Ciclosporin: An Old Ally in the Treatment of Chronic Spontaneous Urticaria

array:25 ["pii" => "S1578219021002006" "issn" => "15782190" "doi" => "10.1016/j.adengl.2021.07.002" "estado" => "S300" "fechaPublicacion" => "2021-09-01" "aid" => "2602" "copyright" => "AEDV" "copyrightAnyo" => "2021" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2021;112:768-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:20 [ "pii" => "S0001731021000971" "issn" => "00017310" "doi" => "10.1016/j.ad.2020.01.012" "estado" => "S300" "fechaPublicacion" => "2021-09-01" "aid" => "2602" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2021;112:768-9" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "es" => array:10 [ "idiomaDefecto" => true "cabecera" => "CARTA CIENTÍFICO CLÍNICA" "titulo" => "Ciclosporina: una vieja amiga en el tratamiento de la urticaria crónica espontánea" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "768" "paginaFinal" => "769" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Ciclosporin: An Old Ally in the Treatment of Chronic Spontaneous Urticaria" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "B. Pinilla Martín, F. Tous Romero, F.J. Ortiz de Frutos" "autores" => array:3 [ 0 => array:2 [ "nombre" => "B." "apellidos" => "Pinilla Martín" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Tous Romero" ] 2 => array:2 [ "nombre" => "F.J." "apellidos" => "Ortiz de Frutos" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219021002006" "doi" => "10.1016/j.adengl.2021.07.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219021002006?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731021000971?idApp=UINPBA000044" "url" => "/00017310/0000011200000008/v1_202109020526/S0001731021000971/v1_202109020526/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219021002031" "issn" => "15782190" "doi" => "10.1016/j.adengl.2021.07.005" "estado" => "S300" "fechaPublicacion" => "2021-09-01" "aid" => "2651" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2021;112:770-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "Case and Research Letters" "titulo" => "Clinical and Ultrasound Features of Dermatofibromas in Pediatric Patients" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "770" "paginaFinal" => "772" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Caracterización clínico-ecográfica de dermatomiofibromas en edad pediátrica" ] ] "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" => 1118 "Ancho" => 1500 "Tamanyo" => 226915 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Clinical and ultrasound characteristics." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "H. Álvarez-Garrido, C. Horcajada-Reales, A. Hernández-Nuñez, J. Borbujo" "autores" => array:4 [ 0 => array:2 [ "nombre" => "H." "apellidos" => "Álvarez-Garrido" ] 1 => array:2 [ "nombre" => "C." "apellidos" => "Horcajada-Reales" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Hernández-Nuñez" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Borbujo" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219021002031?idApp=UINPBA000044" "url" => "/15782190/0000011200000008/v2_202110201006/S1578219021002031/v2_202110201006/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219021001839" "issn" => "15782190" "doi" => "10.1016/j.adengl.2021.05.021" "estado" => "S300" "fechaPublicacion" => "2021-09-01" "aid" => "2625" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2021;112:767-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "Case and Research Letters" "titulo" => "Ulcerative Lupus Erythematosus Profundus in a Patient With Limited Cutaneous Systemic Sclerosis" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "767" "paginaFinal" => "768" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Lupus eritematoso profundo ulcerativo en un paciente con esclerosis sistémica cutánea limitada" ] ] "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" => 1127 "Ancho" => 1500 "Tamanyo" => 398502 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Ulcerative lesions on the forehead (A) and scalp (B), along with swollen fingers and nailfold bleeding (C). Histological features showing focal lymphohistiocytic infiltration and hyaline fat necrosis in the lower dermis to the subcutis (D, E). Lymphocytic infiltration was observed in the muscle layers (F). Foam cells were detected in the vessels (G)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "T. Mori, T. Ito, N. Kikuchi, T. Yamamoto" "autores" => array:4 [ 0 => array:2 [ "nombre" => "T." "apellidos" => "Mori" ] 1 => array:2 [ "nombre" => "T." "apellidos" => "Ito" ] 2 => array:2 [ "nombre" => "N." "apellidos" => "Kikuchi" ] 3 => array:2 [ "nombre" => "T." "apellidos" => "Yamamoto" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731021001411" "doi" => "10.1016/j.ad.2019.10.016" "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/S0001731021001411?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219021001839?idApp=UINPBA000044" "url" => "/15782190/0000011200000008/v2_202110201006/S1578219021001839/v2_202110201006/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "Letter to the Editor" "titulo" => "Ciclosporin: An Old Ally in the Treatment of Chronic Spontaneous Urticaria" "tieneTextoCompleto" => true "saludo" => "Dear Editor:" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "768" "paginaFinal" => "769" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "B. Pinilla Martín, F. Tous Romero, F.J. Ortiz de Frutos" "autores" => array:3 [ 0 => array:4 [ "nombre" => "B." "apellidos" => "Pinilla Martín" "email" => array:1 [ 0 => "belenpinillamartin@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Tous Romero" ] 2 => array:2 [ "nombre" => "F.J." "apellidos" => "Ortiz de Frutos" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Ciclosporina: una vieja amiga en el tratamiento de la urticaria crónica espontánea" ] ] "textoCompleto" => "Since the introduction of omalizumab for the treatment of chronic spontaneous urticaria (CSU), it has been possible to control the disease in a high percentage of patients who had been refractory to treatment with high doses of antihistamines<a class="elsevierStyleCrossRef" href="#bib0005">1</a>. According to the most recent European guidelines<a class="elsevierStyleCrossRef" href="#bib0010">2</a>, treatment with ciclosporin is indicated in cases where omalizumab has already failed. In this indication, it is prescribed off-label, although it has traditionally been used for treatment of CSU<a class="elsevierStyleCrossRef" href="#bib0015">3</a>. Published data are scarce, and only 2 randomized clinical trials involving no more than 16 weeks<a class="elsevierStyleCrossRef" href="#bib0020">4</a> and 8 weeks<a class="elsevierStyleCrossRef" href="#bib0025">5</a> of treatment have been performed. Nevertheless, there are cohorts and case series of patients treated with this drug at low doses for longer periods (i.e., up to 10 years)<a class="elsevierStyleCrossRef" href="#bib0030">6</a>. We performed the present study to improve our knowledge of ciclosporin for treatment of CSU in patients whose therapy with omalizumab had already failed.We designed an observational, longitudinal, prospective study of patients diagnosed with CSU and treated with ciclosporin at our center. Previous treatment with omalizumab had failed. We recorded epidemiological and clinical data and assessed the severity of urticaria using the 7-day Urticaria Activity Score (UAS7d). We also recorded the dose of ciclosporin at different points during treatment (baseline, maximum dose, end of treatment), duration of treatment and follow-up, and adverse effects observed.Of a total of 38 patients who had received treatment with omalizumab, 3 (7.9%) did not respond to the biologic and were switched to ciclosporin (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). The UAS7d score at initiation of treatment with ciclosporin was 24, 41, and 42. Ciclosporin was started at 3.8, 3.15, and 3.85 mg/kg/d, respectively. The disease was controlled (UAS7d < 7) in all 3 patients at the first month of treatment, thus making it possible to gradually taper the dose of ciclosporin without flare-ups before suspending it altogether after 5, 14, and 12 months, with doses ranging from 0.46 and 0.68 mg/kg/d. We recorded no recurrences of urticaria in any of the patients. Similarly, no relevant adverse effects were reported during follow-up.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>While ciclosporin has traditionally been used for treatment of CSU, no definitive regimens have been established. A meta-analysis published in 2017<a class="elsevierStyleCrossRef" href="#bib0035">7</a> analyzed various studies from the literature, including 2 clinical trials<a class="elsevierStyleCrossRefs" href="#bib0020">4,5</a>. The results indicate that ciclosporin is an effective treatment for CSU, although they are difficult to extrapolate to real life, since candidates for this approach have long-standing CSU that does not respond to omalizumab and often requires cycles of oral corticosteroids. We must go back to articles published before approval of omalizumab if we are to find regimens for affected patients in the medium term, without inducing the feared adverse effects of ciclosporin. Kessel and Toubi<a class="elsevierStyleCrossRef" href="#bib0030">6</a> performed a prospective study of 20 patients with CSU that could not be controlled with ciclosporin at 3 mg/kg/d for 3 months who received the drug at 1-2 mg/kg/d continuously until control was achieved. In 8 cases, the drug could be discontinued after 8-14 months of treatment; the remaining 12 patients continued to receive ciclosporin for 60-120 months without adverse effects.Boubouka et al.<a class="elsevierStyleCrossRef" href="#bib0040">8</a> reported similar results from their prospective study, in which a cohort of 30 patients with CSU received treatment with ciclosporin at doses ranging from 1.5 to 2.5 mg/kg/d depending on symptoms for 5 months. The disease was controlled in 88% of cases with a final dose of 0.55 mg/kg/d.Our experience indicates that ciclosporin is an option for treating CSU after failure of omalizumab. In our opinion, the most appropriate regimen (i.e., fewer adverse effects with the same efficacy) is an initial dose of 3-4 mg/kg/d until the disease is controlled, followed by gradual tapering to very low doses (<1 mg/kg/d)." "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Pinilla Martín B, Tous Romero F, Ortiz de Frutos FJ. Ciclosporina: una vieja amiga en el tratamiento de la urticaria crónica espontánea. Actas Dermosifiliogr. 2021. https://doi.org/10.1016/j.ad.2020.01.012" ] ] "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"> \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">Sex \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">Age at onset, y \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">Baseline UAS24 h \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">Baseline UAS7 d \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">Baseline dose, mg/kg \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">UAS24 h at 1 mo \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">UAS7d at 1 mo \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">Final dose \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">Duration of treatment, mo \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">Duration of follow-up, mo \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">Patient 1 \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">Female \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">42 \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">6 \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">42 \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">3.85 \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">0 \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">0 \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">0.68 \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">12 \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">6 \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">Patient 2 \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">Female \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">44 \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">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">41 \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">3.15 \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">0 \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">3 \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">0.6 \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">14 \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">4 \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">Patient 3 \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">Female \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">60 \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">2 \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">24 \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">3.8 \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">1 \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">6 \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">0.46 \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">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">2 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2723530.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Results From Our Series" ] ] ] "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" => "Benefits and harms of omalizumab treatment in adolescent and adult patients with chronic idiopathic (spontaneous) urticaria: a meta-analysis of “Real-world” evidence" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.D. Tharp" 1 => "J.A. Bernstein" 2 => "A. Kavati" 3 => "B. Ortiz" 4 => "K. MacDonald" 5 => "K. Denhaerynck" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamadermatol.2018.3447" "Revista" => array:5 [ "tituloSerie" => "JAMA Dermatol." "fecha" => "2019" "volumen" => "155" "paginaInicial" => "29" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30427977" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The EAACI/GA²LEN/EDF/WAO guideline for the definition, classification, diagnosis and management of urticarial" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Zuberbier" 1 => "W. Aberer" 2 => "R. Asero" 3 => "A.H. Abdul Latiff" 4 => "D. Baker" 5 => "B. Ballmer-Weber" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/all.13397" "Revista" => array:6 [ "tituloSerie" => "Allergy." "fecha" => "2018" "volumen" => "73" "paginaInicial" => "1393" "paginaFinal" => "1414" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29336054" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "25 mg/50 mg/100 mg cápsulas blandas EFG [información folleto]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "U.R. Ciclosporina" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2012" "editorial" => "GERMED FARMACÉUTICA, S.L" "editorialLocalizacion" => "Las Matas (Madrid, España)" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cyclosporine in chronic idiopathic urticaria: a double-blind, randomized, placebo-controlled trial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "G.A. Vena" 1 => "N. Cassano" 2 => "D. Colombo" 3 => "E. Peruzzi" 4 => "P. Pigatto" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaad.2006.04.078" "Revista" => array:6 [ "tituloSerie" => "J Am Acad Dermatol." "fecha" => "2006" "volumen" => "55" "paginaInicial" => "705" "paginaFinal" => "709" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17010756" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Randomized double-blind study of cyclosporin in chronic ‘idiopathic’ urticaria" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.E. Grattan" 1 => "B.F. O’Donnell" 2 => "D.M. Francis" 3 => "N. Niimi" 4 => "R.J. Barlow" 5 => "P.T. Seed" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1046/j.1365-2133.2000.03664.x" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol." "fecha" => "2000" "volumen" => "143" "paginaInicial" => "365" "paginaFinal" => "372" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10951147" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cyclosporine-A in severe chronic urticaria: the option for long-term therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Kessel" 1 => "E. Toubi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1398-9995.2010.02419.x" "Revista" => array:6 [ "tituloSerie" => "Allergy." "fecha" => "2010" "volumen" => "65" "paginaInicial" => "1478" "paginaFinal" => "1482" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20626384" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cyclosporine for chronic spontaneous urticaria: a meta-analysis and systematic review" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Kulthanan" 1 => "P. Chaweekulrat" 2 => "C. Komoltri" 3 => "S. Hunnangkul" 4 => "P. Tuchinda" 5 => "L. Chularojanamontri" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaip.2017.07.017" "Revista" => array:5 [ "tituloSerie" => "J Allergy Clin Inmunol Pract." "fecha" => "2017" "volumen" => "6" "paginaInicial" => "586" "paginaFinal" => "599" ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of autoinmune uricaria with low-dose cyclosporin a: a one-year follow-up" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Boubouka" 1 => "C. Harissi" 2 => "D. Kouimintzis" 3 => "D. Kalogeromitros" 4 => "P. Stavropoulos" 5 => "A. Katsarou" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2340/00015555-0939" "Revista" => array:6 [ "tituloSerie" => "Acta Derm Venereol." "fecha" => "2011" "volumen" => "91" "paginaInicial" => "50" "paginaFinal" => "54" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21264453" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011200000008/v2_202110201006/S1578219021002006/v2_202110201006/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/15782190/0000011200000008/v2_202110201006/S1578219021002006/v2_202110201006/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219021002006?idApp=UINPBA000044"]

Estadísticas

Letter to the Editor

Ciclosporin: An Old Ally in the Treatment of Chronic Spontaneous Urticaria

Ciclosporina: una vieja amiga en el tratamiento de la urticaria crónica espontánea

B. Pinilla Martín

Autor para correspondencia

belenpinillamartin@gmail.com

Corresponding author.

, F. Tous Romero, F.J. Ortiz de Frutos

Servicio de Dermatología, Hospital Universitario 12 de Octubre, Madrid, Spain

Leído

3875

Veces
se ha leído el artículo

1393

Total PDF

2482

Total HTML

Compartir estadísticas

 array:25 [
  "pii" => "S1578219021002006"
  "issn" => "15782190"
  "doi" => "10.1016/j.adengl.2021.07.002"
  "estado" => "S300"
  "fechaPublicacion" => "2021-09-01"
  "aid" => "2602"
  "copyright" => "AEDV"
  "copyrightAnyo" => "2021"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "cor"
  "cita" => "Actas Dermosifiliogr. 2021;112:768-9"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:20 [
      "pii" => "S0001731021000971"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2020.01.012"
      "estado" => "S300"
      "fechaPublicacion" => "2021-09-01"
      "aid" => "2602"
      "copyright" => "AEDV"
      "documento" => "simple-article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "cor"
      "cita" => "Actas Dermosifiliogr. 2021;112:768-9"
      "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">CARTA CIENT&#205;FICO CL&#205;NICA</span>"
        "titulo" => "Ciclosporina&#58; una vieja amiga en el tratamiento de la urticaria cr&#243;nica espont&#225;nea"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "768"
            "paginaFinal" => "769"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Ciclosporin&#58; An Old Ally in the Treatment of Chronic Spontaneous Urticaria"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "B&#46; Pinilla Mart&#237;n, F&#46; Tous Romero, F&#46;J&#46; Ortiz de Frutos"
            "autores" => array:3 [
              0 => array:2 [
                "nombre" => "B&#46;"
                "apellidos" => "Pinilla Mart&#237;n"
              ]
              1 => array:2 [
                "nombre" => "F&#46;"
                "apellidos" => "Tous Romero"
              ]
              2 => array:2 [
                "nombre" => "F&#46;J&#46;"
                "apellidos" => "Ortiz de Frutos"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1578219021002006"
          "doi" => "10.1016/j.adengl.2021.07.002"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219021002006?idApp=UINPBA000044"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731021000971?idApp=UINPBA000044"
      "url" => "/00017310/0000011200000008/v1_202109020526/S0001731021000971/v1_202109020526/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S1578219021002031"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2021.07.005"
    "estado" => "S300"
    "fechaPublicacion" => "2021-09-01"
    "aid" => "2651"
    "copyright" => "AEDV"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2021;112:770-2"
    "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" => "Clinical and Ultrasound Features of Dermatofibromas in Pediatric Patients"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "770"
          "paginaFinal" => "772"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Caracterizaci&#243;n cl&#237;nico-ecogr&#225;fica de dermatomiofibromas en edad pedi&#225;trica"
        ]
      ]
      "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" => 1118
              "Ancho" => 1500
              "Tamanyo" => 226915
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0005"
              "detalle" => "Figure "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinical and ultrasound characteristics&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "H&#46; &#193;lvarez-Garrido, C&#46; Horcajada-Reales, A&#46; Hern&#225;ndez-Nu&#241;ez, J&#46; Borbujo"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "H&#46;"
              "apellidos" => "&#193;lvarez-Garrido"
            ]
            1 => array:2 [
              "nombre" => "C&#46;"
              "apellidos" => "Horcajada-Reales"
            ]
            2 => array:2 [
              "nombre" => "A&#46;"
              "apellidos" => "Hern&#225;ndez-Nu&#241;ez"
            ]
            3 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Borbujo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219021002031?idApp=UINPBA000044"
    "url" => "/15782190/0000011200000008/v2_202110201006/S1578219021002031/v2_202110201006/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1578219021001839"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2021.05.021"
    "estado" => "S300"
    "fechaPublicacion" => "2021-09-01"
    "aid" => "2625"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "cor"
    "cita" => "Actas Dermosifiliogr. 2021;112:767-8"
    "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" => "Ulcerative Lupus Erythematosus Profundus in a Patient With Limited Cutaneous Systemic Sclerosis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "767"
          "paginaFinal" => "768"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Lupus eritematoso profundo ulcerativo en un paciente con esclerosis sist&#233;mica cut&#225;nea limitada"
        ]
      ]
      "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" => 1127
              "Ancho" => 1500
              "Tamanyo" => 398502
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0005"
              "detalle" => "Figure "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Ulcerative lesions on the forehead &#40;A&#41; and scalp &#40;B&#41;&#44; along with swollen fingers and nailfold bleeding &#40;C&#41;&#46; Histological features showing focal lymphohistiocytic infiltration and hyaline fat necrosis in the lower dermis to the subcutis &#40;D&#44; E&#41;&#46; Lymphocytic infiltration was observed in the muscle layers &#40;F&#41;&#46; Foam cells were detected in the vessels &#40;G&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "T&#46; Mori, T&#46; Ito, N&#46; Kikuchi, T&#46; Yamamoto"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "T&#46;"
              "apellidos" => "Mori"
            ]
            1 => array:2 [
              "nombre" => "T&#46;"
              "apellidos" => "Ito"
            ]
            2 => array:2 [
              "nombre" => "N&#46;"
              "apellidos" => "Kikuchi"
            ]
            3 => array:2 [
              "nombre" => "T&#46;"
              "apellidos" => "Yamamoto"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731021001411"
        "doi" => "10.1016/j.ad.2019.10.016"
        "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/S0001731021001411?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219021001839?idApp=UINPBA000044"
    "url" => "/15782190/0000011200000008/v2_202110201006/S1578219021001839/v2_202110201006/en/main.assets"
  ]
  "en" => array:14 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "Ciclosporin&#58; An Old Ally in the Treatment of Chronic Spontaneous Urticaria"
    "tieneTextoCompleto" => true
    "saludo" => "Dear Editor&#58;"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "768"
        "paginaFinal" => "769"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "B&#46; Pinilla Mart&#237;n, F&#46; Tous Romero, F&#46;J&#46; Ortiz de Frutos"
        "autores" => array:3 [
          0 => array:4 [
            "nombre" => "B&#46;"
            "apellidos" => "Pinilla Mart&#237;n"
            "email" => array:1 [
              0 => "belenpinillamartin@gmail.com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "F&#46;"
            "apellidos" => "Tous Romero"
          ]
          2 => array:2 [
            "nombre" => "F&#46;J&#46;"
            "apellidos" => "Ortiz de Frutos"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicio de Dermatolog&#237;a&#44; Hospital Universitario 12 de Octubre&#44; Madrid&#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" => "Ciclosporina&#58; una vieja amiga en el tratamiento de la urticaria cr&#243;nica espont&#225;nea"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Since the introduction of omalizumab for the treatment of chronic spontaneous urticaria &#40;CSU&#41;&#44; it has been possible to control the disease in a high percentage of patients who had been refractory to treatment with high doses of antihistamines<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a>&#46; According to the most recent European guidelines<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#44; treatment with ciclosporin is indicated in cases where omalizumab has already failed&#46; In this indication&#44; it is prescribed off-label&#44; although it has traditionally been used for treatment of CSU<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#46; Published data are scarce&#44; and only 2 randomized clinical trials involving no more than 16 weeks<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> and 8 weeks<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> of treatment have been performed&#46; Nevertheless&#44; there are cohorts and case series of patients treated with this drug at low doses for longer periods &#40;i&#46;e&#46;&#44; up to 10 years&#41;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>&#46; We performed the present study to improve our knowledge of ciclosporin for treatment of CSU in patients whose therapy with omalizumab had already failed&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">We designed an observational&#44; longitudinal&#44; prospective study of patients diagnosed with CSU and treated with ciclosporin at our center&#46; Previous treatment with omalizumab had failed&#46; We recorded epidemiological and clinical data and assessed the severity of urticaria using the 7-day Urticaria Activity Score &#40;UAS7d&#41;&#46; We also recorded the dose of ciclosporin at different points during treatment &#40;baseline&#44; maximum dose&#44; end of treatment&#41;&#44; duration of treatment and follow-up&#44; and adverse effects observed&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Of a total of 38 patients who had received treatment with omalizumab&#44; 3 &#40;7&#46;9&#37;&#41; did not respond to the biologic and were switched to ciclosporin &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46; The UAS7d score at initiation of treatment with ciclosporin was 24&#44; 41&#44; and 42&#46; Ciclosporin was started at 3&#46;8&#44; 3&#46;15&#44; and 3&#46;85&#8201;mg&#47;kg&#47;d&#44; respectively&#46; The disease was controlled &#40;UAS7d&#8201;&#60;&#8201;7&#41; in all 3 patients at the first month of treatment&#44; thus making it possible to gradually taper the dose of ciclosporin without flare-ups before suspending it altogether after 5&#44; 14&#44; and 12 months&#44; with doses ranging from 0&#46;46 and 0&#46;68&#8201;mg&#47;kg&#47;d&#46; We recorded no recurrences of urticaria in any of the patients&#46; Similarly&#44; no relevant adverse effects were reported during follow-up&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">While ciclosporin has traditionally been used for treatment of CSU&#44; no definitive regimens have been established&#46; A meta-analysis published in 2017<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> analyzed various studies from the literature&#44; including 2 clinical trials<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">4&#44;5</span></a>&#46; The results indicate that ciclosporin is an effective treatment for CSU&#44; although they are difficult to extrapolate to real life&#44; since candidates for this approach have long-standing CSU that does not respond to omalizumab and often requires cycles of oral corticosteroids&#46; We must go back to articles published before approval of omalizumab if we are to find regimens for affected patients in the medium term&#44; without inducing the feared adverse effects of ciclosporin&#46; Kessel and Toubi<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> performed a prospective study of 20 patients with CSU that could not be controlled with ciclosporin at 3&#8201;mg&#47;kg&#47;d for 3 months who received the drug at 1-2&#8201;mg&#47;kg&#47;d continuously until control was achieved&#46; In 8 cases&#44; the drug could be discontinued after 8-14 months of treatment&#59; the remaining 12 patients continued to receive ciclosporin for 60-120 months without adverse effects&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Boubouka et al&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> reported similar results from their prospective study&#44; in which a cohort of 30 patients with CSU received treatment with ciclosporin at doses ranging from 1&#46;5 to 2&#46;5&#8201;mg&#47;kg&#47;d depending on symptoms for 5 months&#46; The disease was controlled in 88&#37; of cases with a final dose of 0&#46;55&#8201;mg&#47;kg&#47;d&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Our experience indicates that ciclosporin is an option for treating CSU after failure of omalizumab&#46; In our opinion&#44; the most appropriate regimen &#40;i&#46;e&#46;&#44; fewer adverse effects with the same efficacy&#41; is an initial dose of 3-4&#8201;mg&#47;kg&#47;d until the disease is controlled&#44; followed by gradual tapering to very low doses &#40;&#60;1&#8201;mg&#47;kg&#47;d&#41;&#46;</p></span>"
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Pinilla Mart&#237;n B&#44; Tous Romero F&#44; Ortiz de Frutos FJ&#46; Ciclosporina&#58; una vieja amiga en el tratamiento de la urticaria cr&#243;nica espont&#225;nea&#46; Actas Dermosifiliogr&#46; 2021&#46; <span class="elsevierStyleInterRef" id="intr0005" href="https://doi.org/10.1016/j.ad.2020.01.012">https&#58;&#47;&#47;doi&#46;org&#47;10&#46;1016&#47;j&#46;ad&#46;2020&#46;01&#46;012</span></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">&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">Sex&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">Age at onset&#44; y&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">Baseline UAS24&#8201;h&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">Baseline UAS7 d&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">Baseline dose&#44; mg&#47;kg&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">UAS24&#8201;h at 1 mo&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">UAS7d at 1 mo&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">Final dose&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">Duration of treatment&#44; mo&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">Duration of follow-up&#44; mo&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">Patient 1&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">Female&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">42&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">6&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">42&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">3&#46;85&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">0&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">0&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">0&#46;68&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">12&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">6&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">Patient 2&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">Female&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">44&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">5&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">41&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">3&#46;15&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">0&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">3&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">0&#46;6&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">14&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">4&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">Patient 3&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">Female&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">60&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">2&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">24&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">3&#46;8&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">1&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">6&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">0&#46;46&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">5&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">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2723530.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Results From Our Series</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" => "Benefits and harms of omalizumab treatment in adolescent and adult patients with chronic idiopathic &#40;spontaneous&#41; urticaria&#58; a meta-analysis of &#8220;Real-world&#8221; evidence"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "M&#46;D&#46; Tharp"
                            1 => "J&#46;A&#46; Bernstein"
                            2 => "A&#46; Kavati"
                            3 => "B&#46; Ortiz"
                            4 => "K&#46; MacDonald"
                            5 => "K&#46; Denhaerynck"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/jamadermatol.2018.3447"
                      "Revista" => array:5 [
                        "tituloSerie" => "JAMA Dermatol&#46;"
                        "fecha" => "2019"
                        "volumen" => "155"
                        "paginaInicial" => "29"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30427977"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The EAACI&#47;GA&#178;LEN&#47;EDF&#47;WAO guideline for the definition&#44; classification&#44; diagnosis and management of urticarial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46; Zuberbier"
                            1 => "W&#46; Aberer"
                            2 => "R&#46; Asero"
                            3 => "A&#46;H&#46; Abdul Latiff"
                            4 => "D&#46; Baker"
                            5 => "B&#46; Ballmer-Weber"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/all.13397"
                      "Revista" => array:6 [
                        "tituloSerie" => "Allergy&#46;"
                        "fecha" => "2018"
                        "volumen" => "73"
                        "paginaInicial" => "1393"
                        "paginaFinal" => "1414"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29336054"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "25 mg&#47;50 mg&#47;100 mg c&#225;psulas blandas EFG &#91;informaci&#243;n folleto&#93;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "U&#46;R&#46; Ciclosporina"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2012"
                        "editorial" => "GERMED FARMAC&#201;UTICA&#44; S&#46;L"
                        "editorialLocalizacion" => "Las Matas &#40;Madrid&#44; Espa&#241;a&#41;"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cyclosporine in chronic idiopathic urticaria&#58; a double-blind&#44; randomized&#44; placebo-controlled trial"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "G&#46;A&#46; Vena"
                            1 => "N&#46; Cassano"
                            2 => "D&#46; Colombo"
                            3 => "E&#46; Peruzzi"
                            4 => "P&#46; Pigatto"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2006.04.078"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Acad Dermatol&#46;"
                        "fecha" => "2006"
                        "volumen" => "55"
                        "paginaInicial" => "705"
                        "paginaFinal" => "709"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17010756"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Randomized double-blind study of cyclosporin in chronic &#8216;idiopathic&#8217; urticaria"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;E&#46; Grattan"
                            1 => "B&#46;F&#46; O&#8217;Donnell"
                            2 => "D&#46;M&#46; Francis"
                            3 => "N&#46; Niimi"
                            4 => "R&#46;J&#46; Barlow"
                            5 => "P&#46;T&#46; Seed"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1046/j.1365-2133.2000.03664.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol&#46;"
                        "fecha" => "2000"
                        "volumen" => "143"
                        "paginaInicial" => "365"
                        "paginaFinal" => "372"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10951147"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cyclosporine-A in severe chronic urticaria&#58; the option for long-term therapy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "A&#46; Kessel"
                            1 => "E&#46; Toubi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1398-9995.2010.02419.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Allergy&#46;"
                        "fecha" => "2010"
                        "volumen" => "65"
                        "paginaInicial" => "1478"
                        "paginaFinal" => "1482"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20626384"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cyclosporine for chronic spontaneous urticaria&#58; a meta-analysis and systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Kulthanan"
                            1 => "P&#46; Chaweekulrat"
                            2 => "C&#46; Komoltri"
                            3 => "S&#46; Hunnangkul"
                            4 => "P&#46; Tuchinda"
                            5 => "L&#46; Chularojanamontri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaip.2017.07.017"
                      "Revista" => array:5 [
                        "tituloSerie" => "J Allergy Clin Inmunol Pract&#46;"
                        "fecha" => "2017"
                        "volumen" => "6"
                        "paginaInicial" => "586"
                        "paginaFinal" => "599"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of autoinmune uricaria with low-dose cyclosporin a&#58; a one-year follow-up"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Boubouka"
                            1 => "C&#46; Harissi"
                            2 => "D&#46; Kouimintzis"
                            3 => "D&#46; Kalogeromitros"
                            4 => "P&#46; Stavropoulos"
                            5 => "A&#46; Katsarou"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2340/00015555-0939"
                      "Revista" => array:6 [
                        "tituloSerie" => "Acta Derm Venereol&#46;"
                        "fecha" => "2011"
                        "volumen" => "91"
                        "paginaInicial" => "50"
                        "paginaFinal" => "54"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21264453"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000011200000008/v2_202110201006/S1578219021002006/v2_202110201006/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/15782190/0000011200000008/v2_202110201006/S1578219021002006/v2_202110201006/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219021002006?idApp=UINPBA000044"
]

Información del artículo

ISSN: 15782190
Idioma original: Inglés

DOI:10.1016/j.adengl.2021.07.002

Datos actualizados diariamente

año/Mes	Html	Pdf	Total

2024 Noviembre	7	12	19
2024 Octubre	81	40	121
2024 Septiembre	83	25	108
2024 Agosto	113	65	178
2024 Julio	76	26	102
2024 Junio	93	29	122
2024 Mayo	81	30	111
2024 Abril	78	29	107
2024 Marzo	102	25	127
2024 Febrero	78	28	106
2024 Enero	76	30	106
2023 Diciembre	47	20	67
2023 Noviembre	90	31	121
2023 Octubre	99	25	124
2023 Septiembre	69	35	104
2023 Agosto	33	7	40
2023 Julio	53	35	88
2023 Junio	58	26	84
2023 Mayo	54	27	81
2023 Abril	29	23	52
2023 Marzo	44	36	80
2023 Febrero	51	20	71
2023 Enero	33	24	57
2022 Diciembre	39	38	77
2022 Noviembre	32	23	55
2022 Octubre	30	27	57
2022 Septiembre	28	28	56
2022 Agosto	24	37	61
2022 Julio	26	39	65
2022 Junio	26	21	47
2022 Mayo	41	41	82
2022 Abril	60	38	98
2022 Marzo	64	65	129
2022 Febrero	70	40	110
2022 Enero	82	43	125
2021 Diciembre	77	42	119
2021 Noviembre	65	47	112
2021 Octubre	75	68	143
2021 Septiembre	89	61	150
2021 Agosto	66	50	116
2021 Julio	60	37	97

Mostrar todo

Indexada en:

Síguenos:

Estadísticas

Indexada en:

Síguenos:

Estadísticas

Suscríbase a la newsletter