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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Introducci&#243;n</span><p id="par0005" class="elsevierStylePara elsevierViewall">La psoriasis es una de las dermatosis inflamatorias cr&#243;nicas m&#225;s frecuentes&#44; con una prevalencia en adultos de 0&#44;14-1&#44;92&#37; a nivel mundial&#59; siendo esta m&#225;s alta en los pa&#237;ses europeos&#44; de 1&#44;83-1&#44;92&#37;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">1</span></a>&#44; as&#237; como en Espa&#241;a&#44; de 2&#44;3&#37;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">2</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Tanto por cl&#237;nica&#44; distribuci&#243;n topogr&#225;fica y sintomatolog&#237;a &#8211;en particular en las formas de psoriasis eccematosas y de localizaci&#243;n palmoplantar&#8211; a menudo se plantea el diagn&#243;stico diferencial o la asociaci&#243;n con el eccema de contacto al&#233;rgico &#40;ECA&#41;&#44; circunstancia que justifica la realizaci&#243;n de pruebas epicut&#225;neas &#40;PE&#41; como un procedimiento frecuente en el circuito diagn&#243;stico<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">La descripci&#243;n de los pacientes con psoriasis en los que se realizan PE para descartar ECA podr&#237;a permitir mejorar el conocimiento de este perfil de sujetos y plantear estrategias de optimizaci&#243;n en el diagn&#243;stico y el manejo&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">El objetivo de este estudio es describir el perfil epidemiol&#243;gico&#44; cl&#237;nico y al&#233;rgico de los pacientes con diagn&#243;stico de psoriasis sometidos a PE&#44; y comparar a aquellos con el diagn&#243;stico primario o secundario de psoriasis frente a los que no lo recibieron&#46; Concretamente&#44; se ha analizado este perfil con respecto a los sujetos que presentan un diagn&#243;stico de ECA al final del circuito diagn&#243;stico&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Material y m&#233;todos</span><p id="par0025" class="elsevierStylePara elsevierViewall">Se ha realizado un an&#225;lisis a partir de los datos del Registro Espa&#241;ol de Dermatitis de Contacto &#40;REIDAC&#41;&#44; un registro multic&#233;ntrico nacional prospectivo de pacientes que se someten a pruebas de parche&#46; Para ello&#44; se incluyeron todos aquellos registrados desde el primero de junio de 2018 hasta el 31 de enero de 2023&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">El REIDAC es un registro centralizado desarrollado por el Grupo Espa&#241;ol de Investigaci&#243;n en Dermatitis de Contacto y Alergia Cut&#225;nea &#40;GEIDAC&#41; junto con la Unidad de Investigaci&#243;n de la Fundaci&#243;n Piel Sana y la Academia Espa&#241;ola de Dermatolog&#237;a y Venereolog&#237;a &#40;AEDV&#41; que agrupa las principales Unidades de Dermatitis de Contacto de Espa&#241;a&#46; En el registro se recogieron de forma sucesiva las variables epidemiol&#243;gicas&#44; cl&#237;nicas y al&#233;rgicas de los pacientes a los que se les realizaron PE en los centros incluidos<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">4</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">En este estudio&#44; las variables recogidas fueron sexo&#44; edad&#44; localizaciones afectas&#44; antecedente personal de dermatitis at&#243;pica u otras comorbilidades at&#243;picas &#40;asma&#44; rinoconjuntivitis&#41;&#44; profesi&#243;n&#44; asociaci&#243;n a factores laborales&#44; duraci&#243;n de los s&#237;ntomas&#44; resultados de las PE con la bater&#237;a espa&#241;ola 2022 &#40;positividad&#44; grado de intensidad&#41; y diagn&#243;stico principal&#47;secundario&#46; Se atribuy&#243; como ECA a los pacientes que estaban registrados como &#171;ECA exclusivo&#187;&#44; &#171;ECA predominante&#187; o &#171;ECA contribuyente&#187;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Las pruebas se realizaron seg&#250;n las recomendaciones de la <span class="elsevierStyleItalic">European Society of Contact Dermatitis</span> &#40;ESCD&#41;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">5</span></a>&#46; En el REIDAC&#44; el estudio del ECA se efect&#250;a mediante la bater&#237;a est&#225;ndar espa&#241;ola y aquellas bater&#237;as complementarias y productos propios del paciente seg&#250;n el criterio cl&#237;nico<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">6</span></a>&#46; En este estudio solo se consideraron los datos procedentes de la bater&#237;a est&#225;ndar del GEIDAC&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Los pacientes incluidos se dividieron en tres grupos&#58; aquellos con diagn&#243;stico principal&#47;secundario de psoriasis&#44; los sujetos con diagn&#243;stico de ECA y&#44; finalmente los que recibieron ambos diagn&#243;sticos al final de la evaluaci&#243;n&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Se realiz&#243; un an&#225;lisis descriptivo y se compar&#243; el &#237;ndice MOAHLFAp de los grupos mediante la prueba de <span class="elsevierStyleItalic">X</span><span class="elsevierStyleSup"><span class="elsevierStyleItalic">2</span></span>&#46; El &#237;ndice MOAHLFAp es un acr&#243;nimo que hace referencia a las iniciales en ingl&#233;s de M&#58; male&#44; O&#58; occupational dermatitis&#44; A&#58; atopic dermatitis&#44; H&#58; hand&#44; L&#58; leg&#44; F&#58; face&#44; A&#58; age &#62; 40&#44; y p&#58; positivity rate &#40;&#8805; 1 positive reaction&#41;&#46; Este &#237;ndice permite evaluar y comparar de forma r&#225;pida las caracter&#237;sticas demogr&#225;ficas de la poblaci&#243;n evaluada&#46; Para el an&#225;lisis de los datos se utiliz&#243; el paquete estad&#237;stico Stata 17 &#40;Stata Corp&#46; 2021 Stata Statistical Software&#58; Release 17&#46; College Station&#44; TX&#58; StataCorp LLC&#46; Texas&#44; EE&#46;UU&#46;&#41;&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Resultados</span><p id="par0055" class="elsevierStylePara elsevierViewall">Durante el periodo de estudio se realizaron PE a 11&#46;502 pacientes&#44; de los cuales 513 &#40;4&#44;5&#37;&#41; recibieron el diagn&#243;stico principal o secundario de psoriasis&#44; 3&#46;640 &#40;31&#44;6&#37;&#41; el diagn&#243;stico de ECA y 108 &#40;0&#44;9&#37;&#41; ambos simult&#225;neamente &#40;psoriasis<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ECA&#41;&#46; En total se incluyeron 2&#46;972 &#40;70&#37;&#41; mujeres&#44; 11&#44;7&#37; de las cuales ten&#237;an psoriasis o psoriasis<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ECA&#44; y 1&#46;288 &#40;30&#37;&#41; varones&#44; 21&#44;2&#37; de ellos con psoriasis o psoriasis<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ECA&#46; De los pacientes incluidos&#44; n 2&#44;5&#37; compart&#237;an ambos diagn&#243;sticos&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> muestra las caracter&#237;sticas epidemiol&#243;gicas de los pacientes con psoriasis y psoriasis<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ECA respecto al grupo control &#40;ECA como &#250;nico diagn&#243;stico&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">En las <a class="elsevierStyleCrossRefs" href="#tbl0010">tablas 2-4</a> se comparan los &#237;ndices MOAHLFAp de los grupos con psoriasis y psoriasis<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ECA con los del grupo con ECA&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Los pacientes del grupo con psoriasis &#250;nicamente&#44; respecto al conjunto con ECA&#44; tuvieron mayor edad media y una mayor duraci&#243;n de los s&#237;ntomas de forma previa a la realizaci&#243;n de las PE&#46; Destacaba&#44; adem&#225;s&#44; una mayor proporci&#243;n de varones respecto al grupo control &#40;45 vs&#46; 28&#37; en ECA&#59; p &#60; 0&#44;001&#41;&#46; En cuanto a la localizaci&#243;n de las lesiones&#44; pudo comprobarse un alto porcentaje de afectaci&#243;n de las manos en los pacientes con psoriasis &#40;63 vs&#46; 33&#37; en ECA&#59; p &#60; 0&#44;001&#41;&#44; as&#237; como una menor afectaci&#243;n de la regi&#243;n facial &#40;5 vs&#46; 23&#37; en ECA&#59; p &#60; 0&#44;001&#41;&#44; un menor n&#250;mero de comorbilidades at&#243;picas y menor frecuencia de los antecedentes laborales como desencadenantes &#40;3 vs&#46; 18&#37; en ECA&#59; p &#60; 0&#44;001&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">El grupo de psoriasis<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ECA present&#243;&#44; en global&#44; unas caracter&#237;sticas basales muy similares a los pacientes del grupo con psoriasis&#44; con una mayor proporci&#243;n de varones y escaso contexto at&#243;pico &#40;aunque ambos no estad&#237;sticamente significativos&#44; s&#237; se observ&#243; esta tendencia&#41;&#44; una mayor proporci&#243;n de pacientes mayores de 40 a&#241;os &#40;84 vs&#46; 67&#37; en ECA&#59; p &#60; 0&#44;001&#41;&#44; as&#237; como una mayor afectaci&#243;n de manos &#40;67 vs&#46; 33&#37; en ECA&#59; p &#60; 0&#44;001&#41; y menor afectaci&#243;n facial &#40;10 vs&#46; 23&#37; en ECA&#59; p &#60; 0&#44;01&#41;&#46; No obstante&#44; a diferencia del grupo &#250;nicamente con psoriasis&#44; s&#237; present&#243; una mayor proporci&#243;n de factores laborales como desencadenantes &#40;22 vs&#46; 3&#37; en psoriasis&#59; p &#60; 0&#44;001&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">El tiempo medio desde la aparici&#243;n de las lesiones hasta la valoraci&#243;n fue de 24 meses en los pacientes &#250;nicamente con psoriasis y de 12 meses en los grupos con ECA y psoriasis<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ECA&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">Los antecedentes laborales de los pacientes parcheados se describen en la <a class="elsevierStyleCrossRef" href="#tbl0025">tabla 5</a>&#46; No se encontraron diferencias por profesiones entre los grupos estudiados&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">El porcentaje de positividades de la bater&#237;a espa&#241;ola 2022 en las PE fue significativamente menor en los pacientes &#250;nicamente con psoriasis&#58; 27&#37; &#40;139&#41; presentaron positividad para al menos un al&#233;rgeno&#44; en comparaci&#243;n con 81&#37; &#40;2&#46;959 pacientes&#41; en el grupo con ECA &#40;p &#60; 0&#44;01&#41;&#44; y 80&#37; en el grupo con psoriasis<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ECA &#40;p &#60; 0&#44;001&#41;&#46; Analizando de forma conjunta el grupo con psoriasis y el de psoriasis<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ECA&#44; se deduce un porcentaje global de positividades de la bater&#237;a est&#225;ndar&#44; de todos los pacientes con psoriasis parcheados&#44; de 36&#44;2&#37; &#40;225&#41;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">En la <a class="elsevierStyleCrossRef" href="#tbl0030">tabla 6</a> se muestra la bater&#237;a completa de al&#233;rgenos y sus positividades de los tres grupos&#46;</p><elsevierMultimedia ident="tbl0030"></elsevierMultimedia><p id="par0100" class="elsevierStylePara elsevierViewall">Los al&#233;rgenos de la serie est&#225;ndar detectados con mayor frecuencia en los pacientes con psoriasis fueron el sulfato de n&#237;quel &#40;15&#44;5&#37;&#41;&#44; el cloruro de cobalto y la parafenilendiamina &#40;ambos 2&#44;2&#37;&#41;&#44; hidroper&#243;xidos de linalool &#40;1&#44;8&#37;&#41;&#44; el b&#225;lsamo de Per&#250; &#40;1&#44;8&#37;&#41;&#44; el dicromato pot&#225;sico &#40;1&#44;6&#37;&#41;&#44; la metilcloroisotiazolinona&#47;metilisotiazolinona &#40;1&#44;4&#37;&#41;&#44; mezcla de fragancias II &#40;1&#44;28&#37;&#41; y metilisotiazolinona &#40;1&#44;1&#37;&#41;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">En el caso de los pacientes con psoriasis<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ECA&#44; los al&#233;rgenos detectados con mayor frecuencia fueron el sulfato de n&#237;quel &#40;34&#44;3&#37;&#41;&#44; la metilisotiazolinona &#40;12&#37;&#41; y la metilcloroisotiazolinona&#47;metilisotiazolinona &#40;11&#44;2&#37;&#41;&#44; 2-HEMA &#40;2-hidroxietil metacrilato&#41; &#40;9&#44;2&#37;&#41;&#44; el dicromato pot&#225;sico &#40;8&#44;3&#37;&#41;&#44; hidroper&#243;xidos de linalool &#40;7&#44;5&#37;&#41;&#44; el b&#225;lsamo de Per&#250; y la mezcla de tiuranes &#40;ambos 7&#44;4&#37;&#41;&#44; la mezcla de carbas &#40;6&#44;6&#37;&#41; y el cloruro de cobalto&#44; as&#237; como la parafenilendiamina &#40;ambos 6&#44;5&#37;&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Discusi&#243;n</span><p id="par0110" class="elsevierStylePara elsevierViewall">Presentamos el perfil epidemiol&#243;gico&#44; cl&#237;nico y al&#233;rgico de los pacientes con psoriasis parcheados&#44; compar&#225;ndolos con aquellos con ECA como grupo control&#46; Los resultados evidencian que los grupos con psoriasis y con psoriasis<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ECA presentan un perfil cl&#237;nico y epidemiol&#243;gico muy similar entre s&#237;&#44; con una mayor proporci&#243;n de varones &#40;respecto al global de pacientes parcheados en el REIDAC&#41; y de sujetos mayores de 40 a&#241;os&#44; con lesiones predominantemente en las manos &#40;63 y 67&#37;&#44; respectivamente&#41;&#44; y escasos antecedentes at&#243;picos asociados&#46; Consideramos que puede tratarse de un perfil concreto de pacientes en los que el motivo de consulta plantea el diagn&#243;stico diferencial entre el eccema de manos y la psoriasis palmoplantar&#44; y que lleva a la realizaci&#243;n de PE dentro del circuito diagn&#243;stico&#46; Los resultados de nuestro estudio sugieren que muchas de estas personas con afectaci&#243;n palmar ser&#225;n&#44; de hecho&#44; consideradas psori&#225;sicas al final del circuito diagn&#243;stico&#59; teniendo en cuenta que solo 2&#44;5&#37; de los pacientes incluidos en el estudio recibieron ambos diagn&#243;sticos &#40;psoriasis<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ECA&#41; simult&#225;neamente&#44; y que las PE con la bater&#237;a est&#225;ndar fueron negativas en 73&#37; de los del grupo con psoriasis&#44; en comparaci&#243;n con 19&#37; del grupo con diagn&#243;stico &#250;nicamente de ECA&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Del mismo modo&#44; en el grupo con diagn&#243;stico &#250;nico de psoriasis&#160;debe destacarse la menor relaci&#243;n del motivo de consulta con antecedentes profesionales con respecto a aquellos con ECA o psoriasis<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ECA&#44; a pesar de haber una mayor afectaci&#243;n de las manos&#44; circunstancia relevante en la consideraci&#243;n de la enfermedad como laboral o no y con implicaciones econ&#243;micas&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">La relaci&#243;n entre psoriasis y ECA ha sido objeto de debate&#44; y la evidencia en la literatura actual sigue siendo limitada y heterog&#233;nea<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">7&#8211;14</span></a>&#46; En general&#44; la psoriasis no es una indicaci&#243;n de realizaci&#243;n de PE&#46; No obstante&#44; este procedimiento puede ser de ayuda en el diagn&#243;stico diferencial en algunos grupos seleccionados como en la psoriasis palmoplantar&#44; especialmente ante lesiones persistentes y resistentes al tratamiento&#44; o pacientes con psoriasis tratados con biol&#243;gicos que presenten lesiones cut&#225;neas cl&#237;nicamente sugestivas de dermatitis de contacto<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">3&#44;14&#8211;16</span></a>&#46; De todos modos&#44; es importante conocer que la asociaci&#243;n entre ECA y psoriasis es posible&#44; independientemente de la controversia sobre si el ECA es realmente m&#225;s o menos probable en pacientes con psoriasis<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">3&#44;9&#44;10&#44;12&#44;17&#44;18</span></a>&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Nuestros datos muestran 27&#37; de positividades de la bater&#237;a espa&#241;ola en el grupo &#250;nicamente con psoriasis y 36&#44;2&#37; de positividades si consideramos de forma conjunta los grupos con psoriasis y psoriasis<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ECA&#44; resultados coherentes con el trabajo de Silverberg et al&#46;&#44; donde aproximadamente un tercio de los sujetos con psoriasis presentaron positividad para al menos un al&#233;rgeno en las PE &#40;32&#44;7 vs&#46; 57&#44;8&#37; en el resto de los pacientes parcheados&#41;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">17</span></a>&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Esta observaci&#243;n podr&#237;a tener relaci&#243;n con el hecho de que&#44; en el grupo de pacientes con psoriasis&#44; las PE se realizan con vistas a descartar la existencia de un ECA concomitante o subyacente como parte del proceso diagn&#243;stico&#44; aun cuando se considere la psoriasis como la opci&#243;n m&#225;s probable en muchos casos&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Son escasos los estudios que describen la asociaci&#243;n entre psoriasis y ECA&#44; as&#237; como las caracter&#237;sticas de estos pacientes a partir de poblaciones amplias y representativas de &#225;mbitos geogr&#225;ficos y laborales diferentes&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Dos estudios de la d&#233;cada de los 90 estimaron una prevalencia de ECA en pacientes con psoriasis vulgar en 20-27&#37;<a class="elsevierStyleCrossRefs" href="#bib0130"><span class="elsevierStyleSup">7&#44;8</span></a>&#46; No obstante&#44; estudios posteriores mostraron resultados dispares<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">3&#44;9&#8211;14</span></a>&#46; En 2018&#44; un estudio retrospectivo observacional de 30 a&#241;os describi&#243; unas tasas de ECA similares entre el grupo de pacientes con psoriasis y el de control<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">18</span></a>&#46; M&#225;s recientemente&#44; el Grupo Americano de Dermatitis de Contacto revis&#243; su experiencia cl&#237;nica de 2001-2016&#44; describiendo una menor proporci&#243;n de ECA en pacientes con diagn&#243;stico principal o secundario de psoriasis en comparaci&#243;n con aquellos sin esta patolog&#237;a &#40;32&#44;7 vs&#46; 57&#44;8&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">17</span></a>&#46; Por otro lado&#44; algunos autores defienden que los pacientes con psoriasis palmoplantar podr&#237;an tener una mayor proporci&#243;n de ECA con respecto a aquellos con psoriasis vulgar sin afectaci&#243;n palmoplantar&#44; sugiriendo el posible papel de la hipersensibilidad de contacto como factor desencadenante o agravante en este subgrupo&#44; as&#237; como a una mayor resistencia al tratamiento<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">3&#44;13&#44;15&#44;16</span></a>&#46; Vale la pena subrayar que este &#250;ltimo subgrupo fue&#44; precisamente&#44; destacado en nuestra serie&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Pocos estudios analizan el perfil de al&#233;rgenos espec&#237;fico en los pacientes con psoriasis<a class="elsevierStyleCrossRefs" href="#bib0110"><span class="elsevierStyleSup">3&#44;11&#44;12&#44;17&#8211;19</span></a>&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">En nuestro estudio&#44; en el perfil de positividades de los pacientes &#250;nicamente con psoriasis destaca la positividad para el sulfato de n&#237;quel &#40;15&#44;5&#37; en psoriasis vs&#46; 33&#44;9&#37; en ECA&#41; y una menor positividad en conservantes&#47;liberadores de formaldeh&#237;do&#47;perfumes&#44; aunque cabe destacar que el n&#250;mero de pacientes con psoriasis en cada caso es peque&#241;o&#46; Sin embargo&#44; en su conjunto&#44; los al&#233;rgenos m&#225;s comunes encontrados fueron tambi&#233;n los m&#225;s habituales en la poblaci&#243;n general con ECA&#44; aunque todos los al&#233;rgenos fueron positivos con menos frecuencia en los pacientes con psoriasis&#46; Por otro lado&#44; los que ten&#237;an psoriasis<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ECA presentaron un perfil de positividades superponible a aquellos con ECA&#44; tanto en el tipo de al&#233;rgeno como en su frecuencia&#46; Estos hallazgos coinciden con los descritos en tres estudios retrospectivos m&#225;s recientes basados en poblaciones amplias<a class="elsevierStyleCrossRefs" href="#bib0165"><span class="elsevierStyleSup">14&#44;17&#44;18</span></a>&#46; Debe tenerse en cuenta que en el presente estudio solo se consideraron los al&#233;rgenos incluidos en la bater&#237;a est&#225;ndar del GEIDAC&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">Cabe destacar que existen ciertas limitaciones en este estudio&#46; La primera es el sesgo en la selecci&#243;n de la muestra&#44; pues solo se han tenido en cuenta aquellos pacientes cuyo motivo de consulta ha impulsado a realizar PE&#46; En segundo lugar&#44; en los grupos de psoriasis solo se incluyeron aquellos pacientes en los que constaba la psoriasis como diagn&#243;stico principal o secundario en el REIDAC&#44; ya que el registro de los antecedentes de psoriasis no se incluye como variable en este &#250;ltimo&#46; Por otro lado&#44; puede haber una sobrerrepresentaci&#243;n del subgrupo de psoriasis con afectaci&#243;n palmoplantar en comparaci&#243;n con otros tipos de psoriasis&#44; dado que en muchas ocasiones en este subgrupo se realizan PE para el diagn&#243;stico diferencial con el eccema de manos&#46; Por todo esto&#44; si bien el trabajo muestra la poblaci&#243;n estudiada mediante PE&#44; los resultados no ser&#237;an generalizables a todos los pacientes con psoriasis&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Debe considerarse que los centros participantes pertenecen al Sistema Nacional de Salud&#44; por lo que se excluyen muchos pacientes del &#225;mbito laboral valorados por las mutuas laborales&#44; lo cual puede condicionar los resultados en cuanto a la exposici&#243;n laboral&#46; Finalmente&#44; solo se incluyeron los al&#233;rgenos que se abordan en la bater&#237;a est&#225;ndar del GEIDAC&#46; Este hecho puede explicar el porcentaje de negatividades descrito en los grupos con ECA y psoriasis<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ECA&#44; que podr&#237;a deberse al hecho de que se trate de pacientes con al menos una positividad para un al&#233;rgeno no presente en la bater&#237;a est&#225;ndar&#44; y que&#44; por tanto&#44; no haya sido incluido en este an&#225;lisis&#46; Aunque este hecho permite una homogeneidad entre los centros participantes&#44; puede limitar la identificaci&#243;n de la sensibilizaci&#243;n a al&#233;rgenos emergentes en los grupos en estudio&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conclusi&#243;n</span><p id="par0165" class="elsevierStylePara elsevierViewall">Se presenta la caracterizaci&#243;n de los pacientes parcheados en el REIDAC con diagn&#243;stico de psoriasis&#46; Se observa que 2&#44;5&#37; de estos comparten ambos diagn&#243;sticos&#44; psoriasis<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ECA&#44; de forma simult&#225;nea&#46; De todos los sujetos con diagn&#243;stico de psoriasis&#44; 36&#44;2&#37; presentan positividad para al menos un al&#233;rgeno&#44; demostrando que esta asociaci&#243;n no es infrecuente&#46; En global&#44; los pacientes con psoriasis tienen una mayor edad media&#44; una proporci&#243;n mayor de varones y mayor afectaci&#243;n de las manos&#44; con respecto al conjunto de ECA&#46; El grupo &#250;nicamente con psoriasis presenta&#44; adem&#225;s&#44; menor sospecha laboral y menor porcentaje de positividades &#40;27&#37;&#41;&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">El perfil de sensibilizaci&#243;n fue similar en los grupos con psoriasis respecto a los pacientes con ECA&#44; destacando la positividad para el sulfato de n&#237;quel como al&#233;rgeno m&#225;s frecuente&#46; Los resultados de este estudio permiten plantear&#44; como objetivo plausible&#44; determinar en qu&#233; medida la sensibilizaci&#243;n de contacto encontrada en los pacientes con psoriasis&#44; pudiera influir en la expresi&#243;n cl&#237;nica de la propia psoriasis&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Financiaci&#243;n</span><p id="par0175" class="elsevierStylePara elsevierViewall">El REIDAC es un proyecto de la Academia Espa&#241;ola de Dermatolog&#237;a &#40;AEDV&#41; &#47; Fundaci&#243;n Piel Sana&#46; Actualmente el REIDAC cuenta con la financiaci&#243;n del Ministerio de Sanidad de Espa&#241;a a trav&#233;s de un convenio con la Agencia Espa&#241;ola de Medicamentos Productos Sanitarios &#40;AEMPS&#41;&#46; El REIDAC acepta donaciones no condicionadas por la industria farmac&#233;utica&#46; Las empresas colaboradoras no participan&#44; ni han participado&#44; en la creaci&#243;n o gesti&#243;n del proyecto&#46; La recopilaci&#243;n&#44; gesti&#243;n&#44; an&#225;lisis&#44; interpretaci&#243;n&#44; publicaci&#243;n y revisi&#243;n de los datos generados en el REIDAC es independiente de las fuentes de financiaci&#243;n p&#250;blicas y privadas del proyecto&#46; El REIDAC actualmente recibe apoyo financiero de Sanofi&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Conflicto de intereses</span><p id="par0180" class="elsevierStylePara elsevierViewall">A&#46;M&#46; Gim&#233;nez-Arnau tiene conflictos en relaci&#243;n con asesor&#237;as&#44; becas o conferencias impartidas con las siguientes compa&#241;&#237;as&#58; Almirall&#44; Amgen&#44; AstraZeneca&#44; Avene&#44; Celldex&#44; Escient Pharmaceutials&#44; Genentech&#44; GSK&#44; Instituto Carlos III-FEDER&#44; Leo Pharma&#44; Menarini&#44; Mitsubishi Tanabe Pharma&#44; Novartis&#44; Sanofi&#8211;Regeneron&#44; Servier&#44; Thermo Fisher Scientific y Uriach Pharma&#47;Neucor&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">El resto de los autores declaran no tener ning&#250;n conflicto de inter&#233;s&#46;</p></span></span>"
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        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Antecedentes</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La psoriasis es una dermatosis inflamatoria cr&#243;nica en la que&#44; por cl&#237;nica y distribuci&#243;n topogr&#225;fica&#44; a menudo se plantea el diagn&#243;stico diferencial o la asociaci&#243;n con el eccema de contacto al&#233;rgico &#40;ECA&#41;&#44; circunstancia que lleva a la realizaci&#243;n de pruebas epicut&#225;neas &#40;PE&#41;&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Objetivos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Describir el perfil epidemiol&#243;gico&#44; cl&#237;nico y al&#233;rgico de los pacientes con diagn&#243;stico primario o secundario de psoriasis sometidos a PE&#44; y compararlos con aquellos con diagn&#243;stico de ECA al final del circuito diagn&#243;stico&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">M&#233;todos</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Estudio transversal a partir de los datos del Registro Espa&#241;ol de Dermatitis de Contacto &#40;REIDAC&#41;&#44; entre 2018-2023&#44; seleccionando los pacientes con diagn&#243;stico de psoriasis y&#47;o ECA&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Resultados</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 11&#46;502 pacientes&#44; de los cuales 513 presentaron el diagn&#243;stico principal o secundario de psoriasis&#44; 3&#46;640 el de ECA y 108 fueron registrados con ambos diagn&#243;sticos&#46; Los grupos con psoriasis&#44; y psoriasis y ECA simult&#225;neamente&#44; presentaron una mayor proporci&#243;n de varones&#44; con lesiones predominantemente en las manos y escasa asociaci&#243;n con comorbilidades at&#243;picas&#44; respecto al grupo con ECA&#46; El porcentaje de positividades en las PE con la bater&#237;a espa&#241;ola 2022 fue menor en los sujetos del grupo &#250;nicamente con psoriasis &#40;27&#37; de ellos&#41;&#46; Los al&#233;rgenos m&#225;s comunes en los pacientes con psoriasis fueron tambi&#233;n los m&#225;s habituales en la poblaci&#243;n general con ECA&#46;</p></span> <span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">En su conjunto&#44; 36&#44;2&#37; de los pacientes con psoriasis present&#243; positividades en las PE con la bater&#237;a espa&#241;ola 2022&#46; Aquellos con esta enfermedad mostraron mayor edad media&#44; una proporci&#243;n mayor de varones y mayor afectaci&#243;n de las manos&#44; respecto al grupo con ECA&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Antecedentes"
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          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Objetivos"
          ]
          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "M&#233;todos"
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          3 => array:2 [
            "identificador" => "abst0020"
            "titulo" => "Resultados"
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          4 => array:2 [
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            "titulo" => "Conclusiones"
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      "en" => array:3 [
        "titulo" => "Abstract"
        "resumen" => "<span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Background</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Psoriasis is a chronic inflammatory dermatosis whose clinical and topographic distribution requires differential diagnosis&#44; or the possible association with allergic contact dermatitis &#40;ACD&#41;&#44; requiring patch testing &#40;PT&#41; as part of the diagnostic procedure&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Objectives</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">To describe the epidemiological&#44; clinical&#44; and allergic profile of patients with a primary or secondary diagnosis of psoriasis undergoing PT and compare them with patients with a diagnosis of ACD at the end of the diagnostic process&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Methods</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Cross-sectional study with data from REIDAC from 2018 through 2023 of selected patients with a diagnosis of psoriasis and&#47;or ACD&#46;</p></span> <span id="abst0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Results</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">A total of 11 502 patients were included&#44; 513 of whom had been diagnosed with primary or secondary psoriasis&#44; 3640 with ACD&#44; and 108 with both diseases&#46; Men were more predominant in the groups of patients with psoriasis&#44; psoriasis<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ACD&#44; and lesions were more predominantly seen in the hands with little association with atopic factors vs the ACD group&#46; The rate of positivity in PT to the 2022 Spanish battery of allergens was lower in the group with psoriasis only in 27&#37; of the patients&#46; The most common allergens found in the psoriasis group were also the most common ones found in the overall ACD population&#46;</p></span> <span id="abst0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Overall&#44; 36&#46;2&#37; of psoriatic patients tested positive in PT to the 2022 Spanish battery of allergens&#44; which proved that this association is not uncommon&#46; Overall&#44; psoriatic patients had a higher mean age&#44; were more predominantly men&#44; and showed more hand involvement&#46;</p></span>"
        "secciones" => array:5 [
          0 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Background"
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          1 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Objectives"
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          2 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Methods"
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          3 => array:2 [
            "identificador" => "abst0045"
            "titulo" => "Results"
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          4 => array:2 [
            "identificador" => "abst0050"
            "titulo" => "Conclusions"
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          "leyenda" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">ECA&#58; eccema de contacto al&#233;rgico&#59; PSO&#58; psoriasis&#59; DE&#58; desviaci&#243;n est&#225;ndar&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;640&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#46;015&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">597&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">634&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;39 &#40;0&#44;22-0&#44;71&#41; <a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cara &#40;F&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;841&#41; 23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;27&#41; 5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;19 &#40;0&#44;12-0&#44;27&#41; <a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad &#62;<span class="elsevierStyleHsp" style=""></span>40 &#40;A&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;2&#46;425&#41; 67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;411&#41; 80&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&#44;01 &#40;1&#44;60-2&#44;53&#41; <a class="elsevierStyleCrossRef" href="#tblfn0005">&#42;</a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Al menos un al&#233;rgeno positivo &#40;p&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;09 &#40;0&#44;07-0&#44;11&#41;<a class="elsevierStyleCrossRef" href="#tblfn0010">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
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          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">ECA&#58; eccema de contacto al&#233;rgico&#59; IC&#58; intervalo de confianza&#59; OR&#58; <span class="elsevierStyleItalic">odds ratio</span>&#59; PSO&#58; psoriasis&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">ECA &#40;n&#41; &#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">PSO<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>ECA &#40;n&#41;&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">OR &#40;IC 95&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Hombres &#40;M&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;1&#46;015&#41; 28&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;40&#41; 37&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#44;52 &#40;1&#44;02-2&#44;26&#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="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;597&#41; 18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;23&#41; 22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;42 &#40;0&#44;89-2&#44;28&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dermatitis at&#243;pica &#40;A&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;567&#41; 16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;9&#41; 8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;50 &#40;0&#44;25-0&#44;99&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Manos &#40;H&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;1&#46;196&#41; 33&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;72&#41; 67&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;07 &#40;2&#44;71-6&#44;11&#41; <a class="elsevierStyleCrossRef" href="#tblfn0015">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;209&#41; 6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;1&#41; 1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;15 &#40;0&#44;02-1&#44;10&#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="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cara &#40;F&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#40;841&#41; 23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;11&#41; 10&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;38 &#40;0&#44;20-0&#44;71&#41;<a class="elsevierStyleCrossRef" href="#tblfn0020">&#42;&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Edad &#62;<span class="elsevierStyleHsp" style=""></span>40 &#40;A&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;2&#46;425&#41; 67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#40;91&#41; 84&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;65 &#40;1&#44;57-4&#44;46&#41; <a class="elsevierStyleCrossRef" href="#tblfn0015">&#42;</a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Al menos un al&#233;rgeno positivo &#40;p&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&#40;2&#46;959&#41; 81&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#40;86&#41; 80&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;90 &#40;0&#44;56-1&#44;45&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#40;23&#41; 22&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">614&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Estudiante&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">345&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ama&#47;o de casa&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&nbsp;\t\t\t\t\t\t\n
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                  """
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