Case and Research Letters
Treatment of Localized Cutaneous Leishmaniasis With Intralesional Meglumine Antimoniate and Photodynamic Therapy
Tratamiento de la leishmaniasis localizada mediante el antimoniato de meglumina intralesional y la terapia fotodinámica
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"apellidos" => "Vieira" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731020302751" "doi" => "10.1016/j.ad.2020.02.005" "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/S0001731020302751?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020303115?idApp=UINPBA000044" "url" => "/15782190/0000011100000010/v1_202012160744/S1578219020303115/v1_202012160744/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S1578219020303164" "issn" => "15782190" "doi" => "10.1016/j.adengl.2020.10.021" "estado" => "S300" "fechaPublicacion" => "2020-12-01" "aid" => "2389" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2020;111:896-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Pseudoepitheliomatous Hyperplasia: An Uncommon Reaction in Tattoos" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "896" "paginaFinal" => "897" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Hiperplasia seudoepiteliomatosa: una reacción infrecuente de los tatuajes" ] ] "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" => 605 "Ancho" => 805 "Tamanyo" => 119447 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Tattoo on the left leg. Well-defined raised, thickened lesions are evident in the red-colored areas of skin, with no surrounding inflammatory reaction.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "R. Conejero, C. Conejero, V. Alcalde, J. García-Latasa de Araníbar" "autores" => array:4 [ 0 => array:2 [ "nombre" => "R." "apellidos" => "Conejero" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Conejero" ] 2 => array:2 [ "nombre" => "V." "apellidos" => "Alcalde" ] 3 => array:2 [ "nombre" => "J." 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Costin, F. Bonito, J. Alves, H. Barreiros" "autores" => array:4 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Costin" "email" => array:1 [ 0 => "adelina.costin@hgo.min-saude.pt" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "F." "apellidos" => "Bonito" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "J." "apellidos" => "Alves" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "H." "apellidos" => "Barreiros" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología y venereología, Hospital Garcia de Orta, Almada, Portugal" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Consulta privada, Lisboa, Portugal" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento de la leishmaniasis localizada mediante el antimoniato de meglumina intralesional y la terapia fotodinámica" ] ] "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" => 1000 "Ancho" => 750 "Tamanyo" => 98764 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cutaneous leishmaniasis. Solitary, indurated, crusty plaque on the forehead.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Leishmaniasis, a sandfly vector-borne protozoan infection, encompasses a wide spectrum of clinical presentations. The most common form of Leishmaniasis is cutaneous leishmaniasis.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> It affects primarily adults between the third and 5th decades of life and the lesions are commonly located on exposed body parts. The diverse clinical spectrum of CL depends upon various factors, such as the specific causative strain, geographic location, parasitic load and host immune response.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Case Report</span><p id="par0010" class="elsevierStylePara elsevierViewall">A 31-year-old Portuguese male presented with a 4-month history of a solitary, asymptomatic, 4<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>2<span class="elsevierStyleHsp" style=""></span>cm large, indurated crusty plaque on his forehead (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). His medical history was unremarkable, except for early latent syphilis treated 1<span class="elsevierStyleHsp" style=""></span>year ago with good serological response. His family history was unremarkable. He denied any prescribed or over-the-counter medication. His immunization status was up-to-date and his social and travel history were significant for a recent travel to Mexico about 5 months ago.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The skin biopsy revealed a dermal diffuse inflammatory infiltrate composed by lymphocytes and histiocytes. Leishmania amastigotes were identified in the cytoplasm of dermal macrophages.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The physical examination was otherwise normal. Otorhinolaryngologic endoscopy, bone marrow aspirate and abdominal ultrasound were performed to exclude mucous and visceral involvement; a basic blood panel, viral serologies including HIV and HCV disclosed no abnormalities.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Since it was a solitary lesion in a cosmetically-sensitive location, a combined treatment of intralesional meglumine antimoniate and topical photodynamic therapy was started. The protocol consisted of intralesional injection of 1<span class="elsevierStyleHsp" style=""></span>mL of meglumine antimoniate per session followed by photodynamic therapy with topical methylaminolevulinate, a 3<span class="elsevierStyleHsp" style=""></span>-h incubation period and red light irradiation (light emitting diode lamp (Aktilite®, 630<span class="elsevierStyleHsp" style=""></span>nm, 37<span class="elsevierStyleHsp" style=""></span>J/cm<span class="elsevierStyleSup">2</span>) at weekly intervals on alternate weeks, in a total of 8 sessions. Side effects were minimal and included local erythema and a stinging sensation during the irradiation and immediately afterwards.</p><p id="par0030" class="elsevierStylePara elsevierViewall">At the end of the treatment, the ulcer had given place to an atrophic scar with post-inflammatory hyperpigmentation (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). Although the patient denied a confirmatory biopsy, at 12-month follow-up he remains in clinical remission, corroborated by dermatoscopic absence of vascular structures, yellow follicular "tears" or erythema, displaying only a white central atrophic scar, with resolution of peripheral hyperpigmentation.</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Discussion</span><p id="par0035" class="elsevierStylePara elsevierViewall">The clinical presentation of cutaneous leishmaniasis consists of single or multiple, painless, frequently ulcerated, erythematous plaques with indurated borders, usually on exposed body regions.</p><p id="par0040" class="elsevierStylePara elsevierViewall">The clinical diagnosis can be confirmed by the demonstration of amastigotes on skin biopsy specimens; by the growth of promastigotes in culture medium or molecular testing performed on skin biopsy samples. Dermatoscopy can be a valuable tool as an adjunctive diagnostic and follow-up non-invasive technique for <span class="elsevierStyleItalic">in vivo</span> observation of infectious lesions. In the particular case of cutaneous leishmaniasis, the most commonly described dermatoscopic signs are diffuse erythema and vascular structures; other features include hyperkeratosis, central erosion or ulceration, "yellow tears" and white starburst-like patterns.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Although up to 50% of cutaneous leishmaniasis lesions are self-limited and self-healing, treatment is generally required in order to reduce the residual scar and to avoid further spread or transmission of the parasite.</p><p id="par0050" class="elsevierStylePara elsevierViewall">In the particular case of cutaneous form, there are two possible therapeutic approaches, systemic or lesion-directed.</p><p id="par0055" class="elsevierStylePara elsevierViewall">Systemic treatment including miltefosine, pentavalent antimonials, liposomal amphotericin B, pentamidine or azole derivatives is usually required when there are multiple (>3), large (>4<span class="elsevierStyleHsp" style=""></span>cm) or lesions localized in cosmetically sensitive areas; when there is evidence of loco-regional spread (lymphangitis) or if the patient is immunosuppressed.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">There are several treatment options available for solitary lesions of cutaneous leishmaniasis, such as cryotherapy, topical paromomycin, intralesional antimony derivatives and photodynamic therapy.</p><p id="par0065" class="elsevierStylePara elsevierViewall">Variables such as Leishmania species, the clinical presentation, host immunity status and the risk of extra-cutaneous involvement dictate the best treatment option.</p><p id="par0070" class="elsevierStylePara elsevierViewall">Intralesional antimony derivatives are a safe and effective treatment and represent a viable alternative for patients with few or small lesions and contraindications to systemic treatment.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,9</span></a> It is usually well tolerated and possible side effects are scarring and transient hyperpigmentation. Conversely, the use of photodynamic therapy for the treatment of cutaneous leishmaniasis, is supported by various case reports and case series.<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">6–8</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">The decision to combine both modalities was based on the attempt to minimise the pain associated with the procedure of intralesional administration since only 4 sessions were performed and the theoretical syngergistic effect of two differente mechanisms of action employed, namely, photodynamic therapy relying on systemic immune response and the antimonial derivative with direct parasiticidal effect.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Since a total of 8 sessions would most likely result in lesion clearance using either one of the modalities in monotherapy, the lack of further comparative data imposes a substantial limitation to the rationale used in this study.</p><p id="par0080" class="elsevierStylePara elsevierViewall">Although more robust studies are still needed in order to determine the real value of combined approaches vs monotherapy and the optimal treatment modalities, photodynamic therapy and intralesional antimonial derivatives represent convenient options in the setting of localized cutaneous infection in immunocompetent hosts especially in aesthetically sensitive areas.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conclusion</span><p id="par0085" class="elsevierStylePara elsevierViewall">Local therapy is desirable for patients with uncomplicated localized cutaneous leishmaniasis. We combined two locally-acting effective agents with good tolerability and low risk of side effects achieving a complete clinical response and a good cosmetic outcome.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Case Report" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Discussion" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conclusion" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-08-25" "fechaAceptado" => "2020-02-23" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Costin A, Bonito F, Alves J, Barreiros H. Tratamiento de la leishmaniasis localizada mediante el antimoniato de meglumina intralesional y la terapia fotodinámica. Actas Dermosifiliogr. 2020;111:897–899.</p>" ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1000 "Ancho" => 750 "Tamanyo" => 98764 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cutaneous leishmaniasis. Solitary, indurated, crusty plaque on the forehead.</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" => 562 "Ancho" => 750 "Tamanyo" => 66789 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Treated cutaneous leishmaniasis. Atrophic scar with peripheral hyperpigmentation on the forehead upon completion of 8 sessions of photodynamic therapy and intralesional meglumine.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cutaneous Leishmaniasis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R. Reithinger" 1 => "J. Dujardin" 2 => "H. Louzir" 3 => "C. Pirmez" 4 => "B. Alexander" 5 => "S. Brooker" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S1473-3099(07)70209-8" "Revista" => array:6 [ "tituloSerie" => "Lancet Infect Dis" "fecha" => "2007" "volumen" => "7" "paginaInicial" => "581" "paginaFinal" => "596" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17714672" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dermatoscopic signs in cutaneous leishmaniasis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.L.P. Bustamante" 1 => "J.S. López" 2 => "C.D. Campos" 3 => "R.N. Sintes" 4 => "M.A.F. Pugnaire" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1590/abd1806-4841.20174441" "Revista" => array:6 [ "tituloSerie" => "An Bras Dermatol" "fecha" => "2017" "volumen" => "92" "paginaInicial" => "844" "paginaFinal" => "846" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29364445" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A review of photodynamic therapy in cutaneous leishmaniasis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E.M. Van der Snoek" 1 => "D.J. Robinson" 2 => "J.J. Van Hellemond" 3 => "H.A.M. Neu-mann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1468-3083.2008.02805.x" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2008" "volumen" => "22" "paginaInicial" => "918" "paginaFinal" => "922" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18624853" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Standardization of intralesional meglumine antimoniate treatment for cutaneous leishmaniasis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.C. Duque" 1 => "E.C.F. Vasconcellos" 2 => "M.I.F. Pimentel" 3 => "M.R. Lyra" 4 => "S.J.B. Pacheco" 5 => "M.C.A. Marzochi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1590/0037-8682-0213-2016" "Revista" => array:6 [ "tituloSerie" => "Rev Soc Bras Med Trop" "fecha" => "2016" "volumen" => "49" "paginaInicial" => "774" "paginaFinal" => "782" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28001228" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intralesional treatment of cutaneous leishmaniasis with meglumine antimoniate" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "N. Aste" 1 => "M. Pau" 2 => "C. Ferreli" 3 => "P. Biggio" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1365-2133.1998.02105.x" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "1998" "volumen" => "138" "paginaInicial" => "370" "paginaFinal" => "371" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9602904" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "European DermatologyForum Guidelines on Topical Photodynamic Therapy 2019 Part2: Emerging Indications-Field Cancerization, Photorejuvenationand Inflammatory/Infective Dermatoses" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.A. Morton" 1 => "R.M. Szeimies" 2 => "N. Basset-Séguin" 3 => "P.G. Calzavara-Pinton" 4 => "Y. Gilaberte" 5 => "M. Haedersdal" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/jdv.16044" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol" "fecha" => "2020" "volumen" => "34" "paginaInicial" => "17" "paginaFinal" => "29" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/31805604" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of cutaneous leishmaniasis by photodynamic therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Gardlo" 1 => "Z. Horska" 2 => "C.D. Enk" 3 => "L. Rauch" 4 => "M. Megahed" 5 => "T. Ruzicka" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1067/mjd.2003.218" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol" "fecha" => "2003" "volumen" => "48" "paginaInicial" => "893" "paginaFinal" => "896" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12789181" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Effective treatment of cutaneous leishmaniasis caused by Leishmania tropica with topical photodynamic therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "C. Fink" 1 => "F. Toberer" 2 => "A. Enk" 3 => "P. Gholam" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ddg.13082" "Revista" => array:6 [ "tituloSerie" => "J Dtsch Dermatol Ges" "fecha" => "2016" "volumen" => "14" "paginaInicial" => "836" "paginaFinal" => "838" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27509427" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011100000010/v1_202012160744/S1578219020303206/v1_202012160744/en/main.assets" "Apartado" => array:4 [ "identificador" => "6157" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case and Research Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000011100000010/v1_202012160744/S1578219020303206/v1_202012160744/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020303206?idApp=UINPBA000044" ]
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