What is your diagnosis?
Case for diagnosis. Eyelid edema and erythematous papules disseminated on the face
Ana Cristina M. Garciaa,
, Ângela Marques Barbosaa, Marilda Aparecida Milanez Morgado de Abreub, Carlos Zelandi Filhoc
Corresponding author
a Dermatology Service, Hospital Regional de Presidente Prudente, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
b Department of Health Postgraduate Programs, Instituto de Assistência Médica ao Servidor Público Estadual, São Paulo, SP, Brazil
c Private Laboratory, Presidente Prudente, SP, Brazil
Read
6333
Timeswas read the article
2985
Total PDF
3348
Total HTML
Share statistics
array:23 [ "pii" => "S0365059620302130" "issn" => "03650596" "doi" => "10.1016/j.abd.2019.11.016" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "250" "copyrightAnyo" => "2020" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "crp" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "pt" => array:18 [ "pii" => "S2666275220302915" "issn" => "26662752" "doi" => "10.1016/j.abdp.2020.09.005" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "250" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "crp" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "pt" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Qual o seu diagnóstico?</span>" "titulo" => "Caso para diagnóstico. Pápulas eritematosas disseminadas na face e edema palpebral" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "tieneResumen" => "pt" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "754" "paginaFinal" => "756" ] ] "contieneResumen" => array:1 [ "pt" => true ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "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" => 1041 "Ancho" => 905 "Tamanyo" => 178733 ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Pápulas eritematosas em malares, regiões frontal e mentoniana. Placas formadas por coalescência de pápulas em região palpebral bilateral.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ana Cristina M. Garcia, Ângela Marques Barbosa, Marilda Aparecida Milanez Morgado de Abreu, Carlos Zelandi Filho" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Ana Cristina M." "apellidos" => "Garcia" ] 1 => array:2 [ "nombre" => "Ângela Marques" "apellidos" => "Barbosa" ] 2 => array:2 [ "nombre" => "Marilda Aparecida Milanez Morgado de" "apellidos" => "Abreu" ] 3 => array:2 [ "nombre" => "Carlos" "apellidos" => "Zelandi Filho" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0365059620302130" "doi" => "10.1016/j.abd.2019.11.016" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059620302130?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275220302915?idApp=UINPBA00008Z" "url" => "/26662752/0000009500000006/v1_202012150903/S2666275220302915/v1_202012150903/pt/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S036505962030221X" "issn" => "03650596" "doi" => "10.1016/j.abd.2020.03.015" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "258" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "crp" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">What is your diagnosis?</span>" "titulo" => "Case for diagnosis. Hyperpigmented and excoriated papules and nodules in a diabetic patient" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "757" "paginaFinal" => "759" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 510 "Ancho" => 755 "Tamanyo" => 102269 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Photomicrograph showing a cup-shaped depression of the epidermis, with an overlying keratin plug containing collagen fibers, keratinous debris, and inflammatory cells (Hematoxylin & eosin, ×100).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Catalina Hasbún, Mauricio Sandoval, Sergio González-Bombardiere" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Catalina" "apellidos" => "Hasbún" ] 1 => array:2 [ "nombre" => "Mauricio" "apellidos" => "Sandoval" ] 2 => array:2 [ "nombre" => "Sergio" "apellidos" => "González-Bombardiere" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S266627522030299X" "doi" => "10.1016/j.abdp.2020.09.012" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S266627522030299X?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S036505962030221X?idApp=UINPBA00008Z" "url" => "/03650596/0000009500000006/v2_202011230629/S036505962030221X/v2_202011230629/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S0365059620302129" "issn" => "03650596" "doi" => "10.1016/j.abd.2020.03.012" "estado" => "S300" "fechaPublicacion" => "2020-11-01" "aid" => "249" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by/4.0/" "subdocumento" => "crp" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">What is your diagnosis?</span>" "titulo" => "Case for diagnosis. Phagedenic ulcer on the thorax" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "751" "paginaFinal" => "753" ] ] "contieneResumen" => array:1 [ "en" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1128 "Ancho" => 905 "Tamanyo" => 156128 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">CK7-positive epithelial cells (Immunohistochemistry, x100).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Isabella Lemos Baltazar, Flávia Regina Ferreira, Mariana Galhardo Tressino, Fernanda da Rocha Gonçalves" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Isabella Lemos" "apellidos" => "Baltazar" ] 1 => array:2 [ "nombre" => "Flávia Regina" "apellidos" => "Ferreira" ] 2 => array:2 [ "nombre" => "Mariana Galhardo" "apellidos" => "Tressino" ] 3 => array:2 [ "nombre" => "Fernanda da Rocha" "apellidos" => "Gonçalves" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275220302903" "doi" => "10.1016/j.abdp.2020.09.004" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275220302903?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059620302129?idApp=UINPBA00008Z" "url" => "/03650596/0000009500000006/v2_202011230629/S0365059620302129/v2_202011230629/en/main.assets" ] "en" => array:19 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">What is your diagnosis?</span>" "titulo" => "Case for diagnosis. Eyelid edema and erythematous papules disseminated on the face" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "754" "paginaFinal" => "756" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ana Cristina M. Garcia, Ângela Marques Barbosa, Marilda Aparecida Milanez Morgado de Abreu, Carlos Zelandi Filho" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Ana Cristina M." "apellidos" => "Garcia" "email" => array:1 [ 0 => "ana.mendoncagarcia@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Ângela Marques" "apellidos" => "Barbosa" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Marilda Aparecida Milanez Morgado de" "apellidos" => "Abreu" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0015" ] ] ] 3 => array:3 [ "nombre" => "Carlos Zelandi" "apellidos" => "Filho" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Dermatology Service, Hospital Regional de Presidente Prudente, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Health Postgraduate Programs, Instituto de Assistência Médica ao Servidor Público Estadual, São Paulo, SP, Brazil" "etiqueta" => "b" "identificador" => "aff0015" ] 2 => array:3 [ "entidad" => "Private Laboratory, Presidente Prudente, SP, Brazil" "etiqueta" => "c" "identificador" => "aff0020" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1041 "Ancho" => 905 "Tamanyo" => 178733 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Erythematous papules on the malar areas, forehead and chin. Plaques formed by coalescence of papules on both eyelids.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Case report</span><p id="par0005" class="elsevierStylePara elsevierViewall">The authors report the case of a 47-year-old female patient who presented asymptomatic erythematous papules on the central region of the face for eight months, in addition to periocular edema. She initially associated them with the use of a hair dye, but the lesions persisted despite interrupting its use. The lesions did not worsen with sun exposure or any other factor. The patient reported no associated symptoms, comorbidities, or continuous use of medications.</p><p id="par0010" class="elsevierStylePara elsevierViewall">At dermatological examination, multiple erythematous papules were observed, measuring from 1 to 3<span class="elsevierStyleHsp" style=""></span>mm, distributed over the malar area, forehead and chin. Over the eyelids, these papules coalesced to form plaques, and there was mild bilateral edema (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The skin around the papules presented no changes. No changes were observed in other organs and systems.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The patient had been previously submitted to treatment with prednisone 40<span class="elsevierStyleHsp" style=""></span>mg/day for four months, without response. An extensive laboratory investigation (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) was performed, as well as biopsy of a lesion (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>A and B).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">After histopathological examination of the lesion and other complementary exams, treatment with minocycline and topical betamethasone was then proposed.<span class="elsevierStyleVsp" style="height:1.0px"></span></p></span><span id="sec0011" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0021">What is your diagnosis?</span><p id="par0025" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">a)</span><p id="par0030" class="elsevierStylePara elsevierViewall">Granulomatous rosacea</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">b)</span><p id="par0035" class="elsevierStylePara elsevierViewall">Sarcoidosis</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">c)</span><p id="par0040" class="elsevierStylePara elsevierViewall">Acne agminata</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">d)</span><p id="par0045" class="elsevierStylePara elsevierViewall">Cutaneous tuberculosis</p></li></ul></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Discussion</span><p id="par0050" class="elsevierStylePara elsevierViewall">Described by Radcliffe-Crocker in 1903, lupus miliaris disseminatus faciei (LMDF) or acne agminata is a rare chronic granulomatous inflammatory disease of the face, of unknown etiology. It mainly affects adolescents and young adults of both sexes.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">1–3</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">It is characterized by asymptomatic papules and nodules, brownish or yellowish in color, located mainly on the central region of the face, typically on and around the eyelids. Extrafacial involvement can occur. The onset is abrupt, and the condition usually regresses spontaneously in 12–24 months, leaving punctiform and atrophic scars.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">1–3</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">Histologically, it is characterized by epithelioid granulomas similar to tuberculosis, sarcoidosis, granulomatous rosacea, tuberculoid leprosy, or other granulomatous diseases. Its pattern may vary according to the stage of the lesion: early lesions are characterized by nonspecific and non-granulomatous inflammation, whereas well-developed lesions may present epithelioid granulomas with central necrosis, without central necrosis (sarcoid granuloma), or with abcess formation.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">4,5</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Its etiopathogenesis remains unknown. It was believed to be a manifestation of cutaneous tuberculosis; however, this theory is no longer accepted, as the presence of <span class="elsevierStyleItalic">M. tuberculosis</span> has not been demonstrated, in addition to the fact that the condition does not improve with anti-tuberculosis therapy.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">1,2,6</span></a> Many authors considered it to be a variant of granulomatous rosacea, a hypothesis that has also been discarded, as in rosacea there is a greater predilection for the malar region, association with diffuse erythema, telangiectasias, exacerbation with corticosteroids, and absence of scarring after resolution.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">1,3</span></a> It can also resemble sarcoidosis, but this usually presents systemic manifestations, as well as laboratory and imaging alterations, not observed in LMDF.<a class="elsevierStyleCrossRefs" href="#bib0045"><span class="elsevierStyleSup">1–3,6</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Due to the lack of knowledge of the etiopathogenesis, its treatment is challenging; many drugs have been used as possible treatments, including dapsone, clofazimine, minocycline, doxycycline, tetracycline, prednisone, and isotretinoin.<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">2,7,8</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Although there are no well-established criteria for the diagnosis of LMDF, the authors reached the diagnosis of acne agminata due to the distribution of the lesions and clinical characteristics suggestive of granulomatous disease of the face, and by excluding other differential diagnoses after biopsy and complementary exams.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Financial support</span><p id="par0080" class="elsevierStylePara elsevierViewall">None declared.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Authors’ contributions</span><p id="par0085" class="elsevierStylePara elsevierViewall">Ana Cristina M Garcia: Approval of the final version of the manuscript; elaboration and writing of the manuscript; intellectual participation in propaedeutic and/or therapeutic conduct of studied cases; critical review of the literature; critical review of the manuscript.</p><p id="par0090" class="elsevierStylePara elsevierViewall">Ângela Marques Barbosa: Approval of the final version of the manuscript; intellectual participation in propaedeutic and/or therapeutic conduct of studied cases.</p><p id="par0095" class="elsevierStylePara elsevierViewall">Marilda Aparecida Milanez Morgado de Abreu: Intellectual participation in propaedeutic and/or therapeutic conduct of studied cases; critical review of the manuscript.</p><p id="par0100" class="elsevierStylePara elsevierViewall">Carlos Zelandi Filho: Intellectual participation in propaedeutic and/or therapeutic conduct of studied cases.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conflicts of interest</span><p id="par0105" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:3 [ "identificador" => "xres1418425" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1297634" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "sec0005" "titulo" => "Case report" ] 3 => array:2 [ "identificador" => "sec0011" "titulo" => "What is your diagnosis?" ] 4 => array:2 [ "identificador" => "sec0010" "titulo" => "Discussion" ] 5 => array:2 [ "identificador" => "sec0015" "titulo" => "Financial support" ] 6 => array:2 [ "identificador" => "sec0020" "titulo" => "Authors’ contributions" ] 7 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of interest" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-04-28" "fechaAceptado" => "2019-11-25" "PalabrasClave" => array:1 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1297634" "palabras" => array:3 [ 0 => "Clinical diagnosis" 1 => "Granulomatous disease, chronic" 2 => "Skin abnormalities" ] ] ] ] "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Lupus miliaris disseminatus faciei or acne agminata is a chronic inflammatory disorder of the skin, considered an intriguing entity due to its pathogenesis, which is still largely speculative. It has been linked to tuberculosis, sarcoidosis, rosacea, and other granulomatous diseases, but it is considered an independent entity.</p></span>" ] ] "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "⋆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">How to cite this article: Garcia ACM, Barbosa AM, Abreu MAMM, Zelandi Filho C. Case for diagnosis. Eyelid edema and erythematous papules disseminated on the face. An Bras Dermatol. 2020. <span class="elsevierStyleInterRef" id="intr0005" href="https://doi.org/10.1016/j.abd.2019.11.016">https://doi.org/10.1016/j.abd.2019.11.016</span></p>" ] 1 => array:2 [ "etiqueta" => "⋆⋆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Study conducted at the Hospital Regional de Presidente Prudente, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1041 "Ancho" => 905 "Tamanyo" => 178733 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Erythematous papules on the malar areas, forehead and chin. Plaques formed by coalescence of papules on both eyelids.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1429 "Ancho" => 900 "Tamanyo" => 507110 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">(A) No major changes in the epidermis. Granulomatous inflammation in the middle and deep dermis. Caseous necrosis in the center of the granulomatous process (Hematoxylin & eosin, ×40). (B) Focal necrosis and granulomatous inflammation with giant cells (Hematoxylin & eosin, ×100). Special stains were negative for acid-fast bacilli and fungi.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Note: All exams were within normal range.</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=""><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">Serology for HIV, hepatitis B, hepatitis C, and VDRL \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">PTH, calcium, phosphorus, 25-hydroxyvitamin D, copper, zinc, sodium, potassium \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">Cell blood count, iron, ferritin, glucose, triglycerides \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">Renal function (urea and creatinine) \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">Thyroid function (TSH, fT4), ANA \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">Liver function (transaminases, bilirubins, alkaline phosphatase) \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">Protein electrophoresis \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">Stool parasitology (3 samples) \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">PPD \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">CD4, CD8, CD3 \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">Chest X-ray \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2433434.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Complementary exams – investigation panel.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:8 [ 0 => array:3 [ "identificador" => "bib0045" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Lupus miliaris disseminatus faciei</span>: report of a new case and brief literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "D. Rocas" 1 => "J. Kanitakis" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Dermatol Online J" "fecha" => "2013" "volumen" => "19" "paginaInicial" => "4" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24021364" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0050" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Lupus miliaris disseminatus faciei</span>" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H. Toda-Brito" 1 => "J.M.P. Aranha" 2 => "E.S. Tavares" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Bras Dermatol" "fecha" => "2017" "volumen" => "92" "paginaInicial" => "856" "paginaFinal" => "858" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0055" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Lupus miliaris disseminatus faciei</span>: a distinctive rosacea-like syndrome and not a granulomatous form of rosacea" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.R. Van de Scheur" 1 => "R.I. Van der Waal" 2 => "T.M. Starink" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1159/000068457" "Revista" => array:6 [ "tituloSerie" => "Dermatology" "fecha" => "2003" "volumen" => "206" "paginaInicial" => "120" "paginaFinal" => "123" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12592078" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0060" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Lupus miliaris disseminatus faciei</span> – pathologic study of early, fully developed, and late lesions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. el Darouti" 1 => "H. Zaher" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-4362.1993.tb02835.x" "Revista" => array:6 [ "tituloSerie" => "Int J Dermatol" "fecha" => "1993" "volumen" => "32" "paginaInicial" => "508" "paginaFinal" => "511" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8340186" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0065" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Lupus miliaris disseminatus faciei</span>. Part I: Significance of histopathologic undertones in diagnosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "V.N. Sehgal" 1 => "G. Srivastava" 2 => "A.K. Aggarwal" 3 => "V.R. Belum" 4 => "S. Sharma" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1540-9740.2005.03510.x" "Revista" => array:6 [ "tituloSerie" => "SkinMed" "fecha" => "2005" "volumen" => "4" "paginaInicial" => "151" "paginaFinal" => "156" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15891251" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0070" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Lupus miliaris disseminatus faciei</span> – the DNA of <span class="elsevierStyleItalic">Mycobacterium tuberculosis</span> is not detectable in active lesions by polymerase chain reaction" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. Hodak" 1 => "A. Trattner" 2 => "H. Feuerman" 3 => "M. Feinmesser" 4 => "R. Tsvieli" 5 => "S. Mitrani-Rosenbaum" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2133.1997.tb03797.x" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "1997" "volumen" => "137" "paginaInicial" => "614" "paginaFinal" => "619" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9390342" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0075" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleItalic">Lupus miliaris disseminatus faciei</span>: 6 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Borhan" 1 => "M.D. Vignon-Pennamen" 2 => "P. Morel" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0151-9638(05)79332-7" "Revista" => array:7 [ "tituloSerie" => "Ann Dermatol Venereol" "fecha" => "2005" "volumen" => "132" "numero" => "Pt 1" "paginaInicial" => "526" "paginaFinal" => "530" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16142099" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0080" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Extrafacial <span class="elsevierStyleItalic">lupus miliaris disseminatus</span>" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K.M. Nemer" 1 => "L.Y. McGirt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jdcr.2016.08.007" "Revista" => array:6 [ "tituloSerie" => "JAAD Case Rep" "fecha" => "2016" "volumen" => "2" "paginaInicial" => "363" "paginaFinal" => "365" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27699199" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03650596/0000009500000006/v2_202011230629/S0365059620302130/v2_202011230629/en/main.assets" "Apartado" => array:4 [ "identificador" => "80633" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "What is your Diagnosis?" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03650596/0000009500000006/v2_202011230629/S0365059620302130/v2_202011230629/en/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059620302130?idApp=UINPBA00008Z" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 19 | 11 | 30 |
| 2024 October | 97 | 62 | 159 |
| 2024 September | 147 | 88 | 235 |
| 2024 August | 177 | 119 | 296 |
| 2024 July | 161 | 110 | 271 |
| 2024 June | 124 | 95 | 219 |
| 2024 May | 95 | 67 | 162 |
| 2024 April | 132 | 93 | 225 |
| 2024 March | 117 | 71 | 188 |
| 2024 February | 91 | 105 | 196 |
| 2024 January | 70 | 77 | 147 |
| 2023 December | 64 | 64 | 128 |
| 2023 November | 91 | 69 | 160 |
| 2023 October | 59 | 87 | 146 |
| 2023 September | 81 | 75 | 156 |
| 2023 August | 70 | 48 | 118 |
| 2023 July | 57 | 31 | 88 |
| 2023 June | 62 | 42 | 104 |
| 2023 May | 63 | 20 | 83 |
| 2023 April | 46 | 18 | 64 |
| 2023 March | 79 | 49 | 128 |
| 2023 February | 34 | 38 | 72 |
| 2023 January | 42 | 37 | 79 |
| 2022 December | 44 | 22 | 66 |
| 2022 November | 78 | 48 | 126 |
| 2022 October | 87 | 55 | 142 |
| 2022 September | 54 | 54 | 108 |
| 2022 August | 44 | 41 | 85 |
| 2022 July | 51 | 54 | 105 |
| 2022 June | 47 | 49 | 96 |
| 2022 May | 45 | 52 | 97 |
| 2022 April | 37 | 56 | 93 |
| 2022 March | 34 | 69 | 103 |
| 2022 February | 31 | 32 | 63 |
| 2022 January | 65 | 82 | 147 |
| 2021 December | 37 | 57 | 94 |
| 2021 November | 51 | 64 | 115 |
| 2021 October | 52 | 100 | 152 |
| 2021 September | 39 | 44 | 83 |
| 2021 August | 42 | 37 | 79 |
| 2021 July | 42 | 43 | 85 |
| 2021 June | 28 | 59 | 87 |
| 2021 May | 60 | 76 | 136 |
| 2021 April | 133 | 217 | 350 |
| 2021 March | 93 | 93 | 186 |
| 2021 February | 46 | 24 | 70 |
| 2021 January | 33 | 20 | 53 |
| 2020 December | 28 | 14 | 42 |
| 2020 November | 31 | 14 | 45 |
| 2020 October | 11 | 13 | 24 |
| 2020 September | 20 | 14 | 34 |
| 2020 August | 7 | 6 | 13 |
Show all
