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A dangerous combination" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "555" "paginaFinal" => "557" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "COVID-19, Guillain-Barré y vacuna. Una mezcla peligrosa" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 4041 "Ancho" => 2500 "Tamanyo" => 509523 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Summary of the neurophysiology testing for patient number 1. No distal motor conductions are obtained corresponding to the main nerves of the upper and lower limbs. No “F” responses are obtained in any of the nerves examined. No sensitive responses are obtained in the nerves of the lower limbs.</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">L: left; MNC: motor nerve conduction; R: right; SNC: sensitive nerve conduction.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "I.F. Aomar-Millán, J. Martínez de Victoria-Carazo, J.A. Peregrina-Rivas, I. Villegas-Rodríguez" "autores" => array:4 [ 0 => array:2 [ "nombre" => "I.F." "apellidos" => "Aomar-Millán" ] 1 => array:2 [ "nombre" => "J." "apellidos" => "Martínez de Victoria-Carazo" ] 2 => array:2 [ "nombre" => "J.A." "apellidos" => "Peregrina-Rivas" ] 3 => array:2 [ "nombre" => "I." 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Camafort, L. Alcocer, A. Coca, J.P. Lopez-Lopez, P. López-Jaramillo, C.I. Ponte-Negretti, W. Sebba-Barroso, O. Valdéz, F. Wyss" "autores" => array:9 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Camafort" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Alcocer" ] 2 => array:2 [ "nombre" => "A." "apellidos" => "Coca" ] 3 => array:2 [ "nombre" => "J.P." "apellidos" => "Lopez-Lopez" ] 4 => array:2 [ "nombre" => "P." "apellidos" => "López-Jaramillo" ] 5 => array:2 [ "nombre" => "C.I." "apellidos" => "Ponte-Negretti" ] 6 => array:2 [ "nombre" => "W." "apellidos" => "Sebba-Barroso" ] 7 => array:2 [ "nombre" => "O." "apellidos" => "Valdéz" ] 8 => array:2 [ "nombre" => "F." "apellidos" => "Wyss" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0014256521000758" "doi" => "10.1016/j.rce.2021.02.002" "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/S0014256521000758?idApp=WRCEE" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887421001454?idApp=WRCEE" "url" => "/22548874/0000022100000009/v3_202201140544/S2254887421001454/v3_202201140544/en/main.assets" ] "en" => array:15 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Medicine in Images</span>" "titulo" => "Neutrophilic dermatosis of the dorsal hands" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "553" "paginaFinal" => "554" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "X. Fustà-Novell, S. Bermejo, L. Creus-Vila" "autores" => array:3 [ 0 => array:4 [ "nombre" => "X." "apellidos" => "Fustà-Novell" "email" => array:1 [ 0 => "xfusta@althaia.cat" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "S." "apellidos" => "Bermejo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "L." "apellidos" => "Creus-Vila" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Barcelona, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Nefrología, Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Dermatosis neutrofílica del dorso de manos" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1890 "Ancho" => 905 "Tamanyo" => 351575 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">An 83-year-old male with insulin-dependent type 2 diabetes mellitus who is on haemodialysis for nephrosclerosis consulted for a painful lesion on dorsum of his left hand that had been ongoing for 2 weeks and grew rapidly, with no other symptoms.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Upon examination of the skin, he presented with an ulcerated plaque measuring 7 cm in diameter with raised purplish borders and a similar, smaller lesion on the dorsum of the fifth finger (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A). Blood test results were unremarkable: a complete blood count did not show leukocytosis or neutrophilia and a total protein test revealed no abnormalities. With a clinical suspicion of neutrophilic dermatosis of the dorsal hands (NDDH), treatment was started with oral prednisone (0.5<span class="elsevierStyleHsp" style=""></span>mg/kg/day) and twice-daily applications of betamethasone and gentamicin cream. Bacterial, mycobacterial, and fungal cultures were negative. A skin biopsy showed a dense neutrophil infiltrate, necrosis, and haemorrhage, confirming the NDDH diagnosis. After 15 days of treatment, the lesions had fully resolved (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">It is controversial whether NDDH is its own entity, a variant of Sweet's syndrome or pyoderma gangrenosum, or a combination of both. Its identification is essential, both due to the described associated conditions (haematologic and solid-organ neoplasms, inflammatory bowel disease, diabetes mellitus, infections, chronic glomerulonephritis) and to avoid mistaking lesions for infections, which in many cases may delay diagnosis and lead to unnecessary, aggressive treatments (broad-spectrum antibiotics, surgical debridement). A good, rapid response to treatment with oral corticosteroids is characteristic.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-12-01" "fechaAceptado" => "2019-12-21" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Fustà-Novell X, Bermejo S, Creus-Vila L. Dermatosis neutrofílica del dorso de manos. Rev Clin Esp. 2021;221:553–554.</p>" ] ] "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1890 "Ancho" => 905 "Tamanyo" => 351575 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000022100000009/v3_202201140544/S2254887420300382/v3_202201140544/en/main.assets" "Apartado" => array:4 [ "identificador" => "71811" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Medicine in images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000022100000009/v3_202201140544/S2254887420300382/v3_202201140544/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887420300382?idApp=WRCEE" ]
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