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diagn&#243;stico confirmado de psor&#237;ase palmoplantar&#44; eczema acral&#44; <span class="elsevierStyleItalic">tinea manuum</span> ou <span class="elsevierStyleItalic">tinea pedis</span>&#59; consulta em ambulat&#243;rio do Servi&#231;o de Dermatologia do Hospital das Cl&#237;nicas de Goi&#226;nia&#59; assinatura do Termo de Consentimento Livre e Esclarecido &#40;TCLE&#41;&#59; idade &#62; 18 anos&#46; Foram inclu&#237;dos pacientes com diagn&#243;stico cl&#237;nico de psor&#237;ase vulgar com acometimento acral ou psor&#237;ase palmoplantar confirmada por exame anatomopatol&#243;gico&#59; diagn&#243;stico cl&#237;nico de eczema de contato&#47;at&#243;pico com comprometimento acral confirmado por exame anatomopatol&#243;gico&#59; ou diagn&#243;stico de <span class="elsevierStyleItalic">tinea manuum</span> ou <span class="elsevierStyleItalic">tinea pedis</span> confirmado por exame micol&#243;gico direto para fungos&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">A an&#225;lise das fotografias foi feita por dois dermatologistas com experi&#234;ncia em dermatoscopia&#44; que preencheram a tabela sem saber o diagn&#243;stico do paciente&#46; Os dados foram analisados e organizados de maneira qualiquantitativa&#44; por meio da identifica&#231;&#227;o do &#8220;n&#8221;&#44; sensibilidade e especificidade&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Foram coletados dados de 45 pacientes que apresentavam descama&#231;&#227;o em regi&#227;o palmar ou plantar&#46; Desses&#44; 33 preencheram os crit&#233;rios de inclus&#227;o&#44; dos quais 13 eram portadores de eczema&#44; 12 eram portadores de psor&#237;ase e oito eram portadores de <span class="elsevierStyleItalic">tinea</span>&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#44; mostra a frequ&#234;ncia de achados dermatosc&#243;picos por diagn&#243;stico&#46; A <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a> compila os dados referentes a sensibilidade e especificidade dos sinais dermatosc&#243;picos em rela&#231;&#227;o &#224;s doen&#231;as em estudo&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Para o eczema&#44; os achados dermatosc&#243;picos mais encontrados foram escamas brancas difusas e escamas brancas e amarelas&#46; A sensibilidade foi maior no caso de escamas brancas e amarelas &#40;46&#44;2&#37;&#41;&#46; J&#225; a especificidade foi de 90&#37; nos vasos puntiformes focais&#46; Para psor&#237;ase&#44; o achado mais frequente foi escamas brancas e amarelas&#44; presente em 2&#47;3 dos pacientes&#46; Os achados dermatosc&#243;picos mais sens&#237;veis e mais espec&#237;ficos para o diagn&#243;stico de <span class="elsevierStyleItalic">tinea</span><span class="elsevierStyleItalic">pedis&#47;manuum</span> foram escamas brancas em sulcos&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Os achados dermatosc&#243;picos buscados em cada afec&#231;&#227;o est&#227;o demonstrados nas <a class="elsevierStyleCrossRefs" href="#fig0005">figuras 1 a 3</a>&#46; Na <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#44; &#233; poss&#237;vel observar escamas brancas em sulcos em um paciente portador de <span class="elsevierStyleItalic">tinea pedis</span>&#59; na <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a>&#44; vasos puntiformes e escamas brancas difusas em um paciente portador de psor&#237;ase&#59; e na <a class="elsevierStyleCrossRef" href="#fig0015">figura 3</a>&#44; vasos puntiformes focais&#44; escamas brancas e amarelas e gl&#243;bulos amarronzados em paciente portador de eczema palmar&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">A dermatoscopia tem sido valorizada em &#225;reas que v&#227;o al&#233;m da dermato&#8208;oncologia para diagn&#243;stico precoce de c&#226;ncer de pele melanoma e n&#227;o melanoma&#46; Sua aplicabilidade tem se expandido para a defini&#231;&#227;o de padr&#245;es dermatosc&#243;picos de diversas outras dermatoses&#44; como as inflamat&#243;rias&#46; Al&#233;m disso&#44; a dermatoscopia n&#227;o &#233; usada apenas para fins diagn&#243;sticos&#44; mas tamb&#233;m para avaliar a evolu&#231;&#227;o e a resposta terap&#234;utica&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Uma recente revis&#227;o bibliogr&#225;fica mostrou&#44; na dermatoscopia da psor&#237;ase em placas&#44; a presen&#231;a de vasos puntiformes regularmente distribu&#237;dos com fundo vermelho&#8208;claro e escamas brancas difusas&#44; com 88&#37; de especificidade e 84&#44;9&#37; de sensibilidade&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> Em nosso estudo&#44; os achados de vasos puntiformes difusos apresentaram 90&#44;5&#37; de especificidade e 41&#44;7&#37; de sensibilidade em pacientes portadores de psor&#237;ase palmoplantar&#46; J&#225; as escamas brancas difusas apresentaram 71&#44;4&#37; de especificidade e 33&#44;3&#37; de sensibilidade&#44; evidenciando que a presen&#231;a dos sinais diz muito a favor do diagn&#243;stico de psor&#237;ase&#44; mas a aus&#234;ncia deles n&#227;o afasta o diagn&#243;stico&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">No estudo de Errichetti e Stinco&#44; os achados dermatosc&#243;picos mais comuns na psor&#237;ase palmar foram escamas brancas em fundo eritematoso evidente &#40;100&#37;&#41;&#44; com distribui&#231;&#227;o difusa em 80&#37; deles&#46; Al&#233;m disso&#44; tamb&#233;m foram observados vasos puntiformes distribu&#237;dos regularmente em quatro pacientes &#40;40&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> No presente estudo&#44; foram observados vasos puntiformes difusos em 41&#44;7&#37; e escamas brancas difusas em 33&#44;3&#37; dos pacientes portadores de psor&#237;ase&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">O termo eczema&#44; ou mesmo &#8220;dermatite&#8221;&#44; compreende diversas entidades cl&#237;nicas que compartilham altera&#231;&#245;es histopatol&#243;gicas caracter&#237;sticas&#44; como dermatite de contato&#47;al&#233;rgica&#44; dermatite at&#243;pica e dermatite seborreica&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6&#44;8</span></a> No que diz respeito ao eczema palmoplantar&#44; os achados dermatosc&#243;picos mais frequentes s&#227;o descama&#231;&#227;o amarelada com ou sem escamas brancas&#44; crostas amareladas e vasos puntiformes focais&#46; Os pontos&#47;gl&#243;bulos laranja&#8208;acastanhados correspondem a ves&#237;culas espongi&#243;ticas n&#227;o vis&#237;veis a olho nu&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> Em 2016&#44; Errichetti e Stinco mostraram que em 11 pacientes portadores de eczema cr&#244;nico em m&#227;os&#44; 90&#44;9&#37; tinham escamas amareladas distribu&#237;das focalmente e 72&#44;7&#37; apresentavam pontos&#47;gl&#243;bulos laranja&#8208;acastanhados em fundo eritematoso&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> No presente estudo&#44; dos 13 pacientes portadores de eczema palmar ou plantar&#44; apenas 46&#44;2&#37; apresentaram escamas brancas ou amarelas e 15&#44;4&#37; apresentaram pontos ou gl&#243;bulos amarronzados&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Errichetti e Stinco observaram que escamas brancas difusas sugerem mais fortemente o diagn&#243;stico de psor&#237;ase palmoplantar&#44; enquanto a detec&#231;&#227;o de escamas amareladas&#44; laranja&#8208;acastanhadas e pontos&#47;gl&#243;bulos e crostas laranja&#8208;amareladas falam mais a favor de eczema&#46; A colora&#231;&#227;o das escamas &#40;branca <span class="elsevierStyleItalic">versus</span> amarela&#41; &#233; informa&#231;&#227;o extremamente &#250;til para auxiliar no diagn&#243;stico diferencial de doen&#231;as escamosas acrais&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">7&#44;9</span></a> No entanto&#44; no presente trabalho&#44; observou&#8208;se que apenas 33&#44;3&#37; dos pacientes portadores de psor&#237;ase apresentavam escamas brancas&#44; enquanto 66&#44;7&#37; apresentavam escamas brancas e amarelas&#46; Em contrapartida&#44; nos pacientes portadores de eczema&#44; a mesma porcentagem foi observada nos portadores de escamas brancas e amarelas&#44; e 46&#44;2&#37; apresentavam apenas escamas brancas&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Quanto aos achados dermatosc&#243;picos da <span class="elsevierStyleItalic">tinea manuum&#47;pedis</span>&#44; Errichetti e Stinco observaram escamas esbranqui&#231;adas localizadas principalmente nos sulcos&#44; achado este ausente na psor&#237;ase palmar e eczema cr&#244;nico das m&#227;os&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> Em nosso estudo&#44; 100&#37; dos pacientes portadores de <span class="elsevierStyleItalic">tinea manuum&#47;pedis</span> apresentaram escamas brancas em sulcos&#59; a sensibilidade desse achado foi de 100&#37;&#44; e a especificidade de 96&#37;&#46; A escama branca n&#227;o a diferencia de outras doen&#231;as escamosas&#44; por&#233;m sua localiza&#231;&#227;o t&#237;pica nos sulcos&#44; local de predile&#231;&#227;o dos dermat&#243;fitos&#44; auxilia na diferencia&#231;&#227;o de outras doen&#231;as&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Como limita&#231;&#245;es deste estudo&#44; &#233; importante ressaltar que a foto da dermatoscopia de uma parte da les&#227;o n&#227;o representa o todo&#46; Desse modo&#44; alguns achados dermatosc&#243;picos podem n&#227;o ter sido registrados no momento da foto&#44; mas ainda assim estavam presentes na les&#227;o&#46; Al&#233;m disso&#44; o tempo entre o diagn&#243;stico anatomopatol&#243;gico dos pacientes portadores de psor&#237;ase e eczema e a aplica&#231;&#227;o da dermatoscopia n&#227;o foi avaliada&#44; tampouco se o paciente estava ou n&#227;o em tratamento no momento da avalia&#231;&#227;o&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Apesar de apresentarem caracter&#237;sticas dermatosc&#243;picas sugestivas de determinada doen&#231;a&#44; elas n&#227;o s&#227;o espec&#237;ficas j&#225; que&#44; como observado neste trabalho&#44; algumas caracter&#237;sticas observadas mais frequentemente em portadores de eczema acral tamb&#233;m estiveram presentes em portadores de psor&#237;ase palmoplantar&#46; Assim&#44; &#233; de extrema import&#226;ncia a correla&#231;&#227;o cl&#237;nica e anamnese adequada&#44; al&#233;m da dermatoscopia&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Al&#233;m disso&#44; 100&#37; dos pacientes portadores de <span class="elsevierStyleItalic">tinea mannum&#47;pedis</span> apresentaram escamas em sulcos&#44; com sensibilidade de 100&#37; e especificidade de 96&#37;&#44; e esse &#233; um achado muito sugestivo desse diagn&#243;stico&#44; destacando o papel da dermatoscopia no diagn&#243;stico dessa entidade&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0115" 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="par0120" class="elsevierStylePara elsevierViewall">Mariana Vieira Martins Sampaio Drummond&#58; Conceito e desenho do estudo&#59; coleta de dados&#44; an&#225;lise e interpreta&#231;&#227;o de dados&#59; an&#225;lise estat&#237;stica&#59; reda&#231;&#227;o do manuscrito ou revis&#227;o cr&#237;tica de conte&#250;do intelectual importante&#59; coleta&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o intelectual na conduta proped&#234;utica e&#47;ou terap&#234;utica dos casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Jules Rimet Borges&#58; Conceito e desenho do estudo&#59; reda&#231;&#227;o do manuscrito ou revis&#227;o cr&#237;tica de conte&#250;do intelectual importante&#59;&#160;coleta&#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 na conduta proped&#234;utica e&#47;ou terap&#234;utica dos casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o final da vers&#227;o final do manuscrito&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Ana Maria Quinteiro Ribeiro&#58; Coleta de dados&#44; ou an&#225;lise e interpreta&#231;&#227;o de dados&#59; an&#225;lise estat&#237;stica&#59; reda&#231;&#227;o do manuscrito ou revis&#227;o cr&#237;tica de conte&#250;do intelectual importante&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">B&#225;rbara Alvares Salum Ximenes&#58; Reda&#231;&#227;o do manuscrito ou revis&#227;o cr&#237;tica de conte&#250;do intelectual importante&#46;</p></span><span id="sec0015" 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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                  \t\t\t\t">0&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  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;7&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
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t  " align="" 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">100&#44;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Difusas&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">6&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">46&#44;2&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">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">33&#44;3&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">0&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;0&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="elsevierStyleItalic">Escamas brancas e amarelas</span>&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">6&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">46&#44;2&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
                  \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">66&#44;7&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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#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"><span class="elsevierStyleItalic">Pontos e&#47;ou gl&#243;bulos amarronzados</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">15&#44;4&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">5&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">41&#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  " align="left" valign="\n
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                  \t\t\t\t">0&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;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3563630.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Frequ&#234;ncia de achados dermatosc&#243;picos por diagn&#243;stico</p>"
        ]
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      4 => array:8 [
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        "etiqueta" => "Tabela 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "detalles" => array:1 [
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            "detalle" => "Tabela "
            "rol" => "short"
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col">&nbsp;\t\t\t\t\t\t\n
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                  \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">Eczema&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" scope="col">Eczema&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" scope="col">Psor&#237;ase&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" scope="col">Psor&#237;ase&nbsp;\t\t\t\t\t\t\n
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                  \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"><span class="elsevierStyleItalic">Tinea</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sinais dermatosc&#243;picos&nbsp;\t\t\t\t\t\t\n
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                  \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">S&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \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">E&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-head\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">Vasos puntiformes focais&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"><span class="elsevierStyleBold">7&#44;7</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">90&#44;0</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">16&#44;7&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">95&#44;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;0&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">88&#44;0&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">Vasos puntiformes difusos&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">7&#44;7&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">70&#44;0&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">41&#44;7</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">90&#44;5</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">12&#44;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">76&#44;0&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">Escamas brancas sulcos&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">7&#44;7&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;0&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;0&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">57&#44;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
                  \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><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">96&#44;0</span>&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">Escamas brancas difusas&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">46&#44;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">80&#44;0&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">33&#44;3</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">71&#44;4</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">0&#44;0&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;0&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">Escamas brancas e amarelas&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">46&#44;2</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">55&#44;0</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">66&#44;7&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">66&#44;7&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&#44;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">44&#44;0&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">Pontos e&#47;ou gl&#243;bulos amarronzados&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">15&#44;4</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">75&#44;0</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">41&#44;7&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">90&#44;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">0&#44;0&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">72&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "pt" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Sensibilidade &#40;S&#41; e especificidade &#40;E&#41; de sinais dermatosc&#243;picos para o diagn&#243;stico de eczema&#44; psor&#237;ase e <span class="elsevierStyleItalic">tinea</span></p>"
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        0 => array:2 [
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            0 => array:3 [
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermoscopy image analysis&#58; overview and future directions"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;E&#46; Celebi"
                            1 => "N&#46; Codella"
                            2 => "A&#46; Halpern"
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                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1109/JBHI.2019.2895803"
                      "Revista" => array:6 [
                        "tituloSerie" => "IEEE J Biomed Health Inform&#46;"
                        "fecha" => "2019"
                        "volumen" => "23"
                        "paginaInicial" => "474"
                        "paginaFinal" => "478"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30703051"
                            "web" => "Medline"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermoscopy in general dermatology&#58; a practical overview"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46; Errichetti"
                            1 => "G&#46; Stinco"
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                    0 => array:2 [
                      "doi" => "10.1007/s13555-016-0141-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatol Ther &#40;Heidelb&#41;&#46;"
                        "fecha" => "2016"
                        "volumen" => "6"
                        "paginaInicial" => "471"
                        "paginaFinal" => "507"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27613297"
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                0 => array:2 [
                  "contribucion" => array:1 [
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                      "titulo" => "Prevalence of psoriasis in Brazil &#8211; a geographical survey"
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                          "etal" => false
                          "autores" => array:4 [
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                            2 => "A&#46; Menter"
                            3 => "H&#46;A&#46; Miot"
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                    0 => array:2 [
                      "doi" => "10.1111/ijd.13604"
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                        "tituloSerie" => "Int J Dermatol&#46;"
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                        "volumen" => "56"
                        "paginaInicial" => "e167"
                        "paginaFinal" => "e168"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28345141"
                            "web" => "Medline"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hand eczema&#58; epidemiology&#44; prognosis and prevention"
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                          "etal" => false
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                            0 => "T&#46; Agner"
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                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Eur Acad Dermatol Venereol&#46;"
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                      "titulo" => "Epidemiology of dermatophytoses in an area south of Tehran&#44; Iran"
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                          "etal" => false
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                            0 => "M&#46; Falahati"
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                            2 => "A&#46;R&#46; Lari"
                            3 => "R&#46; Alaghehbandan"
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                    0 => array:2 [
                      "doi" => "10.1023/b:myco.0000003560.65857.cf"
                      "Revista" => array:6 [
                        "tituloSerie" => "Mycopathologia&#46;"
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                        "paginaFinal" => "287"
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                          0 => array:2 [
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                0 => array:2 [
                  "contribucion" => array:1 [
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                      "titulo" => "Dermoscopy of common inflammatory disorders"
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                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Sgouros"
                            1 => "Z&#46; Apalla"
                            2 => "D&#46; Ioannides"
                            3 => "A&#46; Katoulis"
                            4 => "D&#46; Rigopoulos"
                            5 => "E&#46; Sotiriou"
                          ]
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                      ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.det.2018.05.003"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatol Clin&#46;"
                        "fecha" => "2018"
                        "volumen" => "36"
                        "paginaInicial" => "359"
                        "paginaFinal" => "368"
                        "link" => array:1 [
                          0 => array:2 [
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              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermoscopy in differential diagnosis of palmar psoriasis and chronic hand eczema"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46; Errichetti"
                            1 => "G&#46; Stinco"
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/1346-8138.13142"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Dermatol&#46;"
                        "fecha" => "2016"
                        "volumen" => "43"
                        "paginaInicial" => "423"
                        "paginaFinal" => "425"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26460228"
                            "web" => "Medline"
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            7 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "8"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermoscopy as a supportive instrument in the differentiation of the main types of acquired keratoderma due to dermatological disorders"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46; Errichetti"
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/jdv.13566"
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Cartas ‐ Investigação
Dermatoscopia como ferramenta auxiliar para o diagnóstico de doenças escamosas acrais: psoríase palmoplantar, tinea pedis/manuum e eczema
Mariana Vieira Martins Sampaio Drummond
Autor para correspondência
maryy_drummond@hotmail.com

Autor para correspondência.
, Jules Rimet Borges, Ana Maria Quinteiro Ribeiro, Bárbara Alvares Salum Ximenes
Serviço de Dermatologia, Hospital das Clínicas de Goiânia, Goiânia, GO, Brasil
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e dermatoses inflamat&#243;rias &#40;inflamatoscopia&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Dentre as doen&#231;as inflamat&#243;rias avaliadas por dermatoscopia est&#225; a psor&#237;ase&#44; doen&#231;a cr&#244;nica imunomediada que afeta aproximadamente 125 milh&#245;es de pessoas no mundo&#46; A variante palmoplantar &#233; respons&#225;vel por 11&#37;&#8208;39&#37; desses pacientes&#46; A psor&#237;ase pode ser classificada em hipercerat&#243;tica &#40;placas espessas descamativas&#41; e pustulosa&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Outra dermatose inflamat&#243;ria cujo diagn&#243;stico pode ser auxiliado pela dermatoscopia &#233; o eczema acral&#44; doen&#231;a cr&#244;nica com importante impacto negativo na qualidade de vida de seus portadores&#44; associado a fardo econ&#244;mico &#224; sociedade em virtude do comprometimento da capacidade laboral dos pacientes&#46; O eczema acral tem preval&#234;ncia anual m&#233;dia de 10&#37;&#44; com incid&#234;ncia maior em mulheres at&#233; os 30 anos&#46;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleItalic">Tinea manuum</span> e <span class="elsevierStyleItalic">tinea pedis</span> podem ser mais bem avaliadas por meio da dermatoscopia&#46; A <span class="elsevierStyleItalic">tinea</span>&#44; conhecida por dermatofitose&#44; &#233; causada por fungos dermat&#243;fitos que invadem as camadas queratinizadas da pele e seus anexos&#46; As dermatofitoses afetam de 20&#37; a 25&#37; da popula&#231;&#227;o mundial e s&#227;o as infec&#231;&#245;es f&#250;ngicas mais comuns em todo o mundo&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Psor&#237;ase&#44; dermatofitose e eczema acral s&#227;o afec&#231;&#245;es dermatol&#243;gicas diferentes entre si&#44; com manifesta&#231;&#245;es cl&#237;nicas parecidas&#44; de alta preval&#234;ncia nacional e mundialmente&#46; O investimento cient&#237;fico voltado para a diferencia&#231;&#227;o diagn&#243;stica entre elas&#44; por meio da dermatoscopia&#44; afetar&#225; positivamente pacientes&#44; profissionais e o sistema de sa&#250;de&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">Este &#233; um estudo anal&#237;tico&#44; transversal e de acur&#225;cia diagn&#243;stica&#46; Ap&#243;s aprova&#231;&#227;o pelo Comite de &#201;tica e Pesquisa segundo CAAE 52926621&#46;7&#46;0000&#46;5078&#44; a coleta de dados foi feita no Servi&#231;o de Dermatologia do Hospital das Cl&#237;nicas de Goi&#226;nia&#44; no per&#237;odo de 20 de abril de 2021 a 29 de abril de 2022&#46; A amostra selecionada foi consecutiva&#44; formada por pacientes com escamas em palmas ou plantas&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Os crit&#233;rios de inclus&#227;o foram&#58; diagn&#243;stico confirmado de psor&#237;ase palmoplantar&#44; eczema acral&#44; <span class="elsevierStyleItalic">tinea manuum</span> ou <span class="elsevierStyleItalic">tinea pedis</span>&#59; consulta em ambulat&#243;rio do Servi&#231;o de Dermatologia do Hospital das Cl&#237;nicas de Goi&#226;nia&#59; assinatura do Termo de Consentimento Livre e Esclarecido &#40;TCLE&#41;&#59; idade &#62; 18 anos&#46; Foram inclu&#237;dos pacientes com diagn&#243;stico cl&#237;nico de psor&#237;ase vulgar com acometimento acral ou psor&#237;ase palmoplantar confirmada por exame anatomopatol&#243;gico&#59; diagn&#243;stico cl&#237;nico de eczema de contato&#47;at&#243;pico com comprometimento acral confirmado por exame anatomopatol&#243;gico&#59; ou diagn&#243;stico de <span class="elsevierStyleItalic">tinea manuum</span> ou <span class="elsevierStyleItalic">tinea pedis</span> confirmado por exame micol&#243;gico direto para fungos&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">A an&#225;lise das fotografias foi feita por dois dermatologistas com experi&#234;ncia em dermatoscopia&#44; que preencheram a tabela sem saber o diagn&#243;stico do paciente&#46; Os dados foram analisados e organizados de maneira qualiquantitativa&#44; por meio da identifica&#231;&#227;o do &#8220;n&#8221;&#44; sensibilidade e especificidade&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Foram coletados dados de 45 pacientes que apresentavam descama&#231;&#227;o em regi&#227;o palmar ou plantar&#46; Desses&#44; 33 preencheram os crit&#233;rios de inclus&#227;o&#44; dos quais 13 eram portadores de eczema&#44; 12 eram portadores de psor&#237;ase e oito eram portadores de <span class="elsevierStyleItalic">tinea</span>&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">A <a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>&#44; mostra a frequ&#234;ncia de achados dermatosc&#243;picos por diagn&#243;stico&#46; A <a class="elsevierStyleCrossRef" href="#tbl0010">tabela 2</a> compila os dados referentes a sensibilidade e especificidade dos sinais dermatosc&#243;picos em rela&#231;&#227;o &#224;s doen&#231;as em estudo&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Para o eczema&#44; os achados dermatosc&#243;picos mais encontrados foram escamas brancas difusas e escamas brancas e amarelas&#46; A sensibilidade foi maior no caso de escamas brancas e amarelas &#40;46&#44;2&#37;&#41;&#46; J&#225; a especificidade foi de 90&#37; nos vasos puntiformes focais&#46; Para psor&#237;ase&#44; o achado mais frequente foi escamas brancas e amarelas&#44; presente em 2&#47;3 dos pacientes&#46; Os achados dermatosc&#243;picos mais sens&#237;veis e mais espec&#237;ficos para o diagn&#243;stico de <span class="elsevierStyleItalic">tinea</span><span class="elsevierStyleItalic">pedis&#47;manuum</span> foram escamas brancas em sulcos&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Os achados dermatosc&#243;picos buscados em cada afec&#231;&#227;o est&#227;o demonstrados nas <a class="elsevierStyleCrossRefs" href="#fig0005">figuras 1 a 3</a>&#46; Na <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a>&#44; &#233; poss&#237;vel observar escamas brancas em sulcos em um paciente portador de <span class="elsevierStyleItalic">tinea pedis</span>&#59; na <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a>&#44; vasos puntiformes e escamas brancas difusas em um paciente portador de psor&#237;ase&#59; e na <a class="elsevierStyleCrossRef" href="#fig0015">figura 3</a>&#44; vasos puntiformes focais&#44; escamas brancas e amarelas e gl&#243;bulos amarronzados em paciente portador de eczema palmar&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">A dermatoscopia tem sido valorizada em &#225;reas que v&#227;o al&#233;m da dermato&#8208;oncologia para diagn&#243;stico precoce de c&#226;ncer de pele melanoma e n&#227;o melanoma&#46; Sua aplicabilidade tem se expandido para a defini&#231;&#227;o de padr&#245;es dermatosc&#243;picos de diversas outras dermatoses&#44; como as inflamat&#243;rias&#46; Al&#233;m disso&#44; a dermatoscopia n&#227;o &#233; usada apenas para fins diagn&#243;sticos&#44; mas tamb&#233;m para avaliar a evolu&#231;&#227;o e a resposta terap&#234;utica&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Uma recente revis&#227;o bibliogr&#225;fica mostrou&#44; na dermatoscopia da psor&#237;ase em placas&#44; a presen&#231;a de vasos puntiformes regularmente distribu&#237;dos com fundo vermelho&#8208;claro e escamas brancas difusas&#44; com 88&#37; de especificidade e 84&#44;9&#37; de sensibilidade&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a> Em nosso estudo&#44; os achados de vasos puntiformes difusos apresentaram 90&#44;5&#37; de especificidade e 41&#44;7&#37; de sensibilidade em pacientes portadores de psor&#237;ase palmoplantar&#46; J&#225; as escamas brancas difusas apresentaram 71&#44;4&#37; de especificidade e 33&#44;3&#37; de sensibilidade&#44; evidenciando que a presen&#231;a dos sinais diz muito a favor do diagn&#243;stico de psor&#237;ase&#44; mas a aus&#234;ncia deles n&#227;o afasta o diagn&#243;stico&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">No estudo de Errichetti e Stinco&#44; os achados dermatosc&#243;picos mais comuns na psor&#237;ase palmar foram escamas brancas em fundo eritematoso evidente &#40;100&#37;&#41;&#44; com distribui&#231;&#227;o difusa em 80&#37; deles&#46; Al&#233;m disso&#44; tamb&#233;m foram observados vasos puntiformes distribu&#237;dos regularmente em quatro pacientes &#40;40&#37;&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> No presente estudo&#44; foram observados vasos puntiformes difusos em 41&#44;7&#37; e escamas brancas difusas em 33&#44;3&#37; dos pacientes portadores de psor&#237;ase&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">O termo eczema&#44; ou mesmo &#8220;dermatite&#8221;&#44; compreende diversas entidades cl&#237;nicas que compartilham altera&#231;&#245;es histopatol&#243;gicas caracter&#237;sticas&#44; como dermatite de contato&#47;al&#233;rgica&#44; dermatite at&#243;pica e dermatite seborreica&#46;<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6&#44;8</span></a> No que diz respeito ao eczema palmoplantar&#44; os achados dermatosc&#243;picos mais frequentes s&#227;o descama&#231;&#227;o amarelada com ou sem escamas brancas&#44; crostas amareladas e vasos puntiformes focais&#46; Os pontos&#47;gl&#243;bulos laranja&#8208;acastanhados correspondem a ves&#237;culas espongi&#243;ticas n&#227;o vis&#237;veis a olho nu&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> Em 2016&#44; Errichetti e Stinco mostraram que em 11 pacientes portadores de eczema cr&#244;nico em m&#227;os&#44; 90&#44;9&#37; tinham escamas amareladas distribu&#237;das focalmente e 72&#44;7&#37; apresentavam pontos&#47;gl&#243;bulos laranja&#8208;acastanhados em fundo eritematoso&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">7</span></a> No presente estudo&#44; dos 13 pacientes portadores de eczema palmar ou plantar&#44; apenas 46&#44;2&#37; apresentaram escamas brancas ou amarelas e 15&#44;4&#37; apresentaram pontos ou gl&#243;bulos amarronzados&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Errichetti e Stinco observaram que escamas brancas difusas sugerem mais fortemente o diagn&#243;stico de psor&#237;ase palmoplantar&#44; enquanto a detec&#231;&#227;o de escamas amareladas&#44; laranja&#8208;acastanhadas e pontos&#47;gl&#243;bulos e crostas laranja&#8208;amareladas falam mais a favor de eczema&#46; A colora&#231;&#227;o das escamas &#40;branca <span class="elsevierStyleItalic">versus</span> amarela&#41; &#233; informa&#231;&#227;o extremamente &#250;til para auxiliar no diagn&#243;stico diferencial de doen&#231;as escamosas acrais&#46;<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">7&#44;9</span></a> No entanto&#44; no presente trabalho&#44; observou&#8208;se que apenas 33&#44;3&#37; dos pacientes portadores de psor&#237;ase apresentavam escamas brancas&#44; enquanto 66&#44;7&#37; apresentavam escamas brancas e amarelas&#46; Em contrapartida&#44; nos pacientes portadores de eczema&#44; a mesma porcentagem foi observada nos portadores de escamas brancas e amarelas&#44; e 46&#44;2&#37; apresentavam apenas escamas brancas&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">Quanto aos achados dermatosc&#243;picos da <span class="elsevierStyleItalic">tinea manuum&#47;pedis</span>&#44; Errichetti e Stinco observaram escamas esbranqui&#231;adas localizadas principalmente nos sulcos&#44; achado este ausente na psor&#237;ase palmar e eczema cr&#244;nico das m&#227;os&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> Em nosso estudo&#44; 100&#37; dos pacientes portadores de <span class="elsevierStyleItalic">tinea manuum&#47;pedis</span> apresentaram escamas brancas em sulcos&#59; a sensibilidade desse achado foi de 100&#37;&#44; e a especificidade de 96&#37;&#46; A escama branca n&#227;o a diferencia de outras doen&#231;as escamosas&#44; por&#233;m sua localiza&#231;&#227;o t&#237;pica nos sulcos&#44; local de predile&#231;&#227;o dos dermat&#243;fitos&#44; auxilia na diferencia&#231;&#227;o de outras doen&#231;as&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Como limita&#231;&#245;es deste estudo&#44; &#233; importante ressaltar que a foto da dermatoscopia de uma parte da les&#227;o n&#227;o representa o todo&#46; Desse modo&#44; alguns achados dermatosc&#243;picos podem n&#227;o ter sido registrados no momento da foto&#44; mas ainda assim estavam presentes na les&#227;o&#46; Al&#233;m disso&#44; o tempo entre o diagn&#243;stico anatomopatol&#243;gico dos pacientes portadores de psor&#237;ase e eczema e a aplica&#231;&#227;o da dermatoscopia n&#227;o foi avaliada&#44; tampouco se o paciente estava ou n&#227;o em tratamento no momento da avalia&#231;&#227;o&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Apesar de apresentarem caracter&#237;sticas dermatosc&#243;picas sugestivas de determinada doen&#231;a&#44; elas n&#227;o s&#227;o espec&#237;ficas j&#225; que&#44; como observado neste trabalho&#44; algumas caracter&#237;sticas observadas mais frequentemente em portadores de eczema acral tamb&#233;m estiveram presentes em portadores de psor&#237;ase palmoplantar&#46; Assim&#44; &#233; de extrema import&#226;ncia a correla&#231;&#227;o cl&#237;nica e anamnese adequada&#44; al&#233;m da dermatoscopia&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Al&#233;m disso&#44; 100&#37; dos pacientes portadores de <span class="elsevierStyleItalic">tinea mannum&#47;pedis</span> apresentaram escamas em sulcos&#44; com sensibilidade de 100&#37; e especificidade de 96&#37;&#44; e esse &#233; um achado muito sugestivo desse diagn&#243;stico&#44; destacando o papel da dermatoscopia no diagn&#243;stico dessa entidade&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0115" 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="par0120" class="elsevierStylePara elsevierViewall">Mariana Vieira Martins Sampaio Drummond&#58; Conceito e desenho do estudo&#59; coleta de dados&#44; an&#225;lise e interpreta&#231;&#227;o de dados&#59; an&#225;lise estat&#237;stica&#59; reda&#231;&#227;o do manuscrito ou revis&#227;o cr&#237;tica de conte&#250;do intelectual importante&#59; coleta&#44; an&#225;lise e interpreta&#231;&#227;o dos dados&#59; participa&#231;&#227;o intelectual na conduta proped&#234;utica e&#47;ou terap&#234;utica dos casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Jules Rimet Borges&#58; Conceito e desenho do estudo&#59; reda&#231;&#227;o do manuscrito ou revis&#227;o cr&#237;tica de conte&#250;do intelectual importante&#59;&#160;coleta&#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 na conduta proped&#234;utica e&#47;ou terap&#234;utica dos casos estudados&#59; revis&#227;o cr&#237;tica da literatura&#59; aprova&#231;&#227;o final da vers&#227;o final do manuscrito&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Ana Maria Quinteiro Ribeiro&#58; Coleta de dados&#44; ou an&#225;lise e interpreta&#231;&#227;o de dados&#59; an&#225;lise estat&#237;stica&#59; reda&#231;&#227;o do manuscrito ou revis&#227;o cr&#237;tica de conte&#250;do intelectual importante&#59; participa&#231;&#227;o efetiva na orienta&#231;&#227;o da pesquisa&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">B&#225;rbara Alvares Salum Ximenes&#58; Reda&#231;&#227;o do manuscrito ou revis&#227;o cr&#237;tica de conte&#250;do intelectual importante&#46;</p></span><span id="sec0015" 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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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \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">n&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">&#37;&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">n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Focais&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">1&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">7&#44;7&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">16&#44;7&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&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">0&#44;0&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="elsevierStyleHsp" style=""></span>Difusos&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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;7&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">41&#44;7&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
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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">12&#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"><span class="elsevierStyleItalic">Escamas brancas</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&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="elsevierStyleHsp" style=""></span>Sulcos&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">1&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">7&#44;7&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&nbsp;\t\t\t\t\t\t\n
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                  \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
                  \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">100&#44;0&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="elsevierStyleHsp" style=""></span>Difusas&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&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">46&#44;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">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">33&#44;3&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&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;0&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="elsevierStyleItalic">Escamas brancas e amarelas</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">6&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">46&#44;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">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">66&#44;7&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
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&#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"><span class="elsevierStyleItalic">Pontos e&#47;ou gl&#243;bulos amarronzados</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">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">15&#44;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">5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">41&#44;7&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&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;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3563630.png"
              ]
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        "descripcion" => array:1 [
          "pt" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Frequ&#234;ncia de achados dermatosc&#243;picos por diagn&#243;stico</p>"
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      4 => array:8 [
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col">&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" scope="col">Eczema&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col">Eczema&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" scope="col">Psor&#237;ase&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">Psor&#237;ase&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"><span class="elsevierStyleItalic">Tinea</span>&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"><span class="elsevierStyleItalic">Tinea</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr><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">Sinais dermatosc&#243;picos&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">S&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">E&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">S&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">E&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">S&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">E&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">Vasos puntiformes focais&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">7&#44;7</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">90&#44;0</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">16&#44;7&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">95&#44;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;0&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">88&#44;0&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">Vasos puntiformes difusos&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">7&#44;7&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">70&#44;0&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">41&#44;7</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">90&#44;5</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">12&#44;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">76&#44;0&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">Escamas brancas sulcos&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">7&#44;7&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;0&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;0&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">57&#44;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
                  \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><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">96&#44;0</span>&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">Escamas brancas difusas&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">46&#44;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">80&#44;0&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">33&#44;3</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">71&#44;4</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">0&#44;0&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;0&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">Escamas brancas e amarelas&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">46&#44;2</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">55&#44;0</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">66&#44;7&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">66&#44;7&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&#44;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">44&#44;0&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">Pontos e&#47;ou gl&#243;bulos amarronzados&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">15&#44;4</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">75&#44;0</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">41&#44;7&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">90&#44;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">0&#44;0&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">72&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab3563629.png"
              ]
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        ]
        "descripcion" => array:1 [
          "pt" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Sensibilidade &#40;S&#41; e especificidade &#40;E&#41; de sinais dermatosc&#243;picos para o diagn&#243;stico de eczema&#44; psor&#237;ase e <span class="elsevierStyleItalic">tinea</span></p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Refer&#234;ncias"
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        0 => array:2 [
          "identificador" => "bibs0015"
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            0 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermoscopy image analysis&#58; overview and future directions"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;E&#46; Celebi"
                            1 => "N&#46; Codella"
                            2 => "A&#46; Halpern"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1109/JBHI.2019.2895803"
                      "Revista" => array:6 [
                        "tituloSerie" => "IEEE J Biomed Health Inform&#46;"
                        "fecha" => "2019"
                        "volumen" => "23"
                        "paginaInicial" => "474"
                        "paginaFinal" => "478"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30703051"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dermoscopy in general dermatology&#58; a practical overview"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46; Errichetti"
                            1 => "G&#46; Stinco"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s13555-016-0141-6"
                      "Revista" => array:6 [
                        "tituloSerie" => "Dermatol Ther &#40;Heidelb&#41;&#46;"
                        "fecha" => "2016"
                        "volumen" => "6"
                        "paginaInicial" => "471"
                        "paginaFinal" => "507"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27613297"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
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            2 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Prevalence of psoriasis in Brazil &#8211; a geographical survey"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "R&#46; Romiti"
                            1 => "M&#46; Amone"
                            2 => "A&#46; Menter"
                            3 => "H&#46;A&#46; Miot"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/ijd.13604"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Dermatol&#46;"
                        "fecha" => "2017"
                        "volumen" => "56"
                        "paginaInicial" => "e167"
                        "paginaFinal" => "e168"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28345141"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Hand eczema&#58; epidemiology&#44; prognosis and prevention"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
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                            0 => "T&#46; Agner"
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                        ]
                      ]
                    ]
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Eur Acad Dermatol Venereol&#46;"
                        "fecha" => "2020"
                        "volumen" => "34"
                        "paginaInicial" => "4"
                        "paginaFinal" => "12"
                      ]
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                0 => array:2 [
                  "contribucion" => array:1 [
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Informação do artigo
ISSN: 26662752
Idioma original: Português
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