que se leu este artigo
array:22 [ "pii" => "S0365059623001538" "issn" => "03650596" "doi" => "10.1016/j.abd.2022.07.011" "estado" => "S300" "fechaPublicacion" => "2023-11-01" "aid" => "806" "copyright" => "Sociedade Brasileira de Dermatologia" "copyrightAnyo" => "2023" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "itemSiguiente" => array:18 [ "pii" => "S0365059623001629" "issn" => "03650596" "doi" => "10.1016/j.abd.2022.10.013" "estado" => "S300" "fechaPublicacion" => "2023-11-01" "aid" => "815" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter - Tropical/Infectious and parasitic dermatology</span>" "titulo" => "Disseminated varicella with systemic implications in a renal transplant recipient" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "875" "paginaFinal" => "878" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 719 "Ancho" => 1555 "Tamanyo" => 252632 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0170" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">(A) Multinucleated cells with nuclear enlargement and ground-glass appearance (Tzanck cytology). (B) Enlarged multinucleated epithelial cells, with molded nuclei and “ground-glass” chromatin (Hematoxylin & eosin ×40)</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ingrid Rocha Meireles Holanda, Marina Oliveira Dias, Rebecca Perez de Amorim, Aline Lutz Garcia, Ricardo Augusto Monteiro de Barros Almeida, Silvio Alencar Marques" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Ingrid Rocha Meireles" "apellidos" => "Holanda" ] 1 => array:2 [ "nombre" => "Marina Oliveira" "apellidos" => "Dias" ] 2 => array:2 [ "nombre" => "Rebecca Perez de" "apellidos" => "Amorim" ] 3 => array:2 [ "nombre" => "Aline Lutz" "apellidos" => "Garcia" ] 4 => array:2 [ "nombre" => "Ricardo Augusto Monteiro de Barros" "apellidos" => "Almeida" ] 5 => array:2 [ "nombre" => "Silvio Alencar" "apellidos" => "Marques" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275223001935" "doi" => "10.1016/j.abdp.2023.06.027" "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/S2666275223001935?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059623001629?idApp=UINPBA00008Z" "url" => "/03650596/0000009800000006/v2_202310301240/S0365059623001629/v2_202310301240/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0365059623001526" "issn" => "03650596" "doi" => "10.1016/j.abd.2022.06.007" "estado" => "S300" "fechaPublicacion" => "2023-11-01" "aid" => "804" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter - Dermatopathology</span>" "titulo" => "Animal-type melanoma/pigmented epithelioid melanocytoma: three clinical cases of a rare and controversial entity" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "868" "paginaFinal" => "871" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1463 "Ancho" => 3341 "Tamanyo" => 1085030 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Case 1. (A) Dermal melanocytic neoplasm, with abundant amount of pigment and preserved epidermis (Hematoxylin & eosin, ×2). (B) Nests of atypical melanocytes intermingled with abundant melanophages and collagen bundles (Hematoxylin & eosin, ×10). (C) Epithelioid and fusiform melanocytes, with accentuated atypia and macronucleoli (Hematoxylin & eosin, ×40)</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Vittorio Gedda, Francisco González-Coloma, Alejandro Jeldres, Carolyn Rodríguez, Gabriela Coulon, Alex Castro" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Vittorio" "apellidos" => "Gedda" ] 1 => array:2 [ "nombre" => "Francisco" "apellidos" => "González-Coloma" ] 2 => array:2 [ "nombre" => "Alejandro" "apellidos" => "Jeldres" ] 3 => array:2 [ "nombre" => "Carolyn" "apellidos" => "Rodríguez" ] 4 => array:2 [ "nombre" => "Gabriela" "apellidos" => "Coulon" ] 5 => array:2 [ "nombre" => "Alex" "apellidos" => "Castro" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275223001820" "doi" => "10.1016/j.abdp.2022.06.019" "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/S2666275223001820?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059623001526?idApp=UINPBA00008Z" "url" => "/03650596/0000009800000006/v2_202310301240/S0365059623001526/v2_202310301240/en/main.assets" ] "en" => array:17 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter - Dermatopathology</span>" "titulo" => "Melanotrichoblastoma: sixth case report in the literature" "tieneTextoCompleto" => true "saludo" => "Dear Editor," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "871" "paginaFinal" => "874" ] ] "autores" => array:2 [ 0 => array:4 [ "autoresLista" => "Juliana Polizel Ocanha-Xavier" "autores" => array:1 [ 0 => array:4 [ "nombre" => "Juliana Polizel" "apellidos" => "Ocanha-Xavier" "email" => array:1 [ 0 => "jpocanha@gmail.com" ] "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Department of Dermatology, Private Practice, Araçatuba, SP, Brazil" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Department of Pathology, Faculty of Medicine, Universidade do Estado de São Paulo, Botucatu, SP, Brazil" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] 1 => array:3 [ "autoresLista" => "José Cândido Caldeira Xavier-Júnior" "autores" => array:1 [ 0 => array:3 [ "nombre" => "José Cândido Caldeira" "apellidos" => "Xavier-Júnior" "referencia" => array:3 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0015" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0020" ] 2 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0025" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Department of Pathology, Faculty of Medicine, Universidade do Estado de São Paulo, Botucatu, SP, Brazil" "etiqueta" => "a" "identificador" => "aff0015" ] 1 => array:3 [ "entidad" => "Department of Pathology, Faculty of Medicine, Centro Universitário Católico Salesiano Auxilium, Araçatuba, SP, Brazil" "etiqueta" => "b" "identificador" => "aff0020" ] 2 => array:3 [ "entidad" => "Department of Dermatopathology, Instituto de Patologia de Araçatuba, Araçatuba, SP, Brazil" "etiqueta" => "c" "identificador" => "aff0025" ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1874 "Ancho" => 3341 "Tamanyo" => 1364950 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Immunohistochemistry. (A) Diffuse positivity for cytokeratin; note the epidermis as internal positive control (×40). (B) Detail of cytokeratin positivity in the neoplasm; note here also the peripheral palisade and the cleft artifact between the neoplasm stroma and the adjacent dermis (×100). (C) Detail highlighting melanocytes positive for Melan-A. Note the brownish melanin pigment in adjacent neoplastic cells (×400). (D) Ki-67 staining, demonstrating cells in the proliferative phase, with a predominantly peripheral distribution in the tumor (×40)</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Trichoblastomas (TB) are benign tumors derived from the hair follicle, with a low risk of malignant transformation, and are the most common neoplasm arising from nevus sebaceus of Jadassohn. They are neoplasms characterized by a biphasic differentiation into epithelium and the follicular germinative stroma. Histopathology shows a basaloid cells neoplasms in a stroma similar to follicular mesenchyme, well delimited, non-ulcerated, and restricted to the dermis, with numerous histopathological variants described.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Melanotrichoblastoma is rare, with less than ten cases described in the literature; and it is different from pigmented trichoblastoma by the proliferation of intratumor melanocytes.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The aim of this report is to describe a case of melanotrichoblastoma and review the literature regarding the clinical aspects of the cases described to date.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Case report</span><p id="par0015" class="elsevierStylePara elsevierViewall">A 59-year-old female patient presented an asymptomatic lesion that had been growing for one month on the scalp, without the presence of associated nevus sebaceus (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Dermoscopy showed some arboriform telangiectasias and a single blue ovoid nest, visible to the naked eye. Lesion excision was performed due to the hypotheses of basal cell carcinoma, spiradenoma, and hidradenoma. Anatomopathological examination identified a dermal neoplasm of basaloid cells with a monotonous appearance, without connection to the epidermis, arranged in cohesive blocks, with cystic areas, and occasional peripheral palisade and multiple foci of pigmentation (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). The epithelial cell blocks were surrounded by a hypercellular fibrous stroma showing numerous spindle cells without atypia. Cleft artifact was identified between the neoplastic stroma and the adjacent dermis. No calcification, ulceration and/or corneal cysts were observed. To quantify the melanocytes and differentiate the lesion from a pigmented trichoblastoma, the immunohistochemical study was performed (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>) using counterstaining with a magenta chromogen to avoid the influence of the melanin pigment on the interpretation of the slides. The neoplasm was positive for the cytokeratin cocktail (clone: AE1/AE3) and for Melan-A (clone A103) which highlighted the presence of numerous intratumor melanocytes. Ki-67 staining was also performed, which showed sparse positivity in cells predominantly in the periphery of the tumor.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">This is the sixth case of this neoplasm described in the current literature. When analyzing the clinical data of the previously described cases (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>), one can observe a preferential location on the scalp, a mean age of 45 years, higher frequency in the female sex and a rare association with nevus sebaceus.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Discussion</span><p id="par0025" class="elsevierStylePara elsevierViewall">First described in 2002,<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> as a distinct variant of trichoblastoma, melanotrichoblastoma still remains little known among dermatologists and pathologists, with pigmented basal cell carcinoma (BCC) as its main differential diagnosis. It is noteworthy that this differentiation becomes important due to the prognosis and follow-up.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Dermoscopy<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> has shown that, unlike BCC, 87% of TB are symmetrical lesions, with a single homogeneous blue-gray area (in contrast to the multiple ovoid nests of BCC). A total of 61% of TB cases may have arboriform telangiectasias and 69.6% may have white structures (chrysalis included).<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In terms of histopathology, both are basaloid cell neoplasms, which can show different architectural patterns: large solid blocks with cystic areas, micronodules, adenoid-cystic patterns, cord-like patterns, etc. However, trichoblastomas do not have a connection with the epidermis, and exhibit a characteristic hypercellular stroma and cleft artifact between the neoplastic stroma and the adjacent dermis. BCC is usually connected to the epidermis or follicular epithelium, the stroma presents some myxoid differentiation, and there is cleft artifact between the epithelial blocks of the neoplasm and the dermis.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">One study evaluated BRAF, NRAS, KRAS, and HRAS gene expression, and found HRAS mutation in both a nevus sebaceus and the TB arising from it, indicating a possible common origin.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> There are reported cases of multiple lesions derived from nevus sebaceus, such as syringocystadenoma papilliferum, trichoblastoma, tubular apocrine adenoma, sebaceoma, follicular infundibulum tumor, and epithelioma with sebaceous differentiation.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> However, the neoplasm described in the present report is even more uncommon, and its difference lies in the intratumor melanocytic proliferation and not only the presence of pigment.</p><p id="par0040" class="elsevierStylePara elsevierViewall">There is one reported case in the literature of melanoma associated with melanotrichoblastoma, called trichoblastomelanoma, in a 62-year-old female patient, with a slow-growing lesion since childhood, measuring 8<span class="elsevierStyleHsp" style=""></span>cm, with associated axillary lymph nodes.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> The presence of a fibrous capsule suggested degeneration of the lesion to melanoma after the TB onset, and the patient, after undergoing an extensive excision, had a two-year follow-up without disease progression.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> In this case, an NRAS mutation was observed, a rare mutation present in melanomas.</p><p id="par0045" class="elsevierStylePara elsevierViewall">The present case is similar to the cases previously described in the literature, of slow-growth tumors on the scalp, in a 59-year-old woman. However, it was not associated with nevus sebaceus or seborrheic keratosis, as previously described.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,7–10</span></a> According to the authors review, this is the sixth reported case.</p><p id="par0050" class="elsevierStylePara elsevierViewall">It remains under discussion whether a melanotrichoblastoma would be a variant or a synonym of pigmented trichoblastoma, since only after the advent of immunohistochemistry it became possible to identify the presence and quantify melanocytes in tumor blocks. Melanotrichoblastoma highlights the strong association of epithelial and melanocytic cells present in the structure of the hair follicle.</p><p id="par0055" class="elsevierStylePara elsevierViewall">The interaction between keratinocytes and melanocytes in the onset of neoplastic lesions remains a little explored and a little known field, and the presence of lesions consisting of a mixture of these components indicates that it is important to better understand this relationship, even in a pathophysiological context.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Financial support</span><p id="par0060" class="elsevierStylePara elsevierViewall">None declared.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Authors’ contributions</span><p id="par0065" class="elsevierStylePara elsevierViewall">Juliana Polizel Ocanha-Xavier: Study design, investigation, follow-up and surgical excision, original manuscript drafting, review and editing.</p><p id="par0070" class="elsevierStylePara elsevierViewall">José Cândido Caldeira Xavier-Júnior: Investigation, histopathological analysis, manuscript writing, review and editing.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conflicts of interest</span><p id="par0075" class="elsevierStylePara elsevierViewall">None declared.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:6 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Case report" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Discussion" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Financial support" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Authors’ contributions" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Conflicts of interest" ] 5 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2022-05-16" "fechaAceptado" => "2022-07-16" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Study conducted at the Private Practice, Araçatuba; Instituto de Patologia de Araçatuba, Araçatuba, SP, Brazil.</p>" ] ] "multimedia" => array:4 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1258 "Ancho" => 1675 "Tamanyo" => 360496 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Clinical picture of the lesion, located on the scalp. A bluish spot is visible with the naked eye</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2335 "Ancho" => 3341 "Tamanyo" => 1452001 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A) Panoramic view: note the lack of connection with the epidermis and the solid-cystic component of the neoplasm (Hematoxylin & eosin, ×40). (B) Panoramic view of the deep part of the tumor, highlighting the biphasic aspect of the neoplasm and the pigmentation focus (Hematoxylin & eosin, ×40). (C) Note the peripheral palisade and cleft artifact between the neoplasm stroma and adjacent dermis (Hematoxylin & eosin, ×100). (D) Detail of basaloid epithelial cells with intense cytoplasmic melanic pigmentation (Hematoxylin & eosin, ×400)</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1874 "Ancho" => 3341 "Tamanyo" => 1364950 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Immunohistochemistry. (A) Diffuse positivity for cytokeratin; note the epidermis as internal positive control (×40). (B) Detail of cytokeratin positivity in the neoplasm; note here also the peripheral palisade and the cleft artifact between the neoplasm stroma and the adjacent dermis (×100). (C) Detail highlighting melanocytes positive for Melan-A. Note the brownish melanin pigment in adjacent neoplastic cells (×400). (D) Ki-67 staining, demonstrating cells in the proliferative phase, with a predominantly peripheral distribution in the tumor (×40)</p>" ] ] 3 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Reference \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">Sex \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">Age (in years) \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">Location \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">Size (cm) \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">Lesion associated with nevus sebaceus? \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">Kanitakis, et al. 2002.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> \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">Female \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">32 \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">Scalp \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">2.0 \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">No \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">Kim, et al. 2011.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> \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">Male \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">51 \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">Dorsal region \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">6.0 \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">No \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">Hung, et al. 2012.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> \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">Male \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">31 \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">Scalp \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">1.0 \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">Yes \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">Quist and DiMaio, 2017.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> \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">Female \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">25 \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">Scalp \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">1.5 \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">No \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">Mizuta, et al. 2021.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> \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">Female \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">72 \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">Leg \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<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a> \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">No \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">Present case \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">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">59 \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">Scalp \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">0.8 \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">No \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3320940.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tblfn0005" "etiqueta" => "a" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">This case consists in the collision of melanotrichoblastoma with seborrheic keratosis, the measure shown in the article refers to the total dimension of the lesion.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Description of melanotrichoblastoma cases reported in the literature</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:1 [ "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "editores" => "D.E.Elder, D.Massi, R.A.Scolyer, R.Willemze" "titulo" => "WHO Classification of Skin Tumours" "edicion" => "4th ed." 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