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=> 1388 "Ancho" => 2500 "Tamanyo" => 227917 ] ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Ricardo Roa-Chamorro, Pablo González-Bustos, Fernando Jaén-Águila, Juan Diego Mediavilla-García" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Ricardo" "apellidos" => "Roa-Chamorro" ] 1 => array:2 [ "nombre" => "Pablo" "apellidos" => "González-Bustos" ] 2 => array:2 [ "nombre" => "Fernando" "apellidos" => "Jaén-Águila" ] 3 => array:2 [ "nombre" => "Juan Diego" "apellidos" => "Mediavilla-García" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0025775318300484" "doi" => "10.1016/j.medcli.2018.01.001" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0025775318300484?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020618304248?idApp=UINPBA00004N" "url" => "/23870206/0000015100000011/v1_201812070631/S2387020618304248/v1_201812070631/en/main.assets" ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image in medicine</span>" "titulo" => "Not always is an infection" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "e67" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Esther García Martínez, Javier Ruíz Martínez, Jesús Hernández-Gil Sánchez, Carmen Brufau Redondo, Enrique Poblet Martínez" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Esther" "apellidos" => "García Martínez" "email" => array:1 [ 0 => "esther.beni.garmar@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" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Javier" "apellidos" => "Ruíz Martínez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "Jesús" "apellidos" => "Hernández-Gil Sánchez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Carmen" "apellidos" => "Brufau Redondo" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Enrique" "apellidos" => "Poblet Martínez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0015" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital General Universitario Reina Sofía, Murcia, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital General Universitario Reina Sofía, Murcia, Spain" "etiqueta" => "b" "identificador" => "aff0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "No siempre es una infección" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 713 "Ancho" => 950 "Tamanyo" => 177877 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 62-year-old woman who complained of a 10<span class="elsevierStyleHsp" style=""></span>h history of lesions in the right arm, with no other systemic symptoms. A mastectomy with lymph node dissection in 2010 for right breast cancer and subsequent treatment with tamoxifen stood out in the patient's history. After surgery, she developed mild lymphedema. Erythematous papules with a disorganized distribution were observed on examination, some with a pustule in the centre (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Pustule culture was negative. Laboratory parameters showed a mild neutrophilia with 6500<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>10<span class="elsevierStyleSup">3</span>/μl, although the biopsy showed oedema and an intense dermal neutrophilic infiltrate compatible with acute neutrophilic dermatosis (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>, arrow). Empirical treatment was started with oral and topical antibiotics and corticosteroids, with resolution of symptoms after a week. Sweet syndrome localized on lymphedema is a recently described atypical clinical variant, not only after mastectomy, but after cervical cancer and melanoma surgery with involvement of the lower limbs. Due to its presentation, it is frequently confused with an infectious or inflammatory process, and since the clinical presentation is mild without systemic involvement and can resolve spontaneously, it is usually underdiagnosed and poorly treated. In addition, to date, there has been no association with a possible recurrence of the primary tumour.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: García Martínez E, Ruíz Martínez J, Hernández-Gil Sánchez J, Brufau Redondo C, Poblet Martínez E. No siempre es una infección. Med Clin (Barc). 2018;151:e67.</p>" ] ] "multimedia" => array:2 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 784 "Ancho" => 950 "Tamanyo" => 63676 ] ] ] 1 => array:6 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 713 "Ancho" => 950 "Tamanyo" => 177877 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23870206/0000015100000011/v1_201812070631/S2387020618304273/v1_201812070631/en/main.assets" "Apartado" => array:4 [ "identificador" => "51820" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in medicine" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23870206/0000015100000011/v1_201812070631/S2387020618304273/v1_201812070631/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2387020618304273?idApp=UINPBA00004N" ]
