z&#243;ster&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Okaya-Bayazit E et al&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a> &#40;1999&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72 a&#241;os&#47;mujer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Granuloma elastol&#237;tico anular de c&#233;lulas gigantes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Antebrazo izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cicatriz quemadura&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nasca MR et al&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> &#40;1995&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53 a&#241;os&#47;var&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Acn&#233; esteroideo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Espalda&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sitio irradiaci&#243;n Rx&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Huilgol SC et al&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">11</span></a> &#40;1995&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74 a&#241;os&#47;var&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Granuloma anulargeneralizado&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Brazo izquierdo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Punto de vacunaci&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2114540.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Details of cases of isotopic non-response reported in literature&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:11 [
            0 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Wolf&#39;s isotopic response"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46; Wolf"
                            1 => "D&#46; Wolf"
                            2 => "E&#46; Ruocco"
                            3 => "G&#46; Brunetti"
                            4 => "V&#46; Ruocco"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.clindermatol.2010.09.015"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Dermatol"
                        "fecha" => "2011"
                        "volumen" => "29"
                        "paginaInicial" => "237"
                        "paginaFinal" => "240"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21396564"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Carbamazepine-induced Stevens-Johnson syndrome sparing the skin previously affected by herpes zoster infection in a patient with systemic lupus erythematosus&#58; A reverse isotopic phenomenon"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46; Tenea"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000319628"
                      "Revista" => array:6 [
                        "tituloSerie" => "Case Rep Dermatol"
                        "fecha" => "2010"
                        "volumen" => "2"
                        "paginaInicial" => "140"
                        "paginaFinal" => "145"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21076686"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Drug reaction with eosinophilia and systemic symptoms &#40;DRESS&#41; syndrome"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Choudhary"
                            1 => "M&#46; McLeod"
                            2 => "D&#46; Torchia"
                            3 => "P&#46; Romanelli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Clin Aesthetic Dermatol"
                        "fecha" => "2013"
                        "volumen" => "6"
                        "paginaInicial" => "31"
                        "paginaFinal" => "37"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A complex interaction between drug allergy and viral infection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "T&#46; Shiohara"
                            1 => "Y&#46; Kano"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Rev Allergol Immunol"
                        "fecha" => "2007"
                        "volumen" => "33"
                        "paginaInicial" => "124"
                        "paginaFinal" => "133"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous T-cell lymphoma sparing resolving dermatomal herpes zoster lesions&#58; An unusual phenomenon and implications for pathophysiology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;M&#46; Twersky"
                            1 => "J&#46;J&#46; Nordlund"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2003.12.027"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2004"
                        "volumen" => "51"
                        "paginaInicial" => "123"
                        "paginaFinal" => "126"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15243537"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Herpes zoster virus associated &#8220;sparing phenomenon&#8221;&#58; Is it an innate possess of HZV or keratinocyte cytokine&#40;s&#41; mediated or combination&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;P&#46; Kannangara"
                            1 => "A&#46;B&#46;JJr&#46; Fleischer"
                            2 => "G&#46; Yosipovitch"
                            3 => "R&#46;W&#46; Ragunathan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1468-3083.2008.02627.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Eur Acad Dermatol Venereol"
                        "fecha" => "2008"
                        "volumen" => "22"
                        "paginaInicial" => "1373"
                        "paginaFinal" => "1375"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18422536"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Erythema multiforme sparing regressing herpes zoster lesion&#58; &#8220;Reverse isotopic phenomenon&#63;&#8221;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "H&#46; Park"
                            1 => "Y&#46; Kang"
                            2 => "U&#46; Lee"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2008"
                        "volumen" => "58"
                        "numero" => "Suppl 2"
                        "paginaInicial" => "AB40"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Leprosy and herpes zoster&#58; An association or dissociation"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Jain"
                            1 => "S&#46; Dogra"
                            2 => "I&#46; Kaur"
                            3 => "B&#46; Kumar"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Indian J Lepr"
                        "fecha" => "2003"
                        "volumen" => "75"
                        "paginaInicial" => "263"
                        "paginaFinal" => "264"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15267196"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Annular elastolytic giant cell granuloma&#58; Sparing of a burn scar and successful treatment with chloroquine"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46; Ozkaya-Bayazit"
                            1 => "N&#46; B&#252;y&#252;kbabani"
                            2 => "C&#46; Baykal"
                            3 => "A&#46; Ozturk"
                            4 => "M&#46; Okcu"
                            5 => "H&#46;P&#46; Soyer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1046/j.1365-2133.1999.02723.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol"
                        "fecha" => "1999"
                        "volumen" => "140"
                        "paginaInicial" => "525"
                        "paginaFinal" => "530"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10233280"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Nasca MR&#44; Micali G&#44; Ferrau F&#46; Steroid acne sparing an area of previous irradiated skin&#46; Acta Derm Venereol&#46; 1995&#59;75&#58;495&#46;"
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Generalized granuloma annular sparing vaccination sites"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "S&#46;C&#46; Huilgol"
                            1 => "K&#46; Liddell"
                            2 => "M&#46;M&#46; Black"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2230.1995.tb01283.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Dermatol"
                        "fecha" => "1995"
                        "volumen" => "20"
                        "paginaInicial" => "51"
                        "paginaFinal" => "53"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7671397"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000011000000007/v1_201909021030/S1578219018303275/v1_201909021030/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/15782190/0000011000000007/v1_201909021030/S1578219018303275/v1_201909021030/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018303275?idApp=UINPBA000044"
]

Información del artículo

ISSN: 15782190
Idioma original: Inglés

DOI:10.1016/j.adengl.2018.09.013

Datos actualizados diariamente

año/Mes	Html	Pdf	Total

2024 Noviembre	15	8	23
2024 Octubre	107	47	154
2024 Septiembre	119	30	149
2024 Agosto	138	65	203
2024 Julio	103	43	146
2024 Junio	128	38	166
2024 Mayo	105	58	163
2024 Abril	95	25	120
2024 Marzo	95	32	127
2024 Febrero	114	35	149
2024 Enero	83	32	115
2023 Diciembre	83	17	100
2023 Noviembre	116	34	150
2023 Octubre	95	48	143
2023 Septiembre	100	38	138
2023 Agosto	54	30	84
2023 Julio	62	51	113
2023 Junio	56	37	93
2023 Mayo	70	65	135
2023 Abril	52	66	118
2023 Marzo	71	39	110
2023 Febrero	61	39	100
2023 Enero	38	38	76
2022 Diciembre	83	249	332
2022 Noviembre	44	46	90
2022 Octubre	27	24	51
2022 Septiembre	40	47	87
2022 Agosto	25	43	68
2022 Julio	19	44	63
2022 Junio	23	23	46
2022 Mayo	41	41	82
2022 Abril	50	33	83
2022 Marzo	69	51	120
2022 Febrero	47	29	76
2022 Enero	74	37	111
2021 Diciembre	41	37	78
2021 Noviembre	45	34	79
2021 Octubre	65	54	119
2021 Septiembre	75	47	122
2021 Agosto	79	30	109
2021 Julio	37	21	58
2021 Junio	32	19	51
2021 Mayo	42	53	95
2021 Abril	116	89	205
2021 Marzo	47	25	72
2021 Febrero	43	25	68
2021 Enero	41	16	57
2020 Diciembre	35	19	54
2020 Noviembre	30	17	47
2020 Octubre	26	14	40
2020 Septiembre	20	16	36
2020 Agosto	20	21	41
2020 Julio	17	15	32
2020 Junio	17	26	43
2020 Mayo	9	9	18
2020 Abril	15	7	22
2020 Marzo	14	12	26
2020 Febrero	5	2	7
2019 Mayo	1	0	1

Mostrar todo

Indexada en:

Síguenos:

Estadísticas

Indexada en:

Síguenos:

Estadísticas

Suscríbase a la newsletter