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"en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image of the week</span>" "titulo" => "Facial papules with multiple associated neoplasms" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "e3" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Ignacio Hernández Aragüés, Juncal Ruiz Rivero, Verónica Parra Blanco, Cristina Ciudad Blanco" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Ignacio" "apellidos" => "Hernández Aragüés" "email" => array:1 [ 0 => "ignaciohdezaragues@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Juncal" "apellidos" => "Ruiz Rivero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] 2 => array:3 [ "nombre" => "Verónica" "apellidos" => "Parra Blanco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Cristina" "apellidos" => "Ciudad Blanco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Dermatología, Hospital General Universitario Gregorio Marañón, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Servicio de Anatomía Patológica, Hospital General Universitario Gregorio Marañón, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Pápulas faciales con múltiples neoplasias asociadas" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 420 "Ancho" => 532 "Tamanyo" => 56435 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 28-year old female, with a history of craniofacial malformation, right-side parotidectomy as a result of a mucoepidermoid carcinoma, thyroidectomy as a result of follicular adenoma, and prophylactic bilateral mastectomy, who consulted about numerous papules of normal colour and verrucous appearance scattered over her face, predominantly on the perioral (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>) and submental (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>) areas, that she had had for 5 years. A biopsy was made on one of these injuries, showing diffuse proliferation in the form of solid lobes that are connected with the epidermis (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>), and that consist of a thick peripheral layer of picket-fence squamous cells (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>), and scarce areas of clear cytoplasm, compatible with trichilemmoma diagnosis.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Cowden syndrome is an autosomal dominant disease caused by the mutation in the <span class="elsevierStyleItalic">PTEN</span> tumour suppressor gene, characterised by the development of benign and malignant neoplasms, especially in thyroid and breasts. Furthermore, cutaneous injuries are present in up to 80% of affected patients. The most frequent ones are multiple facial trichilemmomas, which constitute Cowden syndrome's pathognomonic lesions.</p><p id="par0015" class="elsevierStylePara elsevierViewall">It is vital for patients with Cowden syndrome to have a multidisciplinary follow-up for the early detection of malignant neoplasms, frequently associated with this condition.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Hernández Aragüés I, Ruiz Rivero J, Parra Blanco V, Ciudad Blanco C. Pápulas faciales con múltiples neoplasias asociadas. 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