Resident's Forum
RF-IgG4-Related Disease 4 Years On
FR-Enfermedad relacionada con IgG4, 4 años después
T. Ródenas-Herranz
, L. Linares-Gonzalez, R. Ruiz-Villaverde
Autor para correspondencia
Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, Spain
Leído
3401
Vecesse ha leído el artículo
1509
Total PDF
1892
Total HTML
Compartir estadísticas
array:25 [ "pii" => "S1578219021000895" "issn" => "15782190" "doi" => "10.1016/j.adengl.2019.07.028" "estado" => "S300" "fechaPublicacion" => "2021-05-01" "aid" => "2544" "copyright" => "AEDV" "copyrightAnyo" => "2020" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Actas Dermosifiliogr. 2021;112:461-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:20 [ "pii" => "S0001731020305093" "issn" => "00017310" "doi" => "10.1016/j.ad.2019.07.018" "estado" => "S300" "fechaPublicacion" => "2021-05-01" "aid" => "2544" "copyright" => "AEDV" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Actas Dermosifiliogr. 2021;112:461-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Foro de Residentes</span>" "titulo" => "FR- Enfermedad relacionada con IgG4, 4 años después" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "461" "paginaFinal" => "462" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "RF- IgG4-Related Disease 4 Years On" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "T. Ródenas-Herranz, L. Linares-González, R. Ruiz-Villaverde" "autores" => array:3 [ 0 => array:2 [ "nombre" => "T." "apellidos" => "Ródenas-Herranz" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Linares-González" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Ruiz-Villaverde" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219021000998" "doi" => "10.1016/j.adengl.2021.02.014" "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/S1578219021000998?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731020305093?idApp=UINPBA000044" "url" => "/00017310/0000011200000005/v1_202105061359/S0001731020305093/v1_202105061359/es/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S157821902100086X" "issn" => "15782190" "doi" => "10.1016/j.adengl.2019.10.014" "estado" => "S300" "fechaPublicacion" => "2021-05-01" "aid" => "2527" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2021;112:463-6" "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" => "Successful Treatment of White Sponge Nevus with Oral Doxycycline: A Case Report and Review of the Literature" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "463" "paginaFinal" => "466" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento del nevus blanco esponjoso. Aportación de un caso con respuesta a doxiciclina oral y revisión de la literatura" ] ] "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" => 1422 "Ancho" => 1500 "Tamanyo" => 354200 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Wrinkled, whitish lesions on the sides of the tongue (A) and on the buccal mucosa (B). Clinical improvement of the lesions on the side of the tongue (C) and on the buccal mucosa (D) after treatment with oral doxycycline.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "E. Amores-Martín, G. Melé-Ninot, E. Del Alcázar Viladomiu, M.T. Fernández-Figueras" "autores" => array:4 [ 0 => array:2 [ "nombre" => "E." "apellidos" => "Amores-Martín" ] 1 => array:2 [ "nombre" => "G." "apellidos" => "Melé-Ninot" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Del Alcázar Viladomiu" ] 3 => array:2 [ "nombre" => "M.T." "apellidos" => "Fernández-Figueras" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731020304701" "doi" => "10.1016/j.ad.2019.10.009" "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/S0001731020304701?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S157821902100086X?idApp=UINPBA000044" "url" => "/15782190/0000011200000005/v1_202105020833/S157821902100086X/v1_202105020833/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S1578219021000925" "issn" => "15782190" "doi" => "10.1016/j.adengl.2021.02.008" "estado" => "S300" "fechaPublicacion" => "2021-05-01" "aid" => "2555" "copyright" => "AEDV" "documento" => "article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Actas Dermosifiliogr. 2021;112:459-60" "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">Images in Dermatology</span>" "titulo" => "Lisch Nodules: A Key Diagnostic Sign of Neurofibromatosis Type 1" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "459" "paginaFinal" => "460" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Nódulos de Lisch: una clave diagnóstica en neurofibromatosis tipo 1" ] ] "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" => 833 "Ancho" => 1500 "Tamanyo" => 235807 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "E. Rodríguez-Lomba, B. Lozano-Masdemont" "autores" => array:2 [ 0 => array:2 [ "nombre" => "E." "apellidos" => "Rodríguez-Lomba" ] 1 => array:2 [ "nombre" => "B." "apellidos" => "Lozano-Masdemont" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731020305263" "doi" => "10.1016/j.ad.2019.02.038" "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/S0001731020305263?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219021000925?idApp=UINPBA000044" "url" => "/15782190/0000011200000005/v1_202105020833/S1578219021000925/v1_202105020833/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Resident's Forum</span>" "titulo" => "RF-IgG4-Related Disease 4 Years On" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "461" "paginaFinal" => "462" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "T. Ródenas-Herranz, L. Linares-Gonzalez, R. Ruiz-Villaverde" "autores" => array:3 [ 0 => array:4 [ "nombre" => "T." "apellidos" => "Ródenas-Herranz" "email" => array:1 [ 0 => "teresarodenash@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Linares-Gonzalez" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Ruiz-Villaverde" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital Universitario San Cecilio, Granada, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "FR-Enfermedad relacionada con IgG4, 4 años después" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Immunoglobulin (Ig) 4–related disease is a clinical and patholological entity with a broad spectrum of clinical manifestations.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Recognized as a systemic disease in 2003<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> after the description of patients with special forms of autoimmune pancreatitis, IgG4-related disease is associated with various extrapancreatic manifestations, with the skin being one of the organs affected. The course of the disease has yet to be suitably characterized. In 2015, Yélamos<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> made a preliminary appraisal of the dermatologic aspects of the disease. What has changed since then?</p><p id="par0010" class="elsevierStylePara elsevierViewall">In epidemiological terms, IgG4-related disease seems to be more common in elderly men, with a mean age of 61.4 (13.4) years and a sex ratio of 4:1 (men:women).<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4,5</span></a> Based on histopathology findings, the prevalence of IgG4-related disease in Japan is estimated to be 2.63-10.2 cases per million inhabitants, with an incidence of 336-1300 new cases per year.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Clinically, the disease presents with a subacute course, and most patients have asthenia or weight loss. In addition, affected patients usually have allergic rhinitis, bronchial asthma, or atopic dermatitis; therefore, the dermatologist plays a particularly relevant role.</p><p id="par0020" class="elsevierStylePara elsevierViewall">When diagnosing and monitoring the disease, we must highlight 3 points<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">a</span><p id="par0025" class="elsevierStylePara elsevierViewall">No specific diagnostic antibodies have been identified.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">b</span><p id="par0030" class="elsevierStylePara elsevierViewall">IgG4 levels can help in the initial diagnosis but not to monitor the disease. There is a correlation with serum IgG4 levels and the number of organs involved.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">c</span><p id="par0035" class="elsevierStylePara elsevierViewall">Plasmablast level (CD19<span class="elsevierStyleSup">+</span>, CD20–, CD27<span class="elsevierStyleSup">+</span>, CD38<span class="elsevierStyleSup">+</span>) (>2000/mL) is a useful biomarker of activity, although it is not widely used or available in most hospitals.</p></li></ul></p><p id="par0040" class="elsevierStylePara elsevierViewall">Irrespective of the criteria set, histopathology is characterized by 2 findings that are extraordinary and practically rule out IgG4-related disease: the presence of granulomas and the presence of a neutrophilic infiltrate.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> Imaging tests are very useful for identifying possible locations for biopsy specimens, and positron emission tomography/computed tomography with fluorodeoxyglucose is the most appropriate, since it evaluates the extension of the disease (uptake is particularly marked in the salivary glands and lymph nodes and in vascular invasion) and the response to immunosuppressive treatment.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Have there been advances in our knowledge of skin disease?</p><p id="par0050" class="elsevierStylePara elsevierViewall">Based on a literature review and their own experience, Tokura et al.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> reported various patterns of cutaneous expression. <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a> shows the primary and secondary forms of skin involvement, the main morphologies of the lesions, and the site affected according to data from the systematic review of Bennet et al.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">The first data from the Spanish registry of IgG4-related disease were published in 2015. As the prevalence of the disease is low,<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> the data retrieved can help us to better characterize it. Salivary gland involvement affects 16% and is closely related to skin involvement. Therefore, given the clinical suspicion and ease of access, skin biopsy can be complemented by salivary gland biopsy to provide the dermatologist with information on the disease, bearing in mind that obliterative fibrosis need not always be present, in contrast with other organs.</p><p id="par0060" class="elsevierStylePara elsevierViewall">Treatment should be tailored to the characteristics of the patient. Of note, not all manifestations of IgG4-related disease require treatment, although close multidisciplinary follow-up is necessary. Rituximab, systemic corticosteroids, and azathioprine are the main drugs used for treatment of the disease.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1366591" "palabras" => array:3 [ 0 => "IfG4" 1 => "Diagnosis" 2 => "IgG4 dermatology" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Ródenas-Herranz T, Linares-Gonzalez L, Ruiz-Villaverde R. FR-Enfermedad relacionada con IgG4, 4 años después. Actas Dermosifiliogr. 2021;112:461–462.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "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">Cutaneous Forms<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> \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">Morphology (Presenting Lesion)<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> \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">Site Affected<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> \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="elsevierStyleBold">IgG4-related disease (primary)</span> \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">Nodule, 40% \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">Face, 23.75% \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><span class="elsevierStyleItalic">IgG4+/IgG > 40%</span> \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">Plaque, 30% \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">Periauricular, 17.5% \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><span class="elsevierStyleItalic">IgG4+plasma</span> × <span class="elsevierStyleItalic">100 > 10</span> \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">Mass, 17.5% \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">Neck, 12.5% \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>Cutaneous plasmacytosis \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">Papule, 12.5% \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">Upper limbs, 10% \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>Pseudolymphoma. Angiolymphoid hyperplasia with eosinophilia \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><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">Back, 7.5% \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>Mikulicz 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"> \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">Chest, 6.25% \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="elsevierStyleBold">IgG4-related disease (secondary)</span> \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><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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">IgG4+/IgG > 40%</span> \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><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"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleItalic">or perivascular IgG4</span> \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><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"><span class="elsevierStyleHsp" style=""></span>Psoriasiform eruptions \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><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"><span class="elsevierStyleHsp" style=""></span>Maculopapular eruptions or nonspecific erythematous eruptions \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><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"><span class="elsevierStyleHsp" style=""></span>Hypergammaglobulinemic purpura and urticaria 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"> \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"><span class="elsevierStyleHsp" style=""></span>Raynaud phenomenon, digital gangrene \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><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></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2586952.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cutaneous Expression of IgG4-Related Disease.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "IgG4-related disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.H. Stone" 1 => "Y. Zen" 2 => "V. Deshpande" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1056/NEJMra1104650" "Revista" => array:6 [ "tituloSerie" => "N Engl J Med" "fecha" => "2012" "volumen" => "366" "paginaInicial" => "539" "paginaFinal" => "551" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22316447" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lymphoplasmacytic sclerosing pancreatitis is a pancreatic lesion of IgG4-related systemic disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T. Kamisawa" 1 => "N. Funata" 2 => "Y. Hayashi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.pas.0000131542.72524.2b" "Revista" => array:5 [ "tituloSerie" => "Am J Surg Pathol" "fecha" => "2004" "volumen" => "28" "paginaInicial" => "1114" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15252326" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dermatological aspects of immunoglobulin G4 (IgG4)-related disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "O. Yélamos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ad.2014.08.007" "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2015" "volumen" => "106" "paginaInicial" => "231" "paginaFinal" => "232" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25306871" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "IgG4-related disease: a concise review of the current literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "O. Ardila-Suarez" 1 => "A. Abril" 2 => "J.A. Gómez-Puerta" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.reuma.2016.05.009" "Revista" => array:6 [ "tituloSerie" => "Reumatol Clin" "fecha" => "2017" "volumen" => "13" "paginaInicial" => "160" "paginaFinal" => "166" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27329319" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "IgG4-related skin disease may have distinct systemic manifestations: a systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "A.E. Bennett" 1 => "N.A. Fenske" 2 => "P. Rodriguez-Waitkus" 3 => "J.L. Messina" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ijd.13369" "Revista" => array:6 [ "tituloSerie" => "Int J Dermatol" "fecha" => "2016" "volumen" => "55" "paginaInicial" => "1184" "paginaFinal" => "1195" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27419384" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Immunoglobulin G4-related disease and its skin manifestations" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Takayama" 1 => "T. Ueno" 2 => "H. Saeki" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/1346-8138.13723" "Revista" => array:6 [ "tituloSerie" => "J Dermatol" "fecha" => "2017" "volumen" => "44" "paginaInicial" => "288" "paginaFinal" => "296" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28256769" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Consensus statement on the pathology of IgG4-related disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V. Deshpande" 1 => "Y. Zen" 2 => "J.K. Chan" 3 => "E.E. Yi" 4 => "Y. Sato" 5 => "T. Yoshino" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/modpathol.2012.72" "Revista" => array:6 [ "tituloSerie" => "Mod Pathol" "fecha" => "2012" "volumen" => "25" "paginaInicial" => "1181" "paginaFinal" => "1192" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22596100" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "IgG4-related skin disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "Y. Tokura" 1 => "H. Yagi" 2 => "H. Yanaguchi" 3 => "Y. Majima" 4 => "A. Kasuya" 5 => "T. Ito" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/bjd.13296" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2014" "volumen" => "171" "paginaInicial" => "959" "paginaFinal" => "967" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25065694" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "IgG4-related disease: results from a Multicenter Spanish Registry" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Fernández-Codina" 1 => "F. Martínez-Valle" 2 => "B. Pinilla" 3 => "C. López" 4 => "I. DeTorres" 5 => "R. Solans-Laqué" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Medicine (Baltimore)" "fecha" => "2015" "volumen" => "94" "paginaInicial" => "e1275" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011200000005/v1_202105020833/S1578219021000895/v1_202105020833/en/main.assets" "Apartado" => array:4 [ "identificador" => "34945" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Resident's Forum" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000011200000005/v1_202105020833/S1578219021000895/v1_202105020833/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219021000895?idApp=UINPBA000044" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Noviembre | 7 | 9 | 16 |
| 2024 Octubre | 72 | 38 | 110 |
| 2024 Septiembre | 71 | 21 | 92 |
| 2024 Agosto | 81 | 46 | 127 |
| 2024 Julio | 59 | 34 | 93 |
| 2024 Junio | 75 | 29 | 104 |
| 2024 Mayo | 60 | 22 | 82 |
| 2024 Abril | 61 | 21 | 82 |
| 2024 Marzo | 52 | 27 | 79 |
| 2024 Febrero | 52 | 32 | 84 |
| 2024 Enero | 52 | 29 | 81 |
| 2023 Diciembre | 43 | 13 | 56 |
| 2023 Noviembre | 61 | 26 | 87 |
| 2023 Octubre | 55 | 22 | 77 |
| 2023 Septiembre | 46 | 30 | 76 |
| 2023 Agosto | 33 | 15 | 48 |
| 2023 Julio | 32 | 25 | 57 |
| 2023 Junio | 35 | 15 | 50 |
| 2023 Mayo | 37 | 23 | 60 |
| 2023 Abril | 31 | 16 | 47 |
| 2023 Marzo | 34 | 27 | 61 |
| 2023 Febrero | 27 | 20 | 47 |
| 2023 Enero | 36 | 50 | 86 |
| 2022 Diciembre | 45 | 66 | 111 |
| 2022 Noviembre | 28 | 30 | 58 |
| 2022 Octubre | 22 | 23 | 45 |
| 2022 Septiembre | 23 | 28 | 51 |
| 2022 Agosto | 23 | 37 | 60 |
| 2022 Julio | 21 | 33 | 54 |
| 2022 Junio | 21 | 22 | 43 |
| 2022 Mayo | 25 | 40 | 65 |
| 2022 Abril | 32 | 23 | 55 |
| 2022 Marzo | 44 | 62 | 106 |
| 2022 Febrero | 33 | 30 | 63 |
| 2022 Enero | 34 | 37 | 71 |
| 2021 Diciembre | 32 | 45 | 77 |
| 2021 Noviembre | 34 | 54 | 88 |
| 2021 Octubre | 40 | 76 | 116 |
| 2021 Septiembre | 39 | 44 | 83 |
| 2021 Agosto | 49 | 38 | 87 |
| 2021 Julio | 40 | 36 | 76 |
| 2021 Junio | 31 | 40 | 71 |
| 2021 Mayo | 53 | 39 | 92 |
| 2021 Abril | 49 | 70 | 119 |
| 2021 Marzo | 61 | 44 | 105 |
| 2021 Febrero | 1 | 2 | 3 |
Mostrar todo
