Pigmented Purpuric Dermatosis: A Review of the Literature

array:25 ["pii" => "S1578219020300317" "issn" => "15782190" "doi" => "10.1016/j.adengl.2020.03.007" "estado" => "S300" "fechaPublicacion" => "2020-04-01" "aid" => "2226" "copyright" => "AEDV" "copyrightAnyo" => "2019" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "rev" "cita" => "Actas Dermosifiliogr. 2020;111:196-204" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:20 [ "pii" => "S0001731019301917" "issn" => "00017310" "doi" => "10.1016/j.ad.2019.02.013" "estado" => "S300" "fechaPublicacion" => "2020-04-01" "aid" => "2226" "copyright" => "AEDV" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "rev" "cita" => "Actas Dermosifiliogr. 2020;111:196-204" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 86 "formatos" => array:2 [ "HTML" => 53 "PDF" => 33 ] ] "es" => array:14 [ "idiomaDefecto" => true "cabecera" => "REVISIÓN" "titulo" => "Dermatosis purpúricas pigmentadas. Revisión de la literatura científica" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:3 [ 0 => "es" 1 => "es" 2 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "196" "paginaFinal" => "204" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Pigmented Purpuric Dermatosis: A Review of the Literature" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 1 "multimedia" => array:5 [ "identificador" => "fig0045" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => false "mostrarDisplay" => true "figura" => array:1 [ 0 => array:4 [ "imagen" => "fx1.jpeg" "Alto" => 1001 "Ancho" => 1333 "Tamanyo" => 87985 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "I. Martínez Pallás, R. Conejero del Mazo, V. Lezcano Biosca" "autores" => array:3 [ 0 => array:2 [ "nombre" => "I." "apellidos" => "Martínez Pallás" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Conejero del Mazo" ] 2 => array:2 [ "nombre" => "V." "apellidos" => "Lezcano Biosca" ] ] ] ] "resumen" => array:1 [ 0 => array:3 [ "titulo" => "Graphical abstract" "clase" => "graphical" "resumen" => "<elsevierMultimedia ident="fig0045"></elsevierMultimedia>" ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219020300317" "doi" => "10.1016/j.adengl.2020.03.007" "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/S1578219020300317?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731019301917?idApp=UINPBA000044" "url" => "/00017310/0000011100000003/v3_202009190646/S0001731019301917/v3_202009190646/es/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S1578219020300238" "issn" => "15782190" "doi" => "10.1016/j.adengl.2020.03.001" "estado" => "S300" "fechaPublicacion" => "2020-04-01" "aid" => "2287" "copyright" => "AEDV" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "rev" "cita" => "Actas Dermosifiliogr. 2020;111:205-21" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Review" "titulo" => "Innovation in Atopic Dermatitis: From Pathogenesis to Treatment" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "205" "paginaFinal" => "221" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Innovación en dermatitis atópica: de la patogenia a la terapéutica" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1641 "Ancho" => 2925 "Tamanyo" => 443688 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Biologic agents and specific targets in the pathogenesis of atopic dermatitis. Abbreviations: IgE, immunoglobulin E; IL, interleukin; OSMRß; oncostatin M receptor ß; Th, T helper (lymphocyte); TSLP, thymic stromal lymphopoietin." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Munera-Campos, J.M. Carrascosa" "autores" => array:2 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Munera-Campos" ] 1 => array:2 [ "nombre" => "J.M." "apellidos" => "Carrascosa" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731019303898" "doi" => "10.1016/j.ad.2019.11.002" "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/S0001731019303898?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020300238?idApp=UINPBA000044" "url" => "/15782190/0000011100000003/v1_202005050702/S1578219020300238/v1_202005050702/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S1578219020300287" "issn" => "15782190" "doi" => "10.1016/j.adengl.2020.03.005" "estado" => "S300" "fechaPublicacion" => "2020-04-01" "aid" => "2291" "copyright" => "AEDV" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Actas Dermosifiliogr. 2020;111:192-5" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "Opinion Article" "titulo" => "Deep Learning and Mathematical Models in Dermatology" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "192" "paginaFinal" => "195" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Deep learning y DerMATología" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2238 "Ancho" => 2508 "Tamanyo" => 346979 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "A, Example of a convolution operation. A computer sees an image (L) as a 4×4 matrix of numbers. Each value of the input image is multiplied by a filter or kernel. Consequently, a new, reduced representation is obtained (a 2×2 feature map). B, Example of a specific operation for the values in the blue box." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Á. Iglesias-Puzas, P. Boixeda" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Á." "apellidos" => "Iglesias-Puzas" ] 1 => array:2 [ "nombre" => "P." "apellidos" => "Boixeda" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S000173101930393X" "doi" => "10.1016/j.ad.2019.01.014" "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/S000173101930393X?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020300287?idApp=UINPBA000044" "url" => "/15782190/0000011100000003/v1_202005050702/S1578219020300287/v1_202005050702/en/main.assets" ] "en" => array:21 [ "idiomaDefecto" => true "cabecera" => "Review" "titulo" => "Pigmented Purpuric Dermatosis: A Review of the Literature" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "196" "paginaFinal" => "204" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "I. Martínez Pallás, R. Conejero del Mazo, V. Lezcano Biosca" "autores" => array:3 [ 0 => array:4 [ "nombre" => "I." "apellidos" => "Martínez Pallás" "email" => array:1 [ 0 => "isabel_mp91@hotmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Conejero del Mazo" ] 2 => array:2 [ "nombre" => "V." "apellidos" => "Lezcano Biosca" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología y Venereología, Hospital Clínico Lozano Blesa, Zaragoza, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Dermatosis purpúricas pigmentadas. Revisión de la literatura científica" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 680 "Ancho" => 904 "Tamanyo" => 76759 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Majocchi disease. Annular red-violaceous lesions on the leg." ] ] ] "textoCompleto" => "IntroductionThe pigmented purpuric dermatoses (PPDs) are a rare group of chronic, benign diseases characterized by multiple petechiae on hyperpigmented, yellowish-brown macules.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> The different variants are distinct clinical forms of the same entity with similar histopathologic features.<a class="elsevierStyleCrossRefs" href="#bib0010">2,3</a>There are 5 classic variants: Schamberg disease (progressive PPD), eczematoid purpura of Doucas and Kapetanakis (pruritic purpura), pigmented purpuric lichenoid dermatosis of Gougerot and Blum, lichen aureus (lichen purpuricus), and Majocchi disease (purpura annularis telangiectodes).<a class="elsevierStyleCrossRef" href="#bib0005">1</a> Less common variants are granulomatous PPD, itching purpura of Loewenthal, linear PPD, transitory PPD, and familial PPD.<a class="elsevierStyleCrossRef" href="#bib0010">2</a>EpidemiologyPPDs are rare and predominantly affect adults,<a class="elsevierStyleCrossRef" href="#bib0005">1</a> although cases have been reported in children.<a class="elsevierStyleCrossRef" href="#bib0020">4</a> The most common variant in both adults and children is Schamberg disease. PPDs, and linear forms in particular,<a class="elsevierStyleCrossRef" href="#bib0030">6</a> are generally more common in men.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> Majocchi disease is more common in women.Etiology and PathogenesisAlthough the causes of the PPDs are unknown, a range of triggering factors have been proposed, including exercise, venous hypertension, diabetes mellitus, infections,<a class="elsevierStyleCrossRefs" href="#bib0010">2,7</a> and various medications (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<a class="elsevierStyleCrossRef" href="#bib0040">8</a> An association with dyslipidemia and autoimmune diseases has been reported for granulomatous PPD.<a class="elsevierStyleCrossRef" href="#bib0045">9</a> In most cases, however, no cause is identified.<a class="elsevierStyleCrossRef" href="#bib0050">10</a><elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Capillary dilation and fragility have been attributed a possible pathogenic role in PPDs.<a class="elsevierStyleCrossRef" href="#bib0050">10</a> It has been hypothesized that the cells responsible for these disorders are cells involved in blood vessel structure, such as fibroblasts and endothelial cells. Whether through activation (e.g., high intravascular pressure) or spontaneously, the function of these cells may be altered, causing red blood cells (RBCs) to leak through the vessel walls,<a class="elsevierStyleCrossRef" href="#bib0055">11</a> triggering a cell-mediated hypersensitivity reaction. Cell-mediated immune response would therefore appear to have a fundamental role in the pathogenesis of PPDs.<a class="elsevierStyleCrossRefs" href="#bib0060">12,13</a> The perivascular inflammatory infiltrate is made up of CD4+ T cells<a class="elsevierStyleCrossRef" href="#bib0070">14</a> (with reduced CD7 expression<a class="elsevierStyleCrossRef" href="#bib0075">15</a>) and CD1a+ dendritic cells.<a class="elsevierStyleCrossRef" href="#bib0060">12</a>The pathogenic role of cell adhesion molecules in PPDs has also been analyzed in several studies. CAMs are membrane proteins that interact with specific ligands that provide and maintain contact between different cells and between cells and extracellular matrix proteins. High expression levels have been observed for adhesion molecules LFA-1 (lymphocyte function antigen-1) and ICAM-1 (intercellular adhesion molecule-1) in inflammatory cells and for ICAM-1 and ELAM-1 (endothelial leukocyte adhesion molecule- 1)<a class="elsevierStyleCrossRef" href="#bib0060">12</a> in endothelial cells. T cells activated by an antigenic stimulus would thus adhere to endothelial cells, fibroblasts, and keratinocytes.<a class="elsevierStyleCrossRef" href="#bib0080">16</a> Cytokines produced by leukocytes (e.g., tumor necrosis factor α) can trigger the expression of these adhesion molecules (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).<elsevierMultimedia ident="fig0005"></elsevierMultimedia>The above cytokines may also result in a decreased release of the endothelial plasminogen activator and/or an excessive increase in the plasminogen activator inhibitor,<a class="elsevierStyleCrossRef" href="#bib0085">17</a> leading to the reduced fibrinolytic activity and intraperivascular deposition of fibrin observed in PPDs.<a class="elsevierStyleCrossRef" href="#bib0090">18</a>Direct immunofluorescence may show fibrinogen, immunoglobulin M, and/or C3 deposition in the superficial dermal vessels.<a class="elsevierStyleCrossRef" href="#bib0050">10</a>Another hypothesis that has emerged in recent years is that PPDs may represent an insidious epitheliotropic T-cell alteration. This theory is supported by the observation of epidermotropism or a monoclonal pattern in the inflammatory infiltrate.<a class="elsevierStyleCrossRefs" href="#bib0075">15,19</a> There have even been some reports of progression to mycosis fungoides.<a class="elsevierStyleCrossRefs" href="#bib0100">20–22</a> As it is difficult to distinguish between purpuric mycosis fungoides and monoclonal PPD, it is essential to integrate clinical, molecular, and histopathologic findings.<a class="elsevierStyleCrossRefs" href="#bib0075">15,20,23</a> Poikiloderma, pruritus, coalescing plaques, a duration of more than 1 year, a monoclonal pattern, and decreased CD7 and CD62 L expression in the infiltrate should all raise suspicion of disease progression, even in the absence of overt lymphocytic atypia.<a class="elsevierStyleCrossRefs" href="#bib0075">15,24</a> Some authors opt to treat disseminated and monoclonal DPP as early-stage mycosis fungoides.Clinical VariantsProgressive PPD or Schamberg Disease<a class="elsevierStyleCrossRefs" href="#bib0005">1,2</a>In progressive PPD or Schamberg disease, lesions usually appear on both lower extremities, but they can also affect the trunk, arms, thighs, or buttocks. They present as orange-red macules with peripheral purpuric spots resembling grains of cayenne pepper (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A and B); these spots acquire a yellowish-brown color as they progress. The lesions are generally asymptomatic, although some patients describe pruritus. They follow a chronic course with numerous relapses and remissions.<elsevierMultimedia ident="fig0010"></elsevierMultimedia>Pruritic Purpura or Eczematoid Purpura of Doucas And Kapetanakis<a class="elsevierStyleCrossRefs" href="#bib0005">1,25</a>Pruritic purpura or eczematoid purpura of Doucas and Kapetanakis is the most extensive and pruritic variant of the PPDs. It mostly affects the lower extremities and is clinically similar to Schamberg disease, with purpuric or petechial macules but with a scaling surface. Eczematoid purpura of Doucas and Kapetanakis has been associated with allergic contact dermatitis to rubber and clothing. Onset is rapid (15–30 days) and the lesions can last for months or years.Pigmented Purpuric Lichenoid Dermatosis of Gougerot and Blum<a class="elsevierStyleCrossRefs" href="#bib0005">1,2,26</a>Lichenoid pigmented purpuric dermatosis of Gougerot and Blum is characterized by violaceous lichenoid papules that tend to merge, forming large plaques that are usually located on the legs but may affect the trunk. The condition follows a chronic course and usually affects elderly men. It should be distinguished from Kaposi sarcoma.Lichen Aureus or Lichen Purpuricus<a class="elsevierStyleCrossRefs" href="#bib0005">1,2,27</a>Lichen aureus or lichen purpuricus is a more localized variant of PPD. Lesions are persistent and are typically solitary or small in number. Lichen aureus is characterized by the sudden appearance of small yellow-orangish papules with a lichenoid appearance and a tendency to coalesce into plaques measuring between 1 and 20 cm associated with millimetric purpuric lesions (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). The condition mostly affects the lower extremities, but lesions can occur on any part of the body. They are usually asymptomatic. Zosteriform<a class="elsevierStyleCrossRef" href="#bib0140">28</a> and segmental variants along the lines of Blaschko<a class="elsevierStyleCrossRef" href="#bib0145">29</a> or following the course of the saphenous<a class="elsevierStyleCrossRef" href="#bib0150">30</a> or cephalic veins<a class="elsevierStyleCrossRef" href="#bib0155">31</a> have been described in children and adolescents.<elsevierMultimedia ident="fig0015"></elsevierMultimedia>Purpura Annularis Telangiectodes or Majocchi Disease<a class="elsevierStyleCrossRefs" href="#bib0005">1,2,25</a>Purpura annularis telangiectodes or Majocchi disease presents with annular red-violaceous macules (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>), followed by darker red telangiectatic puncta. The lesions extend peripherally and their center gradually fades and may acquire an atrophic appearance. The eruption begins in the lower extremities and then spreads to the trunk and arms; it is characterized by large numbers of lesions. A variant known as arciform purpura annularis telangiectodes featuring fewer but larger lesions with a characteristic arched morphology has been described.<a class="elsevierStyleCrossRef" href="#bib0160">32</a><elsevierMultimedia ident="fig0020"></elsevierMultimedia>Other VariantsHersch and Schwayder<a class="elsevierStyleCrossRef" href="#bib0165">33</a> described what is considered to be a rare linear, unilateral form that must be differentiated from linear forms of Schamberg disease and lichen aureus. Higgins and Cox<a class="elsevierStyleCrossRef" href="#bib0170">34</a> described a quadrantic form they attributed to a vascular obstruction in the pelvis.There have also been reports of a transitory variant<a class="elsevierStyleCrossRef" href="#bib0175">35</a> including entities such as angioma serpiginosum,<a class="elsevierStyleCrossRef" href="#bib0180">36</a> which is an uncommon vascular disorder that usually begins in childhood, is more common in females, and shows evidence of estrogen dependence. Angioma serpiginosum is characterized by multiple asymptomatic red-purpuric macules arranged in small groups following a serpiginosum pattern along the extremities.Itching purpura of Loewenthal,<a class="elsevierStyleCrossRef" href="#bib0185">37</a> which has only been described in adults, is considered a more symptomatic variant of Schamberg disease.Granulomatous PPD, described by Saito,<a class="elsevierStyleCrossRef" href="#bib0190">38</a> is a histopathologic form that is more common in women and is clinically indistinguishable from other DPPs.Finally, there have been reports of autosomal dominant familial forms of Schamberg disease and purpura annularis telangiectoides.<a class="elsevierStyleCrossRef" href="#bib0195">39</a>HistopathologyHistopathologically, PPDs are characterized by a perivascular lymphocytic infiltrate centered on the superficial small vessels. Other typical findings are endothelial swelling, luminal narrowing,<a class="elsevierStyleCrossRef" href="#bib0050">10</a> extravasated RBCs, and hemosiderin-laden macrophages (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a> A and B). Perls and Fontana-Masson staining shows hemosiderin (iron) deposits in the superficial dermis, setting DPP apart from stasis dermatitis, which has deeper deposits.<a class="elsevierStyleCrossRef" href="#bib0010">2</a><elsevierMultimedia ident="fig0025"></elsevierMultimedia>A characteristic finding of lichen aureus is an intact epidermis separated from a band-like dermal infiltrate by an area of spared connective tissue (Grenz area)<a class="elsevierStyleCrossRef" href="#bib0135">27</a> (<a class="elsevierStyleCrossRef" href="#fig0030">Fig. 6</a>). This infiltrate is also typical in pigmented purpuric lichenoid dermatosis of Gougerot and Blum.<a class="elsevierStyleCrossRef" href="#bib0130">26</a> Eczematoid purpura of Doucas and Kapetanakis, by contrast, features epidermal spongiosis and neutrophils in the infiltrate.<a class="elsevierStyleCrossRef" href="#bib0125">25</a> Granulomatous PPD is characterized by a perivascular granulomatous infiltrate overlying typical features.<a class="elsevierStyleCrossRef" href="#bib0190">38</a> A comparison of clinical features, location, and histopathologic findings for the most common variants of PPD is provided in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>.<elsevierMultimedia ident="fig0030"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia>While some authors<a class="elsevierStyleCrossRefs" href="#bib0005">1,13</a> consider capillaritis to be a defining feature of DPPs, Ackerman<a class="elsevierStyleCrossRef" href="#bib0200">40</a> does not believe this to be the case as there is an absence of fibrin in the luminal wall and thrombi in the lumina.DiagnosisIn addition to skin biopsy, a blood test is recommended to rule out thrombocytopenia, clotting or autoimmune disorders (antinuclear antibodies, rheumatoid factor), and chronic infections (anti-HCV and anti-HBsAg).<a class="elsevierStyleCrossRef" href="#bib0010">2</a>Differential DiagnosisThe differential diagnosis should include other conditions featuring purpuric manifestations involving the lower extremities. These entities and their main characteristics are summarized in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>.<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>DermoscopyThe most common dermoscopic finding is a diffuse coppery-red background that histopathologically corresponds to the lymphocytic dermal infiltrate, extravasated RBCs, and hemosiderin-laden macrophages.<a class="elsevierStyleCrossRef" href="#bib0205">41</a> Other findings include red globules and dots, which can be explained by the extravasated RBCs, the increased number of blood vessels, and the dilation of these vessels<a class="elsevierStyleCrossRef" href="#bib0210">42</a> (<a class="elsevierStyleCrossRef" href="#fig0035">Fig. 7</a>). Brown dots are observed in almost 50% of patients and correspond to the spherical or elliptical arrangement of melanocytes and melanophages at the dermoepidermal junction. In a third of cases, dermoscopy shows a pigmented pseudo-network that corresponds to the hyperpigmented basal cell layer and incontinentia pigmenti in the papillary dermis. Specific dermoscopic findings reported for lichen aureus include a coppery-red background with brown and red dots and globules, gray dots, and a pseudo-network comprising interconnected pigmented lines<a class="elsevierStyleCrossRef" href="#bib0215">43</a> (<a class="elsevierStyleCrossRef" href="#fig0040">Fig. 8</a>).<elsevierMultimedia ident="fig0035"></elsevierMultimedia><elsevierMultimedia ident="fig0040"></elsevierMultimedia>TreatmentConsidering that DPPs are benign and no standardized treatments with proven effectiveness exist, the risks and benefits of any treatment should be carefully weighed up.Due to the benign, largely asymptomatic nature of the DPPs, no treatment is an option.<a class="elsevierStyleCrossRef" href="#bib0020">4</a> Treatment, however, is often called for because of the chronic nature of the disease, its physical and psychological impacts, and the presence of extensive lesions or itching.Most of the treatment recommendations are based on small case series, and none of them are backed by sufficient evidence to be considered a universal treatment.A range of topical and systemic treatments, detailed below, have been described in small series and case reports.Topical TreatmentsTopical CorticosteroidsTopical corticosteroids are the most common treatments described and have been observed to reduce itching and in some cases clear lesions.<a class="elsevierStyleCrossRefs" href="#bib0010">2,4</a>The most widely used agents are medium- and high-potency corticosteroids (clobetasol and methylprednisolone aceponate)Topical Calcineurin InhibitorsTopical application of tacrolimus<a class="elsevierStyleCrossRef" href="#bib0220">44</a> and pimecrolimus<a class="elsevierStyleCrossRef" href="#bib0225">45</a> for several months has been found to resolve lichen aureus.Given the chronic nature of PPD lesions and the need for long-term treatment, calcineurin inhibitors can be considered a good alternative to topical corticosteroids for clearing or resolving lesions.PhototherapyPhototherapy is a good option for treating extensive disease or PPD that does not respond to topical corticosteroids or calcineurin inhibitors.It has been postulated that phototherapy may be effective because it produces an immunomodulatory effect that modifies T-cell activity and reduces the production of interleukin 2, resulting in improvement.<a class="elsevierStyleCrossRef" href="#bib0230">46</a>Psoralen and UV-A (PUVA) treatment has been used successfully in patients with Schamberg disease, lichenoid purpuric dermatosis, and lichen aureus. In the series published to date, between 7 and 29 sessions with cumulative doses ranging from 16 to 49 J/cm2 have been needed to achieve remission. Retreatment has also proven effective, and in some cases maintenance treatment over several months has been necessary to prolong response.<a class="elsevierStyleCrossRefs" href="#bib0010">2,47–49</a>Narrowband UV-B phototherapy with cumulative doses of between 11 and 49 J/cm<a class="elsevierStyleCrossRef" href="#bib0010">2</a> administered in 24 to 60 sessions has produced favorable responses in patients with different clinical variants of DPP. As with PUVA treatment, there have been reports of recurrence after treatment discontinuation but good response to retreatment.<a class="elsevierStyleCrossRefs" href="#bib0230">46,50,51</a>Narrowband UV-B therapy is considered to be a good option because of its few adverse effects and good tolerability profile. It should therefore be borne in mind as an option for pediatric patients, patients with extensive lesions, and patients resistant to topical treatments.<a class="elsevierStyleCrossRefs" href="#bib0025">5,52</a>Systemic TreatmentsPentoxifyllineThere have been reports of PPD responding to oral pentoxifylline. It has been suggested that pentoxifylline may be effective because it inhibits T-cell adherence to the vascular endothelium by interaction with ICAM-1.<a class="elsevierStyleCrossRefs" href="#bib0265">53,54</a>Pentoxifylline has been used alone, at a dose of 400 mg twice or three times daily for 2 to 3 months,<a class="elsevierStyleCrossRefs" href="#bib0210">42,43</a> or in combination with other drugs such as prostacyclins (prostaglandin I1)<a class="elsevierStyleCrossRef" href="#bib0275">55</a> and oral corticosteroids.<a class="elsevierStyleCrossRef" href="#bib0280">56</a> Pentoxifylline has also been found to be ineffective in the treatment of DPPs.<a class="elsevierStyleCrossRef" href="#bib0285">57</a>Ascorbic Acid and Bioflavonoids (Rutin/Rutoside)As ascorbic acid and bioflavonoids increase collagen production, thereby reducing vascular permeability and improving the vascular endothelial barrier function, high doses of vitamin C combined with a flavonoid glycoside (like rutoside/rutin), present in citrus fruits, administered over several months have resulted in clinical improvements and in some cases resolution.<a class="elsevierStyleCrossRef" href="#bib0290">58</a>Other TreatmentsThere have been isolated reports of response to various systemic treatments, such as griseofulvin,<a class="elsevierStyleCrossRef" href="#bib0295">59</a> colchicine,<a class="elsevierStyleCrossRef" href="#bib0300">60</a> methotrexate,<a class="elsevierStyleCrossRef" href="#bib0305">61</a> and ciclosporin.<a class="elsevierStyleCrossRef" href="#bib0310">62</a>ConclusionsThe DPPs are a common dermatological condition and have a major impact on patient quality of life due to both symptoms and cosmetic concerns. Although the different variants are clinically very similar, there are a number of clinical, histopathologic, and dermoscopic characteristics that help to establish a more specific diagnosis.Finally, while there is insufficient evidence in the literature to recommend any treatment as a first-line treatment, numerous options exist that can achieve considerable improvements.Conflicts of InterestThe authors declare that they have no conflicts of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:15 [ 0 => array:3 [ "identificador" => "xres1332886" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1227991" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1332885" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1227992" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Epidemiology" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Etiology and Pathogenesis" ] 7 => array:3 [ "identificador" => "sec0020" "titulo" => "Clinical Variants" "secciones" => array:6 [ 0 => array:2 [ "identificador" => "sec0025" "titulo" => "Progressive PPD or Schamberg Disease" ] 1 => array:2 [ "identificador" => "sec0030" "titulo" => "Pruritic Purpura or Eczematoid Purpura of Doucas And Kapetanakis" ] 2 => array:2 [ "identificador" => "sec0035" "titulo" => "Pigmented Purpuric Lichenoid Dermatosis of Gougerot and Blum" ] 3 => array:2 [ "identificador" => "sec0040" "titulo" => "Lichen Aureus or Lichen Purpuricus" ] 4 => array:2 [ "identificador" => "sec0045" "titulo" => "Purpura Annularis Telangiectodes or Majocchi Disease" ] 5 => array:2 [ "identificador" => "sec0050" "titulo" => "Other Variants" ] ] ] 8 => array:2 [ "identificador" => "sec0055" "titulo" => "Histopathology" ] 9 => array:3 [ "identificador" => "sec0060" "titulo" => "Diagnosis" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0065" "titulo" => "Differential Diagnosis" ] 1 => array:2 [ "identificador" => "sec0070" "titulo" => "Dermoscopy" ] ] ] 10 => array:3 [ "identificador" => "sec0075" "titulo" => "Treatment" "secciones" => array:4 [ 0 => array:3 [ "identificador" => "sec0080" "titulo" => "Topical Treatments" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0085" "titulo" => "Topical Corticosteroids" ] 1 => array:2 [ "identificador" => "sec0090" "titulo" => "Topical Calcineurin Inhibitors" ] ] ] 1 => array:2 [ "identificador" => "sec0095" "titulo" => "Phototherapy" ] 2 => array:3 [ "identificador" => "sec0100" "titulo" => "Systemic Treatments" "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0105" "titulo" => "Pentoxifylline" ] 1 => array:2 [ "identificador" => "sec0110" "titulo" => "Ascorbic Acid and Bioflavonoids (Rutin/Rutoside)" ] ] ] 3 => array:2 [ "identificador" => "sec0115" "titulo" => "Other Treatments" ] ] ] 11 => array:2 [ "identificador" => "sec0120" "titulo" => "Conclusions" ] 12 => array:2 [ "identificador" => "sec0125" "titulo" => "Conflicts of Interest" ] 13 => array:2 [ "identificador" => "xack460587" "titulo" => "Acknowledgments" ] 14 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-10-21" "fechaAceptado" => "2019-02-24" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1227991" "palabras" => array:4 [ 0 => "Purpuric pigmented dermatosis" 1 => "Review" 2 => "Clinical presentation" 3 => "Treatment" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1227992" "palabras" => array:4 [ 0 => "Dermatosis purpúrico pigmentadas" 1 => "Revisión" 2 => "Presentación clínica" 3 => "Tratamiento" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "The pigmented purpuric dermatoses (PPDs) are a group of benign, chronic diseases. The variants described to date represent different clinical presentations of the same entity, all having similar histopathologic characteristics. We provide an overview of the most common PPDs and describe their clinical, dermatopathologic, and epiluminescence features. PPDs are both rare and benign, and this, together with an as yet poor understanding of the pathogenic mechanisms involved, means that no standardized treatments exist. We review the treatments described to date. However, because most of the descriptions are based on isolated cases or small series, there is insufficient evidence to support the use of any of these treatments as first-line therapy." ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "Las dermatosis purpúrico pigmentadas (DPP) son un grupo de enfermedades benignas y de curso crónico. Las variantes descritas representan distintas formas clínicas de una misma entidad con unas características histopatológicas comunes para todas ellas. Exponemos a continuación un resumen de las variedades más frecuentes, sus características clínicas, dermatopatológicas y de epiluminiscencia. Al tratarse de una entidad clínica poco frecuente, benigna, y no conocerse claramente los mecanismos patogénicos de la misma, no existen tratamientos estandarizados. Se revisan los tratamientos publicados hasta el momento, la mayoría de ellos basados en casos aislados o pequeñas series de casos, sin poder establecer un nivel de evidencia suficiente como para ser recomendado ninguno de ellos como tratamiento de elección." ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Martínez Pallás I, Conejero del Mazo R, Lezcano Biosca V. Dermatosis purpúricas pigmentadas. Revisión de la literatura científica. Actas Dermosifiliogr. 2020;111:196–204." ] ] "multimedia" => array:11 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1547 "Ancho" => 2167 "Tamanyo" => 195004 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Etiologic and pathogenic mechanism. One of the most widely accepted hypotheses is that T cells are activated by an antigenic stimulus and bind to endothelial cells, fibroblasts, and keratinocytes through the expression of adhesion molecules. TNF-α indicates tumor necrosis factor α ; ICAM-1, intercellular adhesion molecule-1; LFA-1, lymphocyte function antigen-1." ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1662 "Ancho" => 755 "Tamanyo" => 204387 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Schamberg disease. A, Orange-red macules that tend to coalesce, forming large plaques. B, Peripheral cayenne pepper spots." ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 579 "Ancho" => 905 "Tamanyo" => 67351 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Lichen aureus. Solitary plaque comprising small coalescing yellow-orange macules on the leg." ] ] 3 => array:8 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 680 "Ancho" => 904 "Tamanyo" => 76759 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Majocchi disease. Annular red-violaceous lesions on the leg." ] ] 4 => array:8 [ "identificador" => "fig0025" "etiqueta" => "Figure 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1636 "Ancho" => 805 "Tamanyo" => 528650 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Histopathological features of Schamberg disease. A, Infiltrate involving small vessels in the superficial dermis. B, Lymphocytic infiltrate, with luminal narrowing and extravasated red blood cells." ] ] 5 => array:8 [ "identificador" => "fig0030" "etiqueta" => "Figure 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 665 "Ancho" => 805 "Tamanyo" => 252604 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0030" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Histopathologic features of lichen aureus. Band-like infiltrate in the papillary dermis and superficial perivascular infiltrate." ] ] 6 => array:8 [ "identificador" => "fig0035" "etiqueta" => "Figure 7" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr7.jpeg" "Alto" => 605 "Ancho" => 805 "Tamanyo" => 51446 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0035" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Dermoscopic features of Schamberg disease. Coppery-red background and red globules." ] ] 7 => array:8 [ "identificador" => "fig0040" "etiqueta" => "Figure 8" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr8.jpeg" "Alto" => 605 "Ancho" => 805 "Tamanyo" => 76549 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0040" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Dermoscopic features of lichen aureus. Brownish-red background with gray dots and a pigmented pseudo-network." ] ] 8 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0045" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Source: Kaplan et al.<a class="elsevierStyleCrossRef" href="#bib0040">8</a>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sedatives \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Phenobarbital, chlordiazepoxide, meprobamate \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Vitamins \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Thiamine (B1) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Diuretics \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Furosemide \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cardiovascular drugs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nitroglycerine, bezafibrate, hydralazine, dipyridamole, sildenafil \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Antibiotics \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ampicillin \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Analgesics \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Nonsteroidal anti-inflammatory drugs, aspirin, acetaminophenol \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stimulants \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pseudoephedrine \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hormones \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Medroxyprogesterone acetate \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Antidiabetic drugs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Glipizide \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Chemotherapy agents \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Topical 5-fluorouracil \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Antivirals \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Interferon α \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Retinoids \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Isotretinoin \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2284703.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Drugs Associated With the Pigmented Purpuric Dermatoses." ] ] 9 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0050" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variant \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Clinical Presentation \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Location \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Histopathologic Findings \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Schamberg disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Red-orange macules with peripheral spots resembling grains of cayenne pepper \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lower limbs and occasionally trunk, arms, thighs, and buttocks \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lymphocytic infiltrate involving the superficial small vessels, extravasated red blood cells, and hemosiderin-laden macrophages \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Eczematoid purpura of Doucas and Kapetanakis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Similar to manifestations of Schamberg disease but with scaling and intense itching \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lower limbs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Infiltrate with higher number of neutrophils and epidermal spongiosis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pigmented purpuric lichenoid dermatosis of Gougerot and Blum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Violaceous lichenoid papules that merge to form plaques \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lower limbs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Band-like dermal infiltrate \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lichen aureus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Isolated persistent red-orange plaque and purpuric lesions \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lower limbs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Unchanged epidermis and band-like dermal infiltrate with Grenz area \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Majocchi disease \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Peripherally extending plaques with telangiectatic punta at edges and fading in the central area \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lower limbs and trunk \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Identical to Schamberg disease \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2284701.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Clinical and Histopathologic Characteristics of the Pigmented Purpuric Dermatoses." ] ] 10 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0055" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Source: Sardana et al.<a class="elsevierStyleCrossRef" href="#bib0010">2</a>, Kim et al.,<a class="elsevierStyleCrossRef" href="#bib0125">25</a> and Risikesan et al.<a class="elsevierStyleCrossRef" href="#bib0130">26</a>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Clinical Entities \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Main characteristics \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Drug-hypersensitivity reactions \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Recent use of causative drug \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Carbamazepine, meprobamate, chlordiazepoxide, furosemide, nitroglycerine, vitamin B1, and topical 5-fluorouracil \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Purpuric contact dermatitis to clothing \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Lesions confined to areas of the skin in contact with clothing; intense itching \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Wool, coloring agents \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Venous stasis purpura \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Signs of chronic venous insufficiency: swelling, varicose veins, feeling of heaviness, venous ulcers \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Hemosiderin deposition in deep dermis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Purpura due to thrombocytopenia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Associated with platelet count < 100–150000/μL \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Senile purpura \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">In elderly patients, purpura can be associated with antiplatelet, anticoagulant, or corticosteroid use \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Purpuric exanthema due to viral infection \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Other signs of infection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Leukocytoclastic vasculitis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Palpable purpuric lesions \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">On histology: fibrinoid necrosis, endothelial swelling, and leukocytoclasis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Schönlein-Henoch purpura \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Age, 3–15 years; symmetric purpura affecting legs and buttocks; joint and abdominal pain \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Kaposi sarcoma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Affects elderly or immunosuppressed patients \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">On histology: spindle cells in the dermis forming irregular vascular lumina \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Purpuric mycosis fungoides \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Onset > 1 year; disseminated, monoclonal profile in infiltrate and loss of CD7 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2284702.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Differential Diagnosis for the Pigmented Purpuric Dermatoses." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:62 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Purpura" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "T.A. Leslie" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:6 [ "paginaInicial" => "1" "paginaFinal" => "27" "edicion" => "9th edn." "serieVolumen" => "101" "serieTitulo" => "Rook’s Textbook of Dermatology" "serieFecha" => "2016" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pigmented purpuric dermatoses: an overview" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K. Sardana" 1 => "R. Sarkar" 2 => "V.N. Sehgal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-4632.2004.02213.x" "Revista" => array:6 [ "tituloSerie" => "Int J Dermatol." "fecha" => "2004" "volumen" => "43" "paginaInicial" => "482" "paginaFinal" => "488" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15230884" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The pathological spectrum and clinical correlation of pigmented purpuric dermatosis—A retrospective review of 107 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Y.-K. Huang" 1 => "C.-K. Lin" 2 => "Y.-H. Wu" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J CutanPathol." "fecha" => "2018" "volumen" => "45" "paginaInicial" => "325" "paginaFinal" => "332" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pigmented purpuric dermatosis: clinicopathologic characterization in a pediatric series" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Coulombe" 1 => "S.E. Jean" 2 => "A. Hatami" 3 => "J. Powell" 4 => "D. Marcoux" 5 => "V. Kokta" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/pde.12519" "Revista" => array:6 [ "tituloSerie" => "Pediatr Dermatol." "fecha" => "2015" "volumen" => "32" "paginaInicial" => "358" "paginaFinal" => "362" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25690369" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pigmented purpuric eruptions of childhood: a series of cases and review of literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P. Tristani-Firouzi" 1 => "K.P. Meadows" 2 => "S. Vanderhooft" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1525-1470.2001.01932.x" "Revista" => array:6 [ "tituloSerie" => "Pediatr Dermatol." "fecha" => "2001" "volumen" => "18" "paginaInicial" => "299" "paginaFinal" => "304" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11576402" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Two cases of unilateral pigmented purpuric dermatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Y. Taketuchi" 1 => "T. Chinen" 2 => "Y. Ichikawa" 3 => "M. Ito" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1346-8138.2001.tb00018.x" "Revista" => array:6 [ "tituloSerie" => "J Dermatol." "fecha" => "2001" "volumen" => "28" "paginaInicial" => "493" "paginaFinal" => "498" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11603391" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The clinical manifestations and etiologic factors of patients with pigmented purpuric dermatoses" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.H. Cho" 1 => "J.D. Lee" 2 => "H. Kang" 3 => "S.H. Cho" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Korean J Dermatol." "fecha" => "2005" "volumen" => "43" "paginaInicial" => "45" "paginaFinal" => "52" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A case of isotretinoin-induced purpura annularis telangiectodes of Majocchi and review of substance-induced pigmented purpuric dermatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Kaplan" 1 => "S.A. Meehan" 2 => "M. Leger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamadermatol.2013.7371" "Revista" => array:6 [ "tituloSerie" => "JAMA Dermatol." "fecha" => "2014" "volumen" => "150" "paginaInicial" => "182" "paginaFinal" => "184" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24284887" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Granulomatous variant of pigmented purpuric dermatosis: report of two cases and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. García-Rodiño" 1 => "M.T. Rodríguez-Granados" 2 => "M.J. Seoane-Pose" 3 => "M. Espasandín-Arias" 4 => "G. Barbeito-Castiñeiras" 5 => "J.M. Suárez-Peñaranda" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ddg.13228_g" "Revista" => array:6 [ "tituloSerie" => "J Dtsch Dermatol Ges." "fecha" => "2017" "volumen" => "15" "paginaInicial" => "565" "paginaFinal" => "569" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28485875" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Purpura simplex (inflammatory purpura without vasculitis): a clinicopathologic study of 174 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K.V. Ratnam" 1 => "W.P. Su" 2 => "M.S. Peters" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/0190-9622(91)70246-x" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol." "fecha" => "1991" "volumen" => "25" "paginaInicial" => "642" "paginaFinal" => "647" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1791222" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Segmental manifestation: a clue to explain the nature of pigmented purpuric dermatoses" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D. Torchio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1440-0960.2011.00809.x" "Revista" => array:6 [ "tituloSerie" => "Australas J Dermatol." "fecha" => "2011" "volumen" => "52" "numero" => "3" "paginaInicial" => "235" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21834827" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cell infltrate in progressive pigmented purpura (Schamberg’s disease): immunophenotype, adhesion receptors and intercellular relationships" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "I. Ghersetich" 1 => "T. Lotti" 2 => "S. Bacci" 3 => "C. Comacchi" 4 => "G. Campanile" 5 => "P. Romagnoli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-4362.1995.tb04419.x" "Revista" => array:6 [ "tituloSerie" => "Int J Dermatol." "fecha" => "1995" "volumen" => "34" "paginaInicial" => "846" "paginaFinal" => "850" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8647662" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cell adhesion molecule expression in capillaritis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "N.P. Burrows" 1 => "R.R. Jones" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0190-9622(09)80062-5" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol." "fecha" => "1994" "volumen" => "31" "numero" => "5 Pt 1" "paginaInicial" => "826" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7929939" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pigmented purpuric eruptions: immunopathologic studies supportive of a common immunophenotype" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B.R. Smoller" 1 => "O.W. Kamel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J CutanPathol." "fecha" => "1991" "volumen" => "18" "paginaInicial" => "423" "paginaFinal" => "427" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pigmented purpuric dermatosis: classification by phenotypic and molecular profiles" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "C.M. Magro" 1 => "J.T. Schaefer" 2 => "A.N. Crowson" 3 => "J. Li" 4 => "C. Morrison" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1309/AQMU3JFE2A66LC7E" "Revista" => array:6 [ "tituloSerie" => "Am J Clin Pathol." "fecha" => "2007" "volumen" => "128" "paginaInicial" => "218" "paginaFinal" => "229" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17638655" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cellular adhesion antigen modulation in purpura pigmentosa chronica" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P. von den Driesch" 1 => "M. Simon Jr" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0190-9622(94)70016-8" "Revista" => array:7 [ "tituloSerie" => "J Am Acad Dermatol." "fecha" => "1994" "volumen" => "30" "numero" => "2 Pt 1" "paginaInicial" => "193" "paginaFinal" => "200" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7507134" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Human dermal mast cells contain and release tumor necrosis factor α, which induces endothelial leukocyte adhesion molecule 1" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L.J. Walsh" 1 => "G. Trinchieri" 2 => "H.A. Waldorf" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1073/pnas.88.10.4220" "Revista" => array:6 [ "tituloSerie" => "Proc Natl Acad Sci USA." "fecha" => "1991" "volumen" => "88" "paginaInicial" => "4220" "paginaFinal" => "4224" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1709737" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Detection of undergraded fibrin and tumor necrosis factor a in venous leg ulcers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.L. Glaudy" 1 => "M. Mirshahi" 2 => "G. Soria" 3 => "J. Soria" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/0190-9622(91)70242-t" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol." "fecha" => "1991" "volumen" => "25" "paginaInicial" => "623" "paginaFinal" => "627" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1791219" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Persistent pigmented purpuric eruption associated with mycosis fungoides: a case report and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Georgala" 1 => "A.C. Katoulis" 2 => "S. Symeonidou" 3 => "C. Georgala" 4 => "G. Vayopou-los" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1468-3083.2001.00198.x" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol." "fecha" => "2001" "volumen" => "15" "paginaInicial" => "62" "paginaFinal" => "64" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11451328" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The spectrum of pigmented purpuric dermatosis and mycosis fungoides: atypical T-cell dyscrasia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.K. Ladrigan" 1 => "B. Poligone" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Cutis." "fecha" => "2014" "volumen" => "94" "paginaInicial" => "297" "paginaFinal" => "300" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25566571" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cutaneous T-cell lymphoid dyscrasia: a unifying term for idiopathic chronic dermatoses with persistent T-cell clones" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Guitart" 1 => "C. Magro" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archderm.143.7.921" "Revista" => array:6 [ "tituloSerie" => "Arch Dermatol." "fecha" => "2007" "volumen" => "143" "paginaInicial" => "921" "paginaFinal" => "932" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17638739" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pigmented purpuric dermatitis preceding the diagnosis of mycosis fungoides by 24 years" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "V. Viseux" 1 => "P. Schoenlaub" 2 => "F. Cnudde" 3 => "P. Le Roux" 4 => "J.P. Leroy" 5 => "P. Plantin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000073103" "Revista" => array:6 [ "tituloSerie" => "Dermatology." "fecha" => "2003" "volumen" => "207" "paginaInicial" => "331" "paginaFinal" => "332" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14571083" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The pigmented and purpuric dermatitis and the many faces of mycosis fungoides [editorial]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "D. Lipsker" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000073083" "Revista" => array:6 [ "tituloSerie" => "Dermatology." "fecha" => "2003" "volumen" => "207" "paginaInicial" => "246" "paginaFinal" => "247" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14571063" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mycosis fungoides presenting as pigmented purpuric dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Hanna" 1 => "N. Walsh" 2 => "Y. D’Intino" 3 => "R.G. Langley" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1525-1470.2006.00259.x" "Revista" => array:6 [ "tituloSerie" => "Pediatr Dermatol." "fecha" => "2006" "volumen" => "23" "paginaInicial" => "350" "paginaFinal" => "354" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16918631" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Characteristics and clinical manifestations of pigmented purpuric dermatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "D.H. Kim" 1 => "S.H. Seo" 2 => "H.H. Ahn" 3 => "Y.C. Kye" 4 => "J.E. Choi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5021/ad.2015.27.4.404" "Revista" => array:7 [ "tituloSerie" => "Ann Dermatol." "fecha" => "2015" "volumen" => "27" "paginaInicial" => "404" "paginaFinal" => "410" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26273156" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0140673616311357" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0130" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Successful topical treatment of pigmented purpuric lichenoid dermatitis of Gougerot-Blum in a young patient: a case report and summary of the most common pigmented purpuric dermatoses" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Risikesan" 1 => "M. Sommerlund" 2 => "M. Ramsing" 3 => "M. Kristensen" 4 => "U. Koppelhus" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000479922" "Revista" => array:6 [ "tituloSerie" => "Case Rep Dermatol." "fecha" => "2017" "volumen" => "9" "paginaInicial" => "169" "paginaFinal" => "176" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29033823" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0135" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lichen aureus: clinicopathological features in a Chinese series" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "Y.P. Zeng" 1 => "K. Fang" 2 => "D.L. Ma" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1684/ejd.2016.2767" "Revista" => array:6 [ "tituloSerie" => "Eur J Dermatol." "fecha" => "2016" "volumen" => "26" "paginaInicial" => "290" "paginaFinal" => "294" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27101633" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0140" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Zosteriform lichen aureus. Pediatric clinical case" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Á Rivera-Rodríguez" 1 => "S. Hernández Ostiz" 2 => "A.L. Morales-Moya" 3 => "L. Prieto-Torres" 4 => "M. Álvarez-Salafranca" 5 => "M. Ara Martín" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5546/aap.2017.e82" "Revista" => array:6 [ "tituloSerie" => "Arch Argent Pediatr." "fecha" => "2017" "volumen" => "115" "paginaInicial" => "e82" "paginaFinal" => "4" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28318188" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0145" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Segmental lichen aureus: a report of two cases treated with methylprednisolone aceponate" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Moche" 1 => "S. Glassman" 2 => "D. Modi" 3 => "W. Grayson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1440-0960.2010.00658.x" "Revista" => array:6 [ "tituloSerie" => "Australas J Dermatol." "fecha" => "2011" "volumen" => "52" "paginaInicial" => "e15" "paginaFinal" => "8" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21834806" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0150" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Segmental lichen aureus in a child" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D. Mishra" 1 => "V. Maheshwari" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-4362.1991.tb03495.x" "Revista" => array:6 [ "tituloSerie" => "Int J Dermatol." "fecha" => "1991" "volumen" => "30" "paginaInicial" => "654" "paginaFinal" => "655" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1938081" "web" => "Medline" ] ] ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0155" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Segmental lichen aureus: combination therapy with pentoxifylline and prostacyclin" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Lee" 1 => "D. Lee" 2 => "S. Chang" 3 => "M. Lee" 4 => "J. Choi" 5 => "K. Moon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Eur Acad Dermatol Vnereol." "fecha" => "2006" "volumen" => "20" "paginaInicial" => "1378" "paginaFinal" => "1380" ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0160" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Purpura annularistelangiectodes of Majocchi: case report and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F.J. Hoesly" 1 => "C.J. Huerter" 2 => "J.M. Shehan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-4632.2009.04160.x" "Revista" => array:6 [ "tituloSerie" => "Int J Dermatol." "fecha" => "2009" "volumen" => "48" "paginaInicial" => "1129" "paginaFinal" => "1133" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19775410" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0165" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Unilateral progressive pigmentary purpura (Schamberg’s disease) in a 15-year-old boy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.S. Hersh" 1 => "T.A. Shwayder" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0190-9622(08)80161-2" "Revista" => array:5 [ "tituloSerie" => "J Am Acad Dermatol." "fecha" => "1991" "volumen" => "24" "paginaInicial" => "651" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2033147" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0170" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A case of quadranticcapillaropathy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E.M. Higgins" 1 => "N.H. Cox" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000248000" "Revista" => array:6 [ "tituloSerie" => "Dermatologica" "fecha" => "1990" "volumen" => "180" "paginaInicial" => "93" "paginaFinal" => "95" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2311802" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0175" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transitory pigmented purpuric dermatoses in a young Japanese female" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Abe" 1 => "T. Syuto" 2 => "H. Ishibuchi" 3 => "Y. Yokoyama" 4 => "O. Ishikawa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1346-8138.2008.00514.x" "Revista" => array:6 [ "tituloSerie" => "J Dermatol." "fecha" => "2008" "volumen" => "35" "paginaInicial" => "525" "paginaFinal" => "528" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18789073" "web" => "Medline" ] ] ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0180" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Angioma serpiginosum: report of an unusual acral case and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Freites-Martinez" 1 => "D. Martinez-Sanchez" 2 => "A. Moreno-Torres" 3 => "M. Huerta-Brogeras" 4 => "A.H. Núñez" 5 => "J. Borbujo" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1590/abd1806-4841.20153794" "Revista" => array:7 [ "tituloSerie" => "Anais Brasileiros de Dermatologia." "fecha" => "2015" "volumen" => "90" "numero" => "3 Suppl 1" "paginaInicial" => "26" "paginaFinal" => "28" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26312666" "web" => "Medline" ] ] ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0185" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Eczematide-like purpura (itching purpura-angiodermatitis pruriginosa disseminata)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P. Sangüeza" 1 => "L. Valda" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Med CutanIbero Lat Am." "fecha" => "1980" "volumen" => "8" "paginaInicial" => "73" "paginaFinal" => "80" ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib0190" "etiqueta" => "38" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Granulomatous pigmented purpuric dermatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R. Saito" 1 => "Y. Matsuoka" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1346-8138.1996.tb02650.x" "Revista" => array:6 [ "tituloSerie" => "J Dermatol." "fecha" => "1996" "volumen" => "23" "paginaInicial" => "551" "paginaFinal" => "555" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8854588" "web" => "Medline" ] ] ] ] ] ] ] ] 38 => array:3 [ "identificador" => "bib0195" "etiqueta" => "39" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Familial pigmented purpuric dermatoses" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G. Sethuraman" 1 => "S. Sugandhan" 2 => "A. Bansal" 3 => "A.K. DAS" 4 => "V.K. Sharma" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1346-8138.2006.00149.x" "Revista" => array:6 [ "tituloSerie" => "J Dermatol." "fecha" => "2006" "volumen" => "33" "paginaInicial" => "639" "paginaFinal" => "641" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16958811" "web" => "Medline" ] ] ] ] ] ] ] ] 39 => array:3 [ "identificador" => "bib0200" "etiqueta" => "40" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Persistent pigmented purpuric dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.B. Ackerman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:6 [ "editores" => "A.B.Ackerman" "titulo" => "Histologic Diagnosis of Inflammatory Skin Diseases" "paginaInicial" => "609" "paginaFinal" => "613" "edicion" => "2nd edn." "serieFecha" => "1997" ] ] ] ] ] ] 40 => array:3 [ "identificador" => "bib0205" "etiqueta" => "41" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dermoscopy of pigmented purpuric dermatoses (lichen aureus): a useful tool for clinical diagnosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P. Zaballos" 1 => "S. Puig" 2 => "J. Malvehy" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archderm.140.10.1290" "Revista" => array:6 [ "tituloSerie" => "Arch Dermatol." "fecha" => "2004" "volumen" => "140" "paginaInicial" => "1290" "paginaFinal" => "1291" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15492206" "web" => "Medline" ] ] ] ] ] ] ] ] 41 => array:3 [ "identificador" => "bib0210" "etiqueta" => "42" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dermatoscopic findings of pigmented purpuric dermatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D.B. Ozkaya" 1 => "N. Emiroglu" 2 => "O. Su" 3 => "F.P. Cengiz" 4 => "A.G. Bahali" 5 => "P. Yildiz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1590/abd1806-4841.20165124" "Revista" => array:6 [ "tituloSerie" => "An Bras Dermatol." "fecha" => "2016" "volumen" => "91" "paginaInicial" => "584" "paginaFinal" => "587" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27828629" "web" => "Medline" ] ] ] ] ] ] ] ] 42 => array:3 [ "identificador" => "bib0215" "etiqueta" => "43" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Possible histopathologic correlates of dermoscopic features in pigmented melanocytic lesions identified by means of optical coherence tomography" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "V. de Giorgi" 1 => "M. Stante" 2 => "D. Massi" 3 => "L. Mavilia" 4 => "P. Cappugi" 5 => "P. Carli" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "ExpDermatol." "fecha" => "2005" "volumen" => "14" "paginaInicial" => "56" "paginaFinal" => "59" ] ] ] ] ] ] 43 => array:3 [ "identificador" => "bib0220" "etiqueta" => "44" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lichen aureus responding to topical tacrolimus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H. Murota" 1 => "I. Katayama" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Cutan Patol." "fecha" => "2011" "volumen" => "38" "paginaInicial" => "984" "paginaFinal" => "989" ] ] ] ] ] ] 44 => array:3 [ "identificador" => "bib0225" "etiqueta" => "45" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Resolution of lichen aureus in a 10 year-old child after topical pimecrolimus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Bohm" 1 => "G. Bonsmann" 2 => "T.A. Luger" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2133.2004.06155.x" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol." "fecha" => "2004" "volumen" => "151" "paginaInicial" => "519" "paginaFinal" => "520" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15327576" "web" => "Medline" ] ] ] ] ] ] ] ] 45 => array:3 [ "identificador" => "bib0230" "etiqueta" => "46" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Respuesta satisfactoria de la dermatosis purpurica pigmentada al tratamiento con fototerapia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Ciudad" 1 => "N. Cano" 2 => "R. Suarez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.adengl.2013.04.009" "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr." "fecha" => "2013" "volumen" => "104" "paginaInicial" => "439" "paginaFinal" => "449" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23683507" "web" => "Medline" ] ] ] ] ] ] ] ] 46 => array:3 [ "identificador" => "bib0235" "etiqueta" => "47" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A case of Schamberg´s disease responding dramatically to PUVA treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "D. Seckin" 1 => "Z. Yazici" 2 => "A. Senol" 3 => "Z. Demircay" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Photodermatol Photoinmunol Photomed." "fecha" => "2008" "volumen" => "24" "paginaInicial" => "95" "paginaFinal" => "96" ] ] ] ] ] ] 47 => array:3 [ "identificador" => "bib0240" "etiqueta" => "48" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Generalized Schamberg’s disease treated with PUVA in a child" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Milea" 1 => "H.-A. Dimov" 2 => "B. Cribier" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0151-9638(07)89195-2" "Revista" => array:6 [ "tituloSerie" => "Ann Dermatol Venereol." "fecha" => "2007" "volumen" => "134" "paginaInicial" => "378" "paginaFinal" => "380" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17483760" "web" => "Medline" ] ] ] ] ] ] ] ] 48 => array:3 [ "identificador" => "bib0245" "etiqueta" => "49" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "PUVA therapy in lichen aureus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T.C. Ling" 1 => "V. Goulden" 2 => "M.J. Goodfield" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Am AcadDermatol." "fecha" => "2001" "volumen" => "45" "paginaInicial" => "145" "paginaFinal" => "146" ] ] ] ] ] ] 49 => array:3 [ "identificador" => "bib0250" "etiqueta" => "50" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of pigmented purpuric dermatoses with narrow-band UVB: a report of six cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "H. Fathy" 1 => "S. Abdelgaber" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Eur Acad Dermatol Vnereol." "fecha" => "2011" "volumen" => "25" "paginaInicial" => "603" "paginaFinal" => "606" ] ] ] ] ] ] 50 => array:3 [ "identificador" => "bib0255" "etiqueta" => "51" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Two cases of eczematid-like purpura of Ducas and Kapetanakis responsive to narrow band ultraviolet B treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.S. Karadag" 1 => "S.G. Bilgili" 2 => "S. Onder" 3 => "O. Calka" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Photodermatol Photoinmunol Photomed." "fecha" => "2013" "volumen" => "29" "paginaInicial" => "97" "paginaFinal" => "99" ] ] ] ] ] ] 51 => array:3 [ "identificador" => "bib0260" "etiqueta" => "52" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Successful treatment of generalized childhood Schamberg´s disease with narrowband ultraviolet B therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "B. Can" 1 => "Z. Turkoglu" 2 => "M. Kavala" 3 => "I. Zindanci" 4 => "E. Kural" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Photodermatol Photoinmunol Photomed." "fecha" => "2011" "volumen" => "27" "paginaInicial" => "216" "paginaFinal" => "218" ] ] ] ] ] ] 52 => array:3 [ "identificador" => "bib0265" "etiqueta" => "53" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Schamberg´s purpura: asociation with persistent hepatitis B surface antigenemia and treatment with pentoxifylline" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A.V. Wahba-Yahav" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Cutis." "fecha" => "1994" "volumen" => "54" "paginaInicial" => "205" "paginaFinal" => "206" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7813245" "web" => "Medline" ] ] ] ] ] ] ] ] 53 => array:3 [ "identificador" => "bib0270" "etiqueta" => "54" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Extensive pigmented purpuric dermatosis successfully treated with pentoxifulline" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.H. Mun" 1 => "S.W. Jwa" 2 => "M. Song" 3 => "H.S. Kim" 4 => "H.C. Ko" 5 => "B.S. Kim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5021/ad.2012.24.3.363" "Revista" => array:6 [ "tituloSerie" => "Ann Dermatol." "fecha" => "2012" "volumen" => "24" "paginaInicial" => "363" "paginaFinal" => "365" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22879726" "web" => "Medline" ] ] ] ] ] ] ] ] 54 => array:3 [ "identificador" => "bib0275" "etiqueta" => "55" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Segmental lichen aureus: combination therapy with pentoxifylline and prostacyclin" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:5 [ 0 => "H.W. Lee" 1 => "D.K. Lee" 2 => "M.W. Lee" 3 => "J.H. Choi" 4 => "K.C. Moon" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1468-3083.2006.01732.x" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol." "fecha" => "2006" "volumen" => "20" "paginaInicial" => "1378" "paginaFinal" => "1380" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17062089" "web" => "Medline" ] ] ] ] ] ] ] ] 55 => array:3 [ "identificador" => "bib0280" "etiqueta" => "56" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Generalized Schamberg disease in a child" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.H. Park" 1 => "H.Y. Kang" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.5021/ad.2013.25.4.524" "Revista" => array:6 [ "tituloSerie" => "Ann Dermatol." "fecha" => "2013" "volumen" => "25" "paginaInicial" => "524" "paginaFinal" => "525" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24371414" "web" => "Medline" ] ] ] ] ] ] ] ] 56 => array:3 [ "identificador" => "bib0285" "etiqueta" => "57" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Should pentoxifylline be regarded as an effective treatment for Schamberg´s disease?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "P.Y. Basak" 1 => "S. Erguin" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Am Acad Dermatol." "fecha" => "2001" "volumen" => "44" "paginaInicial" => "548" "paginaFinal" => "549" ] ] ] ] ] ] 57 => array:3 [ "identificador" => "bib0290" "etiqueta" => "58" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Early treatment with rutoside and ascorbic acid is highly effective for progressive pigmented purpuric dermatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.M. Schober" 1 => "W.K. Peitsch" 2 => "G. Bonsmann" 3 => "D. Metze" 4 => "K. Thomas" 5 => "T. Goerge" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ddg.12520" "Revista" => array:6 [ "tituloSerie" => "J Dtsch Dermatol Ges." "fecha" => "2014" "volumen" => "12" "paginaInicial" => "1112" "paginaFinal" => "1119" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25482694" "web" => "Medline" ] ] ] ] ] ] ] ] 58 => array:3 [ "identificador" => "bib0295" "etiqueta" => "59" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Successful treatment of pigmented purpuric dermatosis with griseofulvin" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "K. Tamaki" 1 => "N. Yasaka" 2 => "A. Osada" 3 => "N. Shibagaki" 4 => "M. Furue" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2133.1996.tb07865.x" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol." "fecha" => "1996" "volumen" => "134" "paginaInicial" => "180" "paginaFinal" => "181" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8745912" "web" => "Medline" ] ] ] ] ] ] ] ] 59 => array:3 [ "identificador" => "bib0300" "etiqueta" => "60" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Benefit of colchicine in the treatment of Schamberg´s disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Geller" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Ann Allergy Asthma Inmmunol." "fecha" => "2000" "volumen" => "85" ] ] ] ] ] ] 60 => array:3 [ "identificador" => "bib0305" "etiqueta" => "61" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Purpura annularis telangiectoides of Majocchi: case report and rewiew of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "F.J. Hoesly" 1 => "C.J. Huerter" 2 => "J.M. Shehan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-4632.2009.04160.x" "Revista" => array:7 [ "tituloSerie" => "Int J Dermatol." "fecha" => "2009" "volumen" => "48" "paginaInicial" => "1129" "paginaFinal" => "1133" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19775410" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S104084281630124X" "estado" => "S300" "issn" => "10408428" ] ] ] ] ] ] ] 61 => array:3 [ "identificador" => "bib0310" "etiqueta" => "62" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Generalized purpuric lichen nitidus. Report of a case and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "E. Rallis" 1 => "C. Verros" 2 => "V. Moussatou" 3 => "D. Sambaziotis" 4 => "P. Papadakis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Dermatol Online J." "fecha" => "2007" "volumen" => "13" "paginaInicial" => "5" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18328199" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack460587" "titulo" => "Acknowledgments" "texto" => "We would like to thank Dr. Valero Torres from the Pathology Laboratory of Hospital Clínico Lozano Blesa for his help with the histopathologic analysis." "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011100000003/v1_202005050702/S1578219020300317/v1_202005050702/en/main.assets" "Apartado" => array:4 [ "identificador" => "6177" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Reviews" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000011100000003/v1_202005050702/S1578219020300317/v1_202005050702/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020300317?idApp=UINPBA000044"]

Estadísticas

Review

Pigmented Purpuric Dermatosis: A Review of the Literature

Dermatosis purpúricas pigmentadas. Revisión de la literatura científica

I. Martínez Pallás

Autor para correspondencia

isabel_mp91@hotmail.com

Corresponding author.

, R. Conejero del Mazo, V. Lezcano Biosca

Servicio de Dermatología y Venereología, Hospital Clínico Lozano Blesa, Zaragoza, Spain

Leído

25061

Veces
se ha leído el artículo

5185

Total PDF

19876

Total HTML

Compartir estadísticas

 array:25 [
  "pii" => "S1578219020300317"
  "issn" => "15782190"
  "doi" => "10.1016/j.adengl.2020.03.007"
  "estado" => "S300"
  "fechaPublicacion" => "2020-04-01"
  "aid" => "2226"
  "copyright" => "AEDV"
  "copyrightAnyo" => "2019"
  "documento" => "article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "rev"
  "cita" => "Actas Dermosifiliogr. 2020;111:196-204"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:20 [
      "pii" => "S0001731019301917"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2019.02.013"
      "estado" => "S300"
      "fechaPublicacion" => "2020-04-01"
      "aid" => "2226"
      "copyright" => "AEDV"
      "documento" => "article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "rev"
      "cita" => "Actas Dermosifiliogr. 2020;111:196-204"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 86
        "formatos" => array:2 [
          "HTML" => 53
          "PDF" => 33
        ]
      ]
      "es" => array:14 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">REVISI&#211;N</span>"
        "titulo" => "Dermatosis purp&#250;ricas pigmentadas&#46; Revisi&#243;n de la literatura cient&#237;fica"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "tieneResumen" => array:3 [
          0 => "es"
          1 => "es"
          2 => "en"
        ]
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "196"
            "paginaFinal" => "204"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Pigmented Purpuric Dermatosis&#58; A Review of the Literature"
          ]
        ]
        "contieneResumen" => array:2 [
          "es" => true
          "en" => true
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 1
          "multimedia" => array:5 [
            "identificador" => "fig0045"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => false
            "mostrarDisplay" => true
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "fx1.jpeg"
                "Alto" => 1001
                "Ancho" => 1333
                "Tamanyo" => 87985
              ]
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "I&#46; Mart&#237;nez Pall&#225;s, R&#46; Conejero del Mazo, V&#46; Lezcano Biosca"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "I&#46;"
                "apellidos" => "Mart&#237;nez Pall&#225;s"
              ]
              1 => array:2 [
                "nombre" => "R&#46;"
                "apellidos" => "Conejero del Mazo"
              ]
              2 => array:2 [
                "nombre" => "V&#46;"
                "apellidos" => "Lezcano Biosca"
              ]
            ]
          ]
        ]
        "resumen" => array:1 [
          0 => array:3 [
            "titulo" => "Graphical abstract"
            "clase" => "graphical"
            "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall"><elsevierMultimedia ident="fig0045"></elsevierMultimedia></p></span>"
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1578219020300317"
          "doi" => "10.1016/j.adengl.2020.03.007"
          "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/S1578219020300317?idApp=UINPBA000044"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731019301917?idApp=UINPBA000044"
      "url" => "/00017310/0000011100000003/v3_202009190646/S0001731019301917/v3_202009190646/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S1578219020300238"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2020.03.001"
    "estado" => "S300"
    "fechaPublicacion" => "2020-04-01"
    "aid" => "2287"
    "copyright" => "AEDV"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "rev"
    "cita" => "Actas Dermosifiliogr. 2020;111:205-21"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Review</span>"
      "titulo" => "Innovation in Atopic Dermatitis&#58; From Pathogenesis to Treatment"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "es"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "205"
          "paginaFinal" => "221"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Innovaci&#243;n en dermatitis at&#243;pica&#58; de la patogenia a la terap&#233;utica"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "es" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1641
              "Ancho" => 2925
              "Tamanyo" => 443688
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0005"
              "detalle" => "Figure "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Biologic agents and specific targets in the pathogenesis of atopic dermatitis&#46;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Abbreviations&#58; IgE&#44; immunoglobulin E&#59; IL&#44; interleukin&#59; OSMR&#223;&#59; oncostatin M receptor &#223;&#59; Th&#44; T helper &#40;lymphocyte&#41;&#59; TSLP&#44; thymic stromal lymphopoietin&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "M&#46; Munera-Campos, J&#46;M&#46; Carrascosa"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Munera-Campos"
            ]
            1 => array:2 [
              "nombre" => "J&#46;M&#46;"
              "apellidos" => "Carrascosa"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731019303898"
        "doi" => "10.1016/j.ad.2019.11.002"
        "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/S0001731019303898?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020300238?idApp=UINPBA000044"
    "url" => "/15782190/0000011100000003/v1_202005050702/S1578219020300238/v1_202005050702/en/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S1578219020300287"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2020.03.005"
    "estado" => "S300"
    "fechaPublicacion" => "2020-04-01"
    "aid" => "2291"
    "copyright" => "AEDV"
    "documento" => "article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "sco"
    "cita" => "Actas Dermosifiliogr. 2020;111:192-5"
    "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">Opinion Article</span>"
      "titulo" => "Deep Learning and Mathematical Models in Dermatology"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "192"
          "paginaFinal" => "195"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "<span class="elsevierStyleItalic">Deep learning</span> y DerMATolog&#237;a"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0010"
          "etiqueta" => "Fig&#46; 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 2238
              "Ancho" => 2508
              "Tamanyo" => 346979
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0025"
              "detalle" => "Fig&#46; "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A&#44; Example of a convolution operation&#46; A computer sees an image &#40;L&#41; as a 4<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>4 matrix of numbers&#46; Each value of the input image is multiplied by a filter or kernel&#46; Consequently&#44; a new&#44; reduced representation is obtained &#40;a 2<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>2 feature map&#41;&#46; B&#44; Example of a specific operation for the values in the blue box&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "&#193;&#46; Iglesias-Puzas, P&#46; Boixeda"
          "autores" => array:2 [
            0 => array:2 [
              "nombre" => "&#193;&#46;"
              "apellidos" => "Iglesias-Puzas"
            ]
            1 => array:2 [
              "nombre" => "P&#46;"
              "apellidos" => "Boixeda"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S000173101930393X"
        "doi" => "10.1016/j.ad.2019.01.014"
        "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/S000173101930393X?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020300287?idApp=UINPBA000044"
    "url" => "/15782190/0000011100000003/v1_202005050702/S1578219020300287/v1_202005050702/en/main.assets"
  ]
  "en" => array:21 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Review</span>"
    "titulo" => "Pigmented Purpuric Dermatosis&#58; A Review of the Literature"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "196"
        "paginaFinal" => "204"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "I&#46; Mart&#237;nez Pall&#225;s, R&#46; Conejero del Mazo, V&#46; Lezcano Biosca"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "I&#46;"
            "apellidos" => "Mart&#237;nez Pall&#225;s"
            "email" => array:1 [
              0 => "isabel_mp91@hotmail.com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "R&#46;"
            "apellidos" => "Conejero del Mazo"
          ]
          2 => array:2 [
            "nombre" => "V&#46;"
            "apellidos" => "Lezcano Biosca"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicio de Dermatolog&#237;a y Venereolog&#237;a&#44; Hospital Cl&#237;nico Lozano Blesa&#44; Zaragoza&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Dermatosis purp&#250;ricas pigmentadas&#46; Revisi&#243;n de la literatura cient&#237;fica"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig0020"
        "etiqueta" => "Figure 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 680
            "Ancho" => 904
            "Tamanyo" => 76759
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0020"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Majocchi disease&#46; Annular red-violaceous lesions on the leg&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The pigmented purpuric dermatoses &#40;PPDs&#41; are a rare group of chronic&#44; benign diseases characterized by multiple petechiae on hyperpigmented&#44; yellowish-brown macules&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The different variants are distinct clinical forms of the same entity with similar histopathologic features&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">There are 5 classic variants&#58; Schamberg disease &#40;progressive PPD&#41;&#44; eczematoid purpura of Doucas and Kapetanakis &#40;pruritic purpura&#41;&#44; pigmented purpuric lichenoid dermatosis of Gougerot and Blum&#44; lichen aureus &#40;lichen purpuricus&#41;&#44; and Majocchi disease &#40;purpura annularis telangiectodes&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Less common variants are granulomatous PPD&#44; itching purpura of Loewenthal&#44; linear PPD&#44; transitory PPD&#44; and familial PPD&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Epidemiology</span><p id="par0015" class="elsevierStylePara elsevierViewall">PPDs are rare and predominantly affect adults&#44;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> although cases have been reported in children&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> The most common variant in both adults and children is Schamberg disease&#46; PPDs&#44; and linear forms in particular&#44;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> are generally more common in men&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Majocchi disease is more common in women&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Etiology and Pathogenesis</span><p id="par0020" class="elsevierStylePara elsevierViewall">Although the causes of the PPDs are unknown&#44; a range of triggering factors have been proposed&#44; including exercise&#44; venous hypertension&#44; diabetes mellitus&#44; infections&#44;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;7</span></a> and various medications &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> An association with dyslipidemia and autoimmune diseases has been reported for granulomatous PPD&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> In most cases&#44; however&#44; no cause is identified&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Capillary dilation and fragility have been attributed a possible pathogenic role in PPDs&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> It has been hypothesized that the cells responsible for these disorders are cells involved in blood vessel structure&#44; such as fibroblasts and endothelial cells&#46; Whether through activation &#40;e&#46;g&#46;&#44; high intravascular pressure&#41; or spontaneously&#44; the function of these cells may be altered&#44; causing red blood cells &#40;RBCs&#41; to leak through the vessel walls&#44;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> triggering a cell-mediated hypersensitivity reaction&#46; Cell-mediated immune response would therefore appear to have a fundamental role in the pathogenesis of PPDs&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;13</span></a> The perivascular inflammatory infiltrate is made up of CD4<span class="elsevierStyleSup">&#43;</span> T cells<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> &#40;with reduced CD7 expression<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a>&#41; and CD1a<span class="elsevierStyleSup">&#43;</span> dendritic cells&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The pathogenic role of cell adhesion molecules in PPDs has also been analyzed in several studies&#46; CAMs are membrane proteins that interact with specific ligands that provide and maintain contact between different cells and between cells and extracellular matrix proteins&#46; High expression levels have been observed for adhesion molecules LFA-1 &#40;lymphocyte function antigen-1&#41; and ICAM-1 &#40;intercellular adhesion molecule-1&#41; in inflammatory cells and for ICAM-1 and ELAM-1 &#40;endothelial leukocyte adhesion molecule- 1&#41;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> in endothelial cells&#46; T cells activated by an antigenic stimulus would thus adhere to endothelial cells&#44; fibroblasts&#44; and keratinocytes&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> Cytokines produced by leukocytes &#40;e&#46;g&#46;&#44; tumor necrosis factor &#945;&#41; can trigger the expression of these adhesion molecules &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">The above cytokines may also result in a decreased release of the endothelial plasminogen activator and&#47;or an excessive increase in the plasminogen activator inhibitor&#44;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> leading to the reduced fibrinolytic activity and intraperivascular deposition of fibrin observed in PPDs&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">Direct immunofluorescence may show fibrinogen&#44; immunoglobulin M&#44; and&#47;or C3 deposition in the superficial dermal vessels&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Another hypothesis that has emerged in recent years is that PPDs may represent an insidious epitheliotropic T-cell alteration&#46; This theory is supported by the observation of epidermotropism or a monoclonal pattern in the inflammatory infiltrate&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">15&#44;19</span></a> There have even been some reports of progression to mycosis fungoides&#46;<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#8211;22</span></a> As it is difficult to distinguish between purpuric mycosis fungoides and monoclonal PPD&#44; it is essential to integrate clinical&#44; molecular&#44; and histopathologic findings&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">15&#44;20&#44;23</span></a> Poikiloderma&#44; pruritus&#44; coalescing plaques&#44; a duration of more than 1&#8239;year&#44; a monoclonal pattern&#44; and decreased CD7 and CD62&#8239;L expression in the infiltrate should all raise suspicion of disease progression&#44; even in the absence of overt lymphocytic atypia&#46;<a class="elsevierStyleCrossRefs" href="#bib0075"><span class="elsevierStyleSup">15&#44;24</span></a> Some authors opt to treat disseminated and monoclonal DPP as early-stage mycosis fungoides&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Clinical Variants</span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Progressive PPD or Schamberg Disease<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a></span><p id="par0050" class="elsevierStylePara elsevierViewall">In progressive PPD or Schamberg disease&#44; lesions usually appear on both lower extremities&#44; but they can also affect the trunk&#44; arms&#44; thighs&#44; or buttocks&#46; They present as orange-red macules with peripheral purpuric spots resembling grains of cayenne pepper &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>A and B&#41;&#59; these spots acquire a yellowish-brown color as they progress&#46; The lesions are generally asymptomatic&#44; although some patients describe pruritus&#46; They follow a chronic course with numerous relapses and remissions&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Pruritic Purpura or Eczematoid Purpura of Doucas And Kapetanakis<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;25</span></a></span><p id="par0055" class="elsevierStylePara elsevierViewall">Pruritic purpura or eczematoid purpura of Doucas and Kapetanakis is the most extensive and pruritic variant of the PPDs&#46; It mostly affects the lower extremities and is clinically similar to Schamberg disease&#44; with purpuric or petechial macules but with a scaling surface&#46; Eczematoid purpura of Doucas and Kapetanakis has been associated with allergic contact dermatitis to rubber and clothing&#46; Onset is rapid &#40;15&#8211;30 days&#41; and the lesions can last for months or years&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Pigmented Purpuric Lichenoid Dermatosis of Gougerot and Blum<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2&#44;26</span></a></span><p id="par0060" class="elsevierStylePara elsevierViewall">Lichenoid pigmented purpuric dermatosis of Gougerot and Blum is characterized by violaceous lichenoid papules that tend to merge&#44; forming large plaques that are usually located on the legs but may affect the trunk&#46; The condition follows a chronic course and usually affects elderly men&#46; It should be distinguished from Kaposi sarcoma&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Lichen Aureus or Lichen Purpuricus<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2&#44;27</span></a></span><p id="par0065" class="elsevierStylePara elsevierViewall">Lichen aureus or lichen purpuricus is a more localized variant of PPD&#46; Lesions are persistent and are typically solitary or small in number&#46; Lichen aureus is characterized by the sudden appearance of small yellow-orangish papules with a lichenoid appearance and a tendency to coalesce into plaques measuring between 1 and 20&#8239;cm associated with millimetric purpuric lesions &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46; The condition mostly affects the lower extremities&#44; but lesions can occur on any part of the body&#46; They are usually asymptomatic&#46; Zosteriform<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">28</span></a> and segmental variants along the lines of Blaschko<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">29</span></a> or following the course of the saphenous<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">30</span></a> or cephalic veins<a class="elsevierStyleCrossRef" href="#bib0155"><span class="elsevierStyleSup">31</span></a> have been described in children and adolescents&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Purpura Annularis Telangiectodes or Majocchi Disease<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2&#44;25</span></a></span><p id="par0070" class="elsevierStylePara elsevierViewall">Purpura annularis telangiectodes or Majocchi disease presents with annular red-violaceous macules &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>&#41;&#44; followed by darker red telangiectatic puncta&#46; The lesions extend peripherally and their center gradually fades and may acquire an atrophic appearance&#46; The eruption begins in the lower extremities and then spreads to the trunk and arms&#59; it is characterized by large numbers of lesions&#46; A variant known as <span class="elsevierStyleItalic">arciform purpura annularis telangiectodes</span> featuring fewer but larger lesions with a characteristic arched morphology has been described&#46;<a class="elsevierStyleCrossRef" href="#bib0160"><span class="elsevierStyleSup">32</span></a></p><elsevierMultimedia ident="fig0020"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Other Variants</span><p id="par0075" class="elsevierStylePara elsevierViewall">Hersch and Schwayder<a class="elsevierStyleCrossRef" href="#bib0165"><span class="elsevierStyleSup">33</span></a> described what is considered to be a rare linear&#44; unilateral form that must be differentiated from linear forms of Schamberg disease and lichen aureus&#46; Higgins and Cox<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">34</span></a> described a quadrantic form they attributed to a vascular obstruction in the pelvis&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">There have also been reports of a transitory variant<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">35</span></a> including entities such as angioma serpiginosum&#44;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">36</span></a> which is an uncommon vascular disorder that usually begins in childhood&#44; is more common in females&#44; and shows evidence of estrogen dependence&#46; Angioma serpiginosum is characterized by multiple asymptomatic red-purpuric macules arranged in small groups following a serpiginosum pattern along the extremities&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Itching purpura of Loewenthal&#44;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">37</span></a> which has only been described in adults&#44; is considered a more symptomatic variant of Schamberg disease&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Granulomatous PPD&#44; described by Saito&#44;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">38</span></a> is a histopathologic form that is more common in women and is clinically indistinguishable from other DPPs&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Finally&#44; there have been reports of autosomal dominant familial forms of Schamberg disease and purpura annularis telangiectoides&#46;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">39</span></a></p></span></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Histopathology</span><p id="par0100" class="elsevierStylePara elsevierViewall">Histopathologically&#44; PPDs are characterized by a perivascular lymphocytic infiltrate centered on the superficial small vessels&#46; Other typical findings are endothelial swelling&#44; luminal narrowing&#44;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> extravasated RBCs&#44; and hemosiderin-laden macrophages &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a> A and B&#41;&#46; Perls and Fontana-Masson staining shows hemosiderin &#40;iron&#41; deposits in the superficial dermis&#44; setting DPP apart from stasis dermatitis&#44; which has deeper deposits&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><p id="par0105" class="elsevierStylePara elsevierViewall">A characteristic finding of lichen aureus is an intact epidermis separated from a band-like dermal infiltrate by an area of spared connective tissue &#40;Grenz area&#41;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> &#40;<a class="elsevierStyleCrossRef" href="#fig0030">Fig&#46; 6</a>&#41;&#46; This infiltrate is also typical in pigmented purpuric lichenoid dermatosis of Gougerot and Blum&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> Eczematoid purpura of Doucas and Kapetanakis&#44; by contrast&#44; features epidermal spongiosis and neutrophils in the infiltrate&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> Granulomatous PPD is characterized by a perivascular granulomatous infiltrate overlying typical features&#46;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">38</span></a> A comparison of clinical features&#44; location&#44; and histopathologic findings for the most common variants of PPD is provided in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46;</p><elsevierMultimedia ident="fig0030"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">While some authors<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;13</span></a> consider capillaritis to be a defining feature of DPPs&#44; Ackerman<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">40</span></a> does not believe this to be the case as there is an absence of fibrin in the luminal wall and thrombi in the lumina&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Diagnosis</span><p id="par0115" class="elsevierStylePara elsevierViewall">In addition to skin biopsy&#44; a blood test is recommended to rule out thrombocytopenia&#44; clotting or autoimmune disorders &#40;antinuclear antibodies&#44; rheumatoid factor&#41;&#44; and chronic infections &#40;anti-HCV and anti-HBsAg&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Differential Diagnosis</span><p id="par0120" class="elsevierStylePara elsevierViewall">The differential diagnosis should include other conditions featuring purpuric manifestations involving the lower extremities&#46; These entities and their main characteristics are summarized in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Dermoscopy</span><p id="par0125" class="elsevierStylePara elsevierViewall">The most common dermoscopic finding is a diffuse coppery-red background that histopathologically corresponds to the lymphocytic dermal infiltrate&#44; extravasated RBCs&#44; and hemosiderin-laden macrophages&#46;<a class="elsevierStyleCrossRef" href="#bib0205"><span class="elsevierStyleSup">41</span></a> Other findings include red globules and dots&#44; which can be explained by the extravasated RBCs&#44; the increased number of blood vessels&#44; and the dilation of these vessels<a class="elsevierStyleCrossRef" href="#bib0210"><span class="elsevierStyleSup">42</span></a> &#40;<a class="elsevierStyleCrossRef" href="#fig0035">Fig&#46; 7</a>&#41;&#46; Brown dots are observed in almost 50&#37; of patients and correspond to the spherical or elliptical arrangement of melanocytes and melanophages at the dermoepidermal junction&#46; In a third of cases&#44; dermoscopy shows a pigmented pseudo-network that corresponds to the hyperpigmented basal cell layer and incontinentia pigmenti in the papillary dermis&#46; Specific dermoscopic findings reported for lichen aureus include a coppery-red background with brown and red dots and globules&#44; gray dots&#44; and a pseudo-network comprising interconnected pigmented lines<a class="elsevierStyleCrossRef" href="#bib0215"><span class="elsevierStyleSup">43</span></a> &#40;<a class="elsevierStyleCrossRef" href="#fig0040">Fig&#46; 8</a>&#41;&#46;</p><elsevierMultimedia ident="fig0035"></elsevierMultimedia><elsevierMultimedia ident="fig0040"></elsevierMultimedia></span></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Treatment</span><p id="par0130" class="elsevierStylePara elsevierViewall">Considering that DPPs are benign and no standardized treatments with proven effectiveness exist&#44; the risks and benefits of any treatment should be carefully weighed up&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Due to the benign&#44; largely asymptomatic nature of the DPPs&#44; no treatment is an option&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Treatment&#44; however&#44; is often called for because of the chronic nature of the disease&#44; its physical and psychological impacts&#44; and the presence of extensive lesions or itching&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Most of the treatment recommendations are based on small case series&#44; and none of them are backed by sufficient evidence to be considered a universal treatment&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">A range of topical and systemic treatments&#44; detailed below&#44; have been described in small series and case reports&#46;</p><span id="sec0080" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Topical Treatments</span><span id="sec0085" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Topical Corticosteroids</span><p id="par0150" class="elsevierStylePara elsevierViewall">Topical corticosteroids are the most common treatments described and have been observed to reduce itching and in some cases clear lesions&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;4</span></a></p><p id="par0155" class="elsevierStylePara elsevierViewall">The most widely used agents are medium- and high-potency corticosteroids &#40;clobetasol and methylprednisolone aceponate&#41;</p></span><span id="sec0090" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Topical Calcineurin Inhibitors</span><p id="par0160" class="elsevierStylePara elsevierViewall">Topical application of tacrolimus<a class="elsevierStyleCrossRef" href="#bib0220"><span class="elsevierStyleSup">44</span></a> and pimecrolimus<a class="elsevierStyleCrossRef" href="#bib0225"><span class="elsevierStyleSup">45</span></a> for several months has been found to resolve lichen aureus&#46;</p><p id="par0165" class="elsevierStylePara elsevierViewall">Given the chronic nature of PPD lesions and the need for long-term treatment&#44; calcineurin inhibitors can be considered a good alternative to topical corticosteroids for clearing or resolving lesions&#46;</p></span></span><span id="sec0095" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Phototherapy</span><p id="par0170" class="elsevierStylePara elsevierViewall">Phototherapy is a good option for treating extensive disease or PPD that does not respond to topical corticosteroids or calcineurin inhibitors&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">It has been postulated that phototherapy may be effective because it produces an immunomodulatory effect that modifies T-cell activity and reduces the production of interleukin 2&#44; resulting in improvement&#46;<a class="elsevierStyleCrossRef" href="#bib0230"><span class="elsevierStyleSup">46</span></a></p><p id="par0180" class="elsevierStylePara elsevierViewall">Psoralen and UV-A &#40;PUVA&#41; treatment has been used successfully in patients with Schamberg disease&#44; lichenoid purpuric dermatosis&#44; and lichen aureus&#46; In the series published to date&#44; between 7 and 29 sessions with cumulative doses ranging from 16 to 49&#8239;J&#47;cm<span class="elsevierStyleSup">2</span> have been needed to achieve remission&#46; Retreatment has also proven effective&#44; and in some cases maintenance treatment over several months has been necessary to prolong response&#46;<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;47&#8211;49</span></a></p><p id="par0185" class="elsevierStylePara elsevierViewall">Narrowband UV-B phototherapy with cumulative doses of between 11 and 49&#8239;J&#47;cm<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> administered in 24 to 60 sessions has produced favorable responses in patients with different clinical variants of DPP&#46; As with PUVA treatment&#44; there have been reports of recurrence after treatment discontinuation but good response to retreatment&#46;<a class="elsevierStyleCrossRefs" href="#bib0230"><span class="elsevierStyleSup">46&#44;50&#44;51</span></a></p><p id="par0190" class="elsevierStylePara elsevierViewall">Narrowband UV-B therapy is considered to be a good option because of its few adverse effects and good tolerability profile&#46; It should therefore be borne in mind as an option for pediatric patients&#44; patients with extensive lesions&#44; and patients resistant to topical treatments&#46;<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;52</span></a></p></span><span id="sec0100" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0120">Systemic Treatments</span><span id="sec0105" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0125">Pentoxifylline</span><p id="par0195" class="elsevierStylePara elsevierViewall">There have been reports of PPD responding to oral pentoxifylline&#46; It has been suggested that pentoxifylline may be effective because it inhibits T-cell adherence to the vascular endothelium by interaction with ICAM-1&#46;<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">53&#44;54</span></a></p><p id="par0200" class="elsevierStylePara elsevierViewall">Pentoxifylline has been used alone&#44; at a dose of 400&#8239;mg twice or three times daily for 2 to 3 months&#44;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">42&#44;43</span></a> or in combination with other drugs such as prostacyclins &#40;prostaglandin I1&#41;<a class="elsevierStyleCrossRef" href="#bib0275"><span class="elsevierStyleSup">55</span></a> and oral corticosteroids&#46;<a class="elsevierStyleCrossRef" href="#bib0280"><span class="elsevierStyleSup">56</span></a> Pentoxifylline has also been found to be ineffective in the treatment of DPPs&#46;<a class="elsevierStyleCrossRef" href="#bib0285"><span class="elsevierStyleSup">57</span></a></p></span><span id="sec0110" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0130">Ascorbic Acid and Bioflavonoids &#40;Rutin&#47;Rutoside&#41;</span><p id="par0205" class="elsevierStylePara elsevierViewall">As ascorbic acid and bioflavonoids increase collagen production&#44; thereby reducing vascular permeability and improving the vascular endothelial barrier function&#44; high doses of vitamin C combined with a flavonoid glycoside &#40;like rutoside&#47;rutin&#41;&#44; present in citrus fruits&#44; administered over several months have resulted in clinical improvements and in some cases resolution&#46;<a class="elsevierStyleCrossRef" href="#bib0290"><span class="elsevierStyleSup">58</span></a></p></span></span><span id="sec0115" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0135">Other Treatments</span><p id="par0210" class="elsevierStylePara elsevierViewall">There have been isolated reports of response to various systemic treatments&#44; such as griseofulvin&#44;<a class="elsevierStyleCrossRef" href="#bib0295"><span class="elsevierStyleSup">59</span></a> colchicine&#44;<a class="elsevierStyleCrossRef" href="#bib0300"><span class="elsevierStyleSup">60</span></a> methotrexate&#44;<a class="elsevierStyleCrossRef" href="#bib0305"><span class="elsevierStyleSup">61</span></a> and ciclosporin&#46;<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">62</span></a></p></span></span><span id="sec0120" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0140">Conclusions</span><p id="par0215" class="elsevierStylePara elsevierViewall">The DPPs are a common dermatological condition and have a major impact on patient quality of life due to both symptoms and cosmetic concerns&#46; Although the different variants are clinically very similar&#44; there are a number of clinical&#44; histopathologic&#44; and dermoscopic characteristics that help to establish a more specific diagnosis&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">Finally&#44; while there is insufficient evidence in the literature to recommend any treatment as a first-line treatment&#44; numerous options exist that can achieve considerable improvements&#46;</p></span><span id="sec0125" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0145">Conflicts of Interest</span><p id="par0225" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:15 [
        0 => array:3 [
          "identificador" => "xres1332886"
          "titulo" => "Abstract"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0005"
            ]
          ]
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec1227991"
          "titulo" => "Keywords"
        ]
        2 => array:3 [
          "identificador" => "xres1332885"
          "titulo" => "Resumen"
          "secciones" => array:1 [
            0 => array:1 [
              "identificador" => "abst0010"
            ]
          ]
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec1227992"
          "titulo" => "Palabras clave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Epidemiology"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Etiology and Pathogenesis"
        ]
        7 => array:3 [
          "identificador" => "sec0020"
          "titulo" => "Clinical Variants"
          "secciones" => array:6 [
            0 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Progressive PPD or Schamberg Disease"
            ]
            1 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Pruritic Purpura or Eczematoid Purpura of Doucas And Kapetanakis"
            ]
            2 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Pigmented Purpuric Lichenoid Dermatosis of Gougerot and Blum"
            ]
            3 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Lichen Aureus or Lichen Purpuricus"
            ]
            4 => array:2 [
              "identificador" => "sec0045"
              "titulo" => "Purpura Annularis Telangiectodes or Majocchi Disease"
            ]
            5 => array:2 [
              "identificador" => "sec0050"
              "titulo" => "Other Variants"
            ]
          ]
        ]
        8 => array:2 [
          "identificador" => "sec0055"
          "titulo" => "Histopathology"
        ]
        9 => array:3 [
          "identificador" => "sec0060"
          "titulo" => "Diagnosis"
          "secciones" => array:2 [
            0 => array:2 [
              "identificador" => "sec0065"
              "titulo" => "Differential Diagnosis"
            ]
            1 => array:2 [
              "identificador" => "sec0070"
              "titulo" => "Dermoscopy"
            ]
          ]
        ]
        10 => array:3 [
          "identificador" => "sec0075"
          "titulo" => "Treatment"
          "secciones" => array:4 [
            0 => array:3 [
              "identificador" => "sec0080"
              "titulo" => "Topical Treatments"
              "secciones" => array:2 [
                0 => array:2 [
                  "identificador" => "sec0085"
                  "titulo" => "Topical Corticosteroids"
                ]
                1 => array:2 [
                  "identificador" => "sec0090"
                  "titulo" => "Topical Calcineurin Inhibitors"
                ]
              ]
            ]
            1 => array:2 [
              "identificador" => "sec0095"
              "titulo" => "Phototherapy"
            ]
            2 => array:3 [
              "identificador" => "sec0100"
              "titulo" => "Systemic Treatments"
              "secciones" => array:2 [
                0 => array:2 [
                  "identificador" => "sec0105"
                  "titulo" => "Pentoxifylline"
                ]
                1 => array:2 [
                  "identificador" => "sec0110"
                  "titulo" => "Ascorbic Acid and Bioflavonoids &#40;Rutin&#47;Rutoside&#41;"
                ]
              ]
            ]
            3 => array:2 [
              "identificador" => "sec0115"
              "titulo" => "Other Treatments"
            ]
          ]
        ]
        11 => array:2 [
          "identificador" => "sec0120"
          "titulo" => "Conclusions"
        ]
        12 => array:2 [
          "identificador" => "sec0125"
          "titulo" => "Conflicts of Interest"
        ]
        13 => array:2 [
          "identificador" => "xack460587"
          "titulo" => "Acknowledgments"
        ]
        14 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2018-10-21"
    "fechaAceptado" => "2019-02-24"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec1227991"
          "palabras" => array:4 [
            0 => "Purpuric pigmented dermatosis"
            1 => "Review"
            2 => "Clinical presentation"
            3 => "Treatment"
          ]
        ]
      ]
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec1227992"
          "palabras" => array:4 [
            0 => "Dermatosis purp&#250;rico pigmentadas"
            1 => "Revisi&#243;n"
            2 => "Presentaci&#243;n cl&#237;nica"
            3 => "Tratamiento"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">The pigmented purpuric dermatoses &#40;PPDs&#41; are a group of benign&#44; chronic diseases&#46; The variants described to date represent different clinical presentations of the same entity&#44; all having similar histopathologic characteristics&#46; We provide an overview of the most common PPDs and describe their clinical&#44; dermatopathologic&#44; and epiluminescence features&#46; PPDs are both rare and benign&#44; and this&#44; together with an as yet poor understanding of the pathogenic mechanisms involved&#44; means that no standardized treatments exist&#46; We review the treatments described to date&#46; However&#44; because most of the descriptions are based on isolated cases or small series&#44; there is insufficient evidence to support the use of any of these treatments as first-line therapy&#46;</p></span>"
      ]
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Las dermatosis purp&#250;rico pigmentadas &#40;DPP&#41; son un grupo de enfermedades benignas y de curso cr&#243;nico&#46; Las variantes descritas representan distintas formas cl&#237;nicas de una misma entidad con unas caracter&#237;sticas histopatol&#243;gicas comunes para todas ellas&#46; Exponemos a continuaci&#243;n un resumen de las variedades m&#225;s frecuentes&#44; sus caracter&#237;sticas cl&#237;nicas&#44; dermatopatol&#243;gicas y de epiluminiscencia&#46; Al tratarse de una entidad cl&#237;nica poco frecuente&#44; benigna&#44; y no conocerse claramente los mecanismos patog&#233;nicos de la misma&#44; no existen tratamientos estandarizados&#46; Se revisan los tratamientos publicados hasta el momento&#44; la mayor&#237;a de ellos basados en casos aislados o peque&#241;as series de casos&#44; sin poder establecer un nivel de evidencia suficiente como para ser recomendado ninguno de ellos como tratamiento de elecci&#243;n&#46;</p></span>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Mart&#237;nez Pall&#225;s I&#44; Conejero del Mazo R&#44; Lezcano Biosca V&#46; Dermatosis purp&#250;ricas pigmentadas&#46; Revisi&#243;n de la literatura cient&#237;fica&#46; Actas Dermosifiliogr&#46; 2020&#59;111&#58;196&#8211;204&#46;</p>"
      ]
    ]
    "multimedia" => array:11 [
      0 => array:8 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1547
            "Ancho" => 2167
            "Tamanyo" => 195004
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Etiologic and pathogenic mechanism&#46; One of the most widely accepted hypotheses is that T cells are activated by an antigenic stimulus and bind to endothelial cells&#44; fibroblasts&#44; and keratinocytes through the expression of adhesion molecules&#46; TNF-&#945; indicates tumor necrosis factor &#945; &#59; ICAM-1&#44; intercellular adhesion molecule-1&#59; LFA-1&#44; lymphocyte function antigen-1&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1662
            "Ancho" => 755
            "Tamanyo" => 204387
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0010"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Schamberg disease&#46; A&#44; Orange-red macules that tend to coalesce&#44; forming large plaques&#46; B&#44; Peripheral cayenne pepper spots&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 579
            "Ancho" => 905
            "Tamanyo" => 67351
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0015"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Lichen aureus&#46; Solitary plaque comprising small coalescing yellow-orange macules on the leg&#46;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "fig0020"
        "etiqueta" => "Figure 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 680
            "Ancho" => 904
            "Tamanyo" => 76759
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0020"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Majocchi disease&#46; Annular red-violaceous lesions on the leg&#46;</p>"
        ]
      ]
      4 => array:8 [
        "identificador" => "fig0025"
        "etiqueta" => "Figure 5"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr5.jpeg"
            "Alto" => 1636
            "Ancho" => 805
            "Tamanyo" => 528650
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0025"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Histopathological features of Schamberg disease&#46; A&#44; Infiltrate involving small vessels in the superficial dermis&#46; B&#44; Lymphocytic infiltrate&#44; with luminal narrowing and extravasated red blood cells&#46;</p>"
        ]
      ]
      5 => array:8 [
        "identificador" => "fig0030"
        "etiqueta" => "Figure 6"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr6.jpeg"
            "Alto" => 665
            "Ancho" => 805
            "Tamanyo" => 252604
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0030"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Histopathologic features of lichen aureus&#46; Band-like infiltrate in the papillary dermis and superficial perivascular infiltrate&#46;</p>"
        ]
      ]
      6 => array:8 [
        "identificador" => "fig0035"
        "etiqueta" => "Figure 7"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr7.jpeg"
            "Alto" => 605
            "Ancho" => 805
            "Tamanyo" => 51446
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0035"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Dermoscopic features of Schamberg disease&#46; Coppery-red background and red globules&#46;</p>"
        ]
      ]
      7 => array:8 [
        "identificador" => "fig0040"
        "etiqueta" => "Figure 8"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr8.jpeg"
            "Alto" => 605
            "Ancho" => 805
            "Tamanyo" => 76549
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0040"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Dermoscopic features of lichen aureus&#46; Brownish-red background with gray dots and a pigmented pseudo-network&#46;</p>"
        ]
      ]
      8 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0045"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Source&#58; Kaplan et al&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sedatives&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Phenobarbital&#44; chlordiazepoxide&#44; meprobamate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vitamins&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Thiamine &#40;B<span class="elsevierStyleInf">1</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diuretics&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Furosemide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cardiovascular drugs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nitroglycerine&#44; bezafibrate&#44; hydralazine&#44; dipyridamole&#44; sildenafil&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Antibiotics&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ampicillin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Analgesics&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Nonsteroidal anti-inflammatory drugs&#44; aspirin&#44; acetaminophenol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Stimulants&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pseudoephedrine&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hormones&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Medroxyprogesterone acetate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Antidiabetic drugs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Glipizide&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Chemotherapy agents&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Topical 5-fluorouracil&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Antivirals&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Interferon &#945;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Retinoids&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Isotretinoin&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2284703.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Drugs Associated With the Pigmented Purpuric Dermatoses&#46;</p>"
        ]
      ]
      9 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0050"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Variant&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Clinical Presentation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Location&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Histopathologic Findings&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Schamberg disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Red-orange macules with peripheral spots resembling grains of cayenne pepper&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lower limbs and occasionally trunk&#44; arms&#44; thighs&#44; and buttocks&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lymphocytic infiltrate involving the superficial small vessels&#44; extravasated red blood cells&#44; and hemosiderin-laden macrophages&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Eczematoid purpura of Doucas and Kapetanakis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Similar to manifestations of Schamberg disease but with scaling and intense itching&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lower limbs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infiltrate with higher number of neutrophils and epidermal spongiosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pigmented purpuric lichenoid dermatosis of Gougerot and Blum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Violaceous lichenoid papules that merge to form plaques&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lower limbs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Band-like dermal infiltrate&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lichen aureus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Isolated persistent red-orange plaque and purpuric lesions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lower limbs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Unchanged epidermis and band-like dermal infiltrate with Grenz area&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Majocchi disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Peripherally extending plaques with telangiectatic punta at edges and fading in the central area&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lower limbs and trunk&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Identical to Schamberg disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2284701.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Clinical and Histopathologic Characteristics of the Pigmented Purpuric Dermatoses&#46;</p>"
        ]
      ]
      10 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0055"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Source&#58; Sardana et al&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#44; Kim et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> and Risikesan et al&#46;<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a></p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Clinical Entities&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Main characteristics&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Drug-hypersensitivity reactions</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Recent use of causative drug&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Carbamazepine&#44; meprobamate&#44; chlordiazepoxide&#44; furosemide&#44; nitroglycerine&#44; vitamin B<span class="elsevierStyleInf">1</span>&#44; and topical 5-fluorouracil&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Purpuric contact dermatitis to clothing</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Lesions confined to areas of the skin in contact with clothing&#59; intense itching&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Wool&#44; coloring agents&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Venous stasis purpura</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Signs of chronic venous insufficiency&#58; swelling&#44; varicose veins&#44; feeling of heaviness&#44; venous ulcers&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Hemosiderin deposition in deep dermis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Purpura due to thrombocytopenia</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Associated with platelet count &#60; 100&#8211;150000&#47;&#956;L&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Senile purpura</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">In elderly patients&#44; purpura can be associated with antiplatelet&#44; anticoagulant&#44; or corticosteroid use&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Purpuric exanthema due to viral infection</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Other signs of infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Leukocytoclastic vasculitis</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Palpable purpuric lesions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">On histology&#58; fibrinoid necrosis&#44; endothelial swelling&#44; and leukocytoclasis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Sch&#246;nlein-Henoch purpura</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age&#44; 3&#8211;15 years&#59; symmetric purpura affecting legs and buttocks&#59; joint and abdominal pain&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Kaposi sarcoma</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Affects elderly or immunosuppressed patients&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">On histology&#58; spindle cells in the dermis forming irregular vascular lumina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Purpuric mycosis fungoides</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Onset &#62;&#8239;1&#8239;year&#59; disseminated&#44; monoclonal profile in infiltrate and loss of CD7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2284702.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Differential Diagnosis for the Pigmented Purpuric Dermatoses&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:62 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Purpura"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T&#46;A&#46; Leslie"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:6 [
                        "paginaInicial" => "1"
                        "paginaFinal" => "27"
                        "edicion" => "9th edn&#46;"
                        "serieVolumen" => "101"
                        "serieTitulo" => "Rook&#8217;s Textbook of Dermatology"
                        "serieFecha" => "2016"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pigmented purpuric dermatoses&#58; an overview"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "K&#46; Sardana"
                            1 => "R&#46; Sarkar"
                            2 => "V&#46;N&#46; Sehgal"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-4632.2004.02213.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Dermatol&#46;"
                        "fecha" => "2004"
                        "volumen" => "43"
                        "paginaInicial" => "482"
                        "paginaFinal" => "488"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15230884"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The pathological spectrum and clinical correlation of pigmented purpuric dermatosis&#8212;A retrospective review of 107 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Y&#46;-K&#46; Huang"
                            1 => "C&#46;-K&#46; Lin"
                            2 => "Y&#46;-H&#46; Wu"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J CutanPathol&#46;"
                        "fecha" => "2018"
                        "volumen" => "45"
                        "paginaInicial" => "325"
                        "paginaFinal" => "332"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pigmented purpuric dermatosis&#58; clinicopathologic characterization in a pediatric series"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Coulombe"
                            1 => "S&#46;E&#46; Jean"
                            2 => "A&#46; Hatami"
                            3 => "J&#46; Powell"
                            4 => "D&#46; Marcoux"
                            5 => "V&#46; Kokta"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/pde.12519"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Dermatol&#46;"
                        "fecha" => "2015"
                        "volumen" => "32"
                        "paginaInicial" => "358"
                        "paginaFinal" => "362"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25690369"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pigmented purpuric eruptions of childhood&#58; a series of cases and review of literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Tristani-Firouzi"
                            1 => "K&#46;P&#46; Meadows"
                            2 => "S&#46; Vanderhooft"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1046/j.1525-1470.2001.01932.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Dermatol&#46;"
                        "fecha" => "2001"
                        "volumen" => "18"
                        "paginaInicial" => "299"
                        "paginaFinal" => "304"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11576402"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Two cases of unilateral pigmented purpuric dermatosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "Y&#46; Taketuchi"
                            1 => "T&#46; Chinen"
                            2 => "Y&#46; Ichikawa"
                            3 => "M&#46; Ito"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1346-8138.2001.tb00018.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dermatol&#46;"
                        "fecha" => "2001"
                        "volumen" => "28"
                        "paginaInicial" => "493"
                        "paginaFinal" => "498"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11603391"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The clinical manifestations and etiologic factors of patients with pigmented purpuric dermatoses"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;H&#46; Cho"
                            1 => "J&#46;D&#46; Lee"
                            2 => "H&#46; Kang"
                            3 => "S&#46;H&#46; Cho"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Korean J Dermatol&#46;"
                        "fecha" => "2005"
                        "volumen" => "43"
                        "paginaInicial" => "45"
                        "paginaFinal" => "52"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A case of isotretinoin-induced purpura annularis telangiectodes of Majocchi and review of substance-induced pigmented purpuric dermatosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "R&#46; Kaplan"
                            1 => "S&#46;A&#46; Meehan"
                            2 => "M&#46; Leger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jamadermatol.2013.7371"
                      "Revista" => array:6 [
                        "tituloSerie" => "JAMA Dermatol&#46;"
                        "fecha" => "2014"
                        "volumen" => "150"
                        "paginaInicial" => "182"
                        "paginaFinal" => "184"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24284887"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Granulomatous variant of pigmented purpuric dermatosis&#58; report of two cases and review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Garc&#237;a-Rodi&#241;o"
                            1 => "M&#46;T&#46; Rodr&#237;guez-Granados"
                            2 => "M&#46;J&#46; Seoane-Pose"
                            3 => "M&#46; Espasand&#237;n-Arias"
                            4 => "G&#46; Barbeito-Casti&#241;eiras"
                            5 => "J&#46;M&#46; Su&#225;rez-Pe&#241;aranda"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/ddg.13228_g"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dtsch Dermatol Ges&#46;"
                        "fecha" => "2017"
                        "volumen" => "15"
                        "paginaInicial" => "565"
                        "paginaFinal" => "569"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28485875"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Purpura simplex &#40;inflammatory purpura without vasculitis&#41;&#58; a clinicopathologic study of 174 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "K&#46;V&#46; Ratnam"
                            1 => "W&#46;P&#46; Su"
                            2 => "M&#46;S&#46; Peters"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/0190-9622(91)70246-x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol&#46;"
                        "fecha" => "1991"
                        "volumen" => "25"
                        "paginaInicial" => "642"
                        "paginaFinal" => "647"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1791222"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Segmental manifestation&#58; a clue to explain the nature of pigmented purpuric dermatoses"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46; Torchio"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1440-0960.2011.00809.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Australas J Dermatol&#46;"
                        "fecha" => "2011"
                        "volumen" => "52"
                        "numero" => "3"
                        "paginaInicial" => "235"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21834827"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cell infltrate in progressive pigmented purpura &#40;Schamberg&#8217;s disease&#41;&#58; immunophenotype&#44; adhesion receptors and intercellular relationships"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "I&#46; Ghersetich"
                            1 => "T&#46; Lotti"
                            2 => "S&#46; Bacci"
                            3 => "C&#46; Comacchi"
                            4 => "G&#46; Campanile"
                            5 => "P&#46; Romagnoli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-4362.1995.tb04419.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Dermatol&#46;"
                        "fecha" => "1995"
                        "volumen" => "34"
                        "paginaInicial" => "846"
                        "paginaFinal" => "850"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8647662"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cell adhesion molecule expression in capillaritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "N&#46;P&#46; Burrows"
                            1 => "R&#46;R&#46; Jones"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0190-9622(09)80062-5"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol&#46;"
                        "fecha" => "1994"
                        "volumen" => "31"
                        "numero" => "5 Pt 1"
                        "paginaInicial" => "826"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7929939"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pigmented purpuric eruptions&#58; immunopathologic studies supportive of a common immunophenotype"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "B&#46;R&#46; Smoller"
                            1 => "O&#46;W&#46; Kamel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J CutanPathol&#46;"
                        "fecha" => "1991"
                        "volumen" => "18"
                        "paginaInicial" => "423"
                        "paginaFinal" => "427"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pigmented purpuric dermatosis&#58; classification by phenotypic and molecular profiles"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "C&#46;M&#46; Magro"
                            1 => "J&#46;T&#46; Schaefer"
                            2 => "A&#46;N&#46; Crowson"
                            3 => "J&#46; Li"
                            4 => "C&#46; Morrison"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1309/AQMU3JFE2A66LC7E"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Clin Pathol&#46;"
                        "fecha" => "2007"
                        "volumen" => "128"
                        "paginaInicial" => "218"
                        "paginaFinal" => "229"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17638655"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cellular adhesion antigen modulation in purpura pigmentosa chronica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46; von den Driesch"
                            1 => "M&#46; Simon Jr"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0190-9622(94)70016-8"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Am Acad Dermatol&#46;"
                        "fecha" => "1994"
                        "volumen" => "30"
                        "numero" => "2 Pt 1"
                        "paginaInicial" => "193"
                        "paginaFinal" => "200"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7507134"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Human dermal mast cells contain and release tumor necrosis factor &#945;&#44; which induces endothelial leukocyte adhesion molecule 1"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "L&#46;J&#46; Walsh"
                            1 => "G&#46; Trinchieri"
                            2 => "H&#46;A&#46; Waldorf"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1073/pnas.88.10.4220"
                      "Revista" => array:6 [
                        "tituloSerie" => "Proc Natl Acad Sci USA&#46;"
                        "fecha" => "1991"
                        "volumen" => "88"
                        "paginaInicial" => "4220"
                        "paginaFinal" => "4224"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1709737"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Detection of undergraded fibrin and tumor necrosis factor a in venous leg ulcers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;L&#46; Glaudy"
                            1 => "M&#46; Mirshahi"
                            2 => "G&#46; Soria"
                            3 => "J&#46; Soria"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/0190-9622(91)70242-t"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol&#46;"
                        "fecha" => "1991"
                        "volumen" => "25"
                        "paginaInicial" => "623"
                        "paginaFinal" => "627"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1791219"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Persistent pigmented purpuric eruption associated with mycosis fungoides&#58; a case report and review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46; Georgala"
                            1 => "A&#46;C&#46; Katoulis"
                            2 => "S&#46; Symeonidou"
                            3 => "C&#46; Georgala"
                            4 => "G&#46; Vayopou-los"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1046/j.1468-3083.2001.00198.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Eur Acad Dermatol Venereol&#46;"
                        "fecha" => "2001"
                        "volumen" => "15"
                        "paginaInicial" => "62"
                        "paginaFinal" => "64"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11451328"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The spectrum of pigmented purpuric dermatosis and mycosis fungoides&#58; atypical T-cell dyscrasia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;K&#46; Ladrigan"
                            1 => "B&#46; Poligone"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cutis&#46;"
                        "fecha" => "2014"
                        "volumen" => "94"
                        "paginaInicial" => "297"
                        "paginaFinal" => "300"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25566571"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous T-cell lymphoid dyscrasia&#58; a unifying term for idiopathic chronic dermatoses with persistent T-cell clones"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46; Guitart"
                            1 => "C&#46; Magro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archderm.143.7.921"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol&#46;"
                        "fecha" => "2007"
                        "volumen" => "143"
                        "paginaInicial" => "921"
                        "paginaFinal" => "932"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17638739"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Pigmented purpuric dermatitis preceding the diagnosis of mycosis fungoides by 24 years"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "V&#46; Viseux"
                            1 => "P&#46; Schoenlaub"
                            2 => "F&#46; Cnudde"
                            3 => "P&#46; Le Roux"
                            4 => "J&#46;P&#46; Leroy"
                            5 => "P&#46; Plantin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000073103"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatology&#46;"
                        "fecha" => "2003"
                        "volumen" => "207"
                        "paginaInicial" => "331"
                        "paginaFinal" => "332"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14571083"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The pigmented and purpuric dermatitis and the many faces of mycosis fungoides &#91;editorial&#93;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "D&#46; Lipsker"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000073083"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatology&#46;"
                        "fecha" => "2003"
                        "volumen" => "207"
                        "paginaInicial" => "246"
                        "paginaFinal" => "247"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14571063"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Mycosis fungoides presenting as pigmented purpuric dermatitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "S&#46; Hanna"
                            1 => "N&#46; Walsh"
                            2 => "Y&#46; D&#8217;Intino"
                            3 => "R&#46;G&#46; Langley"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1525-1470.2006.00259.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Dermatol&#46;"
                        "fecha" => "2006"
                        "volumen" => "23"
                        "paginaInicial" => "350"
                        "paginaFinal" => "354"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16918631"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Characteristics and clinical manifestations of pigmented purpuric dermatosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "D&#46;H&#46; Kim"
                            1 => "S&#46;H&#46; Seo"
                            2 => "H&#46;H&#46; Ahn"
                            3 => "Y&#46;C&#46; Kye"
                            4 => "J&#46;E&#46; Choi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5021/ad.2015.27.4.404"
                      "Revista" => array:7 [
                        "tituloSerie" => "Ann Dermatol&#46;"
                        "fecha" => "2015"
                        "volumen" => "27"
                        "paginaInicial" => "404"
                        "paginaFinal" => "410"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26273156"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673616311357"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Successful topical treatment of pigmented purpuric lichenoid dermatitis of Gougerot-Blum in a young patient&#58; a case report and summary of the most common pigmented purpuric dermatoses"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "J&#46; Risikesan"
                            1 => "M&#46; Sommerlund"
                            2 => "M&#46; Ramsing"
                            3 => "M&#46; Kristensen"
                            4 => "U&#46; Koppelhus"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000479922"
                      "Revista" => array:6 [
                        "tituloSerie" => "Case Rep Dermatol&#46;"
                        "fecha" => "2017"
                        "volumen" => "9"
                        "paginaInicial" => "169"
                        "paginaFinal" => "176"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29033823"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lichen aureus&#58; clinicopathological features in a Chinese series"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "Y&#46;P&#46; Zeng"
                            1 => "K&#46; Fang"
                            2 => "D&#46;L&#46; Ma"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1684/ejd.2016.2767"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Dermatol&#46;"
                        "fecha" => "2016"
                        "volumen" => "26"
                        "paginaInicial" => "290"
                        "paginaFinal" => "294"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27101633"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib0140"
              "etiqueta" => "28"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Zosteriform lichen aureus&#46; Pediatric clinical case"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "&#193; Rivera-Rodr&#237;guez"
                            1 => "S&#46; Hern&#225;ndez Ostiz"
                            2 => "A&#46;L&#46; Morales-Moya"
                            3 => "L&#46; Prieto-Torres"
                            4 => "M&#46; &#193;lvarez-Salafranca"
                            5 => "M&#46; Ara Mart&#237;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5546/aap.2017.e82"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Argent Pediatr&#46;"
                        "fecha" => "2017"
                        "volumen" => "115"
                        "paginaInicial" => "e82"
                        "paginaFinal" => "4"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28318188"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib0145"
              "etiqueta" => "29"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Segmental lichen aureus&#58; a report of two cases treated with methylprednisolone aceponate"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; Moche"
                            1 => "S&#46; Glassman"
                            2 => "D&#46; Modi"
                            3 => "W&#46; Grayson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1440-0960.2010.00658.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Australas J Dermatol&#46;"
                        "fecha" => "2011"
                        "volumen" => "52"
                        "paginaInicial" => "e15"
                        "paginaFinal" => "8"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21834806"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib0150"
              "etiqueta" => "30"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Segmental lichen aureus in a child"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46; Mishra"
                            1 => "V&#46; Maheshwari"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-4362.1991.tb03495.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Dermatol&#46;"
                        "fecha" => "1991"
                        "volumen" => "30"
                        "paginaInicial" => "654"
                        "paginaFinal" => "655"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1938081"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib0155"
              "etiqueta" => "31"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Segmental lichen aureus&#58; combination therapy with pentoxifylline and prostacyclin"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "H&#46; Lee"
                            1 => "D&#46; Lee"
                            2 => "S&#46; Chang"
                            3 => "M&#46; Lee"
                            4 => "J&#46; Choi"
                            5 => "K&#46; Moon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Eur Acad Dermatol Vnereol&#46;"
                        "fecha" => "2006"
                        "volumen" => "20"
                        "paginaInicial" => "1378"
                        "paginaFinal" => "1380"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib0160"
              "etiqueta" => "32"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Purpura annularistelangiectodes of Majocchi&#58; case report and review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "F&#46;J&#46; Hoesly"
                            1 => "C&#46;J&#46; Huerter"
                            2 => "J&#46;M&#46; Shehan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-4632.2009.04160.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Dermatol&#46;"
                        "fecha" => "2009"
                        "volumen" => "48"
                        "paginaInicial" => "1129"
                        "paginaFinal" => "1133"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19775410"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib0165"
              "etiqueta" => "33"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Unilateral progressive pigmentary purpura &#40;Schamberg&#8217;s disease&#41; in a 15-year-old boy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "C&#46;S&#46; Hersh"
                            1 => "T&#46;A&#46; Shwayder"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0190-9622(08)80161-2"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Acad Dermatol&#46;"
                        "fecha" => "1991"
                        "volumen" => "24"
                        "paginaInicial" => "651"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2033147"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib0170"
              "etiqueta" => "34"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A case of quadranticcapillaropathy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46;M&#46; Higgins"
                            1 => "N&#46;H&#46; Cox"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1159/000248000"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatologica"
                        "fecha" => "1990"
                        "volumen" => "180"
                        "paginaInicial" => "93"
                        "paginaFinal" => "95"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2311802"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib0175"
              "etiqueta" => "35"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Transitory pigmented purpuric dermatoses in a young Japanese female"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46; Abe"
                            1 => "T&#46; Syuto"
                            2 => "H&#46; Ishibuchi"
                            3 => "Y&#46; Yokoyama"
                            4 => "O&#46; Ishikawa"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1346-8138.2008.00514.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dermatol&#46;"
                        "fecha" => "2008"
                        "volumen" => "35"
                        "paginaInicial" => "525"
                        "paginaFinal" => "528"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18789073"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            35 => array:3 [
              "identificador" => "bib0180"
              "etiqueta" => "36"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Angioma serpiginosum&#58; report of an unusual acral case and review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "A&#46; Freites-Martinez"
                            1 => "D&#46; Martinez-Sanchez"
                            2 => "A&#46; Moreno-Torres"
                            3 => "M&#46; Huerta-Brogeras"
                            4 => "A&#46;H&#46; N&#250;&#241;ez"
                            5 => "J&#46; Borbujo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/abd1806-4841.20153794"
                      "Revista" => array:7 [
                        "tituloSerie" => "Anais Brasileiros de Dermatologia&#46;"
                        "fecha" => "2015"
                        "volumen" => "90"
                        "numero" => "3 Suppl 1"
                        "paginaInicial" => "26"
                        "paginaFinal" => "28"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26312666"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            36 => array:3 [
              "identificador" => "bib0185"
              "etiqueta" => "37"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Eczematide-like purpura &#40;itching purpura-angiodermatitis pruriginosa disseminata&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46; Sang&#252;eza"
                            1 => "L&#46; Valda"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med CutanIbero Lat Am&#46;"
                        "fecha" => "1980"
                        "volumen" => "8"
                        "paginaInicial" => "73"
                        "paginaFinal" => "80"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            37 => array:3 [
              "identificador" => "bib0190"
              "etiqueta" => "38"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Granulomatous pigmented purpuric dermatosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46; Saito"
                            1 => "Y&#46; Matsuoka"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1346-8138.1996.tb02650.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dermatol&#46;"
                        "fecha" => "1996"
                        "volumen" => "23"
                        "paginaInicial" => "551"
                        "paginaFinal" => "555"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8854588"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            38 => array:3 [
              "identificador" => "bib0195"
              "etiqueta" => "39"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Familial pigmented purpuric dermatoses"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46; Sethuraman"
                            1 => "S&#46; Sugandhan"
                            2 => "A&#46; Bansal"
                            3 => "A&#46;K&#46; DAS"
                            4 => "V&#46;K&#46; Sharma"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1346-8138.2006.00149.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dermatol&#46;"
                        "fecha" => "2006"
                        "volumen" => "33"
                        "paginaInicial" => "639"
                        "paginaFinal" => "641"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16958811"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            39 => array:3 [
              "identificador" => "bib0200"
              "etiqueta" => "40"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Persistent pigmented purpuric dermatitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46;B&#46; Ackerman"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:6 [
                        "editores" => "A&#46;B&#46;Ackerman"
                        "titulo" => "Histologic Diagnosis of Inflammatory Skin Diseases"
                        "paginaInicial" => "609"
                        "paginaFinal" => "613"
                        "edicion" => "2nd edn&#46;"
                        "serieFecha" => "1997"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            40 => array:3 [
              "identificador" => "bib0205"
              "etiqueta" => "41"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermoscopy of pigmented purpuric dermatoses &#40;lichen aureus&#41;&#58; a useful tool for clinical diagnosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Zaballos"
                            1 => "S&#46; Puig"
                            2 => "J&#46; Malvehy"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archderm.140.10.1290"
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Dermatol&#46;"
                        "fecha" => "2004"
                        "volumen" => "140"
                        "paginaInicial" => "1290"
                        "paginaFinal" => "1291"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15492206"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            41 => array:3 [
              "identificador" => "bib0210"
              "etiqueta" => "42"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermatoscopic findings of pigmented purpuric dermatosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;B&#46; Ozkaya"
                            1 => "N&#46; Emiroglu"
                            2 => "O&#46; Su"
                            3 => "F&#46;P&#46; Cengiz"
                            4 => "A&#46;G&#46; Bahali"
                            5 => "P&#46; Yildiz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1590/abd1806-4841.20165124"
                      "Revista" => array:6 [
                        "tituloSerie" => "An Bras Dermatol&#46;"
                        "fecha" => "2016"
                        "volumen" => "91"
                        "paginaInicial" => "584"
                        "paginaFinal" => "587"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27828629"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            42 => array:3 [
              "identificador" => "bib0215"
              "etiqueta" => "43"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Possible histopathologic correlates of dermoscopic features in pigmented melanocytic lesions identified by means of optical coherence tomography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "V&#46; de Giorgi"
                            1 => "M&#46; Stante"
                            2 => "D&#46; Massi"
                            3 => "L&#46; Mavilia"
                            4 => "P&#46; Cappugi"
                            5 => "P&#46; Carli"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "ExpDermatol&#46;"
                        "fecha" => "2005"
                        "volumen" => "14"
                        "paginaInicial" => "56"
                        "paginaFinal" => "59"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            43 => array:3 [
              "identificador" => "bib0220"
              "etiqueta" => "44"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lichen aureus responding to topical tacrolimus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46; Murota"
                            1 => "I&#46; Katayama"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Cutan Patol&#46;"
                        "fecha" => "2011"
                        "volumen" => "38"
                        "paginaInicial" => "984"
                        "paginaFinal" => "989"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            44 => array:3 [
              "identificador" => "bib0225"
              "etiqueta" => "45"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Resolution of lichen aureus in a 10 year-old child after topical pimecrolimus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Bohm"
                            1 => "G&#46; Bonsmann"
                            2 => "T&#46;A&#46; Luger"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2133.2004.06155.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol&#46;"
                        "fecha" => "2004"
                        "volumen" => "151"
                        "paginaInicial" => "519"
                        "paginaFinal" => "520"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15327576"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            45 => array:3 [
              "identificador" => "bib0230"
              "etiqueta" => "46"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Respuesta satisfactoria de la dermatosis purpurica pigmentada al tratamiento con fototerapia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46; Ciudad"
                            1 => "N&#46; Cano"
                            2 => "R&#46; Suarez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.adengl.2013.04.009"
                      "Revista" => array:6 [
                        "tituloSerie" => "Actas Dermosifiliogr&#46;"
                        "fecha" => "2013"
                        "volumen" => "104"
                        "paginaInicial" => "439"
                        "paginaFinal" => "449"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23683507"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            46 => array:3 [
              "identificador" => "bib0235"
              "etiqueta" => "47"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A case of Schamberg&#180;s disease responding dramatically to PUVA treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "D&#46; Seckin"
                            1 => "Z&#46; Yazici"
                            2 => "A&#46; Senol"
                            3 => "Z&#46; Demircay"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Photodermatol Photoinmunol Photomed&#46;"
                        "fecha" => "2008"
                        "volumen" => "24"
                        "paginaInicial" => "95"
                        "paginaFinal" => "96"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            47 => array:3 [
              "identificador" => "bib0240"
              "etiqueta" => "48"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Generalized Schamberg&#8217;s disease treated with PUVA in a child"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Milea"
                            1 => "H&#46;-A&#46; Dimov"
                            2 => "B&#46; Cribier"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s0151-9638(07)89195-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Dermatol Venereol&#46;"
                        "fecha" => "2007"
                        "volumen" => "134"
                        "paginaInicial" => "378"
                        "paginaFinal" => "380"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17483760"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            48 => array:3 [
              "identificador" => "bib0245"
              "etiqueta" => "49"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "PUVA therapy in lichen aureus"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46;C&#46; Ling"
                            1 => "V&#46; Goulden"
                            2 => "M&#46;J&#46; Goodfield"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am AcadDermatol&#46;"
                        "fecha" => "2001"
                        "volumen" => "45"
                        "paginaInicial" => "145"
                        "paginaFinal" => "146"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            49 => array:3 [
              "identificador" => "bib0250"
              "etiqueta" => "50"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of pigmented purpuric dermatoses with narrow-band UVB&#58; a report of six cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "H&#46; Fathy"
                            1 => "S&#46; Abdelgaber"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Eur Acad Dermatol Vnereol&#46;"
                        "fecha" => "2011"
                        "volumen" => "25"
                        "paginaInicial" => "603"
                        "paginaFinal" => "606"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            50 => array:3 [
              "identificador" => "bib0255"
              "etiqueta" => "51"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Two cases of eczematid-like purpura of Ducas and Kapetanakis responsive to narrow band ultraviolet B treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46;S&#46; Karadag"
                            1 => "S&#46;G&#46; Bilgili"
                            2 => "S&#46; Onder"
                            3 => "O&#46; Calka"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Photodermatol Photoinmunol Photomed&#46;"
                        "fecha" => "2013"
                        "volumen" => "29"
                        "paginaInicial" => "97"
                        "paginaFinal" => "99"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            51 => array:3 [
              "identificador" => "bib0260"
              "etiqueta" => "52"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Successful treatment of generalized childhood Schamberg&#180;s disease with narrowband ultraviolet B therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "B&#46; Can"
                            1 => "Z&#46; Turkoglu"
                            2 => "M&#46; Kavala"
                            3 => "I&#46; Zindanci"
                            4 => "E&#46; Kural"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Photodermatol Photoinmunol Photomed&#46;"
                        "fecha" => "2011"
                        "volumen" => "27"
                        "paginaInicial" => "216"
                        "paginaFinal" => "218"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            52 => array:3 [
              "identificador" => "bib0265"
              "etiqueta" => "53"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Schamberg&#180;s purpura&#58; asociation with persistent hepatitis B surface antigenemia and treatment with pentoxifylline"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "A&#46;V&#46; Wahba-Yahav"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cutis&#46;"
                        "fecha" => "1994"
                        "volumen" => "54"
                        "paginaInicial" => "205"
                        "paginaFinal" => "206"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7813245"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            53 => array:3 [
              "identificador" => "bib0270"
              "etiqueta" => "54"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Extensive pigmented purpuric dermatosis successfully treated with pentoxifulline"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;H&#46; Mun"
                            1 => "S&#46;W&#46; Jwa"
                            2 => "M&#46; Song"
                            3 => "H&#46;S&#46; Kim"
                            4 => "H&#46;C&#46; Ko"
                            5 => "B&#46;S&#46; Kim"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5021/ad.2012.24.3.363"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Dermatol&#46;"
                        "fecha" => "2012"
                        "volumen" => "24"
                        "paginaInicial" => "363"
                        "paginaFinal" => "365"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22879726"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            54 => array:3 [
              "identificador" => "bib0275"
              "etiqueta" => "55"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Segmental lichen aureus&#58; combination therapy with pentoxifylline and prostacyclin"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:5 [
                            0 => "H&#46;W&#46; Lee"
                            1 => "D&#46;K&#46; Lee"
                            2 => "M&#46;W&#46; Lee"
                            3 => "J&#46;H&#46; Choi"
                            4 => "K&#46;C&#46; Moon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1468-3083.2006.01732.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Eur Acad Dermatol Venereol&#46;"
                        "fecha" => "2006"
                        "volumen" => "20"
                        "paginaInicial" => "1378"
                        "paginaFinal" => "1380"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17062089"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            55 => array:3 [
              "identificador" => "bib0280"
              "etiqueta" => "56"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Generalized Schamberg disease in a child"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;H&#46; Park"
                            1 => "H&#46;Y&#46; Kang"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.5021/ad.2013.25.4.524"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Dermatol&#46;"
                        "fecha" => "2013"
                        "volumen" => "25"
                        "paginaInicial" => "524"
                        "paginaFinal" => "525"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24371414"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            56 => array:3 [
              "identificador" => "bib0285"
              "etiqueta" => "57"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Should pentoxifylline be regarded as an effective treatment for Schamberg&#180;s disease&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "P&#46;Y&#46; Basak"
                            1 => "S&#46; Erguin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Acad Dermatol&#46;"
                        "fecha" => "2001"
                        "volumen" => "44"
                        "paginaInicial" => "548"
                        "paginaFinal" => "549"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            57 => array:3 [
              "identificador" => "bib0290"
              "etiqueta" => "58"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Early treatment with rutoside and ascorbic acid is highly effective for progressive pigmented purpuric dermatosis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46;M&#46; Schober"
                            1 => "W&#46;K&#46; Peitsch"
                            2 => "G&#46; Bonsmann"
                            3 => "D&#46; Metze"
                            4 => "K&#46; Thomas"
                            5 => "T&#46; Goerge"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/ddg.12520"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dtsch Dermatol Ges&#46;"
                        "fecha" => "2014"
                        "volumen" => "12"
                        "paginaInicial" => "1112"
                        "paginaFinal" => "1119"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25482694"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            58 => array:3 [
              "identificador" => "bib0295"
              "etiqueta" => "59"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Successful treatment of pigmented purpuric dermatosis with griseofulvin"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "K&#46; Tamaki"
                            1 => "N&#46; Yasaka"
                            2 => "A&#46; Osada"
                            3 => "N&#46; Shibagaki"
                            4 => "M&#46; Furue"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2133.1996.tb07865.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol&#46;"
                        "fecha" => "1996"
                        "volumen" => "134"
                        "paginaInicial" => "180"
                        "paginaFinal" => "181"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8745912"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            59 => array:3 [
              "identificador" => "bib0300"
              "etiqueta" => "60"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Benefit of colchicine in the treatment of Schamberg&#180;s disease"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46; Geller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:3 [
                        "tituloSerie" => "Ann Allergy Asthma Inmmunol&#46;"
                        "fecha" => "2000"
                        "volumen" => "85"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            60 => array:3 [
              "identificador" => "bib0305"
              "etiqueta" => "61"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Purpura annularis telangiectoides of Majocchi&#58; case report and rewiew of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "F&#46;J&#46; Hoesly"
                            1 => "C&#46;J&#46; Huerter"
                            2 => "J&#46;M&#46; Shehan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-4632.2009.04160.x"
                      "Revista" => array:7 [
                        "tituloSerie" => "Int J Dermatol&#46;"
                        "fecha" => "2009"
                        "volumen" => "48"
                        "paginaInicial" => "1129"
                        "paginaFinal" => "1133"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19775410"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S104084281630124X"
                          "estado" => "S300"
                          "issn" => "10408428"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            61 => array:3 [
              "identificador" => "bib0310"
              "etiqueta" => "62"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Generalized purpuric lichen nitidus&#46; Report of a case and review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "E&#46; Rallis"
                            1 => "C&#46; Verros"
                            2 => "V&#46; Moussatou"
                            3 => "D&#46; Sambaziotis"
                            4 => "P&#46; Papadakis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Dermatol Online J&#46;"
                        "fecha" => "2007"
                        "volumen" => "13"
                        "paginaInicial" => "5"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18328199"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:4 [
        "identificador" => "xack460587"
        "titulo" => "Acknowledgments"
        "texto" => "<p id="par0230" class="elsevierStylePara elsevierViewall">We would like to thank Dr&#46; Valero Torres from the Pathology Laboratory of Hospital Cl&#237;nico Lozano Blesa for his help with the histopathologic analysis&#46;</p>"
        "vista" => "all"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000011100000003/v1_202005050702/S1578219020300317/v1_202005050702/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "6177"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Reviews"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15782190/0000011100000003/v1_202005050702/S1578219020300317/v1_202005050702/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020300317?idApp=UINPBA000044"
]

Información del artículo

ISSN: 15782190
Idioma original: Inglés

DOI:10.1016/j.adengl.2020.03.007

Datos actualizados diariamente

año/Mes	Html	Pdf	Total

2024 Noviembre	38	13	51
2024 Octubre	481	90	571
2024 Septiembre	381	66	447
2024 Agosto	416	98	514
2024 Julio	389	76	465
2024 Junio	322	55	377
2024 Mayo	327	80	407
2024 Abril	274	91	365
2024 Marzo	333	104	437
2024 Febrero	477	95	572
2024 Enero	383	91	474
2023 Diciembre	350	92	442
2023 Noviembre	465	118	583
2023 Octubre	530	96	626
2023 Septiembre	421	106	527
2023 Agosto	347	102	449
2023 Julio	373	117	490
2023 Junio	314	146	460
2023 Mayo	406	160	566
2023 Abril	283	81	364
2023 Marzo	347	88	435
2023 Febrero	299	71	370
2023 Enero	268	89	357
2022 Diciembre	189	106	295
2022 Noviembre	240	117	357
2022 Octubre	511	125	636
2022 Septiembre	206	118	324
2022 Agosto	85	155	240
2022 Julio	55	131	186
2022 Junio	42	154	196
2022 Mayo	395	142	537
2022 Abril	440	90	530
2022 Marzo	467	137	604
2022 Febrero	422	103	525
2022 Enero	424	101	525
2021 Diciembre	403	82	485
2021 Noviembre	439	81	520
2021 Octubre	419	82	501
2021 Septiembre	445	68	513
2021 Agosto	429	96	525
2021 Julio	371	61	432
2021 Junio	495	75	570
2021 Mayo	493	87	580
2021 Abril	1385	226	1611
2021 Marzo	593	112	705
2021 Febrero	424	83	507
2021 Enero	362	53	415
2020 Diciembre	315	65	380
2020 Noviembre	365	54	419
2020 Octubre	180	40	220
2020 Septiembre	299	36	335
2020 Agosto	219	47	266
2020 Julio	190	57	247
2020 Junio	140	52	192
2020 Mayo	131	73	204
2020 Abril	55	36	91
2020 Marzo	24	15	39

Mostrar todo

Indexada en:

Síguenos:

Estadísticas

Indexada en:

Síguenos:

Estadísticas

Suscríbase a la newsletter