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"apellidos" => "Puig" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219016301470" "doi" => "10.1016/j.adengl.2016.06.016" "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/S1578219016301470?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731016000958?idApp=UINPBA000044" "url" => "/00017310/0000010700000007/v2_201609150132/S0001731016000958/v2_201609150132/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S1578219016301482" "issn" => "15782190" "doi" => "10.1016/j.adengl.2016.06.017" "estado" => "S300" "fechaPublicacion" => "2016-09-01" "aid" => "1345" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2016;107:618-20" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1048 "formatos" => array:3 [ "EPUB" => 36 "HTML" => 825 "PDF" => 187 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Bednar Tumor (Pigmented Dermatofibrosarcoma Protuberans)" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "618" "paginaFinal" => "620" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tumor de Bednar (dermatofibrosarcoma protuberans pigmentado)" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 967 "Ancho" => 1504 "Tamanyo" => 546219 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Histopathology: A, Proliferation of spindle cells and melanin-containing dendritic cells (hematoxylin-eosin, original magnification ×100). B, Melanin-containing dendritic cells and positive staining for S100 protein (S100, original magnification ×200).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.J. Añón-Requena, M. Pico-Valimaña, G. Muñoz-Arias" "autores" => array:3 [ 0 => array:2 [ "nombre" => "M.J." "apellidos" => "Añón-Requena" ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Pico-Valimaña" ] 2 => array:2 [ "nombre" => "G." "apellidos" => "Muñoz-Arias" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S000173101600017X" "doi" => "10.1016/j.ad.2015.10.017" "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/S000173101600017X?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219016301482?idApp=UINPBA000044" "url" => "/15782190/0000010700000007/v2_201704140340/S1578219016301482/v2_201704140340/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1578219016301469" "issn" => "15782190" "doi" => "10.1016/j.adengl.2016.06.015" "estado" => "S300" "fechaPublicacion" => "2016-09-01" "aid" => "1376" "copyright" => "Elsevier España, S.L.U. and AEDV" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2016;107:614-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1057 "formatos" => array:3 [ "EPUB" => 43 "HTML" => 822 "PDF" => 192 ] ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Nevus <span class="elsevierStyleItalic">Spilus</span> Associated With Agminated Blue Nevus: A Rare Combination" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "614" "paginaFinal" => "616" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Nevo <span class="elsevierStyleItalic">spilus</span> asociado a nevus azul agminado: una combinación infrecuente" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 686 "Ancho" => 975 "Tamanyo" => 224334 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Histopathology revealed a combined lesion, with findings characteristic of a blue nevus (a dermal proliferation of spindle-shaped melanocytes associated with melanophages) and findings corresponding to nevus spilus (a lentiginous proliferation of melanocytes at the dermoepidermal junction and nests of melanocytes with no atypia in the superficial dermis). Hematoxylin and eosin, original magnification<span class="elsevierStyleHsp" style=""></span>x10.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "D. Ayala, M.D. Ramón, M. Cabezas, E. Jordá" "autores" => array:4 [ 0 => array:2 [ "nombre" => "D." "apellidos" => "Ayala" ] 1 => array:2 [ "nombre" => "M.D." "apellidos" => "Ramón" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Cabezas" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Jordá" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S000173101600096X" "doi" => "10.1016/j.ad.2016.01.013" "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/S000173101600096X?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219016301469?idApp=UINPBA000044" "url" => "/15782190/0000010700000007/v2_201704140340/S1578219016301469/v2_201704140340/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>" "titulo" => "Initial Evaluation of Patients with Pigmented Skin Lesions" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor:</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "616" "paginaFinal" => "618" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A. Imbernón-Moya, S. Podlipnik, J. Malvehy, S. Puig" "autores" => array:4 [ 0 => array:4 [ "nombre" => "A." "apellidos" => "Imbernón-Moya" "email" => array:1 [ 0 => "adrian_imber88@hotmail.com" ] "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" => "S." "apellidos" => "Podlipnik" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "J." "apellidos" => "Malvehy" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "S." "apellidos" => "Puig" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Severo Ochoa, Leganés, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital Clínic de Barcelona, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Valoración inicial del paciente con lesiones cutáneas pigmentadas" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The incidence of melanoma has increased significantly in Spain in recent decades, and this tumor is now a public health problem.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> The role of the dermatologist is fundamental to the identification of high-risk patients and to the adoption of appropriate primary and secondary preventive measures for the early detection of skin cancer.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1–3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Several well-standardized international clinical guidelines have been drawn up on the management of patients with melanoma,<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4–9</span></a> but no protocols exist on how to take an appropriate medical history and physical examination. The Australian guideline proposes an initial evaluation to determine the future risk of melanoma (grade B recommendation) looking at various factors, including age, sex, past history of melanoma or nonmelanoma skin cancer, family history of melanoma, number of melanocytic and atypical nevi, skin and hair color, skin phototype, and actinic damage.<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">When a patient attends dermatology outpatients for an initial clinical evaluation of a nevus or suspected melanoma, an exhaustive medical history must be taken to detect the main risk factors (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) and a complete physical examination performed.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1–3</span></a> In the literature, we have found no descriptions of a protocol for the initial clinical evaluation of this type of patient. We therefore present our standard approach to the first consultation in the melanoma unit of Hospital Clínic in Barcelona:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">−</span><p id="par0020" class="elsevierStylePara elsevierViewall">Personal history of drug allergy, drinking and smoking, current and previous occupations, known diseases, surgical history, noncutaneous tumors, and usual medical treatments.</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">−</span><p id="par0025" class="elsevierStylePara elsevierViewall">Past dermatologic history: known dermatoses, history of skin tumors, dysplastic nevus syndrome, treatments performed, previously excised nevi, and risk classification (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">−</span><p id="par0030" class="elsevierStylePara elsevierViewall">Family history of dysplastic nevus syndrome and of skin and other tumors.</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">−</span><p id="par0035" class="elsevierStylePara elsevierViewall">History of sun exposure, UV protection (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>), pattern of intermittent or chronic exposure, and time dedicated to outdoor occupational or leisure activities.</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">−</span><p id="par0040" class="elsevierStylePara elsevierViewall">Detailed history of the suspected melanoma lesion<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3,10</span></a>: site, time since onset, presence of a precursor lesion, symptom or sign that prompted consultation, pruritus, pain, bleeding, erosion, ulceration, suppuration, changes in color (multiple shades of dark brown or black, or appearance of various colors, including light brown, dark brown, black, red, blue, gray, and white), changes in morphology (appearance of irregular margins), change in size (rapid or continuous growth), elevation of the lesion, changes in the surrounding skin (erythema, edema, satellite pigmentation), changes in consistency (softening, friability), and previous treatment of the lesion.</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">−</span><p id="par0045" class="elsevierStylePara elsevierViewall">Systems review: constitutional, neurologic, otorhinolaryngologic, respiratory, musculoskeletal, hepatic, gastrointestinal, cutaneous, subcutaneous, and lymphatic signs and symptoms.</p></li></ul></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">We also present our standard procedure for complete physical examination:<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">–</span><p id="par0055" class="elsevierStylePara elsevierViewall">Skin phototype (I-VI),<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2,3</span></a> race (white, black, yellow), eye color (green, blue, gray, brown, black), hair color at 18 years of age (red, fair, brown, black).</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">–</span><p id="par0060" class="elsevierStylePara elsevierViewall">Complete dermatologic examination, including scalp, intertriginous areas, oral, ocular, genital, and anal mucosas, palms, soles, and nails.</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">–</span><p id="par0065" class="elsevierStylePara elsevierViewall">Presence of freckles, solar elastosis, solar lentigines in sun-exposed areas, actinic keratoses, basal cell carcinoma, and squamous cell carcinoma.</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">–</span><p id="par0070" class="elsevierStylePara elsevierViewall">Estimation of the total number of acquired melanocytic nevi, whatever their size (<<span class="elsevierStyleHsp" style=""></span>50, 50-100, 100-200, ><span class="elsevierStyleHsp" style=""></span>200). Evaluation of the number of these lesions and of the clinical type (junctional, compound, intradermal) and size (small, 2-6<span class="elsevierStyleHsp" style=""></span>mm; intermediate, 6-15<span class="elsevierStyleHsp" style=""></span>mm; or large,<span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>15<span class="elsevierStyleHsp" style=""></span>mm) on the trunk and on the upper limbs. Evaluation of the number of clinically atypical nevi and presence of congenital nevi.</p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">–</span><p id="par0075" class="elsevierStylePara elsevierViewall">Description of the suspected lesion: site, diameter, palpation, presence of papules or nodules, size, pigmentation, clinical type, ulceration, areas of regression, adjacent nevi. Physical examination of the regional lymph nodes, presence of hepatomegaly, splenomegaly, and locoregional and/or distant subcutaneous masses or nodules.</p></li><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">–</span><p id="par0080" class="elsevierStylePara elsevierViewall">Dermoscopic features.</p></li><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">–</span><p id="par0085" class="elsevierStylePara elsevierViewall">Photographs of the lesions prior to the surgical excision of suspicious skin lesions (essential).</p></li></ul></p><p id="par0090" class="elsevierStylePara elsevierViewall">In conclusion, the objective of this article has been to present the guideline used in our center for the initial clinical evaluation of nevi or suspected melanoma in the hope that it will help dermatologists evaluating patients with such lesions. Finally, it is essential that we undertake patient education regarding periodic self-examination, the clinical characteristics of melanoma (ABCDE rule and ugly duckling sign), and appropriate measures of photoprotection.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1–3,10</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Imbernón-Moya A, Podlipnik S, Malvehy J, Puig S. Valoración inicial del paciente con lesiones cutáneas pigmentadas. Actas Dermosifiliogr. 2016;107:616–618.</p>" ] ] "multimedia" => array:3 [ 0 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "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=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Phenotype \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">White race<br>Fitzpatrick phototypes I and II<br>Advanced age (> 65 years)<br>Male sex<br>Fair or red hair<br>Blue or green eyes \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">External factors \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Prolonged and intense sun exposure<br>Sunburn in childhood<br>Artificial UV-A tanning beds<br>Residence in equatorial countries \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Past history \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Past history of melanoma and/or nonmelanoma skin cancer (basal cell carcinoma, squamous cell carcinoma, actinic keratosis)<br>History of surgical excision of a dysplastic nevus<br>Parkinson disease<br>Acquired or iatrogenic immunosuppression (solid-organ or hematologic tumors, transplant recipients, immunosuppressant treatments, HIV infection) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Genetic syndromes \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Albinism<br>Xeroderma pigmentosum \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Family history \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">First or second degree relative with a history of melanoma, dysplastic nevus syndrome, or other melanoma-associated tumor (pancreas, renal, breast, lung, colon, central nervous system) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Clinical characteristics of the patient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">More than 100 clinically typical or more than 5 clinically atypical acquired melanocytic nevi (ABCDE rule).<br>Dysplastic nevus syndrome (more than 100 acquired melanocytic nevi with 1 or more larger than 6<span class="elsevierStyleHsp" style=""></span>mm and 1 or more with histology of dysplastic nevus), multiple freckles or solar lentigines<br>Giant congenital melanocytic nevus (><span class="elsevierStyleHsp" style=""></span>20<span class="elsevierStyleHsp" style=""></span>cm) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Genetic factors \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Mutations in genes <span class="elsevierStyleItalic">BRAF, MITF, BAP1, CDK4, CDKN2A</span>.<br><span class="elsevierStyleItalic">MC1R</span> gene polymorphism \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1393461.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Main Risk Factors for Melanoma.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "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=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No history of melanoma \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Personal past history of melanoma \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">First or second degree relative with melanoma \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Personal past history of 2 or more melanomas or personal or family history of melanoma \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1393462.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Classification of Risk of Melanoma.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "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=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Cumulative sun exposure</span>: \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><10 y \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10-18 y \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">>18 y \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Current \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Intense (><span class="elsevierStyleHsp" style=""></span>120<span class="elsevierStyleHsp" style=""></span>h/y) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Moderate (50-120<span class="elsevierStyleHsp" style=""></span>h/y) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mild (<<span class="elsevierStyleHsp" style=""></span>50<span class="elsevierStyleHsp" style=""></span>h/y) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>None (0<span class="elsevierStyleHsp" style=""></span>h/y) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Adequate sun protection</span>: \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><10 y \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10-18 y \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">>18 y \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Current \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Always \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Usually \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Occasionally \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Never/hardly ever \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Level of exposure to artificial UV</span>: \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">UV-A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">PUV-A \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">UV-AB \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Intense (><span class="elsevierStyleHsp" style=""></span>40<span class="elsevierStyleHsp" style=""></span>h/y) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Moderate (20-40<span class="elsevierStyleHsp" style=""></span>h/y) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>Mild (<<span class="elsevierStyleHsp" style=""></span>20<span class="elsevierStyleHsp" style=""></span>h/y) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " colspan="5" align="left" valign="top"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleItalic">Sunburn/UV radiation burn</span>: (E= erythema. B= blisters) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top"><10 y \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10-18 y \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">>18 y \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Current \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>><span class="elsevierStyleHsp" style=""></span>5 episodes/year \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>3-5 episodes/year \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>1-3 episodes/year \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top"><span class="elsevierStyleHsp" style=""></span>None \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab1393460.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Clinical Data to Be Considered in the History of Sun Exposure.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:3 [ "comentario" => "599.e1-599.e12" "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Screening, early detection, education, and trends for melanoma: Current status (2007-2013) and future directions: Part I. 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Year/Month | Html | Total | |
---|---|---|---|
2024 October | 89 | 43 | 132 |
2024 September | 73 | 38 | 111 |
2024 August | 106 | 52 | 158 |
2024 July | 88 | 37 | 125 |
2024 June | 99 | 32 | 131 |
2024 May | 69 | 31 | 100 |
2024 April | 72 | 27 | 99 |
2024 March | 61 | 29 | 90 |
2024 February | 69 | 30 | 99 |
2024 January | 53 | 32 | 85 |
2023 December | 65 | 32 | 97 |
2023 November | 88 | 31 | 119 |
2023 October | 89 | 28 | 117 |
2023 September | 51 | 32 | 83 |
2023 August | 40 | 19 | 59 |
2023 July | 44 | 29 | 73 |
2023 June | 34 | 22 | 56 |
2023 May | 46 | 34 | 80 |
2023 April | 39 | 26 | 65 |
2023 March | 24 | 25 | 49 |
2023 February | 30 | 25 | 55 |
2023 January | 38 | 24 | 62 |
2022 December | 37 | 43 | 80 |
2022 November | 13 | 28 | 41 |
2022 October | 60 | 18 | 78 |
2022 September | 22 | 33 | 55 |
2022 August | 41 | 30 | 71 |
2022 July | 26 | 32 | 58 |
2022 June | 22 | 22 | 44 |
2022 May | 25 | 32 | 57 |
2022 April | 36 | 38 | 74 |
2022 March | 39 | 36 | 75 |
2022 February | 33 | 25 | 58 |
2022 January | 32 | 35 | 67 |
2021 December | 25 | 42 | 67 |
2021 November | 37 | 38 | 75 |
2021 October | 32 | 43 | 75 |
2021 September | 30 | 39 | 69 |
2021 August | 34 | 32 | 66 |
2021 July | 28 | 23 | 51 |
2021 June | 23 | 33 | 56 |
2021 May | 38 | 46 | 84 |
2021 April | 75 | 56 | 131 |
2021 March | 58 | 38 | 96 |
2021 February | 49 | 29 | 78 |
2021 January | 33 | 12 | 45 |
2020 December | 23 | 17 | 40 |
2020 November | 26 | 29 | 55 |
2020 October | 34 | 10 | 44 |
2020 September | 34 | 19 | 53 |
2020 August | 26 | 14 | 40 |
2020 July | 23 | 20 | 43 |
2020 June | 36 | 31 | 67 |
2020 May | 24 | 18 | 42 |
2020 April | 28 | 16 | 44 |
2020 March | 34 | 20 | 54 |
2020 February | 3 | 0 | 3 |
2020 January | 4 | 0 | 4 |
2019 December | 4 | 0 | 4 |
2019 November | 3 | 0 | 3 |
2019 August | 4 | 0 | 4 |
2019 July | 4 | 0 | 4 |
2019 June | 4 | 0 | 4 |
2019 May | 5 | 0 | 5 |
2019 April | 2 | 2 | 4 |
2019 March | 2 | 1 | 3 |
2019 January | 3 | 0 | 3 |
2018 November | 1 | 0 | 1 |
2018 October | 3 | 0 | 3 |
2018 September | 1 | 0 | 1 |
2018 February | 11 | 3 | 14 |
2018 January | 18 | 8 | 26 |
2017 December | 26 | 8 | 34 |
2017 November | 23 | 7 | 30 |
2017 October | 30 | 8 | 38 |
2017 September | 29 | 8 | 37 |
2017 August | 35 | 6 | 41 |
2017 July | 22 | 10 | 32 |
2017 June | 34 | 4 | 38 |
2017 May | 23 | 8 | 31 |
2017 April | 23 | 8 | 31 |
2017 March | 12 | 3 | 15 |
2017 February | 20 | 7 | 27 |
2017 January | 16 | 4 | 20 |
2016 December | 40 | 20 | 60 |
2016 November | 25 | 12 | 37 |
2016 October | 32 | 23 | 55 |
2016 September | 0 | 1 | 1 |