array:23 [
  "pii" => "S1578219019300320"
  "issn" => "15782190"
  "doi" => "10.1016/j.adengl.2017.12.025"
  "estado" => "S300"
  "fechaPublicacion" => "2019-04-01"
  "aid" => "1970"
  "copyright" => "Elsevier España, S.L.U. and AEDV"
  "copyrightAnyo" => "2018"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Actas Dermosifiliogr. 2019;110:255-6"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 4
    "formatos" => array:3 [
      "EPUB" => 1
      "HTML" => 2
      "PDF" => 1
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0001731018302084"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2017.12.011"
      "estado" => "S300"
      "fechaPublicacion" => "2019-04-01"
      "aid" => "1970"
      "copyright" => "AEDV"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Actas Dermosifiliogr. 2019;110:255-6"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 151
        "formatos" => array:3 [
          "EPUB" => 1
          "HTML" => 110
          "PDF" => 40
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fico-cl&#237;nica</span>"
        "titulo" => "Artritis parad&#243;jica por ixekizumab en un paciente con psoriasis en placas"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "255"
            "paginaFinal" => "256"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Paradoxical Arthritis Due to Ixekizumab in a Patient With Plaque Psoriasis"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "D&#46; Vidal, S&#46; Ros, D&#46; Reina"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "D&#46;"
                "apellidos" => "Vidal"
              ]
              1 => array:2 [
                "nombre" => "S&#46;"
                "apellidos" => "Ros"
              ]
              2 => array:2 [
                "nombre" => "D&#46;"
                "apellidos" => "Reina"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1578219019300320"
          "doi" => "10.1016/j.adengl.2017.12.025"
          "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/S1578219019300320?idApp=UINPBA000044"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731018302084?idApp=UINPBA000044"
      "url" => "/00017310/0000011000000003/v1_201904030618/S0001731018302084/v1_201904030618/es/main.assets"
    ]
  ]
  "itemAnterior" => array:18 [
    "pii" => "S1578219019300344"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2019.02.002"
    "estado" => "S300"
    "fechaPublicacion" => "2019-04-01"
    "aid" => "2033"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2019;110:253-5"
    "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">Case and Research Letters</span>"
      "titulo" => "Coexistence of Tumid Lupus Erythematosus and Discoid Lupus Erythematosus"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "253"
          "paginaFinal" => "255"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Coexistencia de lupus eritematoso t&#250;mido y lupus eritematoso discoide"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0015"
          "etiqueta" => "Figure 3"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr3.jpeg"
              "Alto" => 530
              "Ancho" => 750
              "Tamanyo" => 142514
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Scalp biopsy showing perivascular and periadnexal lymphocytic dermatitis with epidermal atrophy&#44; parakeratosis&#44; and the presence of horny plugs in the follicular ostia &#40;hematoxylin-eosin&#44; original magnification<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>20&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "I&#46; Abad&#237;as-Granado, J&#46; S&#225;nchez-Bernal, F&#46; Felipo-Berlanga, M&#46; Ara-Mart&#237;n"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "I&#46;"
              "apellidos" => "Abad&#237;as-Granado"
            ]
            1 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "S&#225;nchez-Bernal"
            ]
            2 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "Felipo-Berlanga"
            ]
            3 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Ara-Mart&#237;n"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731018303521"
        "doi" => "10.1016/j.ad.2018.02.023"
        "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/S0001731018303521?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019300344?idApp=UINPBA000044"
    "url" => "/15782190/0000011000000003/v1_201904030645/S1578219019300344/v1_201904030645/en/main.assets"
  ]
  "en" => array:14 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
    "titulo" => "Paradoxical Arthritis Due to Ixekizumab in a Patient With Plaque Psoriasis"
    "tieneTextoCompleto" => true
    "saludo" => "<span class="elsevierStyleItalic">To the Editor&#58;</span>"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "255"
        "paginaFinal" => "256"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "D&#46; Vidal, S&#46; Ros, D&#46; Reina"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "D&#46;"
            "apellidos" => "Vidal"
            "email" => array:1 [
              0 => "david&#46;vidal&#64;sanitatintegral&#46;org"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "S&#46;"
            "apellidos" => "Ros"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "D&#46;"
            "apellidos" => "Reina"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Servicio de Dermatolog&#237;a&#44; Hospital de Sant Joan Desp&#237; Mois&#232;s Broggi&#44; Sant Joan Desp&#237;&#44; Barcelona&#44; Espa&#241;a"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Reumatolog&#237;a&#44; Hospital de Viladecans&#44; Viladecans&#44; Barcelona&#44; Espa&#241;a"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Servicio de Reumatolog&#237;a&#44; Hospital de Sant Joan Desp&#237; Mois&#232;s Broggi&#44; Sant Joan Desp&#237;&#44; Barcelona&#44; Espa&#241;a"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Artritis parad&#243;jica por ixekizumab en un paciente con psoriasis en placas"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Our patient was a 46-year-old man who had been diagnosed with plaque psoriasis 27 years earlier and reported no previous axial or peripheral joint signs&#46; Over the preceding years he had responded poorly to narrowband ultraviolet-B phototherapy&#44; methotrexate&#44; cyclosporine&#44; etanercept&#44; adalimumab&#44; ustekinumab&#44; and infliximab&#46; At the time of the consultation he had numerous generalized plaques &#40;psoriasis area and severity index &#91;PASI&#93;&#44; 10&#41;&#46; Treatment was started with subcutaneous ixekizumab at the usual dose&#46; After the first dose of 160&#160;mg&#44; the patient reported generalized migratory arthralgias that intensified and became disabling after the second dose of 80&#160;mg&#44; prompting an emergency visit to the rheumatology service&#46; Physical examination revealed pain and marked limitation of cervical spinal cord mobility with no involvement of the lumbar or sacroiliac spinal cord &#40;normal response in the Schober test and negative response to sacroiliac manipulation&#41;&#44; pain and limited mobility of the scapular and pelvic girdles&#44; pain and mild swelling of the carpal joints&#44; and pain without swelling in the ankles&#44; knees&#44; and the small joints of the fingers&#46; The painful joint count &#40;PJC28&#41; was 10 &#40;carpal joints&#44; knees&#44; shoulders&#44; and second and third bilateral metacarpophalangeal joints&#41;&#44; and the swollen joint count &#40;SJC28&#41; was 2 &#40;carpal joints&#41;&#46; Based on these findings&#44; the patient was diagnosed with paradoxical arthritis&#46; With the patient&#39;s consent ixekizumab treatment was discontinued&#44; and he was treated with a tapering dose of oral prednisone &#40;20&#160;mg&#47;d&#41; for 10 days&#44; resulting in almost complete resolution of the joint problems&#46; Upon reaching the end of the corticosteroid regimen&#44; the patient was treated with secukinumab at the usual dose &#40;300&#160;mg&#41;&#46; After 10 months of coordinated monitoring by the dermatology and rheumatology services&#44; the patient&#39;s psoriasis had markedly improved &#40;PASI&#44; 1&#41;&#44; with no adverse effects or joint symptoms&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Ixekizumab is a humanized IgG4 monoclonal antibody that acts to neutralize IL-17A&#44; and in clinical trials has shown high efficacy in patients with plaque psoriasis<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> and psoriatic arthritis&#44;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> with an acceptable safety profile<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> and no adverse effects on joints&#46; In the present case&#44; the coincidence of ixekizumab injections and the sudden onset of joint symptoms in a patient with no history of arthritis&#44; together with the progressive disappearance of these symptoms after ixekizumab discontinuation&#44; suggest a causal relationship between ixekizumab and this adverse effect&#46; The literature describes several cases of so-called paradoxical psoriatic arthritis coinciding with the use of biological treatments for plaque psoriasis&#44; including efalizumab&#44;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> etanercept&#44; adalimumab&#44;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> infliximab&#44; and ustekinumab&#44;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> but none involving IL-17 inhibitors&#46; The appearance of paradoxical psoriatic arthritis in this case underscores the pathogenic complexity of this disease&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In conclusion&#44; despite the absence from the literature of any reports of adverse joint effects caused by ixekizumab&#44; we describe a case of paradoxical arthritis that was associated with ixekizumab treatment&#44; discontinuation of which was ultimately required&#46; Long-term follow-up studies will be necessary to determine the frequency and causality of this adverse effect&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0020" 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" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Vidal D&#44; Ros S&#44; Reina D&#46; Artritis parad&#243;jica por ixekizumab en un paciente con psoriasis en placas&#46; Actas Dermosifiliogr&#46; 2019&#59;110&#58;255&#8211;256&#46;</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" => "Clinical Efficacy and Safety of Ixekizumab for Treatment of Psoriasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Azevedo"
                            1 => "T&#46; Torres"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ad.2016.09.021"
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2017"
                        "volumen" => "108"
                        "paginaInicial" => "305"
                        "paginaFinal" => "314"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27887675"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ixekizumab for the treatment of patients with active psoriatic arthritis and an inadequate response to tumour necrosis factor inhibitors&#58; Results from the 24-week randomised&#44; double-blind&#44; placebo-controlled period of the SPIRIT-P2 phase 3 trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Nash"
                            1 => "B&#46; Kirkham"
                            2 => "M&#46; Okada"
                            3 => "P&#46; Rahman"
                            4 => "B&#46; Combe"
                            5 => "G&#46;R&#46; Burmester"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(17)31429-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2017"
                        "volumen" => "389"
                        "paginaInicial" => "2317"
                        "paginaFinal" => "2327"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28551073"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short- and long-term safety outcomes with ixekizumab from 7 clinical trials in psoriasis&#58; Etanercept comparisons and integrated data"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46; Strober"
                            1 => "C&#46; Leonardi"
                            2 => "K&#46;A&#46; Papp"
                            3 => "U&#46; Mrowietz"
                            4 => "M&#46; Ohtsuki"
                            5 => "R&#46; Bissonnette"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2016.09.026"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2017"
                        "volumen" => "76"
                        "paginaInicial" => "432"
                        "paginaFinal" => "440"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27889292"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "De novo onset of arthritis in patients previously treated with efalizumab&#58; An observational case series"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Colina"
                            1 => "G&#46; Cianco"
                            2 => "M&#46; Khodeir"
                            3 => "S&#46; Sferra"
                            4 => "P&#46; Scanavacca"
                            5 => "M&#46; Corazza"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Clin Exp Rheumatol"
                        "fecha" => "2011"
                        "volumen" => "29"
                        "paginaInicial" => "141"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Paradoxical onset of psoriatic arthritis during treatment with biologic agents for plaque psoriasis&#58; A combined dermatology and rheumatology clinical study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Napolitano"
                            1 => "N&#46; Balato"
                            2 => "F&#46; Caso"
                            3 => "L&#46; Costa"
                            4 => "M&#46; Megna"
                            5 => "T&#46; Cirillo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Rheumatol"
                        "fecha" => "2017"
                        "volumen" => "35"
                        "paginaInicial" => "137"
                        "paginaFinal" => "140"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27749221"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "New onset or transition of disease state of psoriatic arthritis during treatment with ustekinumab&#58; A single-center retrospective study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Asahina"
                            1 => "Y&#46; Umezawa"
                            2 => "M&#46; Momose"
                            3 => "H&#46; Honda"
                            4 => "K&#46; Yanaba"
                            5 => "H&#46; Nakagawa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/1346-8138.13987"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dermatol"
                        "fecha" => "2017"
                        "volumen" => "44"
                        "paginaInicial" => "1380"
                        "paginaFinal" => "1384"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28771778"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000011000000003/v1_201904030645/S1578219019300320/v1_201904030645/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/15782190/0000011000000003/v1_201904030645/S1578219019300320/v1_201904030645/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019300320?idApp=UINPBA000044"
]
Compartir
Información de la revista

Estadísticas

Siga este enlace para acceder al texto completo del artículo

Case and Research Letters
Paradoxical Arthritis Due to Ixekizumab in a Patient With Plaque Psoriasis
Artritis paradójica por ixekizumab en un paciente con psoriasis en placas
D. Vidala,
Autor para correspondencia
david.vidal@sanitatintegral.org

Corresponding author.
, S. Rosb, D. Reinac
a Servicio de Dermatología, Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí, Barcelona, España
b Servicio de Reumatología, Hospital de Viladecans, Viladecans, Barcelona, España
c Servicio de Reumatología, Hospital de Sant Joan Despí Moisès Broggi, Sant Joan Despí, Barcelona, España
Leído
4038
Veces
se ha leído el artículo
1489
Total PDF
2549
Total HTML
Compartir estadísticas
 array:23 [
  "pii" => "S1578219019300320"
  "issn" => "15782190"
  "doi" => "10.1016/j.adengl.2017.12.025"
  "estado" => "S300"
  "fechaPublicacion" => "2019-04-01"
  "aid" => "1970"
  "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;110:255-6"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 4
    "formatos" => array:3 [
      "EPUB" => 1
      "HTML" => 2
      "PDF" => 1
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0001731018302084"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2017.12.011"
      "estado" => "S300"
      "fechaPublicacion" => "2019-04-01"
      "aid" => "1970"
      "copyright" => "AEDV"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Actas Dermosifiliogr. 2019;110:255-6"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 151
        "formatos" => array:3 [
          "EPUB" => 1
          "HTML" => 110
          "PDF" => 40
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fico-cl&#237;nica</span>"
        "titulo" => "Artritis parad&#243;jica por ixekizumab en un paciente con psoriasis en placas"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "255"
            "paginaFinal" => "256"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Paradoxical Arthritis Due to Ixekizumab in a Patient With Plaque Psoriasis"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "D&#46; Vidal, S&#46; Ros, D&#46; Reina"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "D&#46;"
                "apellidos" => "Vidal"
              ]
              1 => array:2 [
                "nombre" => "S&#46;"
                "apellidos" => "Ros"
              ]
              2 => array:2 [
                "nombre" => "D&#46;"
                "apellidos" => "Reina"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1578219019300320"
          "doi" => "10.1016/j.adengl.2017.12.025"
          "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/S1578219019300320?idApp=UINPBA000044"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731018302084?idApp=UINPBA000044"
      "url" => "/00017310/0000011000000003/v1_201904030618/S0001731018302084/v1_201904030618/es/main.assets"
    ]
  ]
  "itemAnterior" => array:18 [
    "pii" => "S1578219019300344"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2019.02.002"
    "estado" => "S300"
    "fechaPublicacion" => "2019-04-01"
    "aid" => "2033"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2019;110:253-5"
    "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">Case and Research Letters</span>"
      "titulo" => "Coexistence of Tumid Lupus Erythematosus and Discoid Lupus Erythematosus"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "253"
          "paginaFinal" => "255"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Coexistencia de lupus eritematoso t&#250;mido y lupus eritematoso discoide"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0015"
          "etiqueta" => "Figure 3"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr3.jpeg"
              "Alto" => 530
              "Ancho" => 750
              "Tamanyo" => 142514
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Scalp biopsy showing perivascular and periadnexal lymphocytic dermatitis with epidermal atrophy&#44; parakeratosis&#44; and the presence of horny plugs in the follicular ostia &#40;hematoxylin-eosin&#44; original magnification<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>20&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "I&#46; Abad&#237;as-Granado, J&#46; S&#225;nchez-Bernal, F&#46; Felipo-Berlanga, M&#46; Ara-Mart&#237;n"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "I&#46;"
              "apellidos" => "Abad&#237;as-Granado"
            ]
            1 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "S&#225;nchez-Bernal"
            ]
            2 => array:2 [
              "nombre" => "F&#46;"
              "apellidos" => "Felipo-Berlanga"
            ]
            3 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Ara-Mart&#237;n"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731018303521"
        "doi" => "10.1016/j.ad.2018.02.023"
        "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/S0001731018303521?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019300344?idApp=UINPBA000044"
    "url" => "/15782190/0000011000000003/v1_201904030645/S1578219019300344/v1_201904030645/en/main.assets"
  ]
  "en" => array:14 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
    "titulo" => "Paradoxical Arthritis Due to Ixekizumab in a Patient With Plaque Psoriasis"
    "tieneTextoCompleto" => true
    "saludo" => "<span class="elsevierStyleItalic">To the Editor&#58;</span>"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "255"
        "paginaFinal" => "256"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "D&#46; Vidal, S&#46; Ros, D&#46; Reina"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "D&#46;"
            "apellidos" => "Vidal"
            "email" => array:1 [
              0 => "david&#46;vidal&#64;sanitatintegral&#46;org"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "S&#46;"
            "apellidos" => "Ros"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "D&#46;"
            "apellidos" => "Reina"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "aff0015"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Servicio de Dermatolog&#237;a&#44; Hospital de Sant Joan Desp&#237; Mois&#232;s Broggi&#44; Sant Joan Desp&#237;&#44; Barcelona&#44; Espa&#241;a"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Reumatolog&#237;a&#44; Hospital de Viladecans&#44; Viladecans&#44; Barcelona&#44; Espa&#241;a"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
          2 => array:3 [
            "entidad" => "Servicio de Reumatolog&#237;a&#44; Hospital de Sant Joan Desp&#237; Mois&#232;s Broggi&#44; Sant Joan Desp&#237;&#44; Barcelona&#44; Espa&#241;a"
            "etiqueta" => "c"
            "identificador" => "aff0015"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Artritis parad&#243;jica por ixekizumab en un paciente con psoriasis en placas"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Our patient was a 46-year-old man who had been diagnosed with plaque psoriasis 27 years earlier and reported no previous axial or peripheral joint signs&#46; Over the preceding years he had responded poorly to narrowband ultraviolet-B phototherapy&#44; methotrexate&#44; cyclosporine&#44; etanercept&#44; adalimumab&#44; ustekinumab&#44; and infliximab&#46; At the time of the consultation he had numerous generalized plaques &#40;psoriasis area and severity index &#91;PASI&#93;&#44; 10&#41;&#46; Treatment was started with subcutaneous ixekizumab at the usual dose&#46; After the first dose of 160&#160;mg&#44; the patient reported generalized migratory arthralgias that intensified and became disabling after the second dose of 80&#160;mg&#44; prompting an emergency visit to the rheumatology service&#46; Physical examination revealed pain and marked limitation of cervical spinal cord mobility with no involvement of the lumbar or sacroiliac spinal cord &#40;normal response in the Schober test and negative response to sacroiliac manipulation&#41;&#44; pain and limited mobility of the scapular and pelvic girdles&#44; pain and mild swelling of the carpal joints&#44; and pain without swelling in the ankles&#44; knees&#44; and the small joints of the fingers&#46; The painful joint count &#40;PJC28&#41; was 10 &#40;carpal joints&#44; knees&#44; shoulders&#44; and second and third bilateral metacarpophalangeal joints&#41;&#44; and the swollen joint count &#40;SJC28&#41; was 2 &#40;carpal joints&#41;&#46; Based on these findings&#44; the patient was diagnosed with paradoxical arthritis&#46; With the patient&#39;s consent ixekizumab treatment was discontinued&#44; and he was treated with a tapering dose of oral prednisone &#40;20&#160;mg&#47;d&#41; for 10 days&#44; resulting in almost complete resolution of the joint problems&#46; Upon reaching the end of the corticosteroid regimen&#44; the patient was treated with secukinumab at the usual dose &#40;300&#160;mg&#41;&#46; After 10 months of coordinated monitoring by the dermatology and rheumatology services&#44; the patient&#39;s psoriasis had markedly improved &#40;PASI&#44; 1&#41;&#44; with no adverse effects or joint symptoms&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Ixekizumab is a humanized IgG4 monoclonal antibody that acts to neutralize IL-17A&#44; and in clinical trials has shown high efficacy in patients with plaque psoriasis<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> and psoriatic arthritis&#44;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">2</span></a> with an acceptable safety profile<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">3</span></a> and no adverse effects on joints&#46; In the present case&#44; the coincidence of ixekizumab injections and the sudden onset of joint symptoms in a patient with no history of arthritis&#44; together with the progressive disappearance of these symptoms after ixekizumab discontinuation&#44; suggest a causal relationship between ixekizumab and this adverse effect&#46; The literature describes several cases of so-called paradoxical psoriatic arthritis coinciding with the use of biological treatments for plaque psoriasis&#44; including efalizumab&#44;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> etanercept&#44; adalimumab&#44;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> infliximab&#44; and ustekinumab&#44;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a> but none involving IL-17 inhibitors&#46; The appearance of paradoxical psoriatic arthritis in this case underscores the pathogenic complexity of this disease&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In conclusion&#44; despite the absence from the literature of any reports of adverse joint effects caused by ixekizumab&#44; we describe a case of paradoxical arthritis that was associated with ixekizumab treatment&#44; discontinuation of which was ultimately required&#46; Long-term follow-up studies will be necessary to determine the frequency and causality of this adverse effect&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of Interest</span><p id="par0020" 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" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Vidal D&#44; Ros S&#44; Reina D&#46; Artritis parad&#243;jica por ixekizumab en un paciente con psoriasis en placas&#46; Actas Dermosifiliogr&#46; 2019&#59;110&#58;255&#8211;256&#46;</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" => "Clinical Efficacy and Safety of Ixekizumab for Treatment of Psoriasis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Azevedo"
                            1 => "T&#46; Torres"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ad.2016.09.021"
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2017"
                        "volumen" => "108"
                        "paginaInicial" => "305"
                        "paginaFinal" => "314"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27887675"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Ixekizumab for the treatment of patients with active psoriatic arthritis and an inadequate response to tumour necrosis factor inhibitors&#58; Results from the 24-week randomised&#44; double-blind&#44; placebo-controlled period of the SPIRIT-P2 phase 3 trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "P&#46; Nash"
                            1 => "B&#46; Kirkham"
                            2 => "M&#46; Okada"
                            3 => "P&#46; Rahman"
                            4 => "B&#46; Combe"
                            5 => "G&#46;R&#46; Burmester"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(17)31429-0"
                      "Revista" => array:6 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2017"
                        "volumen" => "389"
                        "paginaInicial" => "2317"
                        "paginaFinal" => "2327"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28551073"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Short- and long-term safety outcomes with ixekizumab from 7 clinical trials in psoriasis&#58; Etanercept comparisons and integrated data"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "B&#46; Strober"
                            1 => "C&#46; Leonardi"
                            2 => "K&#46;A&#46; Papp"
                            3 => "U&#46; Mrowietz"
                            4 => "M&#46; Ohtsuki"
                            5 => "R&#46; Bissonnette"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2016.09.026"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2017"
                        "volumen" => "76"
                        "paginaInicial" => "432"
                        "paginaFinal" => "440"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27889292"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "De novo onset of arthritis in patients previously treated with efalizumab&#58; An observational case series"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Colina"
                            1 => "G&#46; Cianco"
                            2 => "M&#46; Khodeir"
                            3 => "S&#46; Sferra"
                            4 => "P&#46; Scanavacca"
                            5 => "M&#46; Corazza"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "Clin Exp Rheumatol"
                        "fecha" => "2011"
                        "volumen" => "29"
                        "paginaInicial" => "141"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Paradoxical onset of psoriatic arthritis during treatment with biologic agents for plaque psoriasis&#58; A combined dermatology and rheumatology clinical study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46; Napolitano"
                            1 => "N&#46; Balato"
                            2 => "F&#46; Caso"
                            3 => "L&#46; Costa"
                            4 => "M&#46; Megna"
                            5 => "T&#46; Cirillo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Rheumatol"
                        "fecha" => "2017"
                        "volumen" => "35"
                        "paginaInicial" => "137"
                        "paginaFinal" => "140"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27749221"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "New onset or transition of disease state of psoriatic arthritis during treatment with ustekinumab&#58; A single-center retrospective study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Asahina"
                            1 => "Y&#46; Umezawa"
                            2 => "M&#46; Momose"
                            3 => "H&#46; Honda"
                            4 => "K&#46; Yanaba"
                            5 => "H&#46; Nakagawa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/1346-8138.13987"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dermatol"
                        "fecha" => "2017"
                        "volumen" => "44"
                        "paginaInicial" => "1380"
                        "paginaFinal" => "1384"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28771778"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000011000000003/v1_201904030645/S1578219019300320/v1_201904030645/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/15782190/0000011000000003/v1_201904030645/S1578219019300320/v1_201904030645/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019300320?idApp=UINPBA000044"
]
Información del artículo
ISSN: 15782190
Idioma original: Inglés
Datos actualizados diariamente
año/Mes Html Pdf Total
2024 Noviembre 15 5 20
2024 Octubre 88 45 133
2024 Septiembre 59 33 92
2024 Agosto 85 62 147
2024 Julio 79 40 119
2024 Junio 80 28 108
2024 Mayo 77 29 106
2024 Abril 80 17 97
2024 Marzo 70 29 99
2024 Febrero 58 33 91
2024 Enero 49 32 81
2023 Diciembre 57 15 72
2023 Noviembre 71 24 95
2023 Octubre 57 19 76
2023 Septiembre 46 28 74
2023 Agosto 42 12 54
2023 Julio 50 34 84
2023 Junio 46 18 64
2023 Mayo 50 26 76
2023 Abril 36 23 59
2023 Marzo 38 17 55
2023 Febrero 44 19 63
2023 Enero 34 22 56
2022 Diciembre 40 33 73
2022 Noviembre 24 24 48
2022 Octubre 32 19 51
2022 Septiembre 24 32 56
2022 Agosto 26 25 51
2022 Julio 28 39 67
2022 Junio 39 25 64
2022 Mayo 43 41 84
2022 Abril 46 25 71
2022 Marzo 45 49 94
2022 Febrero 43 24 67
2022 Enero 47 33 80
2021 Diciembre 33 39 72
2021 Noviembre 32 38 70
2021 Octubre 63 63 126
2021 Septiembre 29 28 57
2021 Agosto 52 23 75
2021 Julio 83 23 106
2021 Junio 38 20 58
2021 Mayo 41 38 79
2021 Abril 54 39 93
2021 Marzo 49 24 73
2021 Febrero 77 21 98
2021 Enero 29 13 42
2020 Diciembre 42 11 53
2020 Noviembre 15 20 35
2020 Octubre 22 6 28
2020 Septiembre 25 13 38
2020 Agosto 14 21 35
2020 Julio 14 6 20
2020 Junio 28 28 56
2020 Mayo 21 16 37
2020 Abril 16 12 28
2020 Marzo 21 7 28
2020 Febrero 1 0 1
2019 Mayo 1 0 1
2019 Abril 1 1 2
Mostrar todo

Siga este enlace para acceder al texto completo del artículo

Idiomas
Actas Dermo-Sifiliográficas
es en

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

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