Resident's Forum
Effect of Biologic Therapy on Cardiovascular Risk in Patients With Psoriasis
FR- Tratamientos biológicos y su efecto en el riesgo cardiovascular de los pacientes con psoriasis
Á. González-Cantero
, A.I. Sánchez-Moya, C. Pérez-Hortet
Autor para correspondencia
Servicio de Dermatología, Complejo Hospitalario de Toledo, Toledo, Spain
Leído
4190
Vecesse ha leído el artículo
1709
Total PDF
2481
Total HTML
Compartir estadísticas
array:24 [ "pii" => "S1578219019302483" "issn" => "15782190" "doi" => "10.1016/j.adengl.2018.08.002" "estado" => "S300" "fechaPublicacion" => "2019-10-01" "aid" => "2190" "copyright" => "Elsevier España, S.L.U. and AEDV" "copyrightAnyo" => "2019" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Actas Dermosifiliogr. 2019;110:685-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 11 "formatos" => array:2 [ "HTML" => 9 "PDF" => 2 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0001731019301243" "issn" => "00017310" "doi" => "10.1016/j.ad.2018.08.009" "estado" => "S300" "fechaPublicacion" => "2019-10-01" "aid" => "2190" "copyright" => "AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Actas Dermosifiliogr. 2019;110:685-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 192 "formatos" => array:2 [ "HTML" => 141 "PDF" => 51 ] ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Foro de Residentes</span>" "titulo" => "FR- Tratamientos biológicos y su efecto en el riesgo cardiovascular de los pacientes con psoriasis" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "685" "paginaFinal" => "686" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Effect of Biologic Therapy on Cardiovascular Risk in Patients With Psoriasis" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Á. González-Cantero, A.I. Sánchez-Moya, C. Pérez-Hortet" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Á." "apellidos" => "González-Cantero" ] 1 => array:2 [ "nombre" => "A.I." "apellidos" => "Sánchez-Moya" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Pérez-Hortet" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219019302483" "doi" => "10.1016/j.adengl.2018.08.002" "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/S1578219019302483?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731019301243?idApp=UINPBA000044" "url" => "/00017310/0000011000000008/v1_201910020711/S0001731019301243/v1_201910020711/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219019300964" "issn" => "15782190" "doi" => "10.1016/j.adengl.2019.03.004" "estado" => "S300" "fechaPublicacion" => "2019-10-01" "aid" => "2066" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Actas Dermosifiliogr. 2019;110:e1" "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-Images in Dermatology</span>" "titulo" => "Giant Nevus Lipomatosus Cutaneous Superficialis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "e1" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Nevus lipomatoso superficial gigante" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 559 "Ancho" => 900 "Tamanyo" => 91433 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "V.A. González-Delgado, P. Cordero-Romero, J.M. Martín" "autores" => array:3 [ 0 => array:2 [ "nombre" => "V.A." "apellidos" => "González-Delgado" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "Cordero-Romero" ] 2 => array:2 [ "nombre" => "J.M." "apellidos" => "Martín" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731018304320" "doi" => "10.1016/j.ad.2017.12.020" "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/S0001731018304320?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019300964?idApp=UINPBA000044" "url" => "/15782190/0000011000000008/v1_201910050935/S1578219019300964/v1_201910050935/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219019302252" "issn" => "15782190" "doi" => "10.1016/j.adengl.2019.07.005" "estado" => "S300" "fechaPublicacion" => "2019-10-01" "aid" => "2180" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2019;110:683-4" "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 for Diagnosis</span>" "titulo" => "Tumors Distributed Linearly Near the Scapula in a Young Man" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "683" "paginaFinal" => "684" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tumoraciones con distribución lineal en la región escapular de un varón joven" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 680 "Ancho" => 905 "Tamanyo" => 95441 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Morales-Conde, J. Raya-Maldonado, B. García-Bravo, J.J. Ríos-Martin" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Morales-Conde" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Raya-Maldonado" ] 2 => array:2 [ "nombre" => "B." "apellidos" => "García-Bravo" ] 3 => array:2 [ "nombre" => "J.J." "apellidos" => "Ríos-Martin" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731019301140" "doi" => "10.1016/j.ad.2018.04.012" "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/S0001731019301140?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019302252?idApp=UINPBA000044" "url" => "/15782190/0000011000000008/v1_201910050935/S1578219019302252/v1_201910050935/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Resident's Forum</span>" "titulo" => "Effect of Biologic Therapy on Cardiovascular Risk in Patients With Psoriasis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "685" "paginaFinal" => "686" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Á. González-Cantero, A.I. Sánchez-Moya, C. Pérez-Hortet" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Á." "apellidos" => "González-Cantero" "email" => array:1 [ 0 => "Alvarogc261893@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "A.I." "apellidos" => "Sánchez-Moya" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Pérez-Hortet" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Complejo Hospitalario de Toledo, Toledo, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "FR- Tratamientos biológicos y su efecto en el riesgo cardiovascular de los pacientes con psoriasis" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">In the last 10 years, a number of epidemiological studies have shown psoriasis, especially the severe forms, to be associated with an increased risk of death, mainly due to heart disease.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a> A recent population-based study of 8760 patients with psoriasis found that involvement of more than 10% of the body surface area was associated with a higher risk of mortality than that found in the general population (hazard ratio [HR], 2.1; 95% CI, 1.5-3.1). This increase remained significant after adjustment for traditional risk factors (HR, 1.8; 95% CI, 1.2-2.6).<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">These findings, and the fact that we now know that inflammation plays a fundamental role in the pathogenesis of atherosclerosis,<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">3</span></a> have given rise to a growing interest in assessing the effect on cardiovascular risk of the systemic medications used to treat psoriasis. In a recent article published in the prestigious <span class="elsevierStyleItalic">Journal of the American Academy of Dermatology,</span> Wu et al.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">4</span></a> reported the results of a population-based study (data recorded in an administrative claims database between 2000 and 2014), the objectives of which were to assess and compare the risk of major cardiovascular events and the effect of cumulative treatment exposure on cardiovascular event risk in patients with psoriasis treated with tumor necrosis factor α inhibitors (TNFi) or phototherapy. The study included 11 410 patients treated with TNFi and 12 433 treated with phototherapy. The TNFi cohort exhibited a lower cardiovascular event risk than the patients treated with phototherapy (HR, 0.87; 95% CI, 0.60-0.99; <span class="elsevierStyleItalic">P<span class="elsevierStyleHsp" style=""></span></span>=<span class="elsevierStyleHsp" style=""></span>.046). The risk reduction associated with 6 months of cumulative exposure was 11.2% greater in the patients who received TNFi compared to those on phototherapy. Based on these findings, the authors estimated that treating 161 patients with TNFi rather than phototherapy would prevent 1 cardiovascular event per year.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Despite its limitations, this study makes an important contribution to the growing body of evidence on the association between TNFi therapy and a reduction in cardiovascular risk. One important study in this respect is a recent placebo-controlled clinical trial (CANTOS) that assessed the efficacy in reducing cardiovascular risk of canakinumab, an interleukin-1β inhibitor biologic agent. That study, which included 10 061 patients with a history of myocardial infarction and elevated C-reactive protein levels, demonstrated—for the first time—that treatment with a biologic drug significantly reduces the number of cardiovascular events.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">5</span></a> The authors of another recent study in patients with psoriasis reported a significant reduction in vascular and systemic inflammation after treatment with ustekinumab.<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">6</span></a> All of these findings have generated a growing interest in understanding the effect on cardiovascular risk of the systemic medications used to treat patients with psoriasis. At this point, randomized clinical trials are needed to answer the questions currently being raised in the fields of cardiology and dermatology.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Furthermore, early diagnosis of subclinical atherosclerosis in these patients would be of interest. This can be obtained using non-invasive imaging methods, such as femoral artery ultrasound, a technique that has proved useful in patients with psoriasis.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">7</span></a> Using this method, we can identify patients with very high cardiovascular risk and take appropriate measures at an early stage.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1160811" "palabras" => array:4 [ 0 => "Psoriasis" 1 => "Cardiovascular disease" 2 => "Systemic therapies" 3 => "Biologic therapy" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: González-Cantero Á, Sánchez-Moya AI, Pérez-Hortet C. FR- Tratamientos biológicos y su efecto en el riesgo cardiovascular de los pacientes con psoriasis. Actas Dermosifiliogr. 2019;110:685–686.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:7 [ 0 => array:3 [ "identificador" => "bib0040" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The risk of mortality in patients with psoriasis: Results from a population-based study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.M. Gelfand" 1 => "A.B. Troxel" 2 => "J.D. Lewis" 3 => "S.K. Kurd" 4 => "D.B. Shin" 5 => "X. Wang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archderm.143.12.1493" "Revista" => array:7 [ "tituloSerie" => "Arch Dermatol" "fecha" => "2007" "volumen" => "143" "paginaInicial" => "1493" "paginaFinal" => "1499" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18086997" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1473309914708278" "estado" => "S300" "issn" => "14733099" ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0045" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Objective measures of psoriasis severity predict mortality: A prospective population-based cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.H. Noe" 1 => "D.B. Shin" 2 => "M.T. Wan" 3 => "J.M. Gelfand" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jid.2017.07.841" "Revista" => array:7 [ "tituloSerie" => "J Invest Dermatol" "fecha" => "2018" "volumen" => "138" "paginaInicial" => "228" "paginaFinal" => "230" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28843488" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1386653214003102" "estado" => "S300" "issn" => "13866532" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0050" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Inflammation in atherosclerosis: From pathophysiology to practice" "autores" => array:1 [ 0 => array:3 [ "colaboracion" => "Leducq Transatlantic Network on Atherothrombosis" "etal" => false "autores" => array:3 [ 0 => "P. Libby" 1 => "P.M. Ridker" 2 => "G.K. Hansson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jacc.2009.09.009" "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2009" "volumen" => "54" "paginaInicial" => "2129" "paginaFinal" => "2138" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19942084" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0055" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The risk of cardiovascular events in psoriasis patients treated with tumor necrosis factor-α inhibitors versus phototherapy: An observational cohort study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Wu F .J." 1 => "M. Sundaram" 2 => "M. Cloutier" 3 => "M. Gauthier-Loiselle" 4 => "A. Guérin" 5 => "R. Singh" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2018.02.050" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2018" "volumen" => "79" "paginaInicial" => "60" "paginaFinal" => "68" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29499292" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0060" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Antiinflammatory therapy with canakinumab for atherosclerotic disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "P.M. Ridker" 1 => "B.M. Everett" 2 => "T. Thuren" 3 => "T. MacFadyen" 4 => "MacFadyen JG" 5 => "T. Chang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMoa1707914" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2017" "volumen" => "377" "paginaInicial" => "1119" "paginaFinal" => "1131" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28845751" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0065" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ustekinumab treatment is associated with decreased systemic and vascular inflammation in patients with moderate to severe psoriasis: Feasibility study using 18F-fluorodeoxyglucose positron emission tomography-computed tomography" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.S. Kim" 1 => "W.K. Lee" 2 => "K. Pak" 3 => "J. Han" 4 => "G.W. Kim" 5 => "H. Kim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2018.03.011" "Revista" => array:2 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2018" ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0070" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Femoral artery ultrasound for improving the detection of atherosclerosis in psoriasis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Gonzalez-Cantero" 1 => "J. Gonzalez-Cantero" 2 => "A.I. Sanchez-Moya" 3 => "C. Perez-Hortet" 4 => "S. Arias-Santiago" 5 => "J.L. Martin-Rodriguez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2018.07.007" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2018" "volumen" => "80" "paginaInicial" => "784" "paginaFinal" => "786" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30025828" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011000000008/v1_201910050935/S1578219019302483/v1_201910050935/en/main.assets" "Apartado" => array:4 [ "identificador" => "34945" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Resident's Forum" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000011000000008/v1_201910050935/S1578219019302483/v1_201910050935/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219019302483?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 12 | 10 | 22 |
| 2024 Octubre | 67 | 42 | 109 |
| 2024 Septiembre | 61 | 22 | 83 |
| 2024 Agosto | 87 | 66 | 153 |
| 2024 Julio | 65 | 28 | 93 |
| 2024 Junio | 77 | 34 | 111 |
| 2024 Mayo | 121 | 32 | 153 |
| 2024 Abril | 75 | 24 | 99 |
| 2024 Marzo | 64 | 31 | 95 |
| 2024 Febrero | 51 | 22 | 73 |
| 2024 Enero | 50 | 26 | 76 |
| 2023 Diciembre | 56 | 23 | 79 |
| 2023 Noviembre | 61 | 32 | 93 |
| 2023 Octubre | 54 | 31 | 85 |
| 2023 Septiembre | 34 | 28 | 62 |
| 2023 Agosto | 36 | 18 | 54 |
| 2023 Julio | 42 | 37 | 79 |
| 2023 Junio | 40 | 22 | 62 |
| 2023 Mayo | 44 | 32 | 76 |
| 2023 Abril | 36 | 27 | 63 |
| 2023 Marzo | 42 | 19 | 61 |
| 2023 Febrero | 43 | 24 | 67 |
| 2023 Enero | 37 | 42 | 79 |
| 2022 Diciembre | 46 | 38 | 84 |
| 2022 Noviembre | 36 | 37 | 73 |
| 2022 Octubre | 25 | 22 | 47 |
| 2022 Septiembre | 27 | 32 | 59 |
| 2022 Agosto | 29 | 42 | 71 |
| 2022 Julio | 28 | 41 | 69 |
| 2022 Junio | 28 | 35 | 63 |
| 2022 Mayo | 31 | 35 | 66 |
| 2022 Abril | 43 | 24 | 67 |
| 2022 Marzo | 45 | 55 | 100 |
| 2022 Febrero | 37 | 34 | 71 |
| 2022 Enero | 49 | 40 | 89 |
| 2021 Diciembre | 52 | 41 | 93 |
| 2021 Noviembre | 52 | 45 | 97 |
| 2021 Octubre | 48 | 59 | 107 |
| 2021 Septiembre | 48 | 38 | 86 |
| 2021 Agosto | 26 | 27 | 53 |
| 2021 Julio | 32 | 19 | 51 |
| 2021 Junio | 20 | 26 | 46 |
| 2021 Mayo | 52 | 49 | 101 |
| 2021 Abril | 110 | 101 | 211 |
| 2021 Marzo | 59 | 25 | 84 |
| 2021 Febrero | 49 | 18 | 67 |
| 2021 Enero | 20 | 14 | 34 |
| 2020 Diciembre | 21 | 13 | 34 |
| 2020 Noviembre | 23 | 13 | 36 |
| 2020 Octubre | 21 | 18 | 39 |
| 2020 Septiembre | 36 | 11 | 47 |
| 2020 Agosto | 26 | 21 | 47 |
| 2020 Julio | 17 | 10 | 27 |
| 2020 Junio | 27 | 21 | 48 |
| 2020 Mayo | 14 | 9 | 23 |
| 2020 Abril | 17 | 11 | 28 |
| 2020 Marzo | 22 | 9 | 31 |
| 2020 Febrero | 1 | 2 | 3 |
| 2020 Enero | 9 | 2 | 11 |
Mostrar todo
