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em Monterrey&#44; M&#233;xico&#46; Foi elaborado um question&#225;rio com perguntas sobre produtos de higiene e protetores solares&#44; incluindo o tempo de uso&#46; Pacientes e controles foram testadas com adesivos utilizando al&#233;rgenos das s&#233;ries AllergyEAZE Standard&#44; Cosmetic e Photopatch&#46; As leituras foram realizadas 48 e 96 horas ap&#243;s a aplica&#231;&#227;o&#46; As rea&#231;&#245;es foram medidas pelos crit&#233;rios do North American Contact Dermatitis Group&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">2</span></a> Pacientes com AFF atendidas em nossa cl&#237;nica de dermatologia no per&#237;odo de 2012 a 2018 foram inclu&#237;das no estudo&#46; O teste exato de Fisher foi utilizado para comparar os grupos&#46; A signific&#226;ncia estat&#237;stica foi considerada com p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">A m&#233;dia de idade foi de 59&#44;1 para as pacientes com AFF e de 56&#44;5 anos para as controles&#46; Dezesseis casos estavam na p&#243;s&#8208;menopausa&#46; Dez pacientes relataram sintomas m&#237;nimos &#40;principalmente prurido&#41;&#46; Sete casos apresentavam pelo menos uma doen&#231;a autoimune&#59; l&#237;quen plano pigmentoso foi a mais comum&#46; Nove pacientes tinham hist&#243;ria familiar de autoimunidade&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Alopecia fora do couro cabeludo foi observada em 15 casos&#46; Todos tinham envolvimento de sobrancelha&#59; 12 casos&#44; de membros&#59; e 10&#44; de c&#237;lios&#46; Oito indiv&#237;duos apresentavam p&#225;pulas faciais&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a> descreve o uso de produtos de higiene&#46; O uso de filtro solar em pacientes com AFF foi quase o dobro do que nos controles saud&#225;veis &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;035&#41;&#46; Base de maquiagem era utilizada por 14 mulheres em cada grupo&#46; Os casos de AFF usavam mais hidratantes faciais em compara&#231;&#227;o com os controles&#44; sem signific&#226;ncia estat&#237;stica&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Rea&#231;&#245;es positivas a pelo menos um al&#233;rgeno ocorreram em 15 pacientes&#44; contra 10 controles&#59; nenhuma diferen&#231;a significativa foi encontrada&#46; Os al&#233;rgenos mais comuns em AFF foram butilcarbamato de iodopropinila e pr&#243;polis &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46; Os produtos de higiene das pacientes foram revisados&#44; e recomenda&#231;&#245;es foram feitas para evit&#225;&#8208;los&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Aldoori et al&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">3</span></a> sugeriram fatores ambientais associados &#224; AFF&#44; com uma diferen&#231;a significativa no uso de filtro solar em compara&#231;&#227;o com os controles&#46; Eles realizaram testes de contato em 40 pacientes&#59; foram encontradas mais rea&#231;&#245;es positivas ao hidroper&#243;xido de linalol e ao b&#225;lsamo do Peru em indiv&#237;duos com AFF quando comparados a indiv&#237;duos testados com adesivos em geral&#46; Rocha et al&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">4</span></a> n&#227;o observaram diferen&#231;as em 63 pacientes com AFF em compara&#231;&#227;o com indiv&#237;duos testados com adesivos locais&#59; fotoalergia n&#227;o foi detectada&#46; Os al&#233;rgenos identificados na AFF s&#227;o incapazes de explicar a associa&#231;&#227;o entre a doen&#231;a e o uso de protetor solar&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">5</span></a> Thompson et al&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">6</span></a> encontraram nanopart&#237;culas de di&#243;xido de tit&#226;nio &#40;TiO<span class="elsevierStyleInf">2</span>&#41; em fios de cabelo de pacientes com AFF e controles assintom&#225;ticos&#59; n&#227;o foram encontradas rea&#231;&#245;es positivas em testes de contato realizados em oito pacientes com AFF utilizando cinco tipos de tit&#226;nio&#46; N&#227;o est&#225; claro se o TiO<span class="elsevierStyleInf">2</span> desempenha um papel na patog&#234;nese da AFF&#46; Recentemente&#44; Rudnicka et al&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">7</span></a> analisaram testes de contato em 20 pacientes com AFF e 24 controles saud&#225;veis e encontraram rea&#231;&#245;es positivas nos testes de contato a um ou mais al&#233;rgenos em 65&#37; dos casos&#44; enquanto apenas 37&#44;5&#37; dos controles tiveram uma rea&#231;&#227;o positiva&#46; Os al&#233;rgenos mais comuns encontrados no grupo AFF foram cloreto de cobalto hexa&#8208;hidratado 35&#37;&#44; sulfato de n&#237;quel hexa&#8208;hidratado 25&#37;&#44; e dicromato de pot&#225;ssio 15&#37;&#46; Em nosso estudo&#44; 83&#44;3&#37; dos casos e 55&#44;5&#37; dos controles apresentaram pelo menos um al&#233;rgeno com rea&#231;&#227;o positiva&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">O presente estudo incluiu controles saud&#225;veis pareados por sexo e idade&#44; enquanto a maioria das publica&#231;&#245;es anteriores utilizou uma popula&#231;&#227;o geral nos testes de contato&#46; As limita&#231;&#245;es incluem o pequeno tamanho da amostra&#44; vi&#233;s de mem&#243;ria para uso de filtro solar&#44; falta de estudos gen&#233;ticos e generaliza&#231;&#227;o em decorr&#234;ncia da homogeneidade racial&#47;&#233;tnica&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Em conclus&#227;o&#44; a etiopatogenia da AFF permanece desconhecida&#46; Aumento do uso de filtro solar e maior preval&#234;ncia de alergia de contato foram demonstrados neste estudo nos pacientes com AFF&#44; levantando a quest&#227;o de que as respostas al&#233;rgicas&#47;imunol&#243;gicas em pacientes geneticamente predispostos poderiam ser desencadeadas por subst&#226;ncias ex&#243;genas&#46; A maior preval&#234;ncia estatisticamente n&#227;o significativa de alergia de contato no presente estudo e a heterogeneidade de resultados em estudos anteriores endossam a necessidade de novas pesquisas para confirmar essa associa&#231;&#227;o&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0050" 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="par0055" class="elsevierStylePara elsevierViewall">Sonia Sofia Ocampo&#8208;Garza&#58; Concep&#231;&#227;o e planejamento do estudo&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o de dados&#59; reda&#231;&#227;o do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final submetida&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Maira Elizabeth Herz&#8208;Ruelas&#58; Concep&#231;&#227;o e planejamento do estudo&#59; An&#225;lise e interpreta&#231;&#227;o de dados&#59; revis&#227;o do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final submetida&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Sonia Chavez&#8208;Alvarez&#58; Concep&#231;&#227;o e planejamento do estudo&#59; revis&#227;o do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final submetida&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">David Marcelo de la Fuente&#8208;Rodriguez&#58; Obten&#231;&#227;o de dados&#59; aprova&#231;&#227;o da vers&#227;o final submetida&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Jorge Ocampo&#8208;Candiani&#58; Concep&#231;&#227;o e planejamento do estudo&#59; An&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final submetida&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0080" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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    "fechaRecibido" => "2020-05-31"
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        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Como citar este artigo&#58; Ocampo&#8208;Garza SS&#44; Herz&#8208;Ruelas ME&#44; Chavez&#8208;Alvarez S&#44; Fuente&#8208;Rodriguez DM&#44; Ocampo&#8208;Candiani J&#46; Association of frontal fibrosing alopecia and contact allergens in everyday skincare products in Hispanic females&#58; a case&#8208;control study&#46; An Bras Dermatol&#46; 2021&#59;96&#58;776&#8211;8&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Trabalho realizado no Hospital Universitario Dr&#46; Jos&#233; Eleuterio Gonz&#225;lez&#44; Monterrey&#44; NL&#44; M&#233;xico&#46;</p>"
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                  <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">Produto&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">AFF&#44; n &#40;&#37;&#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">Controles&#44; n &#40;&#37;&#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">p&#8208;valor&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">Base de maquiagem&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;77&#44;8&#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">14 &#40;77&#44;8&#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">0&#44;999&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">Protetor solar&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 &#40;83&#44;3&#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">8 &#40;44&#44;4&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;035&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">Removedor de maquiagem&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 &#40;55&#44;6&#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">11 &#40;61&#44;1&#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">0&#44;999&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">Hidratante facial&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">17 &#40;94&#44;4&#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">14 &#40;77&#44;8&#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">0&#44;338&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">Creme antienvelhecimento&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;66&#44;7&#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">6 &#40;33&#44;3&#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">0&#44;094&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">Xampu&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 &#40;100&#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">18 &#40;100&#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">N&#47;A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Condicionador&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;50&#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">12 &#40;66&#44;7&#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">0&#44;5&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">Creme para pentear&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">8 &#40;44&#44;4&#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">9 &#40;50&#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">0&#44;999&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">Tratamentos capilares&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;22&#44;2&#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">4 &#40;22&#44;2&#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">0&#44;999&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">Tintura para cabelo&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">11 &#40;61&#44;1&#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">14 &#40;77&#44;8&#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">0&#44;471&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">Permanentes &#40;ondulado ou alisamento de cabelo&#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">1 &#40;5&#44;6&#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">3 &#40;16&#44;7&#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">0&#44;603&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">Desodorante&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
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                  \t\t\t\t">15 &#40;83&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">18 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;229&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Perfume&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;5&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0 603&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Hexahidrato de sulfato de n&#237;quel&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1 &#40;5&#44;6&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Pr&#243;polis&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3 &#40;16&#44;7&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2 &#40;11&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;999&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Dissulfito de s&#243;dio&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2 &#40;11&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">0&#44;486&nbsp;\t\t\t\t\t\t\n
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                      "titulo" => "Frontal Fibrosing Alopecia&#58; An Update on Pathogenesis Diagnosis&#44; and Treatment"
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                      "titulo" => "Photopatch and patch testing in 63 patients with frontal fibrosing alopecia&#58; a case series"
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                          "etal" => false
                          "autores" => array:5 [
                            0 => "D&#46;H&#46; Marks"
                            1 => "A&#46; Manatis-Lornell"
                            2 => "D&#46; Hagigeorges"
                            3 => "J&#46;De&#46; Yu"
                            4 => "M&#46;M&#46; Senna"
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                      "Revista" => array:6 [
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                0 => array:2 [
                  "contribucion" => array:1 [
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                      "titulo" => "Identification of titanium dioxide on the hair shaft of patients with and without frontal fibrosing alopecia&#58; A pilot study of 20 patients"
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                          "etal" => false
                          "autores" => array:4 [
                            0 => "C&#46;T&#46; Thompson"
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                            2 => "A&#46; Kolivras"
                            3 => "A&#46; Tosti"
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                    0 => array:2 [
                      "doi" => "10.1111/bjd.17639"
                      "Revista" => array:6 [
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                        "paginaFinal" => "217"
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Allergic contact dermatitis in patients with frontal fibrosing alopecia&#58; An international multi&#8208;center study"
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Carta ‐ Investigação
Associação de alopecia fibrosante frontal e alérgenos de contato em produtos de cuidado diário da pele em mulheres hispânicas: um estudo de caso‐controle
Sonia Sofia Ocampo‐Garzaa, Maira Elizabeth Herz‐Ruelasa, Sonia Chavez‐Alvareza, David Marcelo de la Fuente‐Rodriguezb, Jorge Ocampo‐Candiania,
Corresponding author
jocampo2000@yahoo.com.mx

Autor para correspondência.
a Departamento de Dermatologia, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, NL, México
b Escola de Medicina, Universidad Autónoma de Nuevo León, Monterrey, NL, México
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A alopecia fibrosante frontal &#40;AFF&#41; &#233; uma alopecia cicatricial linfoc&#237;tica prim&#225;ria com etiopatogenia obscura&#46; J&#225; foram propostas hip&#243;teses hormonais&#44; imunomediadas&#44; gen&#233;ticas e ambientais&#59; uma delas est&#225; relacionada ao aumento do uso de filtro solar&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">1</span></a> O objetivo do presente estudo foi identificar uma poss&#237;vel associa&#231;&#227;o entre AFF e o uso de filtro solar nessa popula&#231;&#227;o de pacientes&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Este foi um estudo de caso&#8208;controle com 36 mulheres hisp&#226;nicas&#59; 18 casos e 18 controles foram pareados por sexo e idade&#46; O protocolo foi aprovado pelo Comit&#234; de &#201;tica local do Hospital Universitario Dr&#46; Jos&#233; Eleuterio Gonz&#225;lez&#44; em Monterrey&#44; M&#233;xico&#46; Foi elaborado um question&#225;rio com perguntas sobre produtos de higiene e protetores solares&#44; incluindo o tempo de uso&#46; Pacientes e controles foram testadas com adesivos utilizando al&#233;rgenos das s&#233;ries AllergyEAZE Standard&#44; Cosmetic e Photopatch&#46; As leituras foram realizadas 48 e 96 horas ap&#243;s a aplica&#231;&#227;o&#46; As rea&#231;&#245;es foram medidas pelos crit&#233;rios do North American Contact Dermatitis Group&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">2</span></a> Pacientes com AFF atendidas em nossa cl&#237;nica de dermatologia no per&#237;odo de 2012 a 2018 foram inclu&#237;das no estudo&#46; O teste exato de Fisher foi utilizado para comparar os grupos&#46; A signific&#226;ncia estat&#237;stica foi considerada com p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">A m&#233;dia de idade foi de 59&#44;1 para as pacientes com AFF e de 56&#44;5 anos para as controles&#46; Dezesseis casos estavam na p&#243;s&#8208;menopausa&#46; Dez pacientes relataram sintomas m&#237;nimos &#40;principalmente prurido&#41;&#46; Sete casos apresentavam pelo menos uma doen&#231;a autoimune&#59; l&#237;quen plano pigmentoso foi a mais comum&#46; Nove pacientes tinham hist&#243;ria familiar de autoimunidade&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Alopecia fora do couro cabeludo foi observada em 15 casos&#46; Todos tinham envolvimento de sobrancelha&#59; 12 casos&#44; de membros&#59; e 10&#44; de c&#237;lios&#46; Oito indiv&#237;duos apresentavam p&#225;pulas faciais&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a> descreve o uso de produtos de higiene&#46; O uso de filtro solar em pacientes com AFF foi quase o dobro do que nos controles saud&#225;veis &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;035&#41;&#46; Base de maquiagem era utilizada por 14 mulheres em cada grupo&#46; Os casos de AFF usavam mais hidratantes faciais em compara&#231;&#227;o com os controles&#44; sem signific&#226;ncia estat&#237;stica&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Rea&#231;&#245;es positivas a pelo menos um al&#233;rgeno ocorreram em 15 pacientes&#44; contra 10 controles&#59; nenhuma diferen&#231;a significativa foi encontrada&#46; Os al&#233;rgenos mais comuns em AFF foram butilcarbamato de iodopropinila e pr&#243;polis &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#41;&#46; Os produtos de higiene das pacientes foram revisados&#44; e recomenda&#231;&#245;es foram feitas para evit&#225;&#8208;los&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Aldoori et al&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">3</span></a> sugeriram fatores ambientais associados &#224; AFF&#44; com uma diferen&#231;a significativa no uso de filtro solar em compara&#231;&#227;o com os controles&#46; Eles realizaram testes de contato em 40 pacientes&#59; foram encontradas mais rea&#231;&#245;es positivas ao hidroper&#243;xido de linalol e ao b&#225;lsamo do Peru em indiv&#237;duos com AFF quando comparados a indiv&#237;duos testados com adesivos em geral&#46; Rocha et al&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">4</span></a> n&#227;o observaram diferen&#231;as em 63 pacientes com AFF em compara&#231;&#227;o com indiv&#237;duos testados com adesivos locais&#59; fotoalergia n&#227;o foi detectada&#46; Os al&#233;rgenos identificados na AFF s&#227;o incapazes de explicar a associa&#231;&#227;o entre a doen&#231;a e o uso de protetor solar&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">5</span></a> Thompson et al&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">6</span></a> encontraram nanopart&#237;culas de di&#243;xido de tit&#226;nio &#40;TiO<span class="elsevierStyleInf">2</span>&#41; em fios de cabelo de pacientes com AFF e controles assintom&#225;ticos&#59; n&#227;o foram encontradas rea&#231;&#245;es positivas em testes de contato realizados em oito pacientes com AFF utilizando cinco tipos de tit&#226;nio&#46; N&#227;o est&#225; claro se o TiO<span class="elsevierStyleInf">2</span> desempenha um papel na patog&#234;nese da AFF&#46; Recentemente&#44; Rudnicka et al&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">7</span></a> analisaram testes de contato em 20 pacientes com AFF e 24 controles saud&#225;veis e encontraram rea&#231;&#245;es positivas nos testes de contato a um ou mais al&#233;rgenos em 65&#37; dos casos&#44; enquanto apenas 37&#44;5&#37; dos controles tiveram uma rea&#231;&#227;o positiva&#46; Os al&#233;rgenos mais comuns encontrados no grupo AFF foram cloreto de cobalto hexa&#8208;hidratado 35&#37;&#44; sulfato de n&#237;quel hexa&#8208;hidratado 25&#37;&#44; e dicromato de pot&#225;ssio 15&#37;&#46; Em nosso estudo&#44; 83&#44;3&#37; dos casos e 55&#44;5&#37; dos controles apresentaram pelo menos um al&#233;rgeno com rea&#231;&#227;o positiva&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">O presente estudo incluiu controles saud&#225;veis pareados por sexo e idade&#44; enquanto a maioria das publica&#231;&#245;es anteriores utilizou uma popula&#231;&#227;o geral nos testes de contato&#46; As limita&#231;&#245;es incluem o pequeno tamanho da amostra&#44; vi&#233;s de mem&#243;ria para uso de filtro solar&#44; falta de estudos gen&#233;ticos e generaliza&#231;&#227;o em decorr&#234;ncia da homogeneidade racial&#47;&#233;tnica&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Em conclus&#227;o&#44; a etiopatogenia da AFF permanece desconhecida&#46; Aumento do uso de filtro solar e maior preval&#234;ncia de alergia de contato foram demonstrados neste estudo nos pacientes com AFF&#44; levantando a quest&#227;o de que as respostas al&#233;rgicas&#47;imunol&#243;gicas em pacientes geneticamente predispostos poderiam ser desencadeadas por subst&#226;ncias ex&#243;genas&#46; A maior preval&#234;ncia estatisticamente n&#227;o significativa de alergia de contato no presente estudo e a heterogeneidade de resultados em estudos anteriores endossam a necessidade de novas pesquisas para confirmar essa associa&#231;&#227;o&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0050" 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="par0055" class="elsevierStylePara elsevierViewall">Sonia Sofia Ocampo&#8208;Garza&#58; Concep&#231;&#227;o e planejamento do estudo&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o de dados&#59; reda&#231;&#227;o do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final submetida&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Maira Elizabeth Herz&#8208;Ruelas&#58; Concep&#231;&#227;o e planejamento do estudo&#59; An&#225;lise e interpreta&#231;&#227;o de dados&#59; revis&#227;o do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final submetida&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Sonia Chavez&#8208;Alvarez&#58; Concep&#231;&#227;o e planejamento do estudo&#59; revis&#227;o do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final submetida&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">David Marcelo de la Fuente&#8208;Rodriguez&#58; Obten&#231;&#227;o de dados&#59; aprova&#231;&#227;o da vers&#227;o final submetida&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Jorge Ocampo&#8208;Candiani&#58; Concep&#231;&#227;o e planejamento do estudo&#59; An&#225;lise e interpreta&#231;&#227;o dos dados&#59; revis&#227;o do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final submetida&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0080" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Trabalho realizado no Hospital Universitario Dr&#46; Jos&#233; Eleuterio Gonz&#225;lez&#44; Monterrey&#44; NL&#44; M&#233;xico&#46;</p>"
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                  <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">Produto&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">AFF&#44; n &#40;&#37;&#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">Controles&#44; n &#40;&#37;&#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">p&#8208;valor&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">Base de maquiagem&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;77&#44;8&#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">14 &#40;77&#44;8&#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">0&#44;999&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">Protetor solar&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 &#40;83&#44;3&#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">8 &#40;44&#44;4&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;035&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">Removedor de maquiagem&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 &#40;55&#44;6&#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">11 &#40;61&#44;1&#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">0&#44;999&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">Hidratante facial&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">17 &#40;94&#44;4&#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">14 &#40;77&#44;8&#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">0&#44;338&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">Creme antienvelhecimento&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;66&#44;7&#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">6 &#40;33&#44;3&#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">0&#44;094&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">Xampu&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 &#40;100&#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">18 &#40;100&#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">N&#47;A&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Condicionador&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;50&#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">12 &#40;66&#44;7&#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">0&#44;5&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">Creme para pentear&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">8 &#40;44&#44;4&#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">9 &#40;50&#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">0&#44;999&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">Tratamentos capilares&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;22&#44;2&#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">4 &#40;22&#44;2&#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">0&#44;999&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">Tintura para cabelo&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">11 &#40;61&#44;1&#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">14 &#40;77&#44;8&#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">0&#44;471&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">Permanentes &#40;ondulado ou alisamento de cabelo&#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">1 &#40;5&#44;6&#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">3 &#40;16&#44;7&#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
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                  \t\t\t\t">0&#44;603&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Desodorante&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">15 &#40;83&#44;3&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">18 &#40;100&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;229&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Perfume&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">14 &#40;77&#44;8&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">16 &#40;88&#44;9&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;658&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">p&#8208;valor&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0 &#40;0&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2 &#40;11&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;486&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Mistura de fragr&#226;ncias 8&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0 &#40;0&#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
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                  \t\t\t\t">2 &#40;11&#44;1&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;486&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Butilcarbamato de iodopropinila&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;16&#44;7&#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">1 &#40;5&#44;6&#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
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                  \t\t\t\t">0 603&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">Hexahidrato de sulfato de n&#237;quel&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 &#40;5&#44;6&#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">2 &#40;11&#44;1&#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
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                  \t\t\t\t">0&#44;999&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">Pr&#243;polis&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;16&#44;7&#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">1 &#40;5&#44;6&#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">0&#44;603&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Metildibromo glutaronitrila&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;11&#44;1&#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">2 &#40;11&#44;1&#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">0&#44;999&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">Dissulfito de s&#243;dio&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0 &#40;0&#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">2 &#40;11&#44;1&#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">0&#44;486&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Al&#233;rgenos de contato positivos mais comuns</p>"
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      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Refer&#234;ncias"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:7 [
            0 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Frontal Fibrosing Alopecia&#58; An Update on Pathogenesis Diagnosis&#44; and Treatment"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s40257-019-00424-y"
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                        "tituloSerie" => "Am J Clin Dermatol&#46;"
                        "fecha" => "2019"
                        "volumen" => "20"
                        "paginaInicial" => "379"
                        "paginaFinal" => "390"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30659454"
                            "web" => "Medline"
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              "identificador" => "bib0045"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "North American Contact Dermatitis Group Patch Test Results&#58; 2015&#8208;2016"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;G&#46; DeKoven"
                            1 => "E&#46;M&#46; Warshaw"
                            2 => "K&#46;A&#46; Zug"
                            3 => "H&#46;I&#46; Maibach"
                            4 => "D&#46;V&#46; Belsito"
                            5 => "D&#46; Sasseville"
                          ]
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                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1097/DER.0000000000000417"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatitis&#46;"
                        "fecha" => "2018"
                        "volumen" => "29"
                        "paginaInicial" => "297"
                        "paginaFinal" => "309"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30422882"
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              "identificador" => "bib0050"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Frontal fibrosing alopecia&#58; possible association with leave&#8208;on facial skin care products and sunscreens&#59; a questionnaire study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "N&#46; Aldoori"
                            1 => "K&#46; Dobson"
                            2 => "C&#46;R&#46; Holden"
                            3 => "A&#46;J&#46; McDonagh"
                            4 => "M&#46; Harries"
                            5 => "A&#46;G&#46; Messenger"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/bjd.14535"
                      "Revista" => array:6 [
                        "tituloSerie" => "Br J Dermatol&#46;"
                        "fecha" => "2016"
                        "volumen" => "175"
                        "paginaInicial" => "762"
                        "paginaFinal" => "767"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26987767"
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              "identificador" => "bib0055"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Photopatch and patch testing in 63 patients with frontal fibrosing alopecia&#58; a case series"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "V&#46;B&#46; Rocha"
                            1 => "A&#46; Donati"
                            2 => "L&#46;A&#46; Contin"
                            3 => "P&#46; Kakizaki"
                            4 => "C&#46;J&#46; Machado"
                            5 => "F&#46;F&#46; Brito"
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                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
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                0 => array:2 [
                  "contribucion" => array:1 [
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                      "titulo" => "No difference in relevant potential allergens in SPF&#8208;containing facial moisturizers&#58; implications in frontal fibrosing alopecia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "D&#46;H&#46; Marks"
                            1 => "A&#46; Manatis-Lornell"
                            2 => "D&#46; Hagigeorges"
                            3 => "J&#46;De&#46; Yu"
                            4 => "M&#46;M&#46; Senna"
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                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Drugs Ther Perspect&#46;"
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                        "volumen" => "35"
                        "paginaInicial" => "347"
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Article information
ISSN: 26662752
Original language: Portuguese
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