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This is a cross section of the reticular dermis demonstrating ink between the collagen fibers, without bolus formation</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Samir Arbache, Sergio Henrique Hirata" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Samir" "apellidos" => "Arbache" ] 1 => array:2 [ "nombre" => "Sergio Henrique" "apellidos" => "Hirata" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275223002436" "doi" => "10.1016/j.abdp.2023.09.024" "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/S2666275223002436?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S036505962300212X?idApp=UINPBA00008Z" "url" => "/03650596/0000009900000001/v1_202401040817/S036505962300212X/v1_202401040817/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Correspondence</span>" "titulo" => "Comment related to the publication “Elevation of transaminases after MMP® session with methotrexate for alopecia areata treatment ‒ How much do we know about the risks of systemic absorption of the technique?” ‒ Answer" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">Dear Editor,</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "162" "paginaFinal" => "163" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Renata Heck, Renan Rangel Bonamigo" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Renata" "apellidos" => "Heck" "email" => array:1 [ 0 => "reheck2@yahoo.com.br" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Renan Rangel" "apellidos" => "Bonamigo" "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Service of Dermatology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Faculty of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We agree with the consideration that, regarding the cause of the increase in transaminase levels in the described patient, there are no means of affirming with certainty the association with the MMP® technique.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> We reinforce, however, that she had already shown an elevation of transaminase levels with the previous use of the medication when administered orally. We attributed it to the technique used after excluding other possible causes such as infections, alcohol consumption, physical activity, or use of any other medication, in addition to the transitoriness of transaminitis in relation to the procedure.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The technique involves the penetration of needles into the dermis,<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">2,3</span></a> where vascularization is prominent in the scalp, with biological plausibility in affirming the possibility of absorption of the drug used. Additionally the patient is likely to be susceptible to methotrexate-related adverse effects, despite the small, absorbed dose.</p><p id="par0015" class="elsevierStylePara elsevierViewall">We reaffirm the importance of reporting unexpected adverse effects related to the recent use of percutaneous treatment techniques, aiming at patient safety through adequate monitoring.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0020" class="elsevierStylePara elsevierViewall">None declared.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors' contributions</span><p id="par0025" class="elsevierStylePara elsevierViewall">Renan Rangel Bonamigo: Drafting and editing of the manuscript and critical review of important intellectual content; effective participation in research orientation; intellectual participation in the propaedeutic and/or therapeutic conduct of the studied cases; critical review of the literature; approval of the final version of the manuscript.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Renata Heck: Design and planning of the study; drafting and editing of the manuscript and critical review of important intellectual content; effective participation in research orientation; intellectual participation in the propaedeutic and/or therapeutic conduct of the studied cases; critical review of the literature; approval of the final version of the manuscript.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Financial support" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Authors' contributions" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflicts of interest" ] 3 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2023-08-14" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "⋆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Study conducted at the Service of Dermatology, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0015" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Elevation of transaminases after MMP® session with methotrexate for alopecia areata treatment - how much do we know about the risks of systemic absorption of the technique?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "B.L. Nogueira" 1 => "R.R. Bonamigo" 2 => "R. Heck" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.abd.2021.01.013" "Revista" => array:6 [ "tituloSerie" => "An Bras Dermatol" "fecha" => "2023" "volumen" => "98" "paginaInicial" => "390" "paginaFinal" => "391" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/36581558" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0005" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Treatment of idiopathic guttate hypomelanosis with a tattoo device versus a handheld needle" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Arbache" 1 => "M.T. de Mendonca" 2 => "S.T. Arbache" 3 => "S.H. Hirata" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jdin.2021.01.005" "Revista" => array:6 [ "tituloSerie" => "JAAD Int" "fecha" => "2021" "volumen" => "3" "paginaInicial" => "14" "paginaFinal" => "16" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34409366" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0010" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "How much medication is delivered in a novel drug delivery technique that uses a tattoo machine?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Arbache" 1 => "E.C. Mattos" 2 => "M.F. Diniz" 3 => "P.Y.A. Paiva" 4 => "D. Roth" 5 => "S.T. Arbache" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/ijd.14408" "Revista" => array:6 [ "tituloSerie" => "Int J Dermatol" "fecha" => "2019" "volumen" => "58" "paginaInicial" => "750" "paginaFinal" => "755" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30828798" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/03650596/0000009900000001/v1_202401040817/S0365059623002106/v1_202401040817/en/main.assets" "Apartado" => array:4 [ "identificador" => "96905" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Correspondences" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03650596/0000009900000001/v1_202401040817/S0365059623002106/v1_202401040817/en/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059623002106?idApp=UINPBA00008Z" ]
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