E-Case for Diagnosis
Recurrent Facial Edema
Edema facial recurrente
J. Sabater Abad
, C. Lloret Ruiz, E. Quecedo Estébanez
Autor para correspondencia
Servicio de Dermatología, Hospital Arnau de Vilanova, Valencia, Spain
Leído
6129
Vecesse ha leído el artículo
1981
Total PDF
4148
Total HTML
Compartir estadísticas
array:24 [ "pii" => "S1578219018304013" "issn" => "15782190" "doi" => "10.1016/j.adengl.2018.11.005" "estado" => "S300" "fechaPublicacion" => "2019-01-01" "aid" => "1868" "copyright" => "Elsevier España, S.L.U. and AEDV" "copyrightAnyo" => "2017" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2019;110:e3-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731017306646" "issn" => "00017310" "doi" => "10.1016/j.ad.2017.03.025" "estado" => "S300" "fechaPublicacion" => "2019-01-01" "aid" => "1868" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2019;110:e3-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 821 "formatos" => array:2 [ "HTML" => 582 "PDF" => 239 ] ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">E-casos para el diagnóstico</span>" "titulo" => "Edema facial recurrente" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e3" "paginaFinal" => "e4" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Recurrent Facial Edema" ] ] "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" => 826 "Ancho" => 1000 "Tamanyo" => 305076 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A) Hematoxilina-eosina ×40. B) Hematoxilina-eosina ×200. C) Hematoxilina-eosina ×400. D) CD31 ×40.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Sabater Abad, C. Lloret Ruiz, E. Quecedo Estébanez" "autores" => array:3 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Sabater Abad" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Lloret Ruiz" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Quecedo Estébanez" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219018304013" "doi" => "10.1016/j.adengl.2018.11.005" "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/S1578219018304013?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731017306646?idApp=UINPBA000044" "url" => "/00017310/0000011000000001/v1_201901030610/S0001731017306646/v1_201901030610/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219018303974" "issn" => "15782190" "doi" => "10.1016/j.adengl.2017.10.026" "estado" => "S300" "fechaPublicacion" => "2019-01-01" "aid" => "1905" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Actas Dermosifiliogr. 2019;110:53-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 3 "formatos" => array:2 [ "HTML" => 1 "PDF" => 2 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Resident's Forum</span>" "titulo" => "Immunotherapy for Advanced Skin Cancer" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "53" "paginaFinal" => "56" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "FR-Inmunoterapia en el cáncer cutáneo avanzado" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "D. Morgado-Carrasco, F. Terc, S.S. Ertekin, L. Ferrandiz" "autores" => array:4 [ 0 => array:2 [ "nombre" => "D." "apellidos" => "Morgado-Carrasco" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Terc" ] 2 => array:2 [ "nombre" => "S.S." "apellidos" => "Ertekin" ] 3 => array:2 [ "nombre" => "L." "apellidos" => "Ferrandiz" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731018300590" "doi" => "10.1016/j.ad.2017.10.020" "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/S0001731018300590?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018303974?idApp=UINPBA000044" "url" => "/15782190/0000011000000001/v1_201901030631/S1578219018303974/v1_201901030631/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219018304074" "issn" => "15782190" "doi" => "10.1016/j.adengl.2018.11.009" "estado" => "S300" "fechaPublicacion" => "2019-01-01" "aid" => "1885" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2019;110:e1-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 2 "HTML" => 2 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">E-Case for Diagnosis</span>" "titulo" => "Erythematous Papules on the Dorsum of the Hand" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e1" "paginaFinal" => "e2" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Pápulas eritematosas en dorso de mano" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 350 "Ancho" => 233 "Tamanyo" => 37586 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A, Hematoxylin-eosin, magnification ×<span class="elsevierStyleHsp" style=""></span>10. B, Hematoxylin-eosin, magnification ×<span class="elsevierStyleHsp" style=""></span>20.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "C. Maldonado Seral, C. Gómez de Castro, B. Vivanco Allende" "autores" => array:3 [ 0 => array:2 [ "nombre" => "C." "apellidos" => "Maldonado Seral" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Gómez de Castro" ] 2 => array:2 [ "nombre" => "B." "apellidos" => "Vivanco Allende" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731018300073" "doi" => "10.1016/j.ad.2017.05.024" "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/S0001731018300073?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018304074?idApp=UINPBA000044" "url" => "/15782190/0000011000000001/v1_201901030631/S1578219018304074/v1_201901030631/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">E-Case for Diagnosis</span>" "titulo" => "Recurrent Facial Edema" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "e3" "paginaFinal" => "e4" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J. Sabater Abad, C. Lloret Ruiz, E. Quecedo Estébanez" "autores" => array:3 [ 0 => array:4 [ "nombre" => "J." "apellidos" => "Sabater Abad" "email" => array:1 [ 0 => "javiersabater999@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Lloret Ruiz" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Quecedo Estébanez" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital Arnau de Vilanova, Valencia, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Edema facial recurrente" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 586 "Ancho" => 630 "Tamanyo" => 54395 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Local progression of the skin lesions with mandibular involvement.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Medical History</span><p id="par0005" class="elsevierStylePara elsevierViewall">A 77-year-old man sought care for recurrent episodes of swelling in the right malar region that in the previous 5 months had spread to the neck, the left malar region, both nasolabial folds, and the right infraorbital rim. The patient reported only a sensation of tautness in the affected areas.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Physical Examination</span><p id="par0010" class="elsevierStylePara elsevierViewall">Physical examination revealed violaceous coloring and palpable infiltration in the aforementioned regions (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). No macroglossia or lesions in the oral cavity were observed.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Additional Examinations</span><p id="par0015" class="elsevierStylePara elsevierViewall">A 4-mm punch biopsy specimen was taken from one of the lesions and histopathologic examination revealed the presence of multiple irregular dilated vascular channels joined by anastomosis, some lined with mildly atypical endothelial cells, situated among the dermal collagen bundles and around the pilosebaceous follicles. Immunohistochemistry showed CD34<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>and CD31<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>cells lining the vascular channels (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">What Is Your Diagnosis?</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Diagnosis</span><p id="par0025" class="elsevierStylePara elsevierViewall">Cutaneous angiosarcoma of the head and neck.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Clinical Course</span><p id="par0030" class="elsevierStylePara elsevierViewall">Computed tomography of the neck, chest, abdomen, and pelvis was carried out to determine the extent of disease; no distant metastases were detected. Histologic mapping of the affected regions confirmed that the angiosarcoma was locally advanced. Palliative treatment was started with paclitaxel and propranolol as adjuvant therapy. Based on the local progression of the lesions (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>) with mandibular involvement despite treatment, radiation therapy was initiated. At present, the patient is waiting to begin treatment with pazopanib.</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Discussion</span><p id="par0035" class="elsevierStylePara elsevierViewall">Cutaneous angiosarcoma is a rare, aggressive, malignant vascular sarcoma that occurs most frequently in elderly men, affecting the head and neck. It can also appear on the limbs of patients with chronic lymphedema or in areas exposed to radiation therapy.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Although cutaneous angiosarcoma tends to manifest as nodules, plaques, or erythematous or violaceous macules, its great clinical variability often leads to late diagnosis. Tay and Ong<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> reported a case similar to that of our patient. Their patient had an angiosarcoma of the head and neck that mimicked episodes of edema or facial swelling; diagnosis was delayed after the lesion responded partially to corticosteroid treatment. The head-tilt examination maneuver, in which the patient is asked to place his or her head below the level of the heart for 5-10<span class="elsevierStyleHsp" style=""></span>seconds, can be used to increase the congestion of the neoplastic vessels, thus making the lesion more clinically apparent.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">A pathologic examination like that described in our case, plus the detection of CD34<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>and CD31<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>neoplastic cells, allow this entity to be diagnosed. Clinical differential diagnosis should include hematomas, vascular tumors such as hemangioma and Kaposi sarcoma, cutaneous lymphomas and pseudolymphomas, cutaneous metastases, lupus pernio, and other skin tumors such as melanoma, Merkel cell carcinoma, and angiomatoid fibrous histiocytoma.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">The treatment of choice for localized disease is radical surgery, which, if performed early and followed by adjuvant radiation therapy, is the only potentially curative treatment. However, when the tumor is unresectable and/or metastatic disease is present, the prognosis worsens considerably; chemotherapy is the treatment of choice in such cases.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> Radiation therapy can also be used to achieve good local tumor control in cases of metastatic or unresectable disease.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> A recent case report suggests that treatment with oral propranolol is effective for reducing the size of angiosarcomas,<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> although in our case it was difficult to assess the response to this treatment because the patient had already started treatment with paclitaxel.</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conflicts of Interest</span><p id="par0055" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:8 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Medical History" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Physical Examination" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Additional Examinations" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Diagnosis" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Clinical Course" ] 5 => array:2 [ "identificador" => "sec0030" "titulo" => "Discussion" ] 6 => array:2 [ "identificador" => "sec0035" "titulo" => "Conflicts of Interest" ] 7 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Sabater Abad J, Lloret Ruiz C, Quecedo Estébanez E. Edema facial recurrente. Actas Dermosifiliogr. 2019;110:e3–e4.</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" => 689 "Ancho" => 450 "Tamanyo" => 46814 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Edema of the neck, left and right malar region, nasolabial folds, and the right infraorbital rim with violaceous coloring.</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" => 826 "Ancho" => 1000 "Tamanyo" => 305346 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, Hematoxylin-eosin, original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>40. B, Hematoxylin-eosin, original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>200. C, Hematoxylin-eosin, original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>400. D, CD31, original magnification<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>40.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 586 "Ancho" => 630 "Tamanyo" => 54395 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Local progression of the skin lesions with mandibular involvement.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Angiosarcoma: State of the art and perspectives" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "N. Penel" 1 => "S. Marréaud" 2 => "Y.M. Robin" 3 => "P. Hohenberger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.critrevonc.2010.10.007" "Revista" => array:6 [ "tituloSerie" => "Crit Rev Oncol Hematol" "fecha" => "2011" "volumen" => "80" "paginaInicial" => "257" "paginaFinal" => "263" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21055965" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cutaneous angiosarcoma presenting as recurrent angio-oedema of the face" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "Y.K. Tay" 1 => "B.H. Ong" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2000" "volumen" => "143" "paginaInicial" => "1346" "paginaFinal" => "1348" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The Head-Tilt Maneuver. A clinical aid in recognizing head and neck angiosarcomas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.M. Asgari" 1 => "C.J. Cockerell" 2 => "S. Weitzul" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archderm.143.1.75" "Revista" => array:6 [ "tituloSerie" => "Arch Dermatol." "fecha" => "2007" "volumen" => "143" "paginaInicial" => "75" "paginaFinal" => "77" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17224545" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0050" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Angiosarcoma de la piel de la cabeza" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.A. Marini" 1 => "J.G. Casas" 2 => "M.A. de Baldrich" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Argent Dermatol" "fecha" => "2003" "volumen" => "53" "paginaInicial" => "207" "paginaFinal" => "212" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment and prognosis of angiosarcoma of the scalp and face: A retrospective analysis of 48 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Ogawa" 1 => "K. Takahashi" 2 => "Y. Asato" 3 => "Y. Yamamoto" 4 => "K. Taira" 5 => "S. Matori" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1259/bjr/31655219" "Revista" => array:6 [ "tituloSerie" => "Br J Radiol" "fecha" => "2012" "volumen" => "85" "paginaInicial" => "e1127" "paginaFinal" => "e1133" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22806620" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Growth Attenuation of Cutaneous Angiosarcoma With Propranolol-Mediated β-Blockade" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "W. Chow" 1 => "C.N. Amaya" 2 => "S. Rains" 3 => "M. Chow" 4 => "E.B. Dickerson" 5 => "B.A. Bryan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamadermatol.2015.2554" "Revista" => array:6 [ "tituloSerie" => "JAMA Dermatol" "fecha" => "2015" "volumen" => "151" "paginaInicial" => "1226" "paginaFinal" => "1229" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26375166" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011000000001/v1_201901030631/S1578219018304013/v1_201901030631/en/main.assets" "Apartado" => array:4 [ "identificador" => "76903" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "e-Case for Diagnosis" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000011000000001/v1_201901030631/S1578219018304013/v1_201901030631/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219018304013?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 11 | 6 | 17 |
| 2024 Octubre | 85 | 48 | 133 |
| 2024 Septiembre | 96 | 39 | 135 |
| 2024 Agosto | 129 | 67 | 196 |
| 2024 Julio | 144 | 60 | 204 |
| 2024 Junio | 110 | 55 | 165 |
| 2024 Mayo | 154 | 42 | 196 |
| 2024 Abril | 101 | 40 | 141 |
| 2024 Marzo | 81 | 35 | 116 |
| 2024 Febrero | 97 | 33 | 130 |
| 2024 Enero | 88 | 36 | 124 |
| 2023 Diciembre | 75 | 16 | 91 |
| 2023 Noviembre | 106 | 27 | 133 |
| 2023 Octubre | 102 | 32 | 134 |
| 2023 Septiembre | 86 | 35 | 121 |
| 2023 Agosto | 63 | 12 | 75 |
| 2023 Julio | 87 | 34 | 121 |
| 2023 Junio | 87 | 18 | 105 |
| 2023 Mayo | 90 | 22 | 112 |
| 2023 Abril | 69 | 21 | 90 |
| 2023 Marzo | 115 | 23 | 138 |
| 2023 Febrero | 97 | 26 | 123 |
| 2023 Enero | 55 | 34 | 89 |
| 2022 Diciembre | 52 | 42 | 94 |
| 2022 Noviembre | 46 | 24 | 70 |
| 2022 Octubre | 34 | 20 | 54 |
| 2022 Septiembre | 42 | 39 | 81 |
| 2022 Agosto | 51 | 43 | 94 |
| 2022 Julio | 64 | 39 | 103 |
| 2022 Junio | 30 | 29 | 59 |
| 2022 Mayo | 56 | 58 | 114 |
| 2022 Abril | 83 | 31 | 114 |
| 2022 Marzo | 63 | 53 | 116 |
| 2022 Febrero | 79 | 33 | 112 |
| 2022 Enero | 92 | 47 | 139 |
| 2021 Diciembre | 86 | 45 | 131 |
| 2021 Noviembre | 63 | 45 | 108 |
| 2021 Octubre | 94 | 65 | 159 |
| 2021 Septiembre | 68 | 43 | 111 |
| 2021 Agosto | 90 | 28 | 118 |
| 2021 Julio | 81 | 32 | 113 |
| 2021 Junio | 99 | 37 | 136 |
| 2021 Mayo | 71 | 42 | 113 |
| 2021 Abril | 122 | 98 | 220 |
| 2021 Marzo | 105 | 42 | 147 |
| 2021 Febrero | 72 | 35 | 107 |
| 2021 Enero | 48 | 39 | 87 |
| 2020 Diciembre | 44 | 37 | 81 |
| 2020 Noviembre | 42 | 41 | 83 |
| 2020 Octubre | 45 | 12 | 57 |
| 2020 Septiembre | 31 | 19 | 50 |
| 2020 Agosto | 35 | 23 | 58 |
| 2020 Julio | 35 | 22 | 57 |
| 2020 Junio | 37 | 25 | 62 |
| 2020 Mayo | 30 | 17 | 47 |
| 2020 Abril | 13 | 11 | 24 |
| 2020 Marzo | 14 | 4 | 18 |
| 2020 Febrero | 3 | 0 | 3 |
Mostrar todo
