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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">We agree with the consideration that&#44; regarding the cause of the increase in transaminase levels in the described patient&#44; there are no means of affirming with certainty the association with the MMP&#174; technique&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> We reinforce&#44; however&#44; that she had already shown an elevation of transaminase levels with the previous use of the medication when administered orally&#46; We attributed it to the technique used after excluding other possible causes such as infections&#44; alcohol consumption&#44; physical activity&#44; or use of any other medication&#44; in addition to the transitoriness of transaminitis in relation to the procedure&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The technique involves the penetration of needles into the dermis&#44;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">2&#44;3</span></a> where vascularization is prominent in the scalp&#44; with biological plausibility in affirming the possibility of absorption of the drug used&#46; Additionally the patient is likely to be susceptible to methotrexate-related adverse effects&#44; despite the small&#44; absorbed dose&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">We reaffirm the importance of reporting unexpected adverse effects related to the recent use of percutaneous treatment techniques&#44; aiming at patient safety through adequate monitoring&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financial support</span><p id="par0020" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Authors&#39; contributions</span><p id="par0025" class="elsevierStylePara elsevierViewall">Renan Rangel Bonamigo&#58; Drafting and editing of the manuscript and critical review of important intellectual content&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; approval of the final version of the manuscript&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Renata Heck&#58; Design and planning of the study&#59; drafting and editing of the manuscript and critical review of important intellectual content&#59; effective participation in research orientation&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; approval of the final version of the manuscript&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflicts of interest</span><p id="par0035" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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