Case and Research Letters
Skin Involvement as the Presenting Feature of Primary Systemic Anaplastic Lymphoma Kinase-Negative CD30+ Anaplastic Lymphoma
Inicio cutáneo de un linfoma anaplásico CD 30+ ALK negativo primario sistémico
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Presentación de un caso y claves para el diagnóstico diferencial" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 718 "Ancho" => 950 "Tamanyo" => 58555 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Multiple whitish papules in a V-shaped area on the upper chest.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "F.M. Almazán-Fernández, A. Clemente-Ruiz de Almirón, A. Sanz-Trelles, J.C. Ruiz-Carrascosa, R. Naranjo-Sintes" "autores" => array:5 [ 0 => array:2 [ "nombre" => "F.M." "apellidos" => "Almazán-Fernández" ] 1 => array:2 [ "nombre" => "A." 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Messeguer, C. Requena, V. Traves, P. Lorente, C. Guillén-Barona" "autores" => array:5 [ 0 => array:4 [ "nombre" => "F." "apellidos" => "Messeguer" "email" => array:1 [ 0 => "francescmb@comv.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "C." "apellidos" => "Requena" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "V." "apellidos" => "Traves" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "P." "apellidos" => "Lorente" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] ] 4 => array:3 [ "nombre" => "C." "apellidos" => "Guillén-Barona" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Instituto Valenciano de Oncología, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Instituto Valenciano de Oncología, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Servicio de Hematología, Instituto Valenciano de Oncología, Valencia, Spain" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Inicio cutáneo de un linfoma anaplásico CD 30+ ALK negativo primario sistémico" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 713 "Ancho" => 950 "Tamanyo" => 148968 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cutaneous plaque with a shiny, irregular surface and areas of ulceration. The lesion prevented the eye from opening.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We report the case of a 66-year-old man who consulted with a 3-week history of a rapidly growing asymptomatic lesion on his left cheek that for the previous week had prevented him from opening the eye on that side (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Two years earlier at another center the patient had been diagnosed with a primary systemic CD30<span class="elsevierStyleSup">+</span> anaplastic large-cell lymphoma (ALCL), with skin lesions in the same area as the lesion described above and ipsilateral cervical lymph-node involvement at the time of diagnosis. The patient had received chemotherapy (CHOP: cyclophosphamide, doxorubicin, vincristine, and prednisone) and external radiotherapy, with complete remission of the skin lesions and lymph-node involvement.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Examination revealed a 15<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>12<span class="elsevierStyleHsp" style=""></span>cm plaque affecting the malar, infraocular, and preauricular regions on the left side, extending down to the angle of the mandible. The lesion had poorly defined borders and was formed by the confluence of multiple tumors (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><p id="par0025" class="elsevierStylePara elsevierViewall">Histology revealed marked epidermal spongiosis that gave rise to scattered intraepidermal vesicles and intense edema of the papillary dermis (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A). A dense lymphocytic proliferation affected the rest of the dermis and extended into the subcutaneous tissue (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A). The neoplastic infiltrate was formed by large pleomorphic cells with abundant clear cytoplasm. The nuclei were kidney-shaped or oval with unevenly distributed chromatin and prominent nucleoli (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>B).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Immunohistochemistry was positive for CD3 and CD30 (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>C) in 95% of neoplastic cells. CD5 and CD15 expression was focal, with the markers detected in 30% and 20% of the cells, respectively. Ki-67 antigen was positive in 80% to 90% of the neoplastic infiltrate. In addition, 30% of cells were positive for CD4 and 15% were positive for CD8<span class="elsevierStyleSup">+</span>, while anaplastic lymphoma kinase (ALK) 1, CD56, and epithelial membrane antigen were negative. Genetic study of the T-cell receptor showed monoclonal reordering.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Further tests included an analysis of T-cell populations and immunoglobulin levels, a computed tomography of the head, neck, abdomen and pelvis, and a bone-marrow biopsy. All the results were normal or negative.</p><p id="par0040" class="elsevierStylePara elsevierViewall">These findings led to a diagnosis of cutaneous recurrence of ALK-negative CD30<span class="elsevierStyleSup">+</span> anaplastic large-cell lymphoma, and chemotherapy was initiated. The patient showed partial remission after 2 complete cycles of CHOP. One month later the patient suffered a relapse and ESHAP (cytarabine, methylprednisolone, cisplatin, etoposide) therapy was started, resulting in a marked reduction in lesion size by the end of the first cycle.</p><p id="par0045" class="elsevierStylePara elsevierViewall">ALCL can be divided into 2 large groups.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The first is made up of the primary cutaneous ALCLs that, together with lymphomatoid papulosis, are included in the primary cutaneous CD30<span class="elsevierStyleSup">+</span> lymphoproliferative disorders.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The second group is composed of systemic (nodal) ALCLs, which can be subdivided into ALK positive and negative.</p><p id="par0050" class="elsevierStylePara elsevierViewall">The differential diagnosis of the various types of CD30<span class="elsevierStyleSup">+</span> ALCL is complicated but is essential in view of the differences in the prognosis and therapeutic management. ALK protein expression, positive in 80% of systemic ALCLs and negative in almost 100% of primary cutaneous ALCLs, can be useful for differentiating between cutaneous and nodal origins.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3–5</span></a> The expression of this protein is due to chromosomal translocations, usually t(2;5)(p23;q35).</p><p id="par0055" class="elsevierStylePara elsevierViewall">Translocations that affect the <span class="elsevierStyleItalic">MUM1/IRF4</span> gene have recently been reported in primary cutaneous ALCL. The specificity of these translocations and their utility as markers to differentiate between the various CD30<span class="elsevierStyleSup">+</span> lymphoid proliferations has yet to be established.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">The clinical course may also be helpful in orienting the diagnosis. The 5-year survival of primary cutaneous ALCL is 95%. Primary systemic ALCL, however, has a poorer prognosis, with a 5-year survival of 80% in the ALK-positive subgroup and 30% in ALK-negative cases.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,4,7</span></a> There are series of ALK-negative ALCL with cutaneous and nodal involvement at the time of diagnosis, as was the case in our patient, with a survival similar to that of primary cutaneous ALCL.<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3,8</span></a> Given that cutaneous involvement by ALK-negative systemic ALCL is rare, a cutaneous origin with early lymph-node involvement has been suggested to explain the indolent course of these cases.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7,8</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">The treatment of choice for primary systemic ALCL, whether ALK-positive or ALK-negative, is polychemotherapy.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Treatment for primary cutaneous ALCL, however, includes less aggressive options such as no treatment initially, in the hope of spontaneous resolution, or low-dose methotrexate, local radiation therapy, or surgical resection.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> In our case, given the initial diagnosis of primary nodal ALCL, chemotherapy was chosen to treat the recurrence.</p><p id="par0070" class="elsevierStylePara elsevierViewall">In conclusion, a rare case of ALK-negative ALCL with cutaneous and locoregional lymph-node involvement at the time of diagnosis is reported. Further genetic and immunohistochemical studies are necessary to clarify whether cases such as that of the patient presented in this paper are in actual fact primary cutaneous rather than systemic ALCL.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Please cite this article as: Messeguer F, et al. Inicio cutáneo de un linfoma anaplásico CD 30+ ALK negativo primario sistémico. Actas Dermosifiliogr.2011;102:547-48.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 713 "Ancho" => 950 "Tamanyo" => 148968 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Cutaneous plaque with a shiny, irregular surface and areas of ulceration. The lesion prevented the eye from opening.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 622 "Ancho" => 1750 "Tamanyo" => 357433 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A, Dense lymphocytic infiltrate affecting the full thickness of the dermis and reaching the subcutaneous tissue (hematoxylin-eosin, original magnification x20). B, Lymphoid cells with abundant cytoplasm, marked pleomorphism, mitotic activity, and atypia (hematoxylin-eosin, original magnification, x200). C, Intense positivity for the CD30 marker in almost the entire specimen (x20).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S.H. Swerdlow" 1 => "E. Campo" 2 => "N.L. Harris" 3 => "E.S. Jaffe" 4 => "S. Pileri" 5 => "S. Hea" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2008" "editorial" => "IARC Press" "editorialLocalizacion" => "Lyon" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary cutaneous CD30+ lymphoproliferative disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Calzado-Villarreal" 1 => "I. Polo-Rodríguez" 2 => "P.L. Ortiz-Romero" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Actas Dermosifiliogr" "fecha" => "2010" "volumen" => "101" "paginaInicial" => "119" "paginaFinal" => "128" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20223154" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adverse effects of activated cytotoxic T lymphocytes on the clinical outcome of nodal anaplastic large cell lymphoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.L. Ten Berge" 1 => "D.F. Dukers" 2 => "J.J. Oudejans" 3 => "K. Pulford" 4 => "G.J. Ossenkoppele" 5 => "D. de Jong" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "1999" "volumen" => "93" "paginaInicial" => "2688" "paginaFinal" => "2696" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10194449" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The World Health Organization classification of tumours. Pathology and genetics. Tumours of haematopoietic and lymphoid tissues" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "E. Jaffe" 1 => "N. Harris" 2 => "H. Stein" 3 => "J. Vardiman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:3 [ "fecha" => "2001" "editorial" => "IARC Press" "editorialLocalizacion" => "Lyon" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "ALK-negative systemic anaplastic large cell lymphoma: differential diagnostic and prognostic aspects--a review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "R.L. Ten Berge" 1 => "J.J. Oudejans" 2 => "G.J. Ossenkoppele" 3 => "C.J. Meijer" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1002/path.1331" "Revista" => array:6 [ "tituloSerie" => "J Pathol" "fecha" => "2003" "volumen" => "200" "paginaInicial" => "4" "paginaFinal" => "15" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12692835" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "IRF4 gene rearrangements define a subgroup of CD30-positive cutaneous T-cell lymphoma: a study of 54 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Pham-Ledard" 1 => "M. Prochazkova-Carlotti" 2 => "E. Laharanne" 3 => "B. Vergier" 4 => "T. Jouary" 5 => "M. Beylot-Barry" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1038/jid.2009.314" "Revista" => array:6 [ "tituloSerie" => "J Invest Dermatol" "fecha" => "2010" "volumen" => "130" "paginaInicial" => "816" "paginaFinal" => "825" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19812605" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "ALK expression in extranodal anaplastic large cell lymphoma favours systemic disease with (primary) nodal involvement and a good prognosis and occurs before dissemination" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R.L. Ten Berge" 1 => "J.J. Oudejans" 2 => "G.J. Ossenkoppele" 3 => "K. Pulford" 4 => "R. Willemze" 5 => "B. Falini" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Clin Pathol" "fecha" => "2000" "volumen" => "53" "paginaInicial" => "445" "paginaFinal" => "450" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10911802" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Primary and secondary cutaneous CD30(+) lymphoproliferative disorders: a report from the Dutch Cutaneous Lymphoma Group on the long-term follow-up data of 219 patients and guidelines for diagnosis and treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.W. Bekkenk" 1 => "F.A. Geelen" 2 => "P.C. van Voorst Vader" 3 => "F. Heule" 4 => "M.L. Geerts" 5 => "W.A. van Vloten" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "2000" "volumen" => "95" "paginaInicial" => "3653" "paginaFinal" => "3661" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10845893" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anaplastic large cell lymphoma: changes in the World Health Organization classification and perspectives for targeted therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "B. Falini" 1 => "M.P. Martelli" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3324/haematol.2009.008250" "Revista" => array:6 [ "tituloSerie" => "Haematologica" "fecha" => "2009" "volumen" => "94" "paginaInicial" => "897" "paginaFinal" => "900" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19570751" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Non-mycosis fungoides cutaneous T-cell lymphoma: reclassification according to the WHO-EORTC classification" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Weaver" 1 => "A.K. Mahindra" 2 => "B. Pohlman" 3 => "T. Jin" 4 => "E.D. Hsi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1600-0560.2010.01526.x" "Revista" => array:6 [ "tituloSerie" => "J Cutan Pathol" "fecha" => "2010" "volumen" => "37" "paginaInicial" => "516" "paginaFinal" => "524" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20132421" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000010200000007/v1_201304241231/S1578219011000333/v1_201304241231/en/main.assets" "Apartado" => array:4 [ "identificador" => "6169" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Cases and Research Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000010200000007/v1_201304241231/S1578219011000333/v1_201304241231/en/main.pdf?idApp=UINPBA000044&text.app=https://www.actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219011000333?idApp=UINPBA000044" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 63 | 40 | 103 |
| 2024 September | 69 | 23 | 92 |
| 2024 August | 95 | 48 | 143 |
| 2024 July | 76 | 29 | 105 |
| 2024 June | 91 | 56 | 147 |
| 2024 May | 75 | 33 | 108 |
| 2024 April | 72 | 25 | 97 |
| 2024 March | 94 | 28 | 122 |
| 2024 February | 86 | 36 | 122 |
| 2024 January | 54 | 32 | 86 |
| 2023 December | 49 | 17 | 66 |
| 2023 November | 74 | 31 | 105 |
| 2023 October | 56 | 23 | 79 |
| 2023 September | 79 | 27 | 106 |
| 2023 August | 55 | 22 | 77 |
| 2023 July | 69 | 39 | 108 |
| 2023 June | 82 | 19 | 101 |
| 2023 May | 82 | 29 | 111 |
| 2023 April | 59 | 22 | 81 |
| 2023 March | 57 | 19 | 76 |
| 2023 February | 58 | 19 | 77 |
| 2023 January | 44 | 37 | 81 |
| 2022 December | 63 | 51 | 114 |
| 2022 November | 36 | 22 | 58 |
| 2022 October | 35 | 16 | 51 |
| 2022 September | 31 | 39 | 70 |
| 2022 August | 18 | 29 | 47 |
| 2022 July | 17 | 32 | 49 |
| 2022 June | 19 | 20 | 39 |
| 2022 May | 41 | 20 | 61 |
| 2022 April | 47 | 38 | 85 |
| 2022 March | 35 | 50 | 85 |
| 2022 February | 24 | 23 | 47 |
| 2022 January | 29 | 39 | 68 |
| 2021 December | 23 | 45 | 68 |
| 2021 November | 22 | 40 | 62 |
| 2021 October | 33 | 46 | 79 |
| 2021 September | 26 | 44 | 70 |
| 2021 August | 25 | 35 | 60 |
| 2021 July | 12 | 34 | 46 |
| 2021 June | 20 | 32 | 52 |
| 2021 May | 37 | 29 | 66 |
| 2021 April | 49 | 41 | 90 |
| 2021 March | 69 | 23 | 92 |
| 2021 February | 66 | 21 | 87 |
| 2021 January | 39 | 16 | 55 |
| 2020 December | 31 | 14 | 45 |
| 2020 November | 23 | 17 | 40 |
| 2020 October | 22 | 7 | 29 |
| 2020 September | 24 | 13 | 37 |
| 2020 August | 22 | 20 | 42 |
| 2020 July | 26 | 12 | 38 |
| 2020 June | 23 | 32 | 55 |
| 2020 May | 22 | 25 | 47 |
| 2020 April | 34 | 16 | 50 |
| 2020 March | 23 | 22 | 45 |
| 2020 February | 5 | 16 | 21 |
| 2020 January | 0 | 10 | 10 |
| 2019 December | 4 | 2 | 6 |
| 2019 September | 4 | 1 | 5 |
| 2019 July | 0 | 2 | 2 |
| 2019 June | 2 | 23 | 25 |
| 2019 May | 0 | 51 | 51 |
| 2019 April | 1 | 17 | 18 |
| 2019 March | 2 | 15 | 17 |
| 2019 February | 0 | 2 | 2 |
| 2019 January | 2 | 1 | 3 |
| 2018 December | 1 | 0 | 1 |
| 2018 November | 1 | 3 | 4 |
| 2018 October | 2 | 0 | 2 |
| 2018 May | 0 | 1 | 1 |
| 2018 April | 0 | 1 | 1 |
| 2018 February | 39 | 6 | 45 |
| 2018 January | 50 | 3 | 53 |
| 2017 December | 58 | 7 | 65 |
| 2017 November | 47 | 3 | 50 |
| 2017 October | 43 | 4 | 47 |
| 2017 September | 33 | 5 | 38 |
| 2017 August | 46 | 7 | 53 |
| 2017 July | 40 | 6 | 46 |
| 2017 June | 54 | 15 | 69 |
| 2017 May | 54 | 6 | 60 |
| 2017 April | 46 | 8 | 54 |
| 2017 March | 40 | 3 | 43 |
| 2017 February | 26 | 10 | 36 |
| 2017 January | 30 | 4 | 34 |
| 2016 December | 55 | 4 | 59 |
| 2016 November | 73 | 6 | 79 |
| 2016 October | 85 | 8 | 93 |
| 2016 September | 56 | 10 | 66 |
| 2016 August | 65 | 11 | 76 |
| 2016 July | 54 | 2 | 56 |
| 2016 June | 9 | 17 | 26 |
| 2016 May | 7 | 10 | 17 |
| 2016 April | 2 | 7 | 9 |
| 2016 March | 6 | 8 | 14 |
| 2016 February | 7 | 10 | 17 |
| 2016 January | 7 | 6 | 13 |
| 2015 December | 7 | 7 | 14 |
| 2015 November | 22 | 10 | 32 |
| 2015 October | 22 | 10 | 32 |
| 2015 September | 21 | 8 | 29 |
| 2015 August | 17 | 5 | 22 |
| 2015 July | 86 | 7 | 93 |
| 2015 June | 58 | 4 | 62 |
| 2015 May | 99 | 16 | 115 |
| 2015 April | 67 | 21 | 88 |
| 2015 March | 50 | 7 | 57 |
| 2015 February | 61 | 9 | 70 |
| 2015 January | 65 | 10 | 75 |
| 2014 December | 53 | 11 | 64 |
| 2014 November | 38 | 10 | 48 |
| 2014 October | 59 | 14 | 73 |
| 2014 September | 48 | 9 | 57 |
| 2014 August | 41 | 13 | 54 |
| 2014 July | 53 | 13 | 66 |
| 2014 June | 64 | 8 | 72 |
| 2014 May | 69 | 12 | 81 |
| 2014 April | 58 | 12 | 70 |
| 2014 March | 62 | 13 | 75 |
| 2014 February | 43 | 15 | 58 |
| 2014 January | 57 | 11 | 68 |
| 2013 December | 48 | 10 | 58 |
| 2013 November | 45 | 21 | 66 |
| 2013 October | 43 | 13 | 56 |
| 2013 September | 31 | 11 | 42 |
| 2013 August | 10 | 5 | 15 |
| 2013 July | 7 | 15 | 22 |
| 2013 June | 10 | 9 | 19 |
| 2013 May | 8 | 8 | 16 |
| 2013 April | 9 | 16 | 25 |
| 2013 March | 12 | 4 | 16 |
| 2013 February | 29 | 5 | 34 |
| 2013 January | 14 | 3 | 17 |
| 2012 December | 9 | 4 | 13 |
| 2012 September | 2 | 0 | 2 |
| 2012 July | 1 | 0 | 1 |
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