Research letter
The use of alternative medicine in children with atopic dermatitis
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MW: molecular weight; PC: positive control (botulinum toxin and antibody anti-toxin); Pt: patient reported; NC: negative control (botulinum toxin alone); C1: control 1 (normal individual without previous contact with the toxin); C2: control 2 (responsive patient with previous contact with the toxin); C3: control 3 (responsive patient with previous contact with the toxin).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.V. Aun, T.M. Chung, K.S. Santos, L.M.R. Battistella, L.V. Rizzo, J. Kalil, P. Giavina-Bianchi" "autores" => array:7 [ 0 => array:2 [ "nombre" => "M.V." "apellidos" => "Aun" ] 1 => array:2 [ "nombre" => "T.M." "apellidos" => "Chung" ] 2 => array:2 [ "nombre" => "K.S." "apellidos" => "Santos" ] 3 => array:2 [ "nombre" => "L.M.R." "apellidos" => "Battistella" ] 4 => array:2 [ "nombre" => "L.V." "apellidos" => "Rizzo" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Kalil" ] 6 => array:2 [ "nombre" => "P." "apellidos" => "Giavina-Bianchi" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S030105461200167X?idApp=UINPBA00004N" "url" => "/03010546/0000004100000004/v1_201307160011/S030105461200167X/v1_201307160011/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0301054612001115" "issn" => "03010546" "doi" => "10.1016/j.aller.2012.02.004" "estado" => "S300" "fechaPublicacion" => "2013-07-01" "aid" => "386" "copyright" => "SEICAP" "documento" => "simple-article" "crossmark" => 0 "subdocumento" => "cor" "cita" => "Allergol Immunopathol (Madr). 2013;41:273-5" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1309 "formatos" => array:3 [ "EPUB" => 7 "HTML" => 803 "PDF" => 499 ] ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Research letter</span>" "titulo" => "Allergy shots: Do patients feel pain or fear?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "273" "paginaFinal" => "275" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1336 "Ancho" => 1523 "Tamanyo" => 60152 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Boxplots of visual analogue scales (VAS) scores for pain and fear.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M.B. Ferreira, L.P. Viegas, A.S. Santos, M.P. Barbosa" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M.B." "apellidos" => "Ferreira" ] 1 => array:2 [ "nombre" => "L.P." "apellidos" => "Viegas" ] 2 => array:2 [ "nombre" => "A.S." "apellidos" => "Santos" ] 3 => array:2 [ "nombre" => "M.P." "apellidos" => "Barbosa" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0301054612001115?idApp=UINPBA00004N" "url" => "/03010546/0000004100000004/v1_201307160011/S0301054612001115/v1_201307160011/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Research letter</span>" "titulo" => "The use of alternative medicine in children with atopic dermatitis" "tieneTextoCompleto" => true "saludo" => "<span class="elsevierStyleItalic">To the Editor</span>," "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "275" "paginaFinal" => "276" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "O.U. Soyer, I. Aksoy, Y. Dallar" "autores" => array:3 [ 0 => array:4 [ "nombre" => "O.U." "apellidos" => "Soyer" "email" => array:1 [ 0 => "ozgeusoyer@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "I." "apellidos" => "Aksoy" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Y." "apellidos" => "Dallar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Hacettepe University, School of Medicine, Department of Pediatric Allergy, Ankara, Turkey" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "The Ministry of Health of Turkey, Ankara Education and Research Hospital, Department of Pediatrics, Ankara, Turkey" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases during childhood and the prevalence is increasing worldwide.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Although effective treatment options exist, absolute clinical improvement is unachievable: this might lead to search for alternative methods to cure disease especially by parents of children with AD. Fear of side effects of long term use of corticosteroids might also contribute to this attitude of parents. Limited data are available about alternative medicine (AM) use in AD during childhood.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Our aim was to establish the prevalence and diversity of alternative medicines and to demonstrate risk factors associated with their use in children with AD.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Children aged 6 months to 18 years with at least three month-duration of AD admitted to the pediatric allergy outpatient department of Ankara Education and Research Hospital were enrolled in the study. The diagnosis of AD was based on United Kingdom (UK) Working Party's Diagnostic Criteria<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> and severity was assessed by SCORAD index.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> We administered a questionnaire to parents designated to evaluate the varieties of AM used, the reasons for trying AM, who recommended AM, whether the child had any benefit or adverse event due to AM utilisation, impact of AD on quality of life of child and opinion about the control level of AD according to parents. The physicians also noted demographic characteristics and disease related features. The study was approved by the Ethics Committee of Ministry of Health, Ankara Education and Research Hospital and parents provided written informed consent.</p><p id="par0015" class="elsevierStylePara elsevierViewall">All parents invited to study, agreed to participate. During February–August 2010, 68 patients [60.3% male, median 1.33 year (interquartile range; 0.79–5 years) were included. The median age at onset of AD symptoms was 9.5 (1.5–26.75) months. In the last year, the patients had been admitted for medical care with a median of three (2–4) times because of AD. The median of patients’ SCORAD index was 20 (16.1–28.8), and 23 (33.8%) of them had atopy. Thirty parents (44.1%) agreed with the proposal that “AD affects quality of life of my child” and 27 parents (39.7%) with “My child's AD is not under control”.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Alternative treatment recommendations were done mainly by relatives (26.5%) and friends (19.1%) to 33 parents and used by 20 (29.4%) patients. Praying was the most commonly tried alternative method (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>15). However, five patients used two or more types of AM for AD (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). The other advised but not accomplished alternative treatment modalities were praying (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>8), application of barley juice (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1), wrapping with wet bran (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1), peeling of diseased skin (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1) and cauterisation with hot metal (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1). The most common reason cited by parents for application of AM was unresponsiveness to medical treatment (80%). Three children who utilised AM [praying (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2), application of olive oil (<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1)] had a somewhat improvement as reported by their parents but two children had cutaneous infection after the application of chicken stool and juice of hibiscus. Logistic regression analysis revealed no relation between use of AM and gender, age, family history of AD, atopy, total number of admittance to health care due to AD, impact of AD on quality of life, parental educational background, SCORAD index, and serum IgE levels.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Alternative treatment modalities change in different cultures and countries. Herbal medicine and homeopathy were the most commonly reported alternative treatments in UK for management of AD in children, whereas in our population, we found that praying was the most commonly used AM. The lack of satisfactory improvement by conventional medicine was the most decisive factor for AM use.<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2,5</span></a> Because of the chronic nature of the disease, prolonged treatment durations might compel parents to use alternative methods in AD. However, preference for AM was not associated with severity of disease, parental education level and impairment in quality of life due to AD. Also, the physicians should be aware of use of alternative methods in patients with a sudden worsening of AD.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Ethical disclosures</span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Patients’ data protection</span><p id="par0030" class="elsevierStylePara elsevierViewall">Confidentiality of Data. The authors declare that they have followed the protocols of their work centre on the publication of patient data and that all the patients included in the study have received sufficient information and have given their informed consent in writing to participate in that study.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Right to privacy and informed consent</span><p id="par0035" class="elsevierStylePara elsevierViewall">Right to privacy and informed consent. The authors declare that no patient data appears in this article.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Protection of human subjects and animals in research</span><p id="par0040" class="elsevierStylePara elsevierViewall">Protection of human and animal subjects. The authors declare that no experiments were performed on humans or animals for this investigation.</p></span></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:3 [ "identificador" => "sec0005" "titulo" => "Ethical disclosures" "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0010" "titulo" => "Patients’ data protection" ] 1 => array:2 [ "identificador" => "sec0015" "titulo" => "Right to privacy and informed consent" ] 2 => array:2 [ "identificador" => "sec0020" "titulo" => "Protection of human subjects and animals in research" ] ] ] 1 => array:2 [ "identificador" => "xack50652" "titulo" => "Acknowledgements" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "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"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td 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" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>20 \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><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">Praying \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">15 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><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">Scratching with praying \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><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">Wheat spraying \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><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">Application of juice of hibiscus \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><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">Mud bathing \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><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">Application of coal powder \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><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">Application of chicken stool \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><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">Application of olive oil \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><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">Application of spring water \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><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">Drinking grapefruit juice \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="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab337091.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Types of alternative treatments used in patients with AD.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Diagnosis and treatment of atopic dermatitis in children and adults: European Academy of Allergology and Clinical Immunology/American Academy of Allergy, Asthma and Immunology/PRACTALL Consensus Report" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.A. Akdis" 1 => "M. Akdis" 2 => "T. Bieber" 3 => "C. Bindslev-Jensen" 4 => "M. Boguniewicz" 5 => "P. Eigenmann" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1398-9995.2006.01153.x" "Revista" => array:6 [ "tituloSerie" => "Allergy" "fecha" => "2006" "volumen" => "61" "paginaInicial" => "969" "paginaFinal" => "987" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16867052" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The use of alternative medicine in pediatric patients with atopic dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "R. Hughes" 1 => "D. Ward" 2 => "A.M. Tobin" 3 => "K. Keegan" 4 => "B. Kirby" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1525-1470.2007.00355.x" "Revista" => array:6 [ "tituloSerie" => "Pediatr Dermatol" "fecha" => "2007" "volumen" => "24" "paginaInicial" => "118" "paginaFinal" => "120" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17461804" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The U. K. Working Party's Diagnostic Criteria for Atopic Dermatitis. I. Derivation of a minimum set of discriminators for atopic dermatitis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.C. Williams" 1 => "P.G. Burney" 2 => "R.J. Hay" 3 => "C.B. Archer" 4 => "M.J. Shipley" 5 => "J.J. Hunter" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "1994" "volumen" => "131" "paginaInicial" => "383" "paginaFinal" => "396" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7918015" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:1 [ "titulo" => "Severity scoring of atopic dermatitis: the SCORAD index. Consensus Report of the European task force on atopic dermatitis" ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Dermatology" "fecha" => "1993" "volumen" => "186" "paginaInicial" => "23" "paginaFinal" => "31" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8435513" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The use of complementary medicine in children with atopic dermatitis in secondary care in Leicester" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G.A. Johnston" 1 => "R.M. Bilbao" 2 => "R.A. Graham-Brown" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Br J Dermatol" "fecha" => "2003" "volumen" => "149" "paginaInicial" => "566" "paginaFinal" => "571" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14510990" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:3 [ "identificador" => "xack50652" "titulo" => "Acknowledgements" "texto" => "<p id="par0045" class="elsevierStylePara elsevierViewall">This study was presented at <span class="elsevierStyleGrantSponsor">European Academy of Allergy and Clinical Immunology Congress in 2011 in Istanbul, Turkey</span> and awarded as best poster presentation.</p>" ] ] ] "idiomaDefecto" => "en" "url" => "/03010546/0000004100000004/v1_201307160011/S0301054612001747/v1_201307160011/en/main.assets" "Apartado" => array:4 [ "identificador" => "5561" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Research Letter" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/03010546/0000004100000004/v1_201307160011/S0301054612001747/v1_201307160011/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0301054612001747?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 2 | 0 | 2 |
| 2024 October | 12 | 3 | 15 |
| 2024 September | 24 | 4 | 28 |
| 2024 August | 22 | 2 | 24 |
| 2024 July | 16 | 7 | 23 |
| 2024 June | 22 | 4 | 26 |
| 2024 May | 12 | 4 | 16 |
| 2024 April | 13 | 2 | 15 |
| 2024 March | 20 | 4 | 24 |
| 2024 February | 12 | 6 | 18 |
| 2024 January | 13 | 2 | 15 |
| 2023 December | 15 | 5 | 20 |
| 2023 November | 9 | 11 | 20 |
| 2023 October | 13 | 5 | 18 |
| 2023 September | 16 | 9 | 25 |
| 2023 August | 11 | 5 | 16 |
| 2023 July | 23 | 5 | 28 |
| 2023 June | 21 | 10 | 31 |
| 2023 May | 36 | 5 | 41 |
| 2023 April | 27 | 6 | 33 |
| 2023 March | 30 | 6 | 36 |
| 2023 February | 18 | 3 | 21 |
| 2023 January | 26 | 3 | 29 |
| 2022 December | 14 | 10 | 24 |
| 2022 November | 17 | 5 | 22 |
| 2022 October | 15 | 5 | 20 |
| 2022 September | 19 | 6 | 25 |
| 2022 August | 11 | 20 | 31 |
| 2022 July | 19 | 6 | 25 |
| 2022 June | 13 | 4 | 17 |
| 2022 May | 14 | 9 | 23 |
| 2022 April | 14 | 13 | 27 |
| 2022 March | 13 | 9 | 22 |
| 2022 February | 8 | 4 | 12 |
| 2022 January | 16 | 9 | 25 |
| 2021 December | 12 | 14 | 26 |
| 2021 November | 8 | 16 | 24 |
| 2021 October | 15 | 10 | 25 |
| 2021 September | 13 | 14 | 27 |
| 2021 August | 12 | 18 | 30 |
| 2021 July | 13 | 13 | 26 |
| 2021 June | 17 | 6 | 23 |
| 2021 May | 13 | 9 | 22 |
| 2021 April | 31 | 25 | 56 |
| 2021 March | 15 | 4 | 19 |
| 2021 February | 5 | 12 | 17 |
| 2021 January | 7 | 11 | 18 |
| 2020 December | 2 | 2 | 4 |
| 2020 November | 0 | 1 | 1 |
| 2020 October | 0 | 1 | 1 |
| 2020 July | 0 | 1 | 1 |
| 2020 May | 0 | 1 | 1 |
| 2020 April | 0 | 1 | 1 |
| 2020 January | 0 | 1 | 1 |
| 2019 December | 0 | 2 | 2 |
| 2019 November | 0 | 3 | 3 |
| 2019 September | 0 | 1 | 1 |
| 2019 August | 0 | 1 | 1 |
| 2019 July | 0 | 4 | 4 |
| 2019 June | 0 | 14 | 14 |
| 2019 May | 0 | 19 | 19 |
| 2019 April | 0 | 12 | 12 |
| 2019 March | 0 | 2 | 2 |
| 2019 February | 0 | 3 | 3 |
| 2018 February | 3 | 1 | 4 |
| 2018 January | 3 | 5 | 8 |
| 2017 December | 3 | 1 | 4 |
| 2017 November | 3 | 0 | 3 |
| 2017 October | 6 | 5 | 11 |
| 2017 September | 3 | 0 | 3 |
| 2017 August | 7 | 6 | 13 |
| 2017 July | 4 | 1 | 5 |
| 2017 June | 8 | 5 | 13 |
| 2017 May | 9 | 14 | 23 |
| 2017 April | 15 | 10 | 25 |
| 2017 March | 11 | 2 | 13 |
| 2017 February | 17 | 4 | 21 |
| 2017 January | 4 | 3 | 7 |
| 2016 December | 11 | 5 | 16 |
| 2016 November | 18 | 1 | 19 |
| 2016 October | 28 | 5 | 33 |
| 2016 September | 15 | 6 | 21 |
| 2016 August | 14 | 2 | 16 |
| 2016 July | 6 | 13 | 19 |
| 2016 June | 12 | 7 | 19 |
| 2016 May | 8 | 1 | 9 |
| 2016 April | 11 | 7 | 18 |
| 2016 March | 13 | 13 | 26 |
| 2016 February | 14 | 10 | 24 |
| 2016 January | 11 | 13 | 24 |
| 2015 December | 13 | 7 | 20 |
| 2015 November | 7 | 3 | 10 |
| 2015 October | 9 | 7 | 16 |
| 2015 September | 9 | 1 | 10 |
| 2015 August | 6 | 4 | 10 |
| 2015 July | 1 | 2 | 3 |
| 2015 June | 6 | 4 | 10 |
| 2015 May | 4 | 4 | 8 |
| 2015 April | 6 | 9 | 15 |
| 2015 March | 6 | 1 | 7 |
| 2015 February | 4 | 2 | 6 |
| 2015 January | 14 | 3 | 17 |
| 2014 December | 17 | 6 | 23 |
| 2014 November | 6 | 1 | 7 |
| 2014 October | 16 | 8 | 24 |
| 2014 September | 13 | 5 | 18 |
| 2014 August | 16 | 3 | 19 |
| 2014 July | 24 | 8 | 32 |
| 2014 June | 2 | 0 | 2 |
| 2014 May | 0 | 1 | 1 |
| 2014 April | 0 | 4 | 4 |
| 2014 March | 21 | 9 | 30 |
| 2014 February | 16 | 8 | 24 |
| 2014 January | 14 | 7 | 21 |
| 2013 December | 15 | 5 | 20 |
| 2013 November | 11 | 8 | 19 |
| 2013 October | 16 | 3 | 19 |
| 2013 September | 17 | 6 | 23 |
| 2013 August | 17 | 11 | 28 |
| 2013 July | 6 | 9 | 15 |
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