array:24 [
  "pii" => "S1578219016301470"
  "issn" => "15782190"
  "doi" => "10.1016/j.adengl.2016.06.016"
  "estado" => "S300"
  "fechaPublicacion" => "2016-09-01"
  "aid" => "1375"
  "copyright" => "Elsevier España, S.L.U. and AEDV"
  "copyrightAnyo" => "2016"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Actas Dermosifiliogr. 2016;107:616-8"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 664
    "formatos" => array:3 [
      "EPUB" => 52
      "HTML" => 461
      "PDF" => 151
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0001731016000958"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2016.01.012"
      "estado" => "S300"
      "fechaPublicacion" => "2016-09-01"
      "aid" => "1375"
      "copyright" => "AEDV"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Actas Dermosifiliogr. 2016;107:616-8"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 427
        "formatos" => array:3 [
          "EPUB" => 2
          "HTML" => 311
          "PDF" => 114
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fico-cl&#237;nica</span>"
        "titulo" => "Valoraci&#243;n inicial del paciente con lesiones cut&#225;neas pigmentadas"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "616"
            "paginaFinal" => "618"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Initial Evaluation of Patients with Pigmented Skin Lesions"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "A&#46; Imbern&#243;n-Moya, S&#46; Podlipnik, J&#46; Malvehy, S&#46; Puig"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Imbern&#243;n-Moya"
              ]
              1 => array:2 [
                "nombre" => "S&#46;"
                "apellidos" => "Podlipnik"
              ]
              2 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "Malvehy"
              ]
              3 => array:2 [
                "nombre" => "S&#46;"
                "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 Espa&#241;a&#44; S&#46;L&#46;U&#46; 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 &#40;Pigmented Dermatofibrosarcoma Protuberans&#41;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "618"
          "paginaFinal" => "620"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Tumor de Bednar &#40;dermatofibrosarcoma protuberans pigmentado&#41;"
        ]
      ]
      "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&#58; A&#44; Proliferation of spindle cells and melanin-containing dendritic cells &#40;hematoxylin-eosin&#44; original magnification &#215;100&#41;&#46; B&#44; Melanin-containing dendritic cells and positive staining for S100 protein &#40;S100&#44; original magnification &#215;200&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "M&#46;J&#46; A&#241;&#243;n-Requena, M&#46; Pico-Valima&#241;a, G&#46; Mu&#241;oz-Arias"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "M&#46;J&#46;"
              "apellidos" => "A&#241;&#243;n-Requena"
            ]
            1 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Pico-Valima&#241;a"
            ]
            2 => array:2 [
              "nombre" => "G&#46;"
              "apellidos" => "Mu&#241;oz-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 Espa&#241;a&#44; S&#46;L&#46;U&#46; 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&#58; 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&#58; una combinaci&#243;n 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&#44; with findings characteristic of a blue nevus &#40;a dermal proliferation of spindle-shaped melanocytes associated with melanophages&#41; and findings corresponding to nevus spilus &#40;a lentiginous proliferation of melanocytes at the dermoepidermal junction and nests of melanocytes with no atypia in the superficial dermis&#41;&#46; Hematoxylin and eosin&#44; original magnification<span class="elsevierStyleHsp" style=""></span>x10&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "D&#46; Ayala, M&#46;D&#46; Ram&#243;n, M&#46; Cabezas, E&#46; Jord&#225;"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "D&#46;"
              "apellidos" => "Ayala"
            ]
            1 => array:2 [
              "nombre" => "M&#46;D&#46;"
              "apellidos" => "Ram&#243;n"
            ]
            2 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Cabezas"
            ]
            3 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Jord&#225;"
            ]
          ]
        ]
      ]
    ]
    "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&#58;</span>"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "616"
        "paginaFinal" => "618"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "A&#46; Imbern&#243;n-Moya, S&#46; Podlipnik, J&#46; Malvehy, S&#46; Puig"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "A&#46;"
            "apellidos" => "Imbern&#243;n-Moya"
            "email" => array:1 [
              0 => "adrian&#95;imber88&#64;hotmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "S&#46;"
            "apellidos" => "Podlipnik"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Malvehy"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "S&#46;"
            "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 Dermatolog&#237;a&#44; Hospital Severo Ochoa&#44; Legan&#233;s&#44; Madrid&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Dermatolog&#237;a&#44; Hospital Cl&#237;nic de Barcelona&#44; Barcelona&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Valoraci&#243;n inicial del paciente con lesiones cut&#225;neas pigmentadas"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The incidence of melanoma has increased significantly in Spain in recent decades&#44; and this tumor is now a public health problem&#46;<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&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1&#8211;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&#44;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4&#8211;9</span></a> but no protocols exist on how to take an appropriate medical history and physical examination&#46; The Australian guideline proposes an initial evaluation to determine the future risk of melanoma &#40;grade B recommendation&#41; looking at various factors&#44; including age&#44; sex&#44; past history of melanoma or nonmelanoma skin cancer&#44; family history of melanoma&#44; number of melanocytic and atypical nevi&#44; skin and hair color&#44; skin phototype&#44; and actinic damage&#46;<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&#44; an exhaustive medical history must be taken to detect the main risk factors &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41; and a complete physical examination performed&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1&#8211;3</span></a> In the literature&#44; we have found no descriptions of a protocol for the initial clinical evaluation of this type of patient&#46; We therefore present our standard approach to the first consultation in the melanoma unit of Hospital Cl&#237;nic in Barcelona&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#8722;</span><p id="par0020" class="elsevierStylePara elsevierViewall">Personal history of drug allergy&#44; drinking and smoking&#44; current and previous occupations&#44; known diseases&#44; surgical history&#44; noncutaneous tumors&#44; and usual medical treatments&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#8722;</span><p id="par0025" class="elsevierStylePara elsevierViewall">Past dermatologic history&#58; known dermatoses&#44; history of skin tumors&#44; dysplastic nevus syndrome&#44; treatments performed&#44; previously excised nevi&#44; and risk classification &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#8722;</span><p id="par0030" class="elsevierStylePara elsevierViewall">Family history of dysplastic nevus syndrome and of skin and other tumors&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#8722;</span><p id="par0035" class="elsevierStylePara elsevierViewall">History of sun exposure&#44; UV protection &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#44; pattern of intermittent or chronic exposure&#44; and time dedicated to outdoor occupational or leisure activities&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">&#8722;</span><p id="par0040" class="elsevierStylePara elsevierViewall">Detailed history of the suspected melanoma lesion<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3&#44;10</span></a>&#58; site&#44; time since onset&#44; presence of a precursor lesion&#44; symptom or sign that prompted consultation&#44; pruritus&#44; pain&#44; bleeding&#44; erosion&#44; ulceration&#44; suppuration&#44; changes in color &#40;multiple shades of dark brown or black&#44; or appearance of various colors&#44; including light brown&#44; dark brown&#44; black&#44; red&#44; blue&#44; gray&#44; and white&#41;&#44; changes in morphology &#40;appearance of irregular margins&#41;&#44; change in size &#40;rapid or continuous growth&#41;&#44; elevation of the lesion&#44; changes in the surrounding skin &#40;erythema&#44; edema&#44; satellite pigmentation&#41;&#44; changes in consistency &#40;softening&#44; friability&#41;&#44; and previous treatment of the lesion&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">&#8722;</span><p id="par0045" class="elsevierStylePara elsevierViewall">Systems review&#58; constitutional&#44; neurologic&#44; otorhinolaryngologic&#44; respiratory&#44; musculoskeletal&#44; hepatic&#44; gastrointestinal&#44; cutaneous&#44; subcutaneous&#44; and lymphatic signs and symptoms&#46;</p></li></ul></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">We also present our standard procedure for complete physical examination&#58;<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">&#8211;</span><p id="par0055" class="elsevierStylePara elsevierViewall">Skin phototype &#40;I-VI&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;3</span></a> race &#40;white&#44; black&#44; yellow&#41;&#44; eye color &#40;green&#44; blue&#44; gray&#44; brown&#44; black&#41;&#44; hair color at 18 years of age &#40;red&#44; fair&#44; brown&#44; black&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">&#8211;</span><p id="par0060" class="elsevierStylePara elsevierViewall">Complete dermatologic examination&#44; including scalp&#44; intertriginous areas&#44; oral&#44; ocular&#44; genital&#44; and anal mucosas&#44; palms&#44; soles&#44; and nails&#46;</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">&#8211;</span><p id="par0065" class="elsevierStylePara elsevierViewall">Presence of freckles&#44; solar elastosis&#44; solar lentigines in sun-exposed areas&#44; actinic keratoses&#44; basal cell carcinoma&#44; and squamous cell carcinoma&#46;</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">&#8211;</span><p id="par0070" class="elsevierStylePara elsevierViewall">Estimation of the total number of acquired melanocytic nevi&#44; whatever their size &#40;&#60;<span class="elsevierStyleHsp" style=""></span>50&#44; 50-100&#44; 100-200&#44; &#62;<span class="elsevierStyleHsp" style=""></span>200&#41;&#46; Evaluation of the number of these lesions and of the clinical type &#40;junctional&#44; compound&#44; intradermal&#41; and size &#40;small&#44; 2-6<span class="elsevierStyleHsp" style=""></span>mm&#59; intermediate&#44; 6-15<span class="elsevierStyleHsp" style=""></span>mm&#59; or large&#44;<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>15<span class="elsevierStyleHsp" style=""></span>mm&#41; on the trunk and on the upper limbs&#46; Evaluation of the number of clinically atypical nevi and presence of congenital nevi&#46;</p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">&#8211;</span><p id="par0075" class="elsevierStylePara elsevierViewall">Description of the suspected lesion&#58; site&#44; diameter&#44; palpation&#44; presence of papules or nodules&#44; size&#44; pigmentation&#44; clinical type&#44; ulceration&#44; areas of regression&#44; adjacent nevi&#46; Physical examination of the regional lymph nodes&#44; presence of hepatomegaly&#44; splenomegaly&#44; and locoregional and&#47;or distant subcutaneous masses or nodules&#46;</p></li><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">&#8211;</span><p id="par0080" class="elsevierStylePara elsevierViewall">Dermoscopic features&#46;</p></li><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">&#8211;</span><p id="par0085" class="elsevierStylePara elsevierViewall">Photographs of the lesions prior to the surgical excision of suspicious skin lesions &#40;essential&#41;&#46;</p></li></ul></p><p id="par0090" class="elsevierStylePara elsevierViewall">In conclusion&#44; 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&#46; Finally&#44; it is essential that we undertake patient education regarding periodic self-examination&#44; the clinical characteristics of melanoma &#40;ABCDE rule and ugly duckling sign&#41;&#44; and appropriate measures of photoprotection&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1&#8211;3&#44;10</span></a></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; Imbern&#243;n-Moya A&#44; Podlipnik S&#44; Malvehy J&#44; Puig S&#46; Valoraci&#243;n inicial del paciente con lesiones cut&#225;neas pigmentadas&#46; Actas Dermosifiliogr&#46; 2016&#59;107&#58;616&#8211;618&#46;</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&nbsp;\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 &#40;&#62; 65 years&#41;<br>Male sex<br>Fair or red hair<br>Blue or green eyes&nbsp;\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&nbsp;\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&nbsp;\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&nbsp;\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&#47;or nonmelanoma skin cancer &#40;basal cell carcinoma&#44; squamous cell carcinoma&#44; actinic keratosis&#41;<br>History of surgical excision of a dysplastic nevus<br>Parkinson disease<br>Acquired or iatrogenic immunosuppression &#40;solid-organ or hematologic tumors&#44; transplant recipients&#44; immunosuppressant treatments&#44; HIV infection&#41;&nbsp;\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&nbsp;\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&nbsp;\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&nbsp;\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&#44; dysplastic nevus syndrome&#44; or other melanoma-associated tumor &#40;pancreas&#44; renal&#44; breast&#44; lung&#44; colon&#44; central nervous system&#41;&nbsp;\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&nbsp;\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 &#40;ABCDE rule&#41;&#46;<br>Dysplastic nevus syndrome &#40;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&#41;&#44; multiple freckles or solar lentigines<br>Giant congenital melanocytic nevus &#40;&#62;<span class="elsevierStyleHsp" style=""></span>20<span class="elsevierStyleHsp" style=""></span>cm&#41;&nbsp;\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&nbsp;\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&#44; MITF&#44; BAP1&#44; CDK4&#44; CDKN2A</span>&#46;<br><span class="elsevierStyleItalic">MC1R</span> gene polymorphism&nbsp;\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&#46;</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&nbsp;\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&nbsp;\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&nbsp;\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&nbsp;\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&nbsp;\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&nbsp;\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&nbsp;\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&nbsp;\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&#46;</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>&#58;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;10 y&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;18 y&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Current&nbsp;\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 &#40;&#62;<span class="elsevierStyleHsp" style=""></span>120<span class="elsevierStyleHsp" style=""></span>h&#47;y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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 &#40;50-120<span class="elsevierStyleHsp" style=""></span>h&#47;y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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 &#40;&#60;<span class="elsevierStyleHsp" style=""></span>50<span class="elsevierStyleHsp" style=""></span>h&#47;y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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 &#40;0<span class="elsevierStyleHsp" style=""></span>h&#47;y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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>&#58;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;10 y&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;18 y&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Current&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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&#47;hardly ever&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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>&#58;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">UV-A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PUV-A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">UV-AB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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 &#40;&#62;<span class="elsevierStyleHsp" style=""></span>40<span class="elsevierStyleHsp" style=""></span>h&#47;y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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 &#40;20-40<span class="elsevierStyleHsp" style=""></span>h&#47;y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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 &#40;&#60;<span class="elsevierStyleHsp" style=""></span>20<span class="elsevierStyleHsp" style=""></span>h&#47;y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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&#47;UV radiation burn</span>&#58; &#40;E&#61; erythema&#46; B&#61; blisters&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;10 y&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;18 y&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Current&nbsp;\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>&#62;<span class="elsevierStyleHsp" style=""></span>5 episodes&#47;year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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&#47;year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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&#47;year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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&#46;</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&#46;e1-599&#46;e12"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Screening&#44; early detection&#44; education&#44; and trends for melanoma&#58; Current status &#40;2007-2013&#41; and future directions&#58; Part I&#46; Epidemiology&#44; high-risk groups&#44; clinical strategies&#44; and diagnostic technology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;E&#46; Mayer"
                            1 => "S&#46;M&#46; Swetter"
                            2 => "T&#46; Fu"
                            3 => "A&#46;C&#46; Geller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2014"
                        "volumen" => "71"
                        "itemHostRev" => array:3 [
                          "pii" => "S0302283812010196"
                          "estado" => "S300"
                          "issn" => "03022838"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multicenter case-control study of risk factors for cutaneous melanoma in Valencia&#44; Spain"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46; Ballester"
                            1 => "V&#46; Oliver"
                            2 => "J&#46; Ba&#241;uls"
                            3 => "M&#46; Morag&#243;n"
                            4 => "F&#46; Valcuende"
                            5 => "R&#46; Botella-Estrada"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ad.2012.01.014"
                      "Revista" => array:7 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2012"
                        "volumen" => "103"
                        "paginaInicial" => "790"
                        "paginaFinal" => "797"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22626452"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1470204510701467"
                          "estado" => "S300"
                          "issn" => "14702045"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous Melanoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46;C&#46; Paek"
                            1 => "A&#46;J&#46; Sober"
                            2 => "H&#46; Tsao"
                            3 => "M&#46;C&#46;JJr&#46; Mihm"
                            4 => "T&#46;M&#46; Johnson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "titulo" => "Fitzpatrick&#39;s Dermatology in General Medicine"
                        "paginaInicial" => "1134"
                        "paginaFinal" => "1143"
                        "edicion" => "7&#46;&#170; ed&#46;"
                        "serieFecha" => "2008"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Australian Cancer Network and New Zealand Guidelines Group&#46; Clinical practice guidelines for the management of melanoma in Australia and New Zealand&#46;"
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "National Comprehensive Cancer Network&#46; NCCN Clinical Practice Guidelines in Oncology &#40;NCCN Guidelines&#41;&#46;"
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnosis and treatment of melanoma&#46; European consensus-based interdisciplinary guideline&#46; Update 2012"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Garbe"
                            1 => "K&#46; Peris"
                            2 => "A&#46; Hauschild"
                            3 => "P&#46; Saiag"
                            4 => "M&#46; Middleton"
                            5 => "A&#46; Spatz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejca.2012.06.013"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur J Cancer"
                        "fecha" => "2012"
                        "volumen" => "48"
                        "paginaInicial" => "2375"
                        "paginaFinal" => "2390"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22981501"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0302283806008475"
                          "estado" => "S300"
                          "issn" => "03022838"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous melanoma&#58; ESMO Clinical Practice Guidelines for diagnosis&#44; treatment and follow-up"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46; Dummer"
                            1 => "A&#46; Hauschild"
                            2 => "M&#46; Guggenheim"
                            3 => "U&#46; Keilholz"
                            4 => "G&#46; Pentheroudakis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/annonc/mdr033"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Oncol"
                        "fecha" => "2012"
                        "volumen" => "23"
                        "paginaInicial" => "86"
                        "paginaFinal" => "91"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21471564"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Malignant melanoma S3-guideline &#8220;diagnosis&#44; therapy and follow-up of melanoma&#8221; &#91;Article in English&#44; German&#93;"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "German Dermatological Society&#59; Dermatologic Cooperative Oncology Group"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Pflugfelder"
                            1 => "C&#46; Kochs"
                            2 => "A&#46; Blum"
                            3 => "M&#46; Capellaro"
                            4 => "C&#46; Czeschik"
                            5 => "T&#46; Dettenborn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dtsch Dermatol Ges"
                        "fecha" => "2013"
                        "volumen" => "11"
                        "numero" => "Suppl 6"
                        "paginaInicial" => "S1"
                        "paginaFinal" => "S116"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines of care for the management of primary cutaneous melanoma&#46; American Academy of Dermatology"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "American Academy of Dermatology"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;K&#46; Bichakjian"
                            1 => "A&#46;C&#46; Halpern"
                            2 => "T&#46;M&#46; Johnson"
                            3 => "A&#46; Foote Hood"
                            4 => "J&#46;M&#46; Grichnik"
                            5 => "S&#46;M&#46; Swetter"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2011.04.031"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2011"
                        "volumen" => "65"
                        "paginaInicial" => "1032"
                        "paginaFinal" => "1047"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21868127"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0959804910009081"
                          "estado" => "S300"
                          "issn" => "09598049"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Initial evaluation&#44; diagnosis&#44; staging&#44; treatment&#44; and follow-up of patients with primary cutaneous malignant melanoma&#46; Consensus statement of the Network of Catalan and Balearic Melanoma Centers &#91;Article in Spanish&#93;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Mangas"
                            1 => "C&#46; Paradelo"
                            2 => "S&#46; Puig"
                            3 => "F&#46; Gallardo"
                            4 => "J&#46; Marcoval"
                            5 => "A&#46; Azon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2010"
                        "volumen" => "101"
                        "paginaInicial" => "129"
                        "paginaFinal" => "142"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20223155"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673612616900"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000010700000007/v2_201704140340/S1578219016301470/v2_201704140340/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/15782190/0000010700000007/v2_201704140340/S1578219016301470/v2_201704140340/en/main.pdf?idApp=UINPBA000044&text.app=https://www.actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219016301470?idApp=UINPBA000044"
]
Share
Journal Information

Statistics

Follow this link to access the full text of the article

Case and Research Letters
Initial Evaluation of Patients with Pigmented Skin Lesions
Valoración inicial del paciente con lesiones cutáneas pigmentadas
A. Imbernón-Moyaa,
Corresponding author
adrian_imber88@hotmail.com

Corresponding author.
, S. Podlipnikb, J. Malvehyb, S. Puigb
a Servicio de Dermatología, Hospital Severo Ochoa, Leganés, Madrid, Spain
b Servicio de Dermatología, Hospital Clínic de Barcelona, Barcelona, Spain
Read
4791
Times
was read the article
1826
Total PDF
2965
Total HTML
Share statistics
 array:24 [
  "pii" => "S1578219016301470"
  "issn" => "15782190"
  "doi" => "10.1016/j.adengl.2016.06.016"
  "estado" => "S300"
  "fechaPublicacion" => "2016-09-01"
  "aid" => "1375"
  "copyright" => "Elsevier Espa&#241;a&#44; S&#46;L&#46;U&#46; and AEDV"
  "copyrightAnyo" => "2016"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "cita" => "Actas Dermosifiliogr. 2016;107:616-8"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 664
    "formatos" => array:3 [
      "EPUB" => 52
      "HTML" => 461
      "PDF" => 151
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:19 [
      "pii" => "S0001731016000958"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2016.01.012"
      "estado" => "S300"
      "fechaPublicacion" => "2016-09-01"
      "aid" => "1375"
      "copyright" => "AEDV"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "cita" => "Actas Dermosifiliogr. 2016;107:616-8"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 427
        "formatos" => array:3 [
          "EPUB" => 2
          "HTML" => 311
          "PDF" => 114
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Carta cient&#237;fico-cl&#237;nica</span>"
        "titulo" => "Valoraci&#243;n inicial del paciente con lesiones cut&#225;neas pigmentadas"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "616"
            "paginaFinal" => "618"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Initial Evaluation of Patients with Pigmented Skin Lesions"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "A&#46; Imbern&#243;n-Moya, S&#46; Podlipnik, J&#46; Malvehy, S&#46; Puig"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "A&#46;"
                "apellidos" => "Imbern&#243;n-Moya"
              ]
              1 => array:2 [
                "nombre" => "S&#46;"
                "apellidos" => "Podlipnik"
              ]
              2 => array:2 [
                "nombre" => "J&#46;"
                "apellidos" => "Malvehy"
              ]
              3 => array:2 [
                "nombre" => "S&#46;"
                "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 Espa&#241;a&#44; S&#46;L&#46;U&#46; 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 &#40;Pigmented Dermatofibrosarcoma Protuberans&#41;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "618"
          "paginaFinal" => "620"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Tumor de Bednar &#40;dermatofibrosarcoma protuberans pigmentado&#41;"
        ]
      ]
      "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&#58; A&#44; Proliferation of spindle cells and melanin-containing dendritic cells &#40;hematoxylin-eosin&#44; original magnification &#215;100&#41;&#46; B&#44; Melanin-containing dendritic cells and positive staining for S100 protein &#40;S100&#44; original magnification &#215;200&#41;&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "M&#46;J&#46; A&#241;&#243;n-Requena, M&#46; Pico-Valima&#241;a, G&#46; Mu&#241;oz-Arias"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "M&#46;J&#46;"
              "apellidos" => "A&#241;&#243;n-Requena"
            ]
            1 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Pico-Valima&#241;a"
            ]
            2 => array:2 [
              "nombre" => "G&#46;"
              "apellidos" => "Mu&#241;oz-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 Espa&#241;a&#44; S&#46;L&#46;U&#46; 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&#58; 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&#58; una combinaci&#243;n 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&#44; with findings characteristic of a blue nevus &#40;a dermal proliferation of spindle-shaped melanocytes associated with melanophages&#41; and findings corresponding to nevus spilus &#40;a lentiginous proliferation of melanocytes at the dermoepidermal junction and nests of melanocytes with no atypia in the superficial dermis&#41;&#46; Hematoxylin and eosin&#44; original magnification<span class="elsevierStyleHsp" style=""></span>x10&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "D&#46; Ayala, M&#46;D&#46; Ram&#243;n, M&#46; Cabezas, E&#46; Jord&#225;"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "D&#46;"
              "apellidos" => "Ayala"
            ]
            1 => array:2 [
              "nombre" => "M&#46;D&#46;"
              "apellidos" => "Ram&#243;n"
            ]
            2 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Cabezas"
            ]
            3 => array:2 [
              "nombre" => "E&#46;"
              "apellidos" => "Jord&#225;"
            ]
          ]
        ]
      ]
    ]
    "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&#58;</span>"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "616"
        "paginaFinal" => "618"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "A&#46; Imbern&#243;n-Moya, S&#46; Podlipnik, J&#46; Malvehy, S&#46; Puig"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "A&#46;"
            "apellidos" => "Imbern&#243;n-Moya"
            "email" => array:1 [
              0 => "adrian&#95;imber88&#64;hotmail&#46;com"
            ]
            "referencia" => array:2 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "aff0005"
              ]
              1 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "S&#46;"
            "apellidos" => "Podlipnik"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "J&#46;"
            "apellidos" => "Malvehy"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "aff0010"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "S&#46;"
            "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 Dermatolog&#237;a&#44; Hospital Severo Ochoa&#44; Legan&#233;s&#44; Madrid&#44; Spain"
            "etiqueta" => "a"
            "identificador" => "aff0005"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Dermatolog&#237;a&#44; Hospital Cl&#237;nic de Barcelona&#44; Barcelona&#44; Spain"
            "etiqueta" => "b"
            "identificador" => "aff0010"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Valoraci&#243;n inicial del paciente con lesiones cut&#225;neas pigmentadas"
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The incidence of melanoma has increased significantly in Spain in recent decades&#44; and this tumor is now a public health problem&#46;<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&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1&#8211;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&#44;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">4&#8211;9</span></a> but no protocols exist on how to take an appropriate medical history and physical examination&#46; The Australian guideline proposes an initial evaluation to determine the future risk of melanoma &#40;grade B recommendation&#41; looking at various factors&#44; including age&#44; sex&#44; past history of melanoma or nonmelanoma skin cancer&#44; family history of melanoma&#44; number of melanocytic and atypical nevi&#44; skin and hair color&#44; skin phototype&#44; and actinic damage&#46;<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&#44; an exhaustive medical history must be taken to detect the main risk factors &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41; and a complete physical examination performed&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1&#8211;3</span></a> In the literature&#44; we have found no descriptions of a protocol for the initial clinical evaluation of this type of patient&#46; We therefore present our standard approach to the first consultation in the melanoma unit of Hospital Cl&#237;nic in Barcelona&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">&#8722;</span><p id="par0020" class="elsevierStylePara elsevierViewall">Personal history of drug allergy&#44; drinking and smoking&#44; current and previous occupations&#44; known diseases&#44; surgical history&#44; noncutaneous tumors&#44; and usual medical treatments&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">&#8722;</span><p id="par0025" class="elsevierStylePara elsevierViewall">Past dermatologic history&#58; known dermatoses&#44; history of skin tumors&#44; dysplastic nevus syndrome&#44; treatments performed&#44; previously excised nevi&#44; and risk classification &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">&#8722;</span><p id="par0030" class="elsevierStylePara elsevierViewall">Family history of dysplastic nevus syndrome and of skin and other tumors&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">&#8722;</span><p id="par0035" class="elsevierStylePara elsevierViewall">History of sun exposure&#44; UV protection &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#44; pattern of intermittent or chronic exposure&#44; and time dedicated to outdoor occupational or leisure activities&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">&#8722;</span><p id="par0040" class="elsevierStylePara elsevierViewall">Detailed history of the suspected melanoma lesion<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">3&#44;10</span></a>&#58; site&#44; time since onset&#44; presence of a precursor lesion&#44; symptom or sign that prompted consultation&#44; pruritus&#44; pain&#44; bleeding&#44; erosion&#44; ulceration&#44; suppuration&#44; changes in color &#40;multiple shades of dark brown or black&#44; or appearance of various colors&#44; including light brown&#44; dark brown&#44; black&#44; red&#44; blue&#44; gray&#44; and white&#41;&#44; changes in morphology &#40;appearance of irregular margins&#41;&#44; change in size &#40;rapid or continuous growth&#41;&#44; elevation of the lesion&#44; changes in the surrounding skin &#40;erythema&#44; edema&#44; satellite pigmentation&#41;&#44; changes in consistency &#40;softening&#44; friability&#41;&#44; and previous treatment of the lesion&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">&#8722;</span><p id="par0045" class="elsevierStylePara elsevierViewall">Systems review&#58; constitutional&#44; neurologic&#44; otorhinolaryngologic&#44; respiratory&#44; musculoskeletal&#44; hepatic&#44; gastrointestinal&#44; cutaneous&#44; subcutaneous&#44; and lymphatic signs and symptoms&#46;</p></li></ul></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">We also present our standard procedure for complete physical examination&#58;<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">&#8211;</span><p id="par0055" class="elsevierStylePara elsevierViewall">Skin phototype &#40;I-VI&#41;&#44;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;3</span></a> race &#40;white&#44; black&#44; yellow&#41;&#44; eye color &#40;green&#44; blue&#44; gray&#44; brown&#44; black&#41;&#44; hair color at 18 years of age &#40;red&#44; fair&#44; brown&#44; black&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">&#8211;</span><p id="par0060" class="elsevierStylePara elsevierViewall">Complete dermatologic examination&#44; including scalp&#44; intertriginous areas&#44; oral&#44; ocular&#44; genital&#44; and anal mucosas&#44; palms&#44; soles&#44; and nails&#46;</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">&#8211;</span><p id="par0065" class="elsevierStylePara elsevierViewall">Presence of freckles&#44; solar elastosis&#44; solar lentigines in sun-exposed areas&#44; actinic keratoses&#44; basal cell carcinoma&#44; and squamous cell carcinoma&#46;</p></li><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">&#8211;</span><p id="par0070" class="elsevierStylePara elsevierViewall">Estimation of the total number of acquired melanocytic nevi&#44; whatever their size &#40;&#60;<span class="elsevierStyleHsp" style=""></span>50&#44; 50-100&#44; 100-200&#44; &#62;<span class="elsevierStyleHsp" style=""></span>200&#41;&#46; Evaluation of the number of these lesions and of the clinical type &#40;junctional&#44; compound&#44; intradermal&#41; and size &#40;small&#44; 2-6<span class="elsevierStyleHsp" style=""></span>mm&#59; intermediate&#44; 6-15<span class="elsevierStyleHsp" style=""></span>mm&#59; or large&#44;<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>15<span class="elsevierStyleHsp" style=""></span>mm&#41; on the trunk and on the upper limbs&#46; Evaluation of the number of clinically atypical nevi and presence of congenital nevi&#46;</p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">&#8211;</span><p id="par0075" class="elsevierStylePara elsevierViewall">Description of the suspected lesion&#58; site&#44; diameter&#44; palpation&#44; presence of papules or nodules&#44; size&#44; pigmentation&#44; clinical type&#44; ulceration&#44; areas of regression&#44; adjacent nevi&#46; Physical examination of the regional lymph nodes&#44; presence of hepatomegaly&#44; splenomegaly&#44; and locoregional and&#47;or distant subcutaneous masses or nodules&#46;</p></li><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">&#8211;</span><p id="par0080" class="elsevierStylePara elsevierViewall">Dermoscopic features&#46;</p></li><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">&#8211;</span><p id="par0085" class="elsevierStylePara elsevierViewall">Photographs of the lesions prior to the surgical excision of suspicious skin lesions &#40;essential&#41;&#46;</p></li></ul></p><p id="par0090" class="elsevierStylePara elsevierViewall">In conclusion&#44; 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&#46; Finally&#44; it is essential that we undertake patient education regarding periodic self-examination&#44; the clinical characteristics of melanoma &#40;ABCDE rule and ugly duckling sign&#41;&#44; and appropriate measures of photoprotection&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1&#8211;3&#44;10</span></a></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; Imbern&#243;n-Moya A&#44; Podlipnik S&#44; Malvehy J&#44; Puig S&#46; Valoraci&#243;n inicial del paciente con lesiones cut&#225;neas pigmentadas&#46; Actas Dermosifiliogr&#46; 2016&#59;107&#58;616&#8211;618&#46;</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&nbsp;\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 &#40;&#62; 65 years&#41;<br>Male sex<br>Fair or red hair<br>Blue or green eyes&nbsp;\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&nbsp;\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&nbsp;\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&nbsp;\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&#47;or nonmelanoma skin cancer &#40;basal cell carcinoma&#44; squamous cell carcinoma&#44; actinic keratosis&#41;<br>History of surgical excision of a dysplastic nevus<br>Parkinson disease<br>Acquired or iatrogenic immunosuppression &#40;solid-organ or hematologic tumors&#44; transplant recipients&#44; immunosuppressant treatments&#44; HIV infection&#41;&nbsp;\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&nbsp;\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&nbsp;\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&nbsp;\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&#44; dysplastic nevus syndrome&#44; or other melanoma-associated tumor &#40;pancreas&#44; renal&#44; breast&#44; lung&#44; colon&#44; central nervous system&#41;&nbsp;\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&nbsp;\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 &#40;ABCDE rule&#41;&#46;<br>Dysplastic nevus syndrome &#40;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&#41;&#44; multiple freckles or solar lentigines<br>Giant congenital melanocytic nevus &#40;&#62;<span class="elsevierStyleHsp" style=""></span>20<span class="elsevierStyleHsp" style=""></span>cm&#41;&nbsp;\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&nbsp;\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&#44; MITF&#44; BAP1&#44; CDK4&#44; CDKN2A</span>&#46;<br><span class="elsevierStyleItalic">MC1R</span> gene polymorphism&nbsp;\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&#46;</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&nbsp;\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&nbsp;\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&nbsp;\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&nbsp;\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&nbsp;\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&nbsp;\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&nbsp;\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&nbsp;\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&#46;</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>&#58;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;10 y&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;18 y&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Current&nbsp;\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 &#40;&#62;<span class="elsevierStyleHsp" style=""></span>120<span class="elsevierStyleHsp" style=""></span>h&#47;y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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 &#40;50-120<span class="elsevierStyleHsp" style=""></span>h&#47;y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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 &#40;&#60;<span class="elsevierStyleHsp" style=""></span>50<span class="elsevierStyleHsp" style=""></span>h&#47;y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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 &#40;0<span class="elsevierStyleHsp" style=""></span>h&#47;y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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>&#58;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;10 y&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;18 y&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Current&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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&#47;hardly ever&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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>&#58;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">UV-A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">PUV-A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">UV-AB&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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 &#40;&#62;<span class="elsevierStyleHsp" style=""></span>40<span class="elsevierStyleHsp" style=""></span>h&#47;y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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 &#40;20-40<span class="elsevierStyleHsp" style=""></span>h&#47;y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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 &#40;&#60;<span class="elsevierStyleHsp" style=""></span>20<span class="elsevierStyleHsp" style=""></span>h&#47;y&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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&#47;UV radiation burn</span>&#58; &#40;E&#61; erythema&#46; B&#61; blisters&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#60;10 y&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">&#62;18 y&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="left" valign="top">Current&nbsp;\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>&#62;<span class="elsevierStyleHsp" style=""></span>5 episodes&#47;year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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&#47;year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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&#47;year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="" valign="top">&nbsp;\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&#46;</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&#46;e1-599&#46;e12"
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Screening&#44; early detection&#44; education&#44; and trends for melanoma&#58; Current status &#40;2007-2013&#41; and future directions&#58; Part I&#46; Epidemiology&#44; high-risk groups&#44; clinical strategies&#44; and diagnostic technology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;E&#46; Mayer"
                            1 => "S&#46;M&#46; Swetter"
                            2 => "T&#46; Fu"
                            3 => "A&#46;C&#46; Geller"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2014"
                        "volumen" => "71"
                        "itemHostRev" => array:3 [
                          "pii" => "S0302283812010196"
                          "estado" => "S300"
                          "issn" => "03022838"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multicenter case-control study of risk factors for cutaneous melanoma in Valencia&#44; Spain"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "I&#46; Ballester"
                            1 => "V&#46; Oliver"
                            2 => "J&#46; Ba&#241;uls"
                            3 => "M&#46; Morag&#243;n"
                            4 => "F&#46; Valcuende"
                            5 => "R&#46; Botella-Estrada"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ad.2012.01.014"
                      "Revista" => array:7 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2012"
                        "volumen" => "103"
                        "paginaInicial" => "790"
                        "paginaFinal" => "797"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22626452"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1470204510701467"
                          "estado" => "S300"
                          "issn" => "14702045"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous Melanoma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "S&#46;C&#46; Paek"
                            1 => "A&#46;J&#46; Sober"
                            2 => "H&#46; Tsao"
                            3 => "M&#46;C&#46;JJr&#46; Mihm"
                            4 => "T&#46;M&#46; Johnson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:5 [
                        "titulo" => "Fitzpatrick&#39;s Dermatology in General Medicine"
                        "paginaInicial" => "1134"
                        "paginaFinal" => "1143"
                        "edicion" => "7&#46;&#170; ed&#46;"
                        "serieFecha" => "2008"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "Australian Cancer Network and New Zealand Guidelines Group&#46; Clinical practice guidelines for the management of melanoma in Australia and New Zealand&#46;"
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "National Comprehensive Cancer Network&#46; NCCN Clinical Practice Guidelines in Oncology &#40;NCCN Guidelines&#41;&#46;"
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Diagnosis and treatment of melanoma&#46; European consensus-based interdisciplinary guideline&#46; Update 2012"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Garbe"
                            1 => "K&#46; Peris"
                            2 => "A&#46; Hauschild"
                            3 => "P&#46; Saiag"
                            4 => "M&#46; Middleton"
                            5 => "A&#46; Spatz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejca.2012.06.013"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur J Cancer"
                        "fecha" => "2012"
                        "volumen" => "48"
                        "paginaInicial" => "2375"
                        "paginaFinal" => "2390"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22981501"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0302283806008475"
                          "estado" => "S300"
                          "issn" => "03022838"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Cutaneous melanoma&#58; ESMO Clinical Practice Guidelines for diagnosis&#44; treatment and follow-up"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "R&#46; Dummer"
                            1 => "A&#46; Hauschild"
                            2 => "M&#46; Guggenheim"
                            3 => "U&#46; Keilholz"
                            4 => "G&#46; Pentheroudakis"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/annonc/mdr033"
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Oncol"
                        "fecha" => "2012"
                        "volumen" => "23"
                        "paginaInicial" => "86"
                        "paginaFinal" => "91"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21471564"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Malignant melanoma S3-guideline &#8220;diagnosis&#44; therapy and follow-up of melanoma&#8221; &#91;Article in English&#44; German&#93;"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "German Dermatological Society&#59; Dermatologic Cooperative Oncology Group"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "A&#46; Pflugfelder"
                            1 => "C&#46; Kochs"
                            2 => "A&#46; Blum"
                            3 => "M&#46; Capellaro"
                            4 => "C&#46; Czeschik"
                            5 => "T&#46; Dettenborn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dtsch Dermatol Ges"
                        "fecha" => "2013"
                        "volumen" => "11"
                        "numero" => "Suppl 6"
                        "paginaInicial" => "S1"
                        "paginaFinal" => "S116"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Guidelines of care for the management of primary cutaneous melanoma&#46; American Academy of Dermatology"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "American Academy of Dermatology"
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46;K&#46; Bichakjian"
                            1 => "A&#46;C&#46; Halpern"
                            2 => "T&#46;M&#46; Johnson"
                            3 => "A&#46; Foote Hood"
                            4 => "J&#46;M&#46; Grichnik"
                            5 => "S&#46;M&#46; Swetter"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaad.2011.04.031"
                      "Revista" => array:7 [
                        "tituloSerie" => "J Am Acad Dermatol"
                        "fecha" => "2011"
                        "volumen" => "65"
                        "paginaInicial" => "1032"
                        "paginaFinal" => "1047"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21868127"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0959804910009081"
                          "estado" => "S300"
                          "issn" => "09598049"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Initial evaluation&#44; diagnosis&#44; staging&#44; treatment&#44; and follow-up of patients with primary cutaneous malignant melanoma&#46; Consensus statement of the Network of Catalan and Balearic Melanoma Centers &#91;Article in Spanish&#93;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "C&#46; Mangas"
                            1 => "C&#46; Paradelo"
                            2 => "S&#46; Puig"
                            3 => "F&#46; Gallardo"
                            4 => "J&#46; Marcoval"
                            5 => "A&#46; Azon"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:7 [
                        "tituloSerie" => "Actas Dermosifiliogr"
                        "fecha" => "2010"
                        "volumen" => "101"
                        "paginaInicial" => "129"
                        "paginaFinal" => "142"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20223155"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S0140673612616900"
                          "estado" => "S300"
                          "issn" => "01406736"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000010700000007/v2_201704140340/S1578219016301470/v2_201704140340/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/15782190/0000010700000007/v2_201704140340/S1578219016301470/v2_201704140340/en/main.pdf?idApp=UINPBA000044&text.app=https://www.actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219016301470?idApp=UINPBA000044"
]
Article information
ISSN: 15782190
Original language: English
The statistics are updated each day
Year/Month Html Pdf 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
Show all

Follow this link to access the full text of the article

Idiomas
Actas Dermo-Sifiliográficas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?