Cartas ‐ Terapia
Caso de psoríase pustulosa generalizada após vacinação contra COVID‐19 com Moderna/NIAID tratado com sucesso com secuquinumabe
Misaki Kusano
, Ryuto Mukaiyama, Toshiyuki Yamamoto
Autor para correspondência
Departamento de Dermatologia, Fukushima Medical University, Fukushima, Japão
Lido
1916
Vezesque se leu este artigo
544
Total PDF
1372
Total HTML
Compartilhar estatísticas
array:22 [ "pii" => "S2666275224001395" "issn" => "26662752" "doi" => "10.1016/j.abdp.2024.06.002" "estado" => "S300" "fechaPublicacion" => "2024-09-01" "aid" => "979" "copyrightAnyo" => "2024" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "en" => array:17 [ "pii" => "S036505962400120X" "issn" => "03650596" "doi" => "10.1016/j.abd.2023.07.016" "estado" => "S300" "fechaPublicacion" => "2024-09-01" "aid" => "979" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter - Therapy</span>" "titulo" => "A case of generalized pustular psoriasis following Moderna/NIAID COVID-19 vaccination successfully treated with secukinumab" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "773" "paginaFinal" => "775" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 884 "Ancho" => 1505 "Tamanyo" => 181287 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A and B) Multiple erythemas and small pustules with scales on the trunk and extremities, and edema was prominent on both lower legs.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Misaki Kusano, Ryuto Mukaiyama, Toshiyuki Yamamoto" "autores" => array:3 [ 0 => array:2 [ "nombre" => "Misaki" "apellidos" => "Kusano" ] 1 => array:2 [ "nombre" => "Ryuto" "apellidos" => "Mukaiyama" ] 2 => array:2 [ "nombre" => "Toshiyuki" "apellidos" => "Yamamoto" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "pt" => array:9 [ "pii" => "S2666275224001395" "doi" => "10.1016/j.abdp.2024.06.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "pt" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275224001395?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S036505962400120X?idApp=UINPBA00008Z" "url" => "/03650596/0000009900000005/v2_202409130645/S036505962400120X/v2_202409130645/en/main.assets" ] ] "itemSiguiente" => array:18 [ "pii" => "S2666275224001413" "issn" => "26662752" "doi" => "10.1016/j.abdp.2024.06.004" "estado" => "S300" "fechaPublicacion" => "2024-09-01" "aid" => "981" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "pt" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Cartas ‐ Terapia</span>" "titulo" => "Associação de penfigoide bolhoso e doença de Grover induzidos por terapia de <span class="elsevierStyleItalic">checkpoint</span> imunológico" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "775" "paginaFinal" => "777" ] ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1432 "Ancho" => 2175 "Tamanyo" => 475673 ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A) Histopatologia de uma das pápulas eritematosas na região dorsolombar esquerda do paciente. (A) Observam‐se hiperceratose paraceratótica, acantólise suprabasal e células disceratóticas. Discreto infiltrado inflamatório linfocitário com alguns eosinófilos é observado na derme superficial (Hematoxilina & eosina, 20×). Imunofluorescência direta da pele normal da região dorso‐lombar esquerda, adjacente à erosão crostosa: depósitos lineares de IgG (B) e C3 (C) são observados ao longo da zona da membrana basal.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Elena Lucía Pinto‐Pulido, Isabel Polo‐Rodríguez, Marta González‐Cañete, Ileana Medina‐Expósito, María Dolores Vélez‐Velázquez, Susana Medina‐Montalvo" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Elena Lucía" "apellidos" => "Pinto‐Pulido" ] 1 => array:2 [ "nombre" => "Isabel" "apellidos" => "Polo‐Rodríguez" ] 2 => array:2 [ "nombre" => "Marta" "apellidos" => "González‐Cañete" ] 3 => array:2 [ "nombre" => "Ileana" "apellidos" => "Medina‐Expósito" ] 4 => array:2 [ "nombre" => "María Dolores" "apellidos" => "Vélez‐Velázquez" ] 5 => array:2 [ "nombre" => "Susana" "apellidos" => "Medina‐Montalvo" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0365059624001223" "doi" => "10.1016/j.abd.2023.07.018" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059624001223?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275224001413?idApp=UINPBA00008Z" "url" => "/26662752/0000009900000005/v2_202409060549/S2666275224001413/v2_202409060549/pt/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2666275224001218" "issn" => "26662752" "doi" => "10.1016/j.abdp.2024.05.012" "estado" => "S300" "fechaPublicacion" => "2024-09-01" "aid" => "961" "copyright" => "Sociedade Brasileira de Dermatologia" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "pt" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Cartas - Dermatopatologia</span>" "titulo" => "Matricoma melanocítico: lesão pigmentada na região frontal" "tienePdf" => "pt" "tieneTextoCompleto" => "pt" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "769" "paginaFinal" => "772" ] ] "contieneTextoCompleto" => array:1 [ "pt" => true ] "contienePdf" => array:1 [ "pt" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1374 "Ancho" => 2508 "Tamanyo" => 544945 ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Exame físico. (A) Pápula de cor marrom‐escura. (B) Dermatoscopia. Ninhos ovoides azul‐acinzentados e ulceração, circundados por borda eritematosa elevada de 3<span class="elsevierStyleHsp" style=""></span>mm.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Teresa Alonso‐de‐León, Carlos Barrera‐Ochoa, Luis Enrique Cano‐Aguilar, Katia Lizette Munguia‐Galeano, Jorge Felipe Flores‐Ochoa, María Elisa Vega‐Memije" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Teresa" "apellidos" => "Alonso‐de‐León" ] 1 => array:2 [ "nombre" => "Carlos" "apellidos" => "Barrera‐Ochoa" ] 2 => array:2 [ "nombre" => "Luis Enrique" "apellidos" => "Cano‐Aguilar" ] 3 => array:2 [ "nombre" => "Katia Lizette" "apellidos" => "Munguia‐Galeano" ] 4 => array:2 [ "nombre" => "Jorge Felipe" "apellidos" => "Flores‐Ochoa" ] 5 => array:2 [ "nombre" => "María Elisa" "apellidos" => "Vega‐Memije" ] ] ] ] ] "idiomaDefecto" => "pt" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S0365059624001028" "doi" => "10.1016/j.abd.2023.05.011" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365059624001028?idApp=UINPBA00008Z" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275224001218?idApp=UINPBA00008Z" "url" => "/26662752/0000009900000005/v2_202409060549/S2666275224001218/v2_202409060549/pt/main.assets" ] "pt" => array:17 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Cartas ‐ Terapia</span>" "titulo" => "Caso de psoríase pustulosa generalizada após vacinação contra COVID‐19 com Moderna/NIAID tratado com sucesso com secuquinumabe" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">Prezado Editor,</span>" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "773" "paginaFinal" => "775" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Misaki Kusano, Ryuto Mukaiyama, Toshiyuki Yamamoto" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Misaki" "apellidos" => "Kusano" "email" => array:1 [ 0 => "k963@fmu.ac.jp" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Ryuto" "apellidos" => "Mukaiyama" ] 2 => array:2 [ "nombre" => "Toshiyuki" "apellidos" => "Yamamoto" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Departamento de Dermatologia, Fukushima Medical University, Fukushima, Japão" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Autor para correspondência." ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2643 "Ancho" => 1675 "Tamanyo" => 647731 ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A) Pústulas subcórneas na histopatologia (Hematoxilina & eosina, 20×). (B) Acúmulo subcórneo de neutrófilos circundados por pequenas pústulas multiloculares com espongiose (pústula espongiforme de Kogoj, 200×).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Os autores apresentam um caso de desenvolvimento de psoríase pustulosa generalizada (PPG) após vacinação contra COVID‐19 em paciente com psoríase vulgar.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Paciente do sexo feminino, de 64 anos, foi encaminhada ao Departamento de Dermatologia com queixa de febre alta e eritema com pústulas superficiais por todo o corpo sete dias após a terceira dose da vacina de RNA mensageiro Moderna/NIAID contra COVID‐19 (mRNA‐CV). A paciente havia recebido a primeira e a segunda doses da mRNA‐CV da Pfizer/BioNTech. Ela havia desenvolvido psoríase vulgar (PV) cerca de um ano e meio antes, quando foi tratada com apremilaste oral e hidrato de calcipotriol tópico ambulatorialmente com controle da doença. Na consulta inicial, o exame físico revelou múltiplas áreas eritematosas e pequenas pústulas com escamas no tronco e nas extremidades, e edema proeminente na parte inferior das pernas, bilateralmente (<a class="elsevierStyleCrossRef" href="#fig0005">fig. 1</a>). Foi realizada biopsia de pele da área de eritema com pústulas na coxa esquerda. A histopatologia mostrou acúmulo subcórneo de neutrófilos e pequenas pústulas multiloculares com espongiose (pústula espongiforme de Kogoj; <a class="elsevierStyleCrossRef" href="#fig0010">fig. 2</a>). O exame de sangue mostrou que o nível de proteína‐C reativa estava elevado (7,80<span class="elsevierStyleHsp" style=""></span>mg/dL); os leucócitos estavam normais. Não foram observadas disfunções hepática e renal. A paciente foi tratada com secuquinumabe, resultando em melhora significante da erupção cutânea após dois meses.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">Nos últimos anos, houve vários relatos de PPG após vacinação com mRNA‐CV.<a class="elsevierStyleCrossRefs" href="#bib0055"><span class="elsevierStyleSup">1‐8</span></a> Que seja de conhecimento dos autores, nove casos foram relatados (<a class="elsevierStyleCrossRef" href="#tbl0005">tabela 1</a>). A média de idade foi de 52 anos, e a proporção entre homens e mulheres foi de 5:4. Sete dos nove pacientes tinham história de psoríase, enquanto dois pacientes desenvolveram PPG <span class="elsevierStyleItalic">de novo</span>. A duração desde a vacinação até o início dos sintomas variou de quatro a 21 dias. Vacinas de mRNA foram usadas em sete de nove casos (em cinco casos vacinas Pfizer). A maioria dos pacientes desenvolveu lesões pustulosas após a primeira ou segunda dose. Acitretina (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3), etretinato (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1), ciclosporina (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1) e medicamentos biológicos (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>6) foram utilizados no tratamento (com sobreposição). Em relação aos biológicos, foram utilizados secuquinumabe (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3), infliximabe (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1), adalimumabe (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1) e risanquizumabe (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1). Dois dos nove pacientes realizaram análise de sequenciamento de DNA genômico derivado de sangue periférico, que não revelou mutações genéticas em regiões codificantes inteiras de IL36RN.<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">8</span></a> No presente caso, o IL36RN não foi investigado.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Vários mecanismos foram propostos para exacerbação da psoríase pela vacinação contra COVID‐19. Um deles é o mecanismo que envolve a enzima conversora de angiotensina (ECA). Acredita‐se que a atividade da ECA aumente e cause uma tempestade de citocinas inflamatórias pela vacinação contra a COVID‐19.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a> Outro mecanismo é a ativação da via do receptor <span class="elsevierStyleItalic">Toll‐like</span> (TLR). Farkas et al.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">10</span></a> descobriram que as vacinas podem ativar células dendríticas mieloides dérmicas que participam da cascata inflamatória da psoríase. As células dendríticas diferenciam as células T em células Th1 e Th17, liberando mediadores inflamatórios e, em seguida, desencadeiam a liberação <span class="elsevierStyleItalic">downstream</span> de citocinas. Acredita‐se que essas citocinas inflamatórias estejam envolvidas na exacerbação da psoríase,<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a> mas são necessários mais estudos para esclarecer os mecanismos de indução de PPG pela vacinação contra COVID‐19.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Suporte financeiro</span><p id="par0025" class="elsevierStylePara elsevierViewall">Nenhum.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Contribuição dos autores</span><p id="par0030" class="elsevierStylePara elsevierViewall">Misaki Kusano: Aprovação da versão final do manuscrito; revisão crítica da literatura; obtenção, análise e interpretação dos dados; concepção e planejamento do estudo; manejo dos casos estudados; revisão crítica do manuscrito; elaboração e redação do manuscrito.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Ryuto Mukaiyama: Aprovação da versão final do manuscrito; revisão crítica da literatura; revisão crítica do manuscrito; elaboração e redação do manuscrito.</p><p id="par0040" class="elsevierStylePara elsevierViewall">Toshiyuki Yamamoto: Aprovação da versão final do manuscrito; revisão crítica da literatura; obtenção, análise e interpretação dos dados; concepção e planejamento do estudo; revisão crítica do manuscrito; elaboração e redação do manuscrito.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflito de interesses</span><p id="par0045" class="elsevierStylePara elsevierViewall">Nenhum.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Suporte financeiro" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Contribuição dos autores" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Conflito de interesses" ] 3 => array:1 [ "titulo" => "Referências" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2023-04-10" "fechaAceptado" => "2023-07-12" "NotaPie" => array:2 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Como citar este artigo: Kusano M, Mukaiyama R, Yamamoto T. A case of generalized pustular psoriasis following Moderna/NIAID COVID‐19 vaccination successfully treated with secukinumab. An Bras Dermatol. 2024;99:773–5.</p>" ] 1 => array:1 [ "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Trabalho realizado no Fukushima Medical University, Fukushima, Japão.</p>" ] ] "multimedia" => array:3 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1473 "Ancho" => 2508 "Tamanyo" => 391623 ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">(A‐B) Múltiplas áreas eritematosas e pequenas pústulas com escamas no tronco e extremidades, e edema proeminente em ambas as pernas.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figura 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 2643 "Ancho" => 1675 "Tamanyo" => 647731 ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">(A) Pústulas subcórneas na histopatologia (Hematoxilina & eosina, 20×). (B) Acúmulo subcórneo de neutrófilos circundados por pequenas pústulas multiloculares com espongiose (pústula espongiforme de Kogoj, 200×).</p>" ] ] 2 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Tabela 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Tabela " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Autor \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">Idade \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">Gênero \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">História \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">Vacina \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">Dose \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">Dias até o início \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">Tratamento \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">IL‐36RN \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">Onsun N \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">72 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Masculino \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">Psoríase vulgar \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">Vacina inativada \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">1ª \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 \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">Acitretina, infliximabe \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">— \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">Elamin S \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 \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">Feminino \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">Nenhuma \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">DNA(Oxford‐AstraZeneca) \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">1ª \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">21 \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">Acitretina \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">— \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">Perna D \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">40 \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">Masculino \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">Psoríase vulgar \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">mRNA \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">1ª \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 \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">Secuquinumabe \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">— \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">Yamazaki K(in Japanese) \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 \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">Masculino \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">Psoríase vulgar \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">Pfizer/BioNTechBNT162b2 mRNA \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">2ª \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">19 \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">Adalimumabe \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">— \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">Yatsuzuka K \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">65 \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">Masculino \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">Psoríase pustulosa generalizada \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">mRNA \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">2ª \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 \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">Secuquinumabe \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">— \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">Frioui R \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">20 \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">Masculino \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">Psoríase vulgar \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">Pfizer/BioNTechBNT162b2 mRNA \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">1ª \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 \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">Acitretina \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">— \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">Pavia G \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">47 \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">Feminino \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">Psoríase vulgar \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">Pfizer/BioNTechBNT162b2 mRNA \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">2ª \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10 \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">Risanquizumabe \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">— \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">Tachibana K \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 \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">Feminino \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">Impetigo herpetiforme \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">Pfizer/BioNTechBNT162b2 mRNA \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">2ª \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 \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">Etretinato \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">Nenhuma \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">Tachibana K \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 \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">Feminino \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">Psoríase vulgar \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">Pfizer/BioNTechBNT162b2 mRNA \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">1ª \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 \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">Ciclosporina, secuquinumabe \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">Nenhuma \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">Presente caso \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">64 \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">Feminino \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">Psoríase vulgar \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">Moderna/NIAIDmRNA‐1273 \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">3ª \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 \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">Secuquinumabe \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">— \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab3644956.png" ] ] ] ] "descripcion" => array:1 [ "pt" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Casos de psoríase pustulosa generalizada após aplicação de vacina de mRNA contra o coronavírus</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "Referências" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:10 [ 0 => array:3 [ "identificador" => "bib0055" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A generalized pustular psoriasis flare after CoronaVac COVID‐19 vaccination: case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "N. Onsun" 1 => "G. Kaya" 2 => "B.G. Işık" 3 => "B. Güneş" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.34172/hpp.2021.32" "Revista" => array:6 [ "tituloSerie" => "Health Promot Perspect." "fecha" => "2021" "volumen" => "11" "paginaInicial" => "261" "paginaFinal" => "262" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34195051" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0060" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "De novo generalized pustular psoriasis following Oxford‐AstraZeneca COVID‐19 vaccine" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Elamin" 1 => "F. Hinds" 2 => "J. Tolland" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Exp Dermatol." "fecha" => "2022" "volumen" => "47" "paginaInicial" => "153" "paginaFinal" => "155" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0065" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Acute generalized pustular psoriasis exacerbated by the COVID‐19 vaccine" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "D. Perna" 1 => "J. Jones" 2 => "C.R. Schadt" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jdcr.2021.08.035" "Revista" => array:6 [ "tituloSerie" => "JAAD Case Rep." "fecha" => "2021" "volumen" => "17" "paginaInicial" => "1" "paginaFinal" => "3" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34522741" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0070" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Yamazaki K and Nagata S. Practical Dermatology. 2023;V45V:P68‐71." ] ] ] 4 => array:3 [ "identificador" => "bib0075" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Flare‐up of generalized pustular psoriasis combined with systemic capillary leak syndrome after coronavirus disease 2019 mRNA vaccination" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Yatsuzuka" 1 => "M. Murakami" 2 => "Y. Kuroo" 3 => "M. Fukui" 4 => "S. Yoshida" 5 => "J. Muto" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Dermatol." "fecha" => "2022" "volumen" => "49" "paginaInicial" => "454" "paginaFinal" => "458" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0080" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A case of new‐onset acute generalized pustular psoriasis following Pfizer‐BioNTech COVID‐19 vaccine" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "R. Frioui" 1 => "A. Chamli" 2 => "A. Zaouak" 3 => "Imen Hlel" 4 => "F. Khanchel" 5 => "S. Fenniche" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/dth.15444" "Revista" => array:5 [ "tituloSerie" => "Dermatol Ther." "fecha" => "2022" "volumen" => "35" "paginaInicial" => "e15444" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35285114" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0085" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Generalized pustular psoriasis flare in a patient affected by plaque psoriasis after BNT162b2 mRNA COVID‐19 vaccine, successfully treated with risankizumab" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "G. Pavia" 1 => "L. Gargiulo" 2 => "F. Spinelli" 3 => "J. Avagliano" 4 => "M. Valenti" 5 => "R.G. Borroni" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/jdv.18032" "Revista" => array:6 [ "tituloSerie" => "J Eur Acad Dermatol Venereol." "fecha" => "2022" "volumen" => "36" "paginaInicial" => "e502" "paginaFinal" => "e505" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35224780" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0090" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Flare‐up of generalized pustular psoriasis following Pfizer‐BioNTech BNT162b2 mRNA COVID‐19 vaccine: two cases without mutations of IL36RN and CARD14 genes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Tachibana" 1 => "Y. Kawakami" 2 => "M. Tokuda" 3 => "S. Sato" 4 => "S. Sugihara" 5 => "T. Miyake" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/1346-8138.16442" "Revista" => array:6 [ "tituloSerie" => "J Dermatol." "fecha" => "2022" "volumen" => "49" "paginaInicial" => "e393" "paginaFinal" => "e394" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/35560571" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0095" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Psoriasis and risk of the COVID‐19:is there a role for angiotensin converting enzyme (ACE)?" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Shahidi-Dadras" 1 => "M. Tabary" 2 => "R.M. Robati" 3 => "F. Araghi" 4 => "S. Dadkhahfar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1080/09546634.2020.1782819" "Revista" => array:6 [ "tituloSerie" => "J Dermatolog Treat." "fecha" => "2022" "volumen" => "33" "paginaInicial" => "1175" "paginaFinal" => "1176" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32543296" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0100" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Interferon‐alpha and viral triggers promote functional maturation of human monocyte‐derived dendritic cells" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Farkas" 1 => "G. Tonel" 2 => "F.O. Nestle" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1365-2133.2008.08508.x" "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol." "fecha" => "2008" "volumen" => "158" "paginaInicial" => "921" "paginaFinal" => "929" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18371115" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "pt" "url" => "/26662752/0000009900000005/v2_202409060549/S2666275224001395/v2_202409060549/pt/main.assets" "Apartado" => array:4 [ "identificador" => "95144" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Cartas - Terapia" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/26662752/0000009900000005/v2_202409060549/S2666275224001395/v2_202409060549/pt/main.pdf?idApp=UINPBA00008Z&text.app=https://clinics.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2666275224001395?idApp=UINPBA00008Z" ]
| Ano/Mês | Html | Total | |
|---|---|---|---|
| 2024 Novembro | 42 | 12 | 54 |
| 2024 Outubro | 315 | 91 | 406 |
| 2024 Setembro | 373 | 116 | 489 |
| 2024 Agosto | 401 | 157 | 558 |
| 2024 Julho | 241 | 168 | 409 |
