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formas intermedi&#225;rias e com acometimento de outras &#225;reas do corpo n&#227;o se encaixam nos crit&#233;rios j&#225; estabelecidos&#46; Esse fato revela a necessidade de estudos cl&#237;nico&#8208;epidemiol&#243;gicos para melhor entendimento&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Em 184 casos &#40;39&#44;5&#37;&#41; havia alguma doen&#231;a associada&#44; alguns com mais de uma comorbidade&#44; descritos na <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#46; Os dados da literatura mostram 45&#37; dos pacientes com alguma forma de atopia e 19&#37; com doen&#231;as da tireoide&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> Essas associa&#231;&#245;es podem estar relacionadas ao compartilhamento dos mesmos <span class="elsevierStyleItalic">loci</span> gen&#233;ticos&#44; popula&#231;&#245;es de c&#233;lulas do sistema imune e perfil de citocinas presentes nessas doen&#231;as&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> Em nossa amostra n&#227;o foi poss&#237;vel demonstrar maior frequ&#234;ncia de doen&#231;as autoimunes entre os pacientes portadores de formas graves&#46; A s&#237;ndrome de Down &#233; considerada risco para a doen&#231;a em alguns estudos&#46; Entretanto&#44; estudo recente ressaltou essa associa&#231;&#227;o como coincid&#234;ncia&#44; justificada pelo fato de os casos estudados estarem relacionados &#224; presen&#231;a de casos familiares e outros fatores de risco&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">8&#44;9</span></a></p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Pacientes com formas graves foram comparados entre si em rela&#231;&#227;o a g&#234;nero&#44; presen&#231;a de doen&#231;as autoimunes&#44; atopia&#44; s&#237;ndrome de Down&#44; les&#245;es ungueais e presen&#231;a de casos familiares&#46; O teste do Qui&#8208;Quadrado de Pearson mostrou diferen&#231;a estatisticamente significante para maior frequ&#234;ncia das formas graves entre os homens &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; e para presen&#231;a de les&#245;es ungueais &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Os outros par&#226;metros avaliados n&#227;o mostraram diferen&#231;as significantes&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Altera&#231;&#245;es ungueais estavam presentes em 44 pacientes &#40;9&#44;4&#37;&#41;&#44; semelhante &#224; literatura &#40;9&#37; e 46&#37;&#41;&#44; e parecem ser mais comuns naqueles com formas graves&#44; como no presente estudo e relacionadas a pior progn&#243;stico&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Em 63 &#40;13&#44;5&#37;&#41; pacientes havia pelo menos um parente acometido e 22 n&#227;o sabiam informar &#40;4&#44;7&#37;&#41;&#46; M&#227;e ou irm&#227;o em 12 casos cada &#40;2&#44;6&#37;&#41;&#44; tia em cinco &#40;1&#44;1&#37;&#41;&#44; filho em tr&#234;s &#40;0&#44;6&#37;&#41;&#44; tio ou primo em dois cada &#40;0&#44;4&#37;&#41; e pai em um caso &#40;0&#44;2&#37;&#41;&#46; Mais de um parente acometido ocorreu em quatro casos &#40;0&#44;9&#37;&#41;&#46; Na literatura&#44; os casos familiares variam entre 4&#37; e 42&#37;&#44; mais comuns entre os de primeiro grau&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">AA &#233; uma doen&#231;a complexa que afeta a qualidade de vida dos pacientes&#44; com m&#250;ltiplos fatores envolvidos em sua patog&#234;nese&#44; pouco entendidos&#46; Os resultados do presente estudo est&#227;o de acordo com a maioria dos trabalhos publicados&#44; demonstrando as caracter&#237;sticas e o perfil dos portadores dessa doen&#231;a em uma amostra de brasileiros&#46; N&#227;o avaliamos o impacto da doen&#231;a no aspecto biopsicosocial&#46; O tipo de estudo e a aus&#234;ncia de grupo controle limitam o poder estat&#237;stico dos resultados&#46; Entretanto&#44; ser&#225; de grande valia para realiza&#231;&#227;o de trabalhos prospectivos e caso controle&#44; que permitir&#227;o esclarecer as d&#250;vidas relacionadas a essa dermatose&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0095" 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="par0100" class="elsevierStylePara elsevierViewall">Andressa Sato de Aquino Lopes&#58; Concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Leopoldo Duailibe Nogueira Santos&#58; Participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Mariana de Campos Raz&#233;&#58; Participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Rosana Lazzarini&#58; Concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0140" class="elsevierStylePara elsevierViewall">Nenhum&#46;</p></span></span>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0015">Como citar este artigo&#58; Lopes ASA&#44; Santos LDN&#44; Raz&#233; MC&#44; Lazzarini R&#46; Alopecia areata&#58; descriptive analysis in a Brazilian sample&#46; An Bras Dermatol&#46; 2022&#59;97&#58;654&#8211;6&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0020">Trabalho realizado na Cl&#237;nica de Dermatologia&#44; Santa Casa de Miseric&#243;rdia de S&#227;o Paulo&#44; S&#227;o Paulo&#44; SP&#44; BR&#46;</p>"
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t" scope="col">Faixa et&#225;ria de in&#237;cio &#40;em anos&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\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">79&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">106&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">39&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">66&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Barba&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">11&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&#44;4&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">8&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\ttable-entry\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cilios&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&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
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sobrancelhas<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>c&#237;lios&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&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;2&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"><span class="elsevierStyleHsp" style=""></span>Informa&#231;&#227;o ausente&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\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleBold">Total</span>&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"><span class="elsevierStyleBold">466</span>&nbsp;\t\t\t\t\t\t\n
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                  """
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Distribui&#231;&#227;o de 466 pacientes portadores de AA&#44; segundo formas cl&#237;nicas</p>"
        ]
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&#250;mero&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">Tireoidopatia&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">Atopia &#40;asma&#44; rinite&#44; dermatite&#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">56&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12&#44;0&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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">S&#237;ndrome de Down&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</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">Hipertens&#227;o arterial&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\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">Anemia&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  " align="left" valign="\n
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                  \t\t\t\t">1&#44;7&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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Vitiligo&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">8&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">1&#44;7&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">Psor&#237;ase&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">5&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&#44;1&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">Doen&#231;a inflamat&#243;ria intestinal&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">5&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&#44;1&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">L&#250;pus eritematoso&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&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;9&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">Diabetes mellitus&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&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;9&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">Artrite reumatoide&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&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;4&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">Sem doen&#231;as associadas&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">282&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">60&#44;4&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"><span class="elsevierStyleBold">Total</span>&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"><span class="elsevierStyleBold">466</span>&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"><span class="elsevierStyleBold">100&#44;0</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Distribui&#231;&#227;o das doen&#231;as associadas a AA em 466 pacientes</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Refer&#234;ncias"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0015"
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Alopecia areata &#8208; Disease characteristics&#44; clinical evaluation&#44; and new perspectives on pathogenesis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "L&#46;C&#46; Strazzulla"
                            1 => "E&#46;H&#46;C&#46; Wang"
                            2 => "L&#46; Avila"
                            3 => "K&#46; Sicco Lo"
                            4 => "N&#46; Brinster"
                            5 => "A&#46;M&#46; Christiano"
                          ]
                        ]
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                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "J&#46; Am Acad&#46; Dermatol&#46;"
                        "fecha" => "2018"
                        "paginaInicial" => "781"
                        "paginaFinal" => "812"
                      ]
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Carta ‐ Investigação
Alopécia areata: análise descritiva em amostra brasileira
Andressa Sato de Aquino Lopes
Autor para correspondência
dressa_sato@hotmail.com

Autor para correspondência.
, Leopoldo Duailibe Nogueira Santos, Mariana de Campos Razé, Rosana Lazzarini
Clínica de Dermatologia, Santa Casa de Misericórdia de São Paulo, São Paulo, SP, Brasil
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Alop&#233;cia areata &#40;AA&#41; &#233; uma doen&#231;a autoimune na qual os linf&#243;citos TCD8<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>agridem o fol&#237;culo piloso na fase an&#225;gena do ciclo capilar&#44; causando alop&#233;cia&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Clinicamente&#44; observam&#8208;se &#225;reas alop&#233;cias m&#250;ltiplas ou &#250;nicas&#44; ovais ou arredondadas&#46; As formas cl&#237;nicas descritas s&#227;o&#58; em placas&#44; ofi&#225;sica&#44; <span class="elsevierStyleItalic">sisaipho</span>&#44; difusa&#44; total e universal&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">A incid&#234;ncia dessa patologia nos Estados Unidos &#233; de aproximadamente 2&#44;1&#37; com preval&#234;ncia na popula&#231;&#227;o geral de 0&#44;1 a 0&#44;2&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> No Brasil&#44; um estudo demonstrou que a AA corresponde a 1&#44;2&#37; dos atendimentos dermatol&#243;gicos&#44; e &#233; a terceira forma de alop&#233;cia mais diagnosticada ap&#243;s alop&#233;cia androgen&#233;tica e efl&#250;vio tel&#243;geno&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a> Esses indiv&#237;duos t&#234;m maior chance de apresentar doen&#231;as autoimunes como tireoidite&#44; psor&#237;ase&#44; l&#250;pus eritematoso &#40;LE&#41;&#44; doen&#231;a inflamat&#243;ria intestinal&#44; dermatite at&#243;pica&#44; entre outras&#44; al&#233;m do impacto biopsicossocial&#44; especialmente nos casos extensos&#44; quando os pacientes tendem ao isolamento&#46;<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1&#44;3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">A escolha do tratamento depende da extens&#227;o da doen&#231;a e idade do paciente&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Existem poucos estudos epidemiol&#243;gicos em nosso meio&#44; o que objetivou a avalia&#231;&#227;o dos casos acompanhados no ambulat&#243;rio de dermatologia em hospital quatern&#225;rio entre 2000 e 2017&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Os dados foram coletados retrospectivamente e submetidos ao programa estat&#237;stico R vers&#227;o 3&#46;4&#46;2&#46; &#40;R Core Team&#44; 2016&#41;&#44; analisados descritivamente e comparados pelo teste do qui&#8208;quadrado de Pearson&#46; O estudo foi aprovado pelo Comit&#233; de &#201;tica em Pesquisa&#44; n&#176; 29982620&#46;1&#46;0000&#46;5479&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Foram avaliados 466 pacientes&#58; 272 &#40;58&#44;4&#37;&#41; mulheres e 194 homens &#40;41&#44;6&#37;&#41;&#59; 189 &#40;40&#44;6&#37;&#41; brancos&#44; 118 &#40;25&#44;3&#37;&#41; n&#227;o brancos e 159 casos &#40;34&#44;1&#37;&#41; sem informa&#231;&#227;o&#46; As mulheres foram as mais acometidas&#44; enquanto na literatura n&#227;o h&#225; diferen&#231;a entre os sexos&#46; Essa observa&#231;&#227;o reflete o perfil do ambulat&#243;rio&#44; onde h&#225; mais pacientes do sexo feminino&#44; al&#233;m de buscarem atendimento mais precoce para quest&#245;es relacionadas aos cabelos&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">A m&#233;dia das idades foi 33&#44;6 anos &#40;3 a 86 anos&#41;&#44; com desvio&#8208;padr&#227;o de 16&#44;6 anos&#46; A idade de in&#237;cio da doen&#231;a variou entre 0 e 82 anos&#44; com m&#233;dia de 25&#44;6 anos &#40;desvio&#8208;padr&#227;o de 16&#44;6 anos&#41;&#46; Esses dados refor&#231;am a observa&#231;&#227;o de outros estudos com maior frequ&#234;ncia entre adultos jovens&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Em rela&#231;&#227;o &#224; extens&#227;o&#44; os dados est&#227;o relacionados na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#46; Observou&#8208;se que o maior n&#250;mero de casos leves foi semelhante aos observados na literatura&#59; entretanto&#44; os casos graves tiveram frequ&#234;ncia menor&#46; Essa diferen&#231;a pode ser explicada pelo fato de nossa demanda ser espont&#226;nea&#44; enquanto em alguns estudos o banco de dados tinha como base a convoca&#231;&#227;o de pacientes de mais de uma institui&#231;&#227;o&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">As formas graves acometeram mais homens do que mulheres &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41;&#44; semelhante a um estudo de 2017&#46; Esse fato ainda deve ser validado&#44; uma vez que h&#225; relatos de maior gravidade entre mulheres&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Pacientes cuja dermatose teve in&#237;cio antes dos 10 anos de idade ou acima de 60 anos apresentaram formas mais graves do que aqueles com in&#237;cio em outras faixas et&#225;rias &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; o que pode ser observado na <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#46; O in&#237;cio precoce da AA relacionado a maior gravidade est&#225; em concord&#226;ncia com a literatura&#59; entretanto&#44; no grupo aqui estudado os pacientes com doen&#231;a de in&#237;cio tardio tamb&#233;m apresentaram evolu&#231;&#227;o mais grave&#44; fato n&#227;o descrito na literatura&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">7&#44;8</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">As formas cl&#237;nicas da AA observadas entre os casos estudados est&#227;o na <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a>&#46; Algumas delas&#44; localizadas exclusivamente na face&#44; foram agrupadas na mesma tabela&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0065" class="elsevierStylePara elsevierViewall">A classifica&#231;&#227;o cl&#237;nica da AA deveria ser discutida&#44; uma vez que como observado neste estudo&#44; formas intermedi&#225;rias e com acometimento de outras &#225;reas do corpo n&#227;o se encaixam nos crit&#233;rios j&#225; estabelecidos&#46; Esse fato revela a necessidade de estudos cl&#237;nico&#8208;epidemiol&#243;gicos para melhor entendimento&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Em 184 casos &#40;39&#44;5&#37;&#41; havia alguma doen&#231;a associada&#44; alguns com mais de uma comorbidade&#44; descritos na <a class="elsevierStyleCrossRef" href="#tbl0015">tabela 3</a>&#46; Os dados da literatura mostram 45&#37; dos pacientes com alguma forma de atopia e 19&#37; com doen&#231;as da tireoide&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> Essas associa&#231;&#245;es podem estar relacionadas ao compartilhamento dos mesmos <span class="elsevierStyleItalic">loci</span> gen&#233;ticos&#44; popula&#231;&#245;es de c&#233;lulas do sistema imune e perfil de citocinas presentes nessas doen&#231;as&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> Em nossa amostra n&#227;o foi poss&#237;vel demonstrar maior frequ&#234;ncia de doen&#231;as autoimunes entre os pacientes portadores de formas graves&#46; A s&#237;ndrome de Down &#233; considerada risco para a doen&#231;a em alguns estudos&#46; Entretanto&#44; estudo recente ressaltou essa associa&#231;&#227;o como coincid&#234;ncia&#44; justificada pelo fato de os casos estudados estarem relacionados &#224; presen&#231;a de casos familiares e outros fatores de risco&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">8&#44;9</span></a></p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0075" class="elsevierStylePara elsevierViewall">Pacientes com formas graves foram comparados entre si em rela&#231;&#227;o a g&#234;nero&#44; presen&#231;a de doen&#231;as autoimunes&#44; atopia&#44; s&#237;ndrome de Down&#44; les&#245;es ungueais e presen&#231;a de casos familiares&#46; O teste do Qui&#8208;Quadrado de Pearson mostrou diferen&#231;a estatisticamente significante para maior frequ&#234;ncia das formas graves entre os homens &#40;p &#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; e para presen&#231;a de les&#245;es ungueais &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;001&#41;&#46; Os outros par&#226;metros avaliados n&#227;o mostraram diferen&#231;as significantes&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Altera&#231;&#245;es ungueais estavam presentes em 44 pacientes &#40;9&#44;4&#37;&#41;&#44; semelhante &#224; literatura &#40;9&#37; e 46&#37;&#41;&#44; e parecem ser mais comuns naqueles com formas graves&#44; como no presente estudo e relacionadas a pior progn&#243;stico&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Em 63 &#40;13&#44;5&#37;&#41; pacientes havia pelo menos um parente acometido e 22 n&#227;o sabiam informar &#40;4&#44;7&#37;&#41;&#46; M&#227;e ou irm&#227;o em 12 casos cada &#40;2&#44;6&#37;&#41;&#44; tia em cinco &#40;1&#44;1&#37;&#41;&#44; filho em tr&#234;s &#40;0&#44;6&#37;&#41;&#44; tio ou primo em dois cada &#40;0&#44;4&#37;&#41; e pai em um caso &#40;0&#44;2&#37;&#41;&#46; Mais de um parente acometido ocorreu em quatro casos &#40;0&#44;9&#37;&#41;&#46; Na literatura&#44; os casos familiares variam entre 4&#37; e 42&#37;&#44; mais comuns entre os de primeiro grau&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">AA &#233; uma doen&#231;a complexa que afeta a qualidade de vida dos pacientes&#44; com m&#250;ltiplos fatores envolvidos em sua patog&#234;nese&#44; pouco entendidos&#46; Os resultados do presente estudo est&#227;o de acordo com a maioria dos trabalhos publicados&#44; demonstrando as caracter&#237;sticas e o perfil dos portadores dessa doen&#231;a em uma amostra de brasileiros&#46; N&#227;o avaliamos o impacto da doen&#231;a no aspecto biopsicosocial&#46; O tipo de estudo e a aus&#234;ncia de grupo controle limitam o poder estat&#237;stico dos resultados&#46; Entretanto&#44; ser&#225; de grande valia para realiza&#231;&#227;o de trabalhos prospectivos e caso controle&#44; que permitir&#227;o esclarecer as d&#250;vidas relacionadas a essa dermatose&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0095" 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="par0100" class="elsevierStylePara elsevierViewall">Andressa Sato de Aquino Lopes&#58; Concep&#231;&#227;o e planejamento do estudo&#59; elabora&#231;&#227;o e reda&#231;&#227;o do manuscrito&#59; obten&#231;&#227;o&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Leopoldo Duailibe Nogueira Santos&#58; Participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Mariana de Campos Raz&#233;&#58; Participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#59; participa&#231;&#227;o intelectual em conduta proped&#234;utica e&#47;ou terap&#234;utica de casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; revis&#227;o cr&#237;tica do manuscrito&#59; aprova&#231;&#227;o da vers&#227;o final do manuscrito&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Rosana Lazzarini&#58; 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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#44;0&#37;&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">10&#8208;19&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">50&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">63&#44;3&#37;&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</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \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\ttop\n
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                  \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</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</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\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">404<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
            1 => array:1 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \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">Total&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">241&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">59&#44;1&#37;&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">167&nbsp;\t\t\t\t\t\t\n
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                  \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&#44;7&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">Vitiligo&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&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&#44;7&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">Psor&#237;ase&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">5&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&#44;1&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">Doen&#231;a inflamat&#243;ria intestinal&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">5&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&#44;1&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">L&#250;pus eritematoso&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&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;9&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">Diabetes mellitus&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&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;9&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">Artrite reumatoide&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&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;4&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">Sem doen&#231;as associadas&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">282&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">60&#44;4&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"><span class="elsevierStyleBold">Total</span>&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"><span class="elsevierStyleBold">466</span>&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"><span class="elsevierStyleBold">100&#44;0</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Distribui&#231;&#227;o das doen&#231;as associadas a AA em 466 pacientes</p>"
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      ]
    ]
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                            1 => "B&#46;V&#46; Jegasohy"
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                    0 => array:1 [
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                            0 => "Y&#46; Ramot"
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                      "Revista" => array:5 [
                        "tituloSerie" => "Int J Trichol&#46;"
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                    0 => array:2 [
                      "titulo" => "Nail involvement in Alopecia areata&#58; a questionnaire&#8208;based Survey on clinical signs&#44; impact on quality of life and review of the literature"
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ISSN: 26662752
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