Statistics

 array:21 [
  "pii" => "X2013251414053513"
  "issn" => "20132514"
  "doi" => "10.3265/Nefrologia.pre2013.Sep.12270"
  "estado" => "S300"
  "fechaPublicacion" => "2014-01-01"
  "documento" => "article"
  "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
  "subdocumento" => "fla"
  "cita" => "Nefrologia (English Version). 2014;34:131-2"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 7695
    "formatos" => array:3 [
      "EPUB" => 286
      "HTML" => 6733
      "PDF" => 676
    ]
  ]
  "Traduccion" => array:1 [
    "es" => array:17 [
      "pii" => "X0211699514053516"
      "issn" => "02116995"
      "doi" => "10.3265/Nefrologia.pre2013.Sep.12270"
      "estado" => "S300"
      "fechaPublicacion" => "2014-01-01"
      "documento" => "article"
      "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
      "subdocumento" => "fla"
      "cita" => "Nefrologia. 2014;34:131-2"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:2 [
        "total" => 22997
        "formatos" => array:3 [
          "EPUB" => 346
          "HTML" => 21681
          "PDF" => 970
        ]
      ]
      "es" => array:10 [
        "idiomaDefecto" => true
        "titulo" => "Dermatosis perforante adquirida en pacientes con insuficiencia renal crónica. Presentación de dos casos y revisión de la literatura"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "131"
            "paginaFinal" => "132"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Acquired perforating dermatosis in patients with chronic renal failure. A report of two cases and a review of the literature"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:8 [
            "identificador" => "fig1"
            "etiqueta" => "Fig. 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "copyright" => "Elsevier España"
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "12270_19904_50612_es_12270_f1.jpg"
                "Alto" => 586
                "Ancho" => 600
                "Tamanyo" => 245522
              ]
            ]
            "descripcion" => array:1 [
              "es" => "Lesión pretibial."
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "José M. Graña, Llanos Lorente, Carmen Ortega, Yolanda Blanco, María Aparicio, Franz Fernández, Esther Bea, Belén Alemany, Miguel Candel"
            "autores" => array:9 [
              0 => array:2 [
                "nombre" => "José M."
                "apellidos" => "Graña"
              ]
              1 => array:2 [
                "nombre" => "Llanos"
                "apellidos" => "Lorente"
              ]
              2 => array:2 [
                "nombre" => "Carmen"
                "apellidos" => "Ortega"
              ]
              3 => array:2 [
                "nombre" => "Yolanda"
                "apellidos" => "Blanco"
              ]
              4 => array:2 [
                "nombre" => "María"
                "apellidos" => "Aparicio"
              ]
              5 => array:2 [
                "nombre" => "Franz"
                "apellidos" => "Fernández"
              ]
              6 => array:2 [
                "nombre" => "Esther"
                "apellidos" => "Bea"
              ]
              7 => array:2 [
                "nombre" => "Belén"
                "apellidos" => "Alemany"
              ]
              8 => array:2 [
                "nombre" => "Miguel"
                "apellidos" => "Candel"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "X2013251414053513"
          "doi" => "10.3265/Nefrologia.pre2013.Sep.12270"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251414053513?idApp=UINPBA000064"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699514053516?idApp=UINPBA000064"
      "url" => "/02116995/0000003400000001/v0_201502091353/X0211699514053516/v0_201502091354/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:17 [
    "pii" => "X2013251414053505"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.pre2013.Sep.12268"
    "estado" => "S300"
    "fechaPublicacion" => "2014-01-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia (English Version). 2014;34:132-3"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 5084
      "formatos" => array:3 [
        "EPUB" => 293
        "HTML" => 4101
        "PDF" => 690
      ]
    ]
    "en" => array:9 [
      "idiomaDefecto" => true
      "titulo" => "Treatment of infection due to hepatitis C virus in haemodialysis"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "132"
          "paginaFinal" => "133"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Tratamiento de la infección por virus de la hepatitis C en hemodiálisis"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Patricia Hidalgo-Collazos, Laura Marín-Ventura, Rosa Sánchez, Laura García-López, M. Teresa Criado-Illana"
          "autores" => array:5 [
            0 => array:2 [
              "nombre" => "Patricia"
              "apellidos" => "Hidalgo-Collazos"
            ]
            1 => array:2 [
              "nombre" => "Laura"
              "apellidos" => "Marín-Ventura"
            ]
            2 => array:2 [
              "nombre" => "Rosa"
              "apellidos" => "Sánchez"
            ]
            3 => array:2 [
              "nombre" => "Laura"
              "apellidos" => "García-López"
            ]
            4 => array:2 [
              "nombre" => "M. Teresa"
              "apellidos" => "Criado-Illana"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "X0211699514053508"
        "doi" => "10.3265/Nefrologia.pre2013.Sep.12268"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699514053508?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251414053505?idApp=UINPBA000064"
    "url" => "/20132514/0000003400000001/v0_201502091619/X2013251414053505/v0_201502091620/en/main.assets"
  ]
  "itemAnterior" => array:17 [
    "pii" => "X2013251414053521"
    "issn" => "20132514"
    "doi" => "10.3265/Nefrologia.pre2013.Oct.12283"
    "estado" => "S300"
    "fechaPublicacion" => "2014-01-01"
    "documento" => "article"
    "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/"
    "subdocumento" => "fla"
    "cita" => "Nefrologia (English Version). 2014;34:130-1"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 5124
      "formatos" => array:3 [
        "EPUB" => 284
        "HTML" => 4207
        "PDF" => 633
      ]
    ]
    "en" => array:9 [
      "idiomaDefecto" => true
      "titulo" => "Cloudy peritoneal effluent and diarrhoea due to Clostridium difficile"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "130"
          "paginaFinal" => "131"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Efluente peritoneal turbio y diarrea por Clostridium difficile"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "José J. Ribés-Cruz, Miguel González-Rico, Isabel Juan-García, M. Jesús Puchades-Montesa, Isidro Torregrosa-Maicas, Carmela Ramos-Tomás, Miguel A. Solís-Salguero, Patricia Tomás-Simó, Sandra Tejedor-Alonso, Patricia Zambrano-Esteves, Alfonso Miguel-Carrasco"
          "autores" => array:11 [
            0 => array:2 [
              "nombre" => "José J."
              "apellidos" => "Ribés-Cruz"
            ]
            1 => array:2 [
              "nombre" => "Miguel"
              "apellidos" => "González-Rico"
            ]
            2 => array:2 [
              "nombre" => "Isabel"
              "apellidos" => "Juan-García"
            ]
            3 => array:2 [
              "nombre" => "M. Jesús"
              "apellidos" => "Puchades-Montesa"
            ]
            4 => array:2 [
              "nombre" => "Isidro"
              "apellidos" => "Torregrosa-Maicas"
            ]
            5 => array:2 [
              "nombre" => "Carmela"
              "apellidos" => "Ramos-Tomás"
            ]
            6 => array:2 [
              "nombre" => "Miguel A."
              "apellidos" => "Solís-Salguero"
            ]
            7 => array:2 [
              "nombre" => "Patricia"
              "apellidos" => "Tomás-Simó"
            ]
            8 => array:2 [
              "nombre" => "Sandra"
              "apellidos" => "Tejedor-Alonso"
            ]
            9 => array:2 [
              "nombre" => "Patricia"
              "apellidos" => "Zambrano-Esteves"
            ]
            10 => array:2 [
              "nombre" => "Alfonso"
              "apellidos" => "Miguel-Carrasco"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "X0211699514053524"
        "doi" => "10.3265/Nefrologia.pre2013.Oct.12283"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X0211699514053524?idApp=UINPBA000064"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251414053521?idApp=UINPBA000064"
    "url" => "/20132514/0000003400000001/v0_201502091619/X2013251414053521/v0_201502091620/en/main.assets"
  ]
  "en" => array:13 [
    "idiomaDefecto" => true
    "titulo" => "Acquired perforating dermatosis in patients with chronic renal failure. A report of two cases and a review of the literature"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "131"
        "paginaFinal" => "132"
      ]
    ]
    "autores" => array:1 [
      0 => array:3 [
        "autoresLista" => "José M. Graña, Llanos Lorente, Carmen Ortega, Yolanda Blanco, María Aparicio, Franz Fernández, Esther Bea, Belén Alemany, Miguel Candel"
        "autores" => array:9 [
          0 => array:4 [
            "nombre" => "José M."
            "apellidos" => "Graña"
            "email" => array:1 [
              0 => "jografa22@gmail.com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          1 => array:3 [
            "nombre" => "Llanos"
            "apellidos" => "Lorente"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">b</span>"
                "identificador" => "affb"
              ]
            ]
          ]
          2 => array:3 [
            "nombre" => "Carmen"
            "apellidos" => "Ortega"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">c</span>"
                "identificador" => "affc"
              ]
            ]
          ]
          3 => array:3 [
            "nombre" => "Yolanda"
            "apellidos" => "Blanco"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          4 => array:3 [
            "nombre" => "Mar&#237;a"
            "apellidos" => "Aparicio"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          5 => array:3 [
            "nombre" => "Franz"
            "apellidos" => "Fern&#225;ndez"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          6 => array:3 [
            "nombre" => "Esther"
            "apellidos" => "Bea"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          7 => array:3 [
            "nombre" => "Bel&#233;n"
            "apellidos" => "Alemany"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
          8 => array:3 [
            "nombre" => "Miguel"
            "apellidos" => "Candel"
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">a</span>"
                "identificador" => "affa"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:3 [
          0 => array:3 [
            "entidad" => "Servicio de Nefrología, Hospital Universitario de la Ribera, Alzira, Valencia,  "
            "etiqueta" => "<span class="elsevierStyleSup">a</span>"
            "identificador" => "affa"
          ]
          1 => array:3 [
            "entidad" => "Servicio de Medicina Interna, Hospital Universitario de la Ribera, Alzira, Valencia,  "
            "etiqueta" => "<span class="elsevierStyleSup">b</span>"
            "identificador" => "affb"
          ]
          2 => array:3 [
            "entidad" => "Servicio de Dermatología, Hospital Universitario de la Ribera, Alzira, Valencia,  "
            "etiqueta" => "<span class="elsevierStyleSup">c</span>"
            "identificador" => "affc"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "Dermatosis perforante adquirida en pacientes con insuficiencia renal cr&#243;nica&#46; Presentaci&#243;n de dos casos y revisi&#243;n de la literatura"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig1"
        "etiqueta" => "Fig. 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "12270_16025_54651_en_f112270_copy1.jpg"
            "Alto" => 598
            "Ancho" => 651
            "Tamanyo" => 227151
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Pretibial lesion&#46;"
        ]
      ]
    ]
    "textoCompleto" => "<p class="elsevierStylePara"><span class="elsevierStyleBold">To the Editor&#58;</span></p><p class="elsevierStylePara">Acquired perforating dermatosis &#40;APD&#41; is an uncommon cutaneous perforating disorder&#46; It is characterised by the presence of hyperkeratotic papules and nodules and histologically&#44; by transepidermal elimination of various substances&#44; such as keratin&#44; collagen and elastic fibres&#46; It was first described by Mehregan in 1967&#46; There are two types&#58; hereditary and acquired&#44; the latter is generally associated with diabetes mellitus &#40;DM&#41; and chronic renal failure &#40;CRF&#41;&#46;<span class="elsevierStyleSup">1</span></p><p class="elsevierStylePara">In the literature&#44; we also found other cases associated with neoplasia&#44;<span class="elsevierStyleSup">2&#44;3</span> liver diseases and endocrine disorders&#44;<span class="elsevierStyleSup">4</span> AIDS&#44;<span class="elsevierStyleSup">5</span> tuberculosis&#44;<span class="elsevierStyleSup">6</span> etc&#46;</p><p class="elsevierStylePara">There are four classic forms of APD&#44; according to clinical and histological criteria&#58; elastosis perforans serpiginosa&#44; reactive perforating collagenosis&#44; perforating folliculitis and Kyrle disease&#46;</p><p class="elsevierStylePara">As regards the population with CRF on renal replacement therapy&#44; the only studies of this condition date back to 1982&#44;<span class="elsevierStyleSup">7</span> with a reported prevalence of 4&#46;5&#37;-10&#37; in haemodialysis patients in the United States&#44; and 1996&#44;<span class="elsevierStyleSup">8</span> with a prevalence of 11&#37; in the United Kingdom&#46; Only haemodialysis patients have been reported to date&#44; not peritoneal dialysis patients&#46;</p><p class="elsevierStylePara">Many treatments have been used in an attempt to manage this disorder&#44; with varying results&#58; topical and systemic steroids&#44; topical and systemic retinoids&#44; vitamin A&#44; light therapy&#44; methotrexate and cryotherapy&#46; In recent times&#44; allopurinol has been considered as treatment&#44; due to its antioxidant effect&#58; inhibiting xanthine oxidase and reducing the production of oxygen free radicals and&#44; therefore&#44; collagen damage&#46;<span class="elsevierStyleSup">9&#44;10</span></p><p class="elsevierStylePara">We report two cases in our unit&#59; the first was a peritoneal dialysis patient and the second&#44; a haemodialysis patient&#46;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">CASE 1</span></p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara">A 39-year-old female with a history of very debilitating juvenile chronic arthritis from the age of 16 years old&#46; She was not diabetic and had bilateral hip prostheses due to femoral head avascular necrosis&#44; secondary to prolonged steroid treatment&#46; She also had rheumatic mitral regurgitation and was on peritoneal dialysis due to chronic kidney disease&#46; She came to our hospital due to exophytic and hyperkeratotic lesions on the soles of her feet&#44; the pretibial area &#40;Figure 1&#41; and her buttocks&#46; She was transferred to the Dermatology department&#44; the lesions were biopsied and she was diagnosed with reactive perforating collagenosis&#46; After reviewing the literature&#44; treatment was started with allopurinol and a significant improvement was noted in the lesions after one month&#44; with the disappearance of pruritus&#46;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">CASE 2</span></p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara">A 50-year-old male with ESRD secondary to diabetic nephropathy on renal replacement therapy with haemodialysis&#46; He had chronic ischaemic heart disease&#44; ischaemic dilated cardiomyopathy&#44; diabetic retinopathy and had suffered a stroke some years before&#59; he was admitted to internal medicine due to an episode of diabetic ketoacidosis&#46; While hospitalised&#44; multiple maculopapular erythematous lesions were detected with universally distributed central hyperkeratotic scaly areas &#40;Figure 2&#41;&#46; We consulted the Dermatology department&#44; a skin biopsy was taken of the lesions and the patient was diagnosed with Kyrle disease&#46;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">DISCUSSION</span></p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara">Perforating skin disorders are characterised by the transepidermal elimination of some components of the dermis and they have classically been classified into four types&#58; elastosis perforans serpiginosa&#44; reactive perforating collagenosis&#44; perforating folliculitis and Kyrle disease&#46;</p><p class="elsevierStylePara">These four disorders have been reported in patients with CRF&#44; DM or both conditions&#46; APD lesions associated with CRF or DM are usually 2-10mm&#44; hyperkeratotic and are often umbilicated papules generally located in the limbs&#44; particularly the legs&#46; The lesions are usually very pruritic&#44; with positive Koebner phenomenon on scratching&#46; In the cases that we reported&#44; there was a predominance of lower limb lesions and in both cases&#44; pruritus was the main symptom&#46; The presence of lesions on the face&#44; hands and feet is exceptional&#46; Our second patient had major lesions in both feet&#46;</p><p class="elsevierStylePara">APD was also reported in other cases of CRF not due to DM&#44; including obstructive nephropathies&#44; hypertensive nephroangiosclerosis&#44; AIDS&#44; etc&#46; This suggests that the cutaneous changes typical of CRF may act as a trigger in the development of APD&#46; Microdeposits of substances such as calcium salts may promote a local inflammatory reaction&#44; as well as connective tissue degradation&#46; In fact&#44; microcrystal deposits have been observed in the upper dermis in ultrastructure studies carried out on patients with APD&#46;</p><p class="elsevierStylePara">In conclusion&#44; this pathology is relatively common in dialysis units &#40;prevalence varies between 4&#37; and 10&#37;&#41;&#46; It is not always diagnosed and it is occasionally debilitating&#44; due to the pruritus that it causes&#46; Its pathogenesis is unknown&#44; although it may be influenced by the trauma caused by pruritus itself&#46; In any case&#44; it is a relatively unknown condition&#44; and as such&#44; new studies are necessary in order to better define this collagen abnormality&#46;</p><p class="elsevierStylePara"><span class="elsevierStyleBold">&#160;</span></p><p class="elsevierStylePara"><span class="elsevierStyleBold">Conflicts of interest</span></p><p class="elsevierStylePara">&#160;</p><p class="elsevierStylePara">The authors declare that they have no conflicts of interest related to the contents of this article&#46;</p><p class="elsevierStylePara"><a href="grande&#47;12270&#95;16025&#95;54651&#95;en&#95;f112270&#95;copy1&#46;jpg" class="elsevierStyleCrossRefs"><img src="12270_16025_54651_en_f112270_copy1.jpg" alt="Pretibial lesion&#46;"></img></a></p><p class="elsevierStylePara">Figure 1&#46; Pretibial lesion&#46;</p><p class="elsevierStylePara"><a href="grande&#47;12270&#95;16025&#95;54652&#95;en&#95;f212270&#95;copy1&#46;jpg" class="elsevierStyleCrossRefs"><img src="12270_16025_54652_en_f212270_copy1.jpg" alt="Universally distributed hyperkeratotic and erythematous lesions&#46;"></img></a></p><p class="elsevierStylePara">Figure 2&#46; Universally distributed hyperkeratotic and erythematous lesions&#46;</p>"
    "pdfFichero" => "P1-E565-S4505-A12270-EN.pdf"
    "tienePdf" => true
    "PalabrasClave" => array:1 [
      "en" => array:3 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec439282"
          "palabras" => array:1 [
            0 => "Reactive perforating dermatosis"
          ]
        ]
        1 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec439284"
          "palabras" => array:1 [
            0 => "Diabetes mellitus"
          ]
        ]
        2 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec439286"
          "palabras" => array:1 [
            0 => "Chronic kidney disease &#40;CKD&#41;"
          ]
        ]
      ]
    ]
    "multimedia" => array:2 [
      0 => array:8 [
        "identificador" => "fig1"
        "etiqueta" => "Fig. 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "12270_16025_54651_en_f112270_copy1.jpg"
            "Alto" => 598
            "Ancho" => 651
            "Tamanyo" => 227151
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Pretibial lesion&#46;"
        ]
      ]
      1 => array:8 [
        "identificador" => "fig2"
        "etiqueta" => "Fig. 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "copyright" => "Elsevier Espa&#241;a"
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "12270_16025_54652_en_f212270_copy1.jpg"
            "Alto" => 496
            "Ancho" => 657
            "Tamanyo" => 208447
          ]
        ]
        "descripcion" => array:1 [
          "en" => "Universally distributed hyperkeratotic and erythematous lesions&#46;"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliography"
      "seccion" => array:1 [
        0 => array:1 [
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Rapini RP. Perforating disorders. In: Ardnt KA, Le Boit PE, Robinson JK, Wintroub BU, eds. Cutaneous medicine and surgery. 1st ed. Philadelphia: W.B. Saunders Company; 1996. pp. 407-11."
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Pedragosa R, Knobel HJ, Huguet P, Oristrell J, Valdés M, Bosch JA. Reactive perforating collagenosis in Hodgkin's disease. Am J Dermatopathol 1987;9:41-4. <a href="http://www.ncbi.nlm.nih.gov/pubmed/3565711" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Henry JC, Jorizzo JL, Apisarthaanarax P. Reactive perforating collagenosis in the setting of prurigo nodularis. Int J Dermatol 1983;22:386-7. <a href="http://www.ncbi.nlm.nih.gov/pubmed/6618748" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Faver IR, Daoud MS, Su WP. Acquired reactive perforating collagenosis. Report of six cases and review of the literature. J Am Acad Dermatol 1994;30:575-80. <a href="http://www.ncbi.nlm.nih.gov/pubmed/8157784" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Bank DE, Cohen PR, Kohn SR. Reactive perforating collagenosis in a setting of double disaster: acquired inmunodeficiency syndrome and end stage renal disease. J Am Acad Dermatol 1989;21:371-4. <a href="http://www.ncbi.nlm.nih.gov/pubmed/2754070" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Zelger B, Hintner H, Auböck J, Frtsch PO. Acquired perforating dermatosis: transepidermical elimination of DNA material an possible role of lukocytes in pathogenesis. Arch Dermatol 1991;127:695-700. <a href="http://www.ncbi.nlm.nih.gov/pubmed/2024988" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Hood AF, Hardegen GL, Zarate AR, Nigra TP, Gelfand MC. Kyrle's disease in patients with chronic renal failure. Arch Dermatol 1982;118:85-8. <a href="http://www.ncbi.nlm.nih.gov/pubmed/7059223" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Morton CA, Henderson IS, Jones MC, Lowe JG. Acquired perforating dermatosis in a British dialysis population. Br J Dermatol 1996;135:671-7. <a href="http://www.ncbi.nlm.nih.gov/pubmed/8977664" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Kawakami T, Saito R. Acquired reactive perforating collagenosis associsated with diabetes mellitus: eight cases that meet Faver's criteria. Br J Dermatol 1999;140:521-4. <a href="http://www.ncbi.nlm.nih.gov/pubmed/10233279" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:3 [
                  "referenciaCompleta" => "Haftek M, Euvrard S, Kanitakis J, Delawari E, Schmitt D. Acquired perforating dermatosis of diabetes mellitus and renal failure: Further structural clues to its pathogenesis. J Cutan Pathol 1993;20:350-5. <a href="http://www.ncbi.nlm.nih.gov/pubmed/8227611" target="_blank">[Pubmed]</a>"
                  "contribucion" => array:1 [
                    0 => null
                  ]
                  "host" => array:1 [
                    0 => null
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/20132514/0000003400000001/v0_201502091619/X2013251414053513/v0_201502091620/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "35437"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Letters to the Editor - Brief Case Reports"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/20132514/0000003400000001/v0_201502091619/X2013251414053513/v0_201502091620/en/P1-E565-S4505-A12270-EN.pdf?idApp=UINPBA000064&text.app=https://revistanefrologia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/X2013251414053513?idApp=UINPBA000064"
]