array:23 [
  "pii" => "S266627522400078X"
  "issn" => "26662752"
  "doi" => "10.1016/j.abdp.2024.04.016"
  "estado" => "S300"
  "fechaPublicacion" => "2024-07-01"
  "aid" => "947"
  "copyright" => "Sociedade Brasileira de Dermatologia"
  "copyrightAnyo" => "2024"
  "documento" => "simple-article"
  "crossmark" => 1
  "subdocumento" => "crp"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "en" => array:18 [
      "pii" => "S036505962400076X"
      "issn" => "03650596"
      "doi" => "10.1016/j.abd.2023.07.014"
      "estado" => "S300"
      "fechaPublicacion" => "2024-07-01"
      "aid" => "947"
      "copyright" => "Sociedade Brasileira de Dermatologia"
      "documento" => "simple-article"
      "crossmark" => 1
      "subdocumento" => "crp"
      "abierto" => array:3 [
        "ES" => false
        "ES2" => false
        "LATM" => false
      ]
      "gratuito" => false
      "lecturas" => array:1 [
        "total" => 0
      ]
      "en" => array:10 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">Letter - Research</span>"
        "titulo" => "Erythroderma&#58; clinical and etiological study of 88 cases seen in a tertiary hospital over 25 years"
        "tienePdf" => "en"
        "tieneTextoCompleto" => "en"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "584"
            "paginaFinal" => "587"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "en" => true
        ]
        "contienePdf" => array:1 [
          "en" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:8 [
            "identificador" => "fig0005"
            "etiqueta" => "Figure 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 921
                "Ancho" => 2925
                "Tamanyo" => 209291
              ]
            ]
            "detalles" => array:1 [
              0 => array:3 [
                "identificador" => "at0005"
                "detalle" => "Figure "
                "rol" => "short"
              ]
            ]
            "descripcion" => array:1 [
              "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Scatter plot depicting ages in the dermatosis and drug reactions groups&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "Rog&#233;rio Nabor Kondo, Betina Samesima e Singh, Milene Cripa Pizatto de Ara&#250;jo, Vict&#243;ria Prud&#234;ncio Ferreira, Jessica Almeida Marani, Airton dos Santos Gon"
            "autores" => array:6 [
              0 => array:2 [
                "nombre" => "Rog&#233;rio Nabor"
                "apellidos" => "Kondo"
              ]
              1 => array:2 [
                "nombre" => "Betina"
                "apellidos" => "Samesima e Singh"
              ]
              2 => array:2 [
                "nombre" => "Milene Cripa Pizatto de"
                "apellidos" => "Ara&#250;jo"
              ]
              3 => array:2 [
                "nombre" => "Vict&#243;ria Prud&#234;ncio"
                "apellidos" => "Ferreira"
              ]
              4 => array:2 [
                "nombre" => "Jessica Almeida"
                "apellidos" => "Marani"
              ]
              5 => array:2 [
                "nombre" => "Airton dos Santos"
                "apellidos" => "Gon"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "en"
      "Traduccion" => array:1 [
        "pt" => array:9 [
          "pii" => "S2666275224001346"
          "doi" => "10.1016/j.abdp.2024.05.025"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => false
            "ES2" => false
            "LATM" => false
          ]
          "gratuito" => false
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "pt"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275224001346?idApp=UINPBA00008Z"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S036505962400076X?idApp=UINPBA00008Z"
      "url" => "/03650596/0000009900000004/v2_202407191005/S036505962400076X/v2_202407191005/en/main.assets"
    ]
  ]
  "itemSiguiente" => array:17 [
    "pii" => "S2666275224000742"
    "issn" => "26662752"
    "doi" => "10.1016/j.abdp.2024.04.012"
    "estado" => "S300"
    "fechaPublicacion" => "2024-07-01"
    "aid" => "942"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "pt" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Cartas &#8208; Investiga&#231;&#227;o</span>"
      "titulo" => "Insulina inibe o crescimento tumoral de melanoma pela express&#227;o do fator 4 ativador da transcri&#231;&#227;o&#44; sem express&#227;o detect&#225;vel de fator de transcri&#231;&#227;o&#44; CHOP&#58; modelo <span class="elsevierStyleItalic">in vivo</span>"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "587"
          "paginaFinal" => "591"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figura 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 2153
              "Ancho" => 3341
              "Tamanyo" => 729289
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">An&#225;lise imuno&#8208;histoqu&#237;mica da express&#227;o do F4AT e do FTCHOP&#46; Os tecidos obtidos a partir de material tumoral dos grupos controle &#40;A e C&#41; e 4 UI&#47;kg &#40;B e D&#41; foram avaliados a partir da express&#227;o imuno&#8208;histoqu&#237;mica de suas prote&#237;nas&#46; As fotografias foram obtidas pelo microsc&#243;pio Axiolab 5 microscopy &#40;Zeiss&#41; e analisadas com o programa ImageJ FIJI software&#46; Os grupos controle e 4 UI&#47;kg foram escolhidos para representar os extremos de dose&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Daniel do Prado, Marianna Boia&#8208;Ferreia, Hanna Camara da Justa, Andrea Senff&#8208;Ribeiro, S&#233;rgio Lunardon Padilha"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Daniel"
              "apellidos" => "do Prado"
            ]
            1 => array:2 [
              "nombre" => "Marianna"
              "apellidos" => "Boia&#8208;Ferreia"
            ]
            2 => array:2 [
              "nombre" => "Hanna Camara"
              "apellidos" => "da Justa"
            ]
            3 => array:2 [
              "nombre" => "Andrea"
              "apellidos" => "Senff&#8208;Ribeiro"
            ]
            4 => array:2 [
              "nombre" => "S&#233;rgio Lunardon"
              "apellidos" => "Padilha"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0365059624000710"
        "doi" => "10.1016/j.abd.2023.07.012"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059624000710?idApp=UINPBA00008Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275224000742?idApp=UINPBA00008Z"
    "url" => "/26662752/0000009900000004/v1_202406100414/S2666275224000742/v1_202406100414/pt/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S2666275224000687"
    "issn" => "26662752"
    "doi" => "10.1016/j.abdp.2024.04.006"
    "estado" => "S300"
    "fechaPublicacion" => "2024-07-01"
    "aid" => "936"
    "copyright" => "Sociedade Brasileira de Dermatologia"
    "documento" => "simple-article"
    "crossmark" => 1
    "subdocumento" => "crp"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:1 [
      "total" => 0
    ]
    "pt" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Cartas &#8208; Investiga&#231;&#227;o</span>"
      "titulo" => "Efic&#225;cia do minoxidil t&#243;pico a 5&#37; <span class="elsevierStyleItalic">versus</span> 5 mg de biotina oral <span class="elsevierStyleItalic">versus</span> minoxidil t&#243;pico e biotina oral no crescimento capilar em homens&#58; ensaio cl&#237;nico randomizado&#44; cruzado"
      "tienePdf" => "pt"
      "tieneTextoCompleto" => "pt"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "581"
          "paginaFinal" => "584"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "pt" => true
      ]
      "contienePdf" => array:1 [
        "pt" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0010"
          "etiqueta" => "Figura 2"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr2.jpeg"
              "Alto" => 1453
              "Ancho" => 2091
              "Tamanyo" => 224995
            ]
          ]
          "descripcion" => array:1 [
            "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Medida do comprimento das hastes capilares analisado antes &#40;A&#41; e ap&#243;s &#40;B&#41; 36 horas para obter velocidade de crescimento capilar&#46; &#42;Foram medidas dez hastes individuais em cada imagem&#44; para cada interven&#231;&#227;o&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Fl&#225;via de Oliveira Valentim, Anna Carolina Miola, H&#233;lio Amante Miot, Juliano Vilaverde Schmitt"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "Fl&#225;via de Oliveira"
              "apellidos" => "Valentim"
            ]
            1 => array:2 [
              "nombre" => "Anna Carolina"
              "apellidos" => "Miola"
            ]
            2 => array:2 [
              "nombre" => "H&#233;lio Amante"
              "apellidos" => "Miot"
            ]
            3 => array:2 [
              "nombre" => "Juliano Vilaverde"
              "apellidos" => "Schmitt"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "pt"
    "Traduccion" => array:1 [
      "en" => array:9 [
        "pii" => "S0365059624000655"
        "doi" => "10.1016/j.abd.2023.07.008"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => false
          "ES2" => false
          "LATM" => false
        ]
        "gratuito" => false
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "en"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059624000655?idApp=UINPBA00008Z"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275224000687?idApp=UINPBA00008Z"
    "url" => "/26662752/0000009900000004/v1_202406100414/S2666275224000687/v1_202406100414/pt/main.assets"
  ]
  "pt" => array:17 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Cartas &#8208; Investiga&#231;&#227;o</span>"
    "titulo" => "Eritrodermia esfoliativa&#58; estudo cl&#237;nico e etiol&#243;gico de 88 casos atendidos em hospital terci&#225;rio durante 25 anos"
    "tieneTextoCompleto" => true
    "saludo" => "<span class="elsevierStyleItalic">Prezado Editor&#44;</span>"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "584"
        "paginaFinal" => "587"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Rog&#233;rio Nabor Kondo, Betina Samesima e Singh, Milene Cripa Pizatto de Ara&#250;jo, Vict&#243;ria Prud&#234;ncio Ferreira, Jessica Almeida Marani, Airton dos Santos Gon"
        "autores" => array:6 [
          0 => array:4 [
            "nombre" => "Rog&#233;rio Nabor"
            "apellidos" => "Kondo"
            "email" => array:1 [
              0 => "kondo.dermato@gmail.com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">&#42;</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "Betina"
            "apellidos" => "Samesima e Singh"
          ]
          2 => array:2 [
            "nombre" => "Milene Cripa Pizatto de"
            "apellidos" => "Ara&#250;jo"
          ]
          3 => array:2 [
            "nombre" => "Vict&#243;ria Prud&#234;ncio"
            "apellidos" => "Ferreira"
          ]
          4 => array:2 [
            "nombre" => "Jessica Almeida"
            "apellidos" => "Marani"
          ]
          5 => array:2 [
            "nombre" => "Airton dos Santos"
            "apellidos" => "Gon"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Departamento de Cl&#237;nica M&#233;dica&#44; Universidade Estadual de Londrina&#44; Londrina&#44; PR&#44; Brasil"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Autor para correspond&#234;ncia&#46;"
          ]
        ]
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 463
            "Ancho" => 1450
            "Tamanyo" => 76237
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Gr&#225;fico de dispers&#227;o entre as idades do grupo de dermatoses e farmacodermia&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Eritrodermia esfoliativa &#40;EE&#41;&#44; dermatite esfoliativa ou&#44; simplesmente&#44; eritrodermia&#44; primeiramente descrita por Von Hebra em 1868&#44; &#233; dist&#250;rbio raro em que ocorre eritema e descama&#231;&#227;o envolvendo mais que 90&#37; da superf&#237;cie corp&#243;rea&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Estudos pr&#233;vios mostraram que a principal etiologia estava relacionada ao grupo de dermatoses preexistentes &#40;ou subjacentes&#41;&#44; seguido por medicamentos e&#44; menos comumente&#44; &#224;s causas neopl&#225;sicas&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#8211;4</span></a> Pressup&#245;ese que o aumento do uso e acesso a novos f&#225;rmacos e as intera&#231;&#245;es medicamentosas&#44; em especial na popula&#231;&#227;o mais idosa&#44; possam estar modificando a epidemiologia&#44; e a farmacodermia se posicionaria como a principal etiologia da EE&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Para investigar essa hip&#243;tese&#44; foi realizado estudo observacional e retrospectivo&#44; por revis&#227;o dos prontu&#225;rios m&#233;dicos de pacientes com EE diagnosticados no hospital universit&#225;rio da Universidade Estadual de Londrina&#44; no per&#237;odo de 1&#176; de fevereiro de 1996 a 1&#176; fevereiro de 2021&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Os dados foram preenchidos em formul&#225;rios desenvolvidos pelos pr&#243;prios pesquisadores&#46; As informa&#231;&#245;es coletadas foram compiladas em planilha Excel para an&#225;lise estat&#237;stica&#46; Os programas Stata&#174; &#40;vers&#227;o 13&#46;0&#44; Statacorp Texas&#41; e Jamovi 1&#46;6&#46;15 foram usados para an&#225;lise estat&#237;stica&#46; Foram considerados valores de signific&#226;ncia estat&#237;stica &#40;p&#8208;valor&#41; &#60; 0&#44;05 e intervalo de confian&#231;a de 95&#37;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a> apresenta os principais achados do estudo&#46; Totalizaram 88 indiv&#237;duos&#44; dos quais 52 do sexo masculino &#40;59&#44;09&#37;&#41; e 36 do feminino &#40;40&#44;91&#37;&#41;&#44; propor&#231;&#227;o de 1&#44;4&#58;1&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;06&#46; A idade m&#233;dia dos indiv&#237;duos foi de 44&#44;72 anos &#40;varia&#231;&#227;o&#58; 0&#8208;84 anos&#41;&#46; A maioria dos indiv&#237;duos era da ra&#231;a branca &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>74 ou 84&#44;09&#37; &#91;95&#37; IC 76&#44;50&#37;&#8208;94&#44;39&#37;&#93;&#41; <span class="elsevierStyleItalic">versus</span> n&#227;o brancos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14 ou 16&#44;09&#37; &#91;95&#37; IC 13&#44;71&#37;&#8208;66&#44;68&#37;&#93;&#41; e p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;03&#44; dados de acordo com a literatura&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#44;3</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Quanto &#224; etiologia &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#44; as dermatoses preexistentes &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>43 &#91;48&#44;86&#37;&#93;&#41; seguido de rea&#231;&#245;es aos f&#225;rmacos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>41 &#91;46&#44;60&#37;&#93;&#41; foram as principais causas da EE&#44; n&#227;o havendo diferen&#231;as significantes entre elas &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;88&#41;&#44; mas significante quando somadas &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>84 &#91;96&#44;55&#37;&#93;&#41; e comparadas ao restante &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>4 &#91;4&#44;55&#37;&#93;&#41; e p &#60; 0&#44;001&#46; Estudos pr&#233;vios apontam o grupo de dermatoses preexistentes como a principal causa&#44; mas com propor&#231;&#245;es maiores de diferen&#231;a em rela&#231;&#227;o &#224;s rea&#231;&#245;es a medicamentos&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#8211;6</span></a>A dermatite at&#243;pica &#40;DA&#41; foi mais prevalente que a psor&#237;ase &#40;Pso&#41; &#8211; n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>14 &#40;15&#44;90&#37;&#41; <span class="elsevierStyleItalic">vs&#46;</span> n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>12 &#40;13&#44;63&#37;&#41;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;81 &#8211;&#44; o que n&#227;o est&#225; de acordo com a literatura&#44; que mostra a ordem inversa&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> Uma hip&#243;tese seria a influ&#234;ncia do acesso &#224;s terap&#234;uticas imunobiol&#243;gicas para pacientes com Pso pelo Sistema &#218;nico de Sa&#250;de &#40;SUS&#41; no Brasil&#44; o que permite tratar precocemente casos graves evitando a evolu&#231;&#227;o para a forma eritrod&#233;rmica&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> Por outro lado&#44; h&#225; um pressuposto que a falta de medicamentos mais eficazes e acess&#237;veis no SUS para os quadros graves da DA possa estar acarretando a EE nesses pacientes refrat&#225;rios ao tratamento&#46;<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a></p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Em concord&#226;ncia com a literatura&#44;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> as classes de antibi&#243;ticos e de anticonvulsivantes foram as principais causas &#40;<a class="elsevierStyleCrossRefs" href="#tbl0005">tabelas 1 e 2</a>&#41;&#46; A carbamazepina&#44; embora n&#227;o estatisticamente significante quando comparada a todos os medicamentos&#44; foi o usado com mais frequ&#234;ncia &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>7 &#91;7&#44;94&#37;&#93; <span class="elsevierStyleItalic">vs&#46;</span> n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>34 &#91;38&#44;64&#37;&#93;&#44; p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;24&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Anticonvulsivantes s&#227;o as principais causas de <span class="elsevierStyleItalic">&#8220;Drug reaction with eosinophilia and systemic symptoms&#8221;</span> &#40;DRESS&#41; ou rea&#231;&#227;o a drogas com eosinofilia e sintomas sist&#234;micos&#44; que &#233; induzida por medicamentos e se apresenta como erup&#231;&#227;o extensa tipo exantema associada a linfadenopatia&#44; hepatite&#44; anormalidades hematol&#243;gicas com eosinofilia e linf&#243;citos at&#237;picos&#44; e pode envolver outros &#243;rg&#227;os como pulm&#227;o&#44; cora&#231;&#227;o e rins&#46;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> O quadro pode ter desfecho ruim&#44; inclusive a morte do paciente&#44; como aconteceu em dois casos do presente estudo&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">A idade m&#233;dia do grupo das dermatoses foi mais baixa do que do grupo das farmacodermias &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>43&#59; m&#233;dia<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>38&#44;3 anos&#59; 95&#37; IC 30&#44;50&#8208;46&#44;02 <span class="elsevierStyleItalic">versus</span> n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>41&#59; m&#233;dia<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>48&#44;7 anos&#59; 95&#37; IC 41&#44;20&#8208;56&#44;11&#41;&#44; p &#60; 0&#44;001 &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46; Os autores levantam a hip&#243;tese que seja pelo surgimento precoce das doen&#231;as como DA e dermatite seborreica de inf&#226;ncia ou a apresenta&#231;&#227;o ao nascimento&#44; como eritrodermia ictiosiforme n&#227;o bolhosa&#46; J&#225; para a farmacodermia&#44; ao contr&#225;rio&#44; com o avan&#231;ar da idade&#44; h&#225; maior necessidade e frequ&#234;ncia do uso dos f&#225;rmacos&#44; e chances de intera&#231;&#245;es e rea&#231;&#245;es medicamentosas&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Estudos pr&#233;vios mostraram vari&#225;veis raz&#245;es entre a frequ&#234;ncia das dermatoses subjacentes e farmacodermia&#44; 2&#44;6&#58;1 a 6&#44;4&#58;1&#44; como causas de EE&#46; Na compara&#231;&#227;o de estudos pr&#233;vios&#44; os valores mais altos foram observados em um estudo da Singapura &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#41;&#46; Nossos achados parecem indicar tend&#234;ncia de que as rea&#231;&#245;es a f&#225;rmaco se tornem cada vez mais frequentes&#44; e que venham a tornar uma das principais causas da EE&#46; Em contrapartida&#44; as terap&#234;uticas efetivas e acess&#237;veis para as dermatoses preexistentes podem ser potenciais benef&#237;cios para a redu&#231;&#227;o das interna&#231;&#245;es por EE&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">Idosos apresentam maior frequ&#234;ncia de enfermidades e de uso e intera&#231;&#245;es entre medicamentos&#46; Adicionalmente&#44; na senesc&#234;ncia pode haver altera&#231;&#227;o da farmacocin&#233;tica&#44; afetando o metabolismo e a depura&#231;&#227;o do f&#225;rmaco&#44; que aumentam as chances do desenvolvimento das farmacodermias&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Na literatura&#44; os casos indeterminados variam entre 3&#44;9&#37;&#8208;16&#44;8&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">2&#8211;6</span></a> Nosso estudo mostrou preval&#234;ncia baixa &#40;2&#44;27&#37;&#41;&#44; e um dos motivos &#233; a exclus&#227;o de oito casos indeterminados ap&#243;s revis&#227;o de prontu&#225;rios&#46; Desses&#44; sete pacientes haviam iniciados a EE antes da data de in&#237;cio do estudo&#44; mas que continuaram seguimento&#46; Outra exclus&#227;o de caso indeterminado foi por apresentar menos de 90&#37; do corpo acometido&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Neoplasias &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#59; 2&#44;27&#37;&#41; e s&#237;ndrome paraneopl&#225;sicas &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#59; 0&#37;&#41;&#44; foram baixas em nossa amostra&#44; mas est&#225; de acordo com a literatura&#44; que descreve de zero a 17&#44;8&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> A micose fungoide &#40;MF&#41; e a s&#237;ndrome de S&#233;zary &#40;SS&#41; foram as causas neopl&#225;sicas&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Dados sobre a preval&#234;ncia de mortalidade na EE ainda s&#227;o muito escassos&#44;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> mas nossa casu&#237;stica foi de 4&#44;55&#37; e estavam relacionados a dois casos de linfoma &#40;MF e outra com SS&#41; e dois pacientes com DRESS&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">As limita&#231;&#245;es do presente estudo incluem vi&#233;s de sele&#231;&#227;o e tamanho amostral&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">O controle das dermatoses subjacentes com terap&#234;uticas mais efetivas e acess&#237;veis pode substancialmente levar &#224; redu&#231;&#227;o da EE causada por essa etiologia&#46; Em contrapartida&#44; o envelhecimento populacional associado ao aumento da frequ&#234;ncia do uso e o acesso aos novos medicamentos podem manter ou aumentar as rea&#231;&#245;es medicamentosas como as principais causas de EE&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0085" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Contribui&#231;&#227;o dos autores</span><p id="par0090" class="elsevierStylePara elsevierViewall">Rog&#233;rio Nabor Kondo&#58; Concep&#231;&#227;o e o desenho do estudo&#59; levantamento dos dados&#44; ou an&#225;lise e interpreta&#231;&#227;o dos dados&#59; an&#225;lise estat&#237;stica&#59; reda&#231;&#227;o do artigo ou revis&#227;o cr&#237;tica do conte&#250;do intelectual importante&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o final da vers&#227;o final do manuscrito&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Betina Samesima e Singh&#58; Levantamento dos dados&#44; ou an&#225;lise e interpreta&#231;&#227;o dos dados&#59; reda&#231;&#227;o do artigo ou revis&#227;o cr&#237;tica do conte&#250;do intelectual importante&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dadosrevis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o final da vers&#227;o final do manuscrito&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Milene Cripa Pizatto de Ara&#250;jo&#58; Levantamento dos dados&#44; ou an&#225;lise e interpreta&#231;&#227;o dos dados&#59; reda&#231;&#227;o do artigo ou revis&#227;o cr&#237;tica do conte&#250;do intelectual importante&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o final da vers&#227;o final do manuscrito&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Vict&#243;ria Prud&#234;ncio Ferreira&#58; Levantamento dos dados&#44; ou an&#225;lise e interpreta&#231;&#227;o dos dados&#59; reda&#231;&#227;o do artigo ou revis&#227;o cr&#237;tica do conte&#250;do intelectual importante&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o final da vers&#227;o final do manuscrito&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Jessica Almeida Marani&#58; Levantamento dos dados&#44; ou an&#225;lise e interpreta&#231;&#227;o dos dados&#59; reda&#231;&#227;o do artigo ou revis&#227;o cr&#237;tica do conte&#250;do intelectual importante&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o final da vers&#227;o final do manuscrito&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Airton dos Santos Gon&#58; Concep&#231;&#227;o e o desenho do estudo&#59; an&#225;lise estat&#237;stica&#59; reda&#231;&#227;o do artigo ou revis&#227;o cr&#237;tica do conte&#250;do intelectual importante&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o final da vers&#227;o final do manuscrito&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0120" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:4 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Suporte financeiro"
        ]
        1 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Contribui&#231;&#227;o dos autores"
        ]
        2 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Conflito de interesses"
        ]
        3 => array:1 [
          "titulo" => "Refer&#234;ncias"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2023-05-03"
    "fechaAceptado" => "2023-07-10"
    "NotaPie" => array:2 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0040">Como citar este artigo&#58; Kondo RN&#44; Samesima&#8208;Singh B&#44; Ara&#250;jo MCP&#44; Ferreira VP&#44; Marani JA&#44; Gon AS&#46; Erythroderma&#58; clinical and etiological study of 88 cases seen in a tertiary hospital over 25 years&#46; An Bras Dermatol&#46; 2024&#59;99&#58;586&#8211;9&#46;</p>"
      ]
      1 => array:2 [
        "etiqueta" => "&#9734;&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0045">Trabalho realizado na Universidade Estadual de Londrina&#44; Londrina&#44; Paran&#225;&#44; PR&#44; Brasil&#46;</p>"
      ]
    ]
    "multimedia" => array:4 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 463
            "Ancho" => 1450
            "Tamanyo" => 76237
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Gr&#225;fico de dispers&#227;o entre as idades do grupo de dermatoses e farmacodermia&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabela 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Caracter&#237;sticas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>88&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Idade&#44; anos&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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">M&#233;dia<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>DP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#44;72<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>25&#44;08&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">M&#237;nimo &#8211; M&#225;ximo&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&#8208;84&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">Sexo&#44; n &#40;&#37;&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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">Masculino&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">52 &#40;59&#44;09&#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">Feminino&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">36 &#40;40&#44;91&#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">Ra&#231;a&#44; n &#40;&#37;&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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">Branca&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">74 &#40;84&#44;09&#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">Parda&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">7 &#40;7&#44;95&#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">Negra&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;3&#44;41&#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">Amarela&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 &#40;4&#44;55&#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">Etiologias&#44; n &#40;&#37;&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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">Dermatoses&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">43 &#40;48&#44;86&#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">Rea&#231;&#245;es a medicamentos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">41 &#40;46&#44;60&#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">Linfoma cut&#226;neo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;2&#44;27&#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">Indeterminada&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;2&#44;27&#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">Principais dermatoses&#44; n &#40;&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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">Dermatite at&#243;pica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14 &#40;15&#44;91&#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">Psor&#237;ase&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;13&#44;63&#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">Dermatite de contato&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">9 &#40;10&#44;23&#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">Pitir&#237;ase rubra pilar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;3&#44;41&#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">Outros<a class="elsevierStyleCrossRef" href="#tblfn0010"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5 &#40;5&#44;68&#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">Principais classes dos medicamentos&#44; n &#40;&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0015"><span class="elsevierStyleSup">c</span></a>&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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">Antimicrobianos&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">13 &#40;14&#44;77&#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">Anticonvulsivantes&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12 &#40;13&#44;63&#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">Exames laboratoriais&#44; n &#40;&#37;&#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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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">Alterados<a class="elsevierStyleCrossRef" href="#tblfn0020"><span class="elsevierStyleSup">d</span></a>&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">64 &#40;72&#44;73&#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">&#211;bitos&#44; n &#40;&#37;&#41;<a class="elsevierStyleCrossRef" href="#tblfn0025"><span class="elsevierStyleSup">e</span></a>&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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">Sim&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 &#40;4&#44;55&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3563633.png"
              ]
            ]
          ]
          "notaPie" => array:5 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Porcentagem em rela&#231;&#227;o ao n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>88&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0010"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Outros&#58; eritrodermia ictiosiforme cong&#234;nita n&#227;o bolhosa &#40;2&#47;43&#41;&#59; s&#237;ndrome de Netherton &#40;1&#47;43&#41;&#59; dermatite seborreica &#40;1&#47;43&#41;&#59; doen&#231;a de Darier &#40;1&#47;43&#41;&#59; s&#237;ndrome da pele escaldada estafiloc&#243;cica&#46;</p>"
            ]
            2 => array:3 [
              "identificador" => "tblfn0015"
              "etiqueta" => "c"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Porcentagem em rela&#231;&#227;o ao n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>88&#46;</p>"
            ]
            3 => array:3 [
              "identificador" => "tblfn0020"
              "etiqueta" => "d"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0020">72&#44;73&#37; dos pacientes apresentavam pelo menos uma altera&#231;&#227;o laboratorial&#46;</p>"
            ]
            4 => array:3 [
              "identificador" => "tblfn0025"
              "etiqueta" => "e"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0025">&#211;bitos por linfoma cut&#226;neo &#40;2&#47;88&#41;&#44; farmacodermia classificada como DRESS &#40;2&#47;87&#41;&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas demogr&#225;ficas e cl&#237;nicas</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Tabela 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Etiologia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&#250;mero&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleBold">I&#41; Dermatoses</span>&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>Dermatite at&#243;pica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&#44;90&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>Psor&#237;ase&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;63&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>Dermatite de contato&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">7&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">7&#44;95&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>Pitir&#237;ase rubra pilar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;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"><span class="elsevierStyleHsp" style=""></span>Eritrodermia ictiosiforme cong&#234;nita n&#227;o bolhosa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;27&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>Dermatite seborreica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;14&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>Dermatite infectiva&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;14&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>Ictiose linear circunflexa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;14&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>Ceratose folicular&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;14&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>S&#237;ndrome da pele escaldada estafiloc&#243;cica&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;14&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="elsevierStyleBold">II&#41; Farmacodermia</span>&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>Carbamazepina&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">7&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">7&#44;94&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>Ceftriaxona&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;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"><span class="elsevierStyleHsp" style=""></span>Fenobarbital&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;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"><span class="elsevierStyleHsp" style=""></span>&#193;cido valproico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;27&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>Amoxacilina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;27&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>Sulfametoxazol<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>trimetoprim&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;27&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>Alopurinol&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;27&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>Sulfassalazina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;27&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>&#193;cido acetil salic&#237;lico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;14&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>Azitromicina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;14&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>Code&#237;na&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;14&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>Contraste&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;14&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>Dipirona&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;14&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>Levofloxacina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;14&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>N&#8208;acetilciste&#237;na&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;14&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>Piroxican&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;14&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>Norfloxacina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;14&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>Prometazina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;14&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>Vancomicina&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;14&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>Indefinido<a class="elsevierStyleCrossRef" href="#tblfn0030"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#44;68&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="elsevierStyleBold">III&#41; Neopl&#225;sico</span>&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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>Linfoma cut&#226;neo<a class="elsevierStyleCrossRef" href="#tblfn0035"><span class="elsevierStyleSup">b</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;27&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="elsevierStyleBold">IV&#41; Indeterminado</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;27&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="elsevierStyleBold">Total</span>&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">88&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">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3563632.png"
              ]
            ]
          ]
          "notaPie" => array:2 [
            0 => array:3 [
              "identificador" => "tblfn0030"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0030">Causa medicamentosa&#44; mas paciente n&#227;o se recordava da medica&#231;&#227;o ou foi por uso associa&#231;&#245;es v&#225;rios medicamentos como no tratamento de <span class="elsevierStyleItalic">H&#46; pilory</span>&#46;</p>"
            ]
            1 => array:3 [
              "identificador" => "tblfn0035"
              "etiqueta" => "b"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0035">Caso de linfoma cut&#226;neo de c&#233;lulas T e outro de s&#237;ndrome de S&#233;zary&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Eritrodermia segundo a etiologia &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>88&#41;</p>"
        ]
      ]
      3 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Tabela 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Tabela "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">N denota o n&#250;mero de pacientes&#59; propor&#231;&#227;o denota a rela&#231;&#227;o entre dermatoses e farmacodermias&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Estudo &#40;ano&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Dermatoses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Farmacodermias&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Propor&#231;&#227;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Akhyani et al&#46; &#40;2005&#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">97&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">59&#44;7&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">21&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;7&#58;1&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">Fernandes et al&#46; &#40;2008&#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">170&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">58&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6&#58;1&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">Tan et al&#46; &#40;2014&#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">30&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">68&#44;9&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&#44;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&#44;4&#58;1&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">Cesar et al&#46; &#40;2016&#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">103&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">65&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;5&#58;1&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">Miyashiro et al&#46; &#40;2020&#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">309&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">46&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&#44;7&#58;1&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">Presente estudo&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">88&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">48&#44;9&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">46&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;0&#58;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3563634.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Rela&#231;&#227;o entre os casos de dermatoses e farmacodermias</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Refer&#234;ncias"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Erythroderma &#40;exfoliative dermatitis&#41;&#46; Part 1&#58; underlying causes&#44; clinical presentation and pathogenesis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "S&#46; Tso"
                            1 => "F&#46; Satchwell"
                            2 => "H&#46; Moiz"
                            3 => "T&#46; Hari"
                            4 => "S&#46; Dhariwal"
                            5 => "R&#46; Barlow"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/ced.14625"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Dermatol&#46;"
                        "fecha" => "2021"
                        "volumen" => "46"
                        "paginaInicial" => "1001"
                        "paginaFinal" => "1010"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33639006"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Erythroderma&#58; a clinical study of 97 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Akhyani"
                            1 => "Z&#46;S&#46; Ghodsi"
                            2 => "S&#46; Toosi"
                            3 => "H&#46; Dabbaghian"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1471-5945-5-5"
                      "Revista" => array:5 [
                        "tituloSerie" => "BMC Dermatol&#46;"
                        "fecha" => "2005"
                        "volumen" => "5"
                        "paginaInicial" => "5"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15882451"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Eritrodermia&#58; estudo cl&#237;nico&#8208;laboratorial e histopatol&#243;gico de 170 casos"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "N&#46;C&#46; Fernandes"
                            1 => "F&#46;S&#46;M&#46; Pereira"
                            2 => "J&#46;P&#46; Maceira"
                            3 => "T&#46; Cuzzi"
                            4 => "T&#46;F&#46;L&#46;R&#46; Dresch"
                            5 => "P&#46;P&#46; Ara&#250;jo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "An Bras Dermatol&#46;"
                        "fecha" => "2008"
                        "volumen" => "83"
                        "paginaInicial" => "526"
                        "paginaFinal" => "532"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Causes and features of erythroderma"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46;F&#46; Tan"
                            1 => "Y&#46;L&#46; Kong"
                            2 => "A&#46;S&#46; Tan"
                            3 => "H&#46;L&#46; Tey"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ann Acad Med Singap"
                        "fecha" => "2014"
                        "volumen" => "43"
                        "paginaInicial" => "391"
                        "paginaFinal" => "394"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25244987"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Erythroderma&#46; A clinical and etiological study of 103 patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Cesar"
                            1 => "M&#46; Cruz"
                            2 => "A&#46; Mota"
                            3 => "F&#46; Azevedo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.3315/jdcr.2016.1222"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dermatol Case Rep"
                        "fecha" => "2016"
                        "volumen" => "10"
                        "paginaInicial" => "1"
                        "paginaFinal" => "9"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27119000"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Erythroderma&#58; a prospective study of 309 patients followed for 12 years in a tertiary center"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46; Miyashiro"
                            1 => "J&#46;A&#46; Sanches"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1038/s41598-020-66040-7"
                      "Revista" => array:5 [
                        "tituloSerie" => "Sci Rep&#46;"
                        "fecha" => "2020"
                        "volumen" => "10"
                        "paginaInicial" => "9774"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32555205"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of erythrodermic psoriasis with biologics&#58; a systematic review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "O&#46;Y&#46; Carrasquillo"
                            1 => "G&#46; Pab&#243;n-Cartagena"
                            2 => "L&#46;A&#46; Falto-Aizpurua"
                            3 => "M&#46; Santiago-V&#225;zquez"
                            4 => "K&#46;J&#46; Cancel-Artau"
                            5 => "G&#46; Arias-Berrios"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Acad Dermatol&#46;"
                        "fecha" => "2020"
                        "volumen" => "83"
                        "paginaInicial" => "151"
                        "paginaFinal" => "158"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "104&#8208;week safety and effectiveness of dupilumab in the treatment of severe atopic dermatitis&#46; The experience of 5 reference dermatology units in Spain"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;J&#46; Pereyra-Rodriguez"
                            1 => "J&#46; Dominguez-Cruz"
                            2 => "J&#46;C&#46; Armario-Hita"
                            3 => "R&#46;R&#46; Villaverde"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.abd.2020.08.030"
                      "Revista" => array:6 [
                        "tituloSerie" => "An Bras Dermatol&#46;"
                        "fecha" => "2021"
                        "volumen" => "96"
                        "paginaInicial" => "787"
                        "paginaFinal" => "790"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34593266"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Drug&#8208;induced hypersensitivity syndrome &#40;DIHS&#41;&#47;drug reaction with eosinophilia and systemic symptoms &#40;DRESS&#41;&#58; clinical features and pathogenesis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "N&#46; Hama"
                            1 => "R&#46; Abe"
                            2 => "A&#46; Gibson"
                            3 => "E&#46;J&#46; Phillips"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jaip.2022.02.004"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Allergy Clin Immunol Pract&#46;"
                        "fecha" => "2022"
                        "volumen" => "10"
                        "paginaInicial" => "1155"
                        "paginaFinal" => "1167"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35176506"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Adverse drug reactions in older adults&#58; a narrative review of the literature"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "M&#46;B&#46; Zazzara"
                            1 => "K&#46; Palmer"
                            2 => "D&#46;L&#46; Vetrano"
                            3 => "A&#46; Carf&#236;"
                            4 => "G&#46; Onder"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s41999-021-00481-9"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Geriatr Med&#46;"
                        "fecha" => "2021"
                        "volumen" => "12"
                        "paginaInicial" => "463"
                        "paginaFinal" => "473"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/33738772"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "pt"
  "url" => "/26662752/0000009900000004/v1_202406100414/S266627522400078X/v1_202406100414/pt/main.assets"
  "Apartado" => array:4 [
    "identificador" => "95147"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Cartas - Investiga&#231;&#227;o"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/26662752/0000009900000004/v1_202406100414/S266627522400078X/v1_202406100414/pt/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S266627522400078X?idApp=UINPBA00008Z"
]
Share
Journal Information
Vol. 99. Issue 4.
Pages 584-587 (1 July 2024)
Visits
2121
Vol. 99. Issue 4.
Pages 584-587 (1 July 2024)
Cartas ‐ Investigação
Full text access
Eritrodermia esfoliativa: estudo clínico e etiológico de 88 casos atendidos em hospital terciário durante 25 anos
Visits
2121
Rogério Nabor Kondo
Corresponding author
kondo.dermato@gmail.com

Autor para correspondência.
, Betina Samesima e Singh, Milene Cripa Pizatto de Araújo, Victória Prudêncio Ferreira, Jessica Almeida Marani, Airton dos Santos Gon
Departamento de Clínica Médica, Universidade Estadual de Londrina, Londrina, PR, Brasil
This item has received
Article information
Full Text
Bibliography
Download PDF
Statistics
Figures (1)
Tables (3)
Tabela 1. Características demográficas e clínicas
Tabela 2. Eritrodermia segundo a etiologia (n=88)
Tabela 3. Relação entre os casos de dermatoses e farmacodermias
Show moreShow less
Full Text
Prezado Editor,

Eritrodermia esfoliativa (EE), dermatite esfoliativa ou, simplesmente, eritrodermia, primeiramente descrita por Von Hebra em 1868, é distúrbio raro em que ocorre eritema e descamação envolvendo mais que 90% da superfície corpórea.1

Estudos prévios mostraram que a principal etiologia estava relacionada ao grupo de dermatoses preexistentes (ou subjacentes), seguido por medicamentos e, menos comumente, às causas neoplásicas.2–4 Pressupõese que o aumento do uso e acesso a novos fármacos e as interações medicamentosas, em especial na população mais idosa, possam estar modificando a epidemiologia, e a farmacodermia se posicionaria como a principal etiologia da EE.

Para investigar essa hipótese, foi realizado estudo observacional e retrospectivo, por revisão dos prontuários médicos de pacientes com EE diagnosticados no hospital universitário da Universidade Estadual de Londrina, no período de 1° de fevereiro de 1996 a 1° fevereiro de 2021.

Os dados foram preenchidos em formulários desenvolvidos pelos próprios pesquisadores. As informações coletadas foram compiladas em planilha Excel para análise estatística. Os programas Stata® (versão 13.0, Statacorp Texas) e Jamovi 1.6.15 foram usados para análise estatística. Foram considerados valores de significância estatística (p‐valor) < 0,05 e intervalo de confiança de 95%.

A tabela 1 apresenta os principais achados do estudo. Totalizaram 88 indivíduos, dos quais 52 do sexo masculino (59,09%) e 36 do feminino (40,91%), proporção de 1,4:1, p=0,06. A idade média dos indivíduos foi de 44,72 anos (variação: 0‐84 anos). A maioria dos indivíduos era da raça branca (n=74 ou 84,09% [95% IC 76,50%‐94,39%]) versus não brancos (n=14 ou 16,09% [95% IC 13,71%‐66,68%]) e p=0,03, dados de acordo com a literatura.2,3

Tabela 1.

Características demográficas e clínicas

Características  n=88 
Idade, anos   
Média±DP  44,72±25,08 
Mínimo – Máximo  0‐84 
Sexo, n (%)   
Masculino  52 (59,09) 
Feminino  36 (40,91) 
Raça, n (%)   
Branca  74 (84,09) 
Parda  7 (7,95) 
Negra  3 (3,41) 
Amarela  4 (4,55) 
Etiologias, n (%)   
Dermatoses  43 (48,86) 
Reações a medicamentos  41 (46,60) 
Linfoma cutâneo  2 (2,27) 
Indeterminada  2 (2,27) 
Principais dermatoses, n (%)a   
Dermatite atópica  14 (15,91) 
Psoríase  12 (13,63) 
Dermatite de contato  9 (10,23) 
Pitiríase rubra pilar  3 (3,41) 
Outrosb  5 (5,68) 
Principais classes dos medicamentos, n (%)c   
Antimicrobianos  13 (14,77) 
Anticonvulsivantes  12 (13,63) 
Exames laboratoriais, n (%)   
Alteradosd  64 (72,73) 
Óbitos, n (%)e   
Sim  4 (4,55) 
a

Porcentagem em relação ao n=88.

b

Outros: eritrodermia ictiosiforme congênita não bolhosa (2/43); síndrome de Netherton (1/43); dermatite seborreica (1/43); doença de Darier (1/43); síndrome da pele escaldada estafilocócica.

c

Porcentagem em relação ao n=88.

d

72,73% dos pacientes apresentavam pelo menos uma alteração laboratorial.

e

Óbitos por linfoma cutâneo (2/88), farmacodermia classificada como DRESS (2/87).

Quanto à etiologia (tabela 2), as dermatoses preexistentes (n=43 [48,86%]) seguido de reações aos fármacos (n=41 [46,60%]) foram as principais causas da EE, não havendo diferenças significantes entre elas (p=0,88), mas significante quando somadas (n=84 [96,55%]) e comparadas ao restante (n=4 [4,55%]) e p < 0,001. Estudos prévios apontam o grupo de dermatoses preexistentes como a principal causa, mas com proporções maiores de diferença em relação às reações a medicamentos.2–6A dermatite atópica (DA) foi mais prevalente que a psoríase (Pso) – n=14 (15,90%) vs. n=12 (13,63%), p=0,81 –, o que não está de acordo com a literatura, que mostra a ordem inversa.6 Uma hipótese seria a influência do acesso às terapêuticas imunobiológicas para pacientes com Pso pelo Sistema Único de Saúde (SUS) no Brasil, o que permite tratar precocemente casos graves evitando a evolução para a forma eritrodérmica.7 Por outro lado, há um pressuposto que a falta de medicamentos mais eficazes e acessíveis no SUS para os quadros graves da DA possa estar acarretando a EE nesses pacientes refratários ao tratamento.8

Tabela 2.

Eritrodermia segundo a etiologia (n=88)

Etiologia  Número 
I) Dermatoses     
Dermatite atópica  14  15,90 
Psoríase  12  13,63 
Dermatite de contato  7,95 
Pitiríase rubra pilar  3,41 
Eritrodermia ictiosiforme congênita não bolhosa  2,27 
Dermatite seborreica  1,14 
Dermatite infectiva  1,14 
Ictiose linear circunflexa  1,14 
Ceratose folicular  1,14 
Síndrome da pele escaldada estafilocócica  1,14 
II) Farmacodermia     
Carbamazepina  7,94 
Ceftriaxona  3,41 
Fenobarbital  3,41 
Ácido valproico  2,27 
Amoxacilina  2,27 
Sulfametoxazol+trimetoprim  2,27 
Alopurinol  2,27 
Sulfassalazina  2,27 
Ácido acetil salicílico  1,14 
Azitromicina  1,14 
Codeína  1,14 
Contraste  1,14 
Dipirona  1,14 
Levofloxacina  1,14 
N‐acetilcisteína  1,14 
Piroxican  1,14 
Norfloxacina  1,14 
Prometazina  1,14 
Vancomicina  1,14 
Indefinidoa  5,68 
III) Neoplásico     
Linfoma cutâneob  2,27 
IV) Indeterminado  2,27 
Total  88  100 
a

Causa medicamentosa, mas paciente não se recordava da medicação ou foi por uso associações vários medicamentos como no tratamento de H. pilory.

b

Caso de linfoma cutâneo de células T e outro de síndrome de Sézary.

Em concordância com a literatura,1 as classes de antibióticos e de anticonvulsivantes foram as principais causas (tabelas 1 e 2). A carbamazepina, embora não estatisticamente significante quando comparada a todos os medicamentos, foi o usado com mais frequência (n=7 [7,94%] vs. n=34 [38,64%], p=0,24).

Anticonvulsivantes são as principais causas de “Drug reaction with eosinophilia and systemic symptoms” (DRESS) ou reação a drogas com eosinofilia e sintomas sistêmicos, que é induzida por medicamentos e se apresenta como erupção extensa tipo exantema associada a linfadenopatia, hepatite, anormalidades hematológicas com eosinofilia e linfócitos atípicos, e pode envolver outros órgãos como pulmão, coração e rins.9 O quadro pode ter desfecho ruim, inclusive a morte do paciente, como aconteceu em dois casos do presente estudo.

A idade média do grupo das dermatoses foi mais baixa do que do grupo das farmacodermias (n=43; média=38,3 anos; 95% IC 30,50‐46,02 versus n=41; média=48,7 anos; 95% IC 41,20‐56,11), p < 0,001 (fig. 1). Os autores levantam a hipótese que seja pelo surgimento precoce das doenças como DA e dermatite seborreica de infância ou a apresentação ao nascimento, como eritrodermia ictiosiforme não bolhosa. Já para a farmacodermia, ao contrário, com o avançar da idade, há maior necessidade e frequência do uso dos fármacos, e chances de interações e reações medicamentosas.

Figura 1.

Gráfico de dispersão entre as idades do grupo de dermatoses e farmacodermia.

(0.07MB).

Estudos prévios mostraram variáveis razões entre a frequência das dermatoses subjacentes e farmacodermia, 2,6:1 a 6,4:1, como causas de EE. Na comparação de estudos prévios, os valores mais altos foram observados em um estudo da Singapura (tabela 3). Nossos achados parecem indicar tendência de que as reações a fármaco se tornem cada vez mais frequentes, e que venham a tornar uma das principais causas da EE. Em contrapartida, as terapêuticas efetivas e acessíveis para as dermatoses preexistentes podem ser potenciais benefícios para a redução das internações por EE.

Tabela 3.

Relação entre os casos de dermatoses e farmacodermias

Estudo (ano)  Dermatoses  Farmacodermias  Proporção 
Akhyani et al. (2005)  97  59,7  21,6  2,7:1 
Fernandes et al. (2008)  170  58,2  21,7  2,6:1 
Tan et al. (2014)  30  68,9  10,7  6,4:1 
Cesar et al. (2016)  103  65,0  18,4  3,5:1 
Miyashiro et al. (2020)  309  46,2  12,3  3,7:1 
Presente estudo  88  48,9  46,6  1,0:1 

N denota o número de pacientes; proporção denota a relação entre dermatoses e farmacodermias.

Idosos apresentam maior frequência de enfermidades e de uso e interações entre medicamentos. Adicionalmente, na senescência pode haver alteração da farmacocinética, afetando o metabolismo e a depuração do fármaco, que aumentam as chances do desenvolvimento das farmacodermias.10

Na literatura, os casos indeterminados variam entre 3,9%‐16,8%.2–6 Nosso estudo mostrou prevalência baixa (2,27%), e um dos motivos é a exclusão de oito casos indeterminados após revisão de prontuários. Desses, sete pacientes haviam iniciados a EE antes da data de início do estudo, mas que continuaram seguimento. Outra exclusão de caso indeterminado foi por apresentar menos de 90% do corpo acometido.

Neoplasias (n=2; 2,27%) e síndrome paraneoplásicas (n=0; 0%), foram baixas em nossa amostra, mas está de acordo com a literatura, que descreve de zero a 17,8%.6 A micose fungoide (MF) e a síndrome de Sézary (SS) foram as causas neoplásicas.

Dados sobre a prevalência de mortalidade na EE ainda são muito escassos,6 mas nossa casuística foi de 4,55% e estavam relacionados a dois casos de linfoma (MF e outra com SS) e dois pacientes com DRESS.

As limitações do presente estudo incluem viés de seleção e tamanho amostral.

O controle das dermatoses subjacentes com terapêuticas mais efetivas e acessíveis pode substancialmente levar à redução da EE causada por essa etiologia. Em contrapartida, o envelhecimento populacional associado ao aumento da frequência do uso e o acesso aos novos medicamentos podem manter ou aumentar as reações medicamentosas como as principais causas de EE.

Suporte financeiro

Nenhum.

Contribuição dos autores

Rogério Nabor Kondo: Concepção e o desenho do estudo; levantamento dos dados, ou análise e interpretação dos dados; análise estatística; redação do artigo ou revisão crítica do conteúdo intelectual importante; obtenção, análise e interpretação dos dados; participação efetiva na orientação da pesquisa; revisão crítica da literatura; aprovação final da versão final do manuscrito.

Betina Samesima e Singh: Levantamento dos dados, ou análise e interpretação dos dados; redação do artigo ou revisão crítica do conteúdo intelectual importante; obtenção, análise e interpretação dos dadosrevisão crítica da literatura; aprovação final da versão final do manuscrito.

Milene Cripa Pizatto de Araújo: Levantamento dos dados, ou análise e interpretação dos dados; redação do artigo ou revisão crítica do conteúdo intelectual importante; obtenção, análise e interpretação dos dados; revisão crítica da literatura; aprovação final da versão final do manuscrito.

Victória Prudêncio Ferreira: Levantamento dos dados, ou análise e interpretação dos dados; redação do artigo ou revisão crítica do conteúdo intelectual importante; obtenção, análise e interpretação dos dados; revisão crítica da literatura; aprovação final da versão final do manuscrito.

Jessica Almeida Marani: Levantamento dos dados, ou análise e interpretação dos dados; redação do artigo ou revisão crítica do conteúdo intelectual importante; obtenção, análise e interpretação dos dados; revisão crítica da literatura; aprovação final da versão final do manuscrito.

Airton dos Santos Gon: Concepção e o desenho do estudo; análise estatística; redação do artigo ou revisão crítica do conteúdo intelectual importante; obtenção, análise e interpretação dos dados; participação intelectual em conduta propedêutica e/ou terapêutica de casos estudados; revisão crítica da literatura; aprovação final da versão final do manuscrito.

Conflito de interesses

Nenhum.

Referências
[1]
S. Tso, F. Satchwell, H. Moiz, T. Hari, S. Dhariwal, R. Barlow, et al.
Erythroderma (exfoliative dermatitis). Part 1: underlying causes, clinical presentation and pathogenesis.
Clin Exp Dermatol., 46 (2021), pp. 1001-1010
[2]
M. Akhyani, Z.S. Ghodsi, S. Toosi, H. Dabbaghian.
Erythroderma: a clinical study of 97 cases.
BMC Dermatol., 5 (2005), pp. 5
[3]
N.C. Fernandes, F.S.M. Pereira, J.P. Maceira, T. Cuzzi, T.F.L.R. Dresch, P.P. Araújo.
Eritrodermia: estudo clínico‐laboratorial e histopatológico de 170 casos.
An Bras Dermatol., 83 (2008), pp. 526-532
[4]
G.F. Tan, Y.L. Kong, A.S. Tan, H.L. Tey.
Causes and features of erythroderma.
Ann Acad Med Singap, 43 (2014), pp. 391-394
[5]
A. Cesar, M. Cruz, A. Mota, F. Azevedo.
Erythroderma. A clinical and etiological study of 103 patients.
J Dermatol Case Rep, 10 (2016), pp. 1-9
[6]
D. Miyashiro, J.A. Sanches.
Erythroderma: a prospective study of 309 patients followed for 12 years in a tertiary center.
[7]
O.Y. Carrasquillo, G. Pabón-Cartagena, L.A. Falto-Aizpurua, M. Santiago-Vázquez, K.J. Cancel-Artau, G. Arias-Berrios, et al.
Treatment of erythrodermic psoriasis with biologics: a systematic review.
J Am Acad Dermatol., 83 (2020), pp. 151-158
[8]
J.J. Pereyra-Rodriguez, J. Dominguez-Cruz, J.C. Armario-Hita, R.R. Villaverde.
104‐week safety and effectiveness of dupilumab in the treatment of severe atopic dermatitis. The experience of 5 reference dermatology units in Spain.
An Bras Dermatol., 96 (2021), pp. 787-790
[9]
N. Hama, R. Abe, A. Gibson, E.J. Phillips.
Drug‐induced hypersensitivity syndrome (DIHS)/drug reaction with eosinophilia and systemic symptoms (DRESS): clinical features and pathogenesis.
J Allergy Clin Immunol Pract., 10 (2022), pp. 1155-1167
[10]
M.B. Zazzara, K. Palmer, D.L. Vetrano, A. Carfì, G. Onder.
Adverse drug reactions in older adults: a narrative review of the literature.
Eur Geriatr Med., 12 (2021), pp. 463-473

Como citar este artigo: Kondo RN, Samesima‐Singh B, Araújo MCP, Ferreira VP, Marani JA, Gon AS. Erythroderma: clinical and etiological study of 88 cases seen in a tertiary hospital over 25 years. An Bras Dermatol. 2024;99:586–9.

Trabalho realizado na Universidade Estadual de Londrina, Londrina, Paraná, PR, Brasil.

Copyright © 2024. Sociedade Brasileira de Dermatologia
Download PDF
Idiomas
Anais Brasileiros de Dermatologia
Article options
Tools
en pt
Cookies policy Política de cookies
To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.