Images in Clinical Rheumatology
Sarcoid dactylitis as the initial manifestation of systemic sarcoidosis
Dactilitis sarcoidea como manifestación inicial de sarcoidosis sistémica
Read
1744
Timeswas read the article
505
Total PDF
1239
Total HTML
Share statistics
array:24 [ "pii" => "S2173574322001150" "issn" => "21735743" "doi" => "10.1016/j.reumae.2022.02.002" "estado" => "S300" "fechaPublicacion" => "2023-01-01" "aid" => "1607" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología" "copyrightAnyo" => "2022" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Reumatol Clin. 2023;19:57-8" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S1699258X22000729" "issn" => "1699258X" "doi" => "10.1016/j.reuma.2022.02.005" "estado" => "S300" "fechaPublicacion" => "2023-01-01" "aid" => "1607" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "Reumatol Clin. 2023;19:57-8" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Reumatología Clínica en imágenes</span>" "titulo" => "Dactilitis sarcoidea como manifestación inicial de sarcoidosis sistémica" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "57" "paginaFinal" => "58" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Sarcoid Dactylitis as the Initial Manifestation of Systemic Sarcoidosis" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 311 "Ancho" => 905 "Tamanyo" => 57333 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A)<span class="elsevierStyleHsp" style=""></span>Dactilitis y distrofia ungueal en el cuarto dedo del pie derecho. B)<span class="elsevierStyleHsp" style=""></span>Pápulas y placas eritemato-anaranjadas en la columela nasal y en las comisuras labiales (puntas de flecha) correspondientes a sarcoidosis cutánea (lupus pernio). C)<span class="elsevierStyleHsp" style=""></span>La imagen radiológica demuestra la resorción ósea de la falange distal del cuarto dedo del pie derecho.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Xavier Fustà-Novell, Sonia Mínguez-Blasco, Lidia Creus-Vila, Meritxell Sallés-Lizarzaburu" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Xavier" "apellidos" => "Fustà-Novell" ] 1 => array:2 [ "nombre" => "Sonia" "apellidos" => "Mínguez-Blasco" ] 2 => array:2 [ "nombre" => "Lidia" "apellidos" => "Creus-Vila" ] 3 => array:2 [ "nombre" => "Meritxell" "apellidos" => "Sallés-Lizarzaburu" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173574322001150" "doi" => "10.1016/j.reumae.2022.02.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574322001150?idApp=UINPBA00004M" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1699258X22000729?idApp=UINPBA00004M" "url" => "/1699258X/0000001900000001/v1_202212310543/S1699258X22000729/v1_202212310543/es/main.assets" ] ] "itemSiguiente" => array:17 [ "pii" => "S217357432100188X" "issn" => "21735743" "doi" => "10.1016/j.reumae.2021.04.006" "estado" => "S300" "fechaPublicacion" => "2023-01-01" "aid" => "1541" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "cor" "cita" => "Reumatol Clin. 2023;19:59" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>" "titulo" => "Development and feasibility of four checklists for the evaluation of comorbidity in patients with rheumatoid arthritis, spondyloarthriti saxial and psoriatic arthritis: GECOAI project" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "59" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Desarrollo y viabilidad de cuatro checklists para la evaluación de la comorbilidad en pacientes con artritis reumatoide, espondiloartritis axial y artritis psoriásica: proyecto GECOAI" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Danitza del Rosario Meneses-Bardales, Maryan Azalia Valdivia-Lapa" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Danitza del Rosario" "apellidos" => "Meneses-Bardales" ] 1 => array:2 [ "nombre" => "Maryan Azalia" "apellidos" => "Valdivia-Lapa" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357432100188X?idApp=UINPBA00004M" "url" => "/21735743/0000001900000001/v1_202301040853/S217357432100188X/v1_202301040853/en/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S2173574322001848" "issn" => "21735743" "doi" => "10.1016/j.reumae.2022.12.001" "estado" => "S300" "fechaPublicacion" => "2023-01-01" "aid" => "150101" "copyright" => "Elsevier España, S.L.U. and Sociedad Española de Reumatología y Colegio Mexicano de Reumatología" "documento" => "simple-article" "crossmark" => 1 "subdocumento" => "crp" "cita" => "Reumatol Clin. 2023;19:53-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>" "titulo" => "Fatal Pulmonary Veno-Occlusive Disease and Systemic Juvenile Idiopathic Arthritis: Case Report and Literature Review" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "53" "paginaFinal" => "56" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Enfermedad venooclusiva fatal y artritis idiopática juvenil sistémica: caso clínico y revisión de la literatura" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 783 "Ancho" => 1249 "Tamanyo" => 38747 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Portable chest X-ray. Bilateral pulmonary parenchymatous opacity of central predominance, compatible with pulmonary edema. Mild bilateral pleural effusion of right-dominance.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Silvia Escalada-Pellitero, Alberto García-Salido, Daniel Clemente-Garulo, Daniel Azorín-Cuadrillero, Gema De Lama Caro-Patón, Juan Carlos López-Robledillo" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Silvia" "apellidos" => "Escalada-Pellitero" ] 1 => array:2 [ "nombre" => "Alberto" "apellidos" => "García-Salido" ] 2 => array:2 [ "nombre" => "Daniel" "apellidos" => "Clemente-Garulo" ] 3 => array:2 [ "nombre" => "Daniel" "apellidos" => "Azorín-Cuadrillero" ] 4 => array:2 [ "nombre" => "Gema" "apellidos" => "De Lama Caro-Patón" ] 5 => array:2 [ "nombre" => "Juan Carlos" "apellidos" => "López-Robledillo" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574322001848?idApp=UINPBA00004M" "url" => "/21735743/0000001900000001/v1_202301040853/S2173574322001848/v1_202301040853/en/main.assets" ] "en" => array:17 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Clinical Rheumatology</span>" "titulo" => "Sarcoid dactylitis as the initial manifestation of systemic sarcoidosis" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "57" "paginaFinal" => "58" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Xavier Fustà-Novell, Sonia Mínguez-Blasco, Lidia Creus-Vila, Meritxell Sallés-Lizarzaburu" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Xavier" "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" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Sonia" "apellidos" => "Mínguez-Blasco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Lidia" "apellidos" => "Creus-Vila" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 3 => array:3 [ "nombre" => "Meritxell" "apellidos" => "Sallés-Lizarzaburu" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "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 Reumatología, Althaia, Xarxa Assistencial Universitària de Manresa, Manresa, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Dactilitis sarcoidea como manifestación inicial de sarcoidosis sistémica" ] ] "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" => 521 "Ancho" => 1515 "Tamanyo" => 125696 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) Dactylitis and nail dystrophy on the fourth toe of the right foot. B) Papules and erythematous-orange plaques on the nasal columella and labial commissures (arrowheads) corresponding to cutaneous sarcoidosis (lupus pernio). C) The radiological image shows bone resorption of the distal phalanx of the fourth toe of the right foot.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Clinical case</span><p id="par0005" class="elsevierStylePara elsevierViewall">A 45<span class="elsevierStyleHsp" style=""></span>year-old man (originally from Ghana), with no past history of interest, presented for consultation due to swelling, pain and nail alteration on the fourth toe of the right foot of 3<span class="elsevierStyleHsp" style=""></span>months' duration. Physical examination revealed dactylitis and onychodystrophy (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>A), as well as papules and erythematous-orange plaques on the nasal columella and labial commissures (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>B).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Diagnosis and development</span><p id="par0010" class="elsevierStylePara elsevierViewall">Radiological examination showed bone resorption of the distal phalanx of the right fourth toe (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>C). Histopathological examination of the skin lesions revealed multiple non-necrotising granulomas occupying the dermis, without identification of mycobacteria in the Ziehl-Neelsen stain. Laboratory tests: ESR 39<span class="elsevierStyleHsp" style=""></span>mm/1.ª<span class="elsevierStyleHsp" style=""></span>h, CRP 17.8 (<5<span class="elsevierStyleHsp" style=""></span>mg/l); haemogram with leukopenia (3.500/mL) and lymphopenia (700/mL); angiotensin-converting enzyme 119.6<span class="elsevierStyleHsp" style=""></span>U/l (13.3–63.9<span class="elsevierStyleHsp" style=""></span>U/l); renal function, liver parameters, phosphocalcic metabolism and urine sediment normal. PPD and IGRA test were negative. Chest X-ray: bilateral reticular pattern and dubious hilar adenopathies. PET-CT scan was requested, which showed uptake of mediastinal and axillary adenopathies, multiple centroacinar and subpleural pulmonary nodules, hypersplenism and uptake of the lytic lesion of the fourth distal phalanx of the right foot, with no other bone lesions.</p><p id="par0015" class="elsevierStylePara elsevierViewall">With the diagnosis of sarcoid dactylitis in the context of cutaneous (lupus pernio), bone, lymph node and pulmonary sarcoidosis, treatment was started with oral prednisone (0.5<span class="elsevierStyleHsp" style=""></span>mg/kg/day), with improvement of the cutaneous lesions and dactylitis and disappearance of pain. Two months later, the patient discontinued oral prednisone treatment on his own accord, with rapid recurrence of the skin lesions and dactylitis, with subsequent resolution on reintroduction of treatment. The mediastinal adenopathies and the larger peribronchial and subpleural nodules remain stable at the control CT scan performed 6<span class="elsevierStyleHsp" style=""></span>months after the start of treatment.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">Sarcoid dactylitis is a rare manifestation seen in less than 1% of patients with sarcoidosis<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a>. It is characterised by swelling, stiffness and pain of the affected toe, onychodystrophy when involving the distal phalanx and, in severe cases, deformity and bone resorption<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>. African-American patients present more frequently with extrapulmonary sarcoidosis (skin, eyes, bone marrow…) than other races<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>. It has been reported that peripheral bone lesions may be more frequent in black patients<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>. However, recent studies have found that bone sarcoidosis may be more frequent in white patients, although bone involvement of the hands may be more frequent in black patients<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6,7</span></a>. Sarcoid dactylitis has been associated with a worse prognosis and a higher risk of multisystem involvement<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6,7</span></a>, so its recognition is essential to establish an early diagnosis and prevent complications. In addition, concomitant skin lesions (lupus pernio)<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8,9</span></a> are common, highlighting the importance of dermatological examination in patients presenting with dactylitis.</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conflict of interests</span><p id="par0025" class="elsevierStylePara elsevierViewall">The authors have no conflict of interests to declare.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Funding</span><p id="par0030" class="elsevierStylePara elsevierViewall">None.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:6 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Clinical case" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Diagnosis and development" ] 2 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 3 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflict of interests" ] 4 => array:2 [ "identificador" => "sec0025" "titulo" => "Funding" ] 5 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2021-12-21" "fechaAceptado" => "2022-02-13" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Fustà-Novell X, Mínguez-Blasco S, Creus-Vila L, Meritxell Sallés-Lizarzaburu M. Dactilitis sarcoidea como manifestación inicial de sarcoidosis sistémica. Reumatol Clin. 2023;19:57–58.</p>" ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 521 "Ancho" => 1515 "Tamanyo" => 125696 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A) Dactylitis and nail dystrophy on the fourth toe of the right foot. B) Papules and erythematous-orange plaques on the nasal columella and labial commissures (arrowheads) corresponding to cutaneous sarcoidosis (lupus pernio). C) The radiological image shows bone resorption of the distal phalanx of the fourth toe of the right foot.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sarcoid dactylitis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "P. Pitt" 1 => "E.B. Hamilton" 2 => "E.H. Innes" 3 => "K.D. Morley" 4 => "B.E. Monk" 5 => "G.R. Hughes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Ann of the Rheum Dis" "fecha" => "1983" "volumen" => "42" "paginaInicial" => "634" "paginaFinal" => "639" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Dactylitis in sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "T. Mori" 1 => "T. Yamamoto" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/1346-8138.14015" "Revista" => array:7 [ "tituloSerie" => "J Dermatol" "fecha" => "2017" "volumen" => "44" "paginaInicial" => "e340" "paginaFinal" => "1" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28922465" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0165032718300661" "estado" => "S300" "issn" => "01650327" ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sarcoidosis: immunology, rheumatic involvement, and therapeutics" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Barnard" 1 => "L.S. Newman" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Curr Opin Rheumatol" "fecha" => "2001" "volumen" => "13" "paginaInicial" => "84" "paginaFinal" => "91" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Racial difference in sarcoidosis mortality in the United States" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Mirsaeidi" 1 => "R.F. Machado" 2 => "D. Schraufnagel" 3 => "N.J. Sweiss" 4 => "R.P. Baughman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1378/chest.14-1120" "Revista" => array:7 [ "tituloSerie" => "Chest" "fecha" => "2015" "volumen" => "147" "paginaInicial" => "438" "paginaFinal" => "449" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25188873" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0749379716306894" "estado" => "S300" "issn" => "07493797" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Bone sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Wilcox" 1 => "P. Bharadwaj" 2 => "O.P. Sharma" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/00002281-200007000-00016" "Revista" => array:7 [ "tituloSerie" => "Curr Opin Rheumatol" "fecha" => "2000" "volumen" => "12" "paginaInicial" => "321" "paginaFinal" => "330" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10910186" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0165032721005632" "estado" => "S300" "issn" => "01650327" ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Osseous sarcoidosis: Clinical characteristics, treatment, and outcomes – experience from a large, academic hospital" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.A. Sparks" 1 => "J.I. McSparron" 2 => "N. Shah" 3 => "P. Aliabadi" 4 => "V. Paulson" 5 => "C.H. Fanta" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.semarthrit.2014.07.003" "Revista" => array:6 [ "tituloSerie" => "Semin Arthritis Rheum" "fecha" => "2014" "volumen" => "44" "paginaInicial" => "371" "paginaFinal" => "379" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25129260" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical characteristics of patients with bone sarcoidosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "Y. Zhou" 1 => "E.E. Lower" 2 => "H. Li" 3 => "Y. Farhey" 4 => "R.P. Baughman" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.semarthrit.2017.02.004" "Revista" => array:7 [ "tituloSerie" => "Semin Arthritis Rheum" "fecha" => "2017" "volumen" => "47" "paginaInicial" => "143" "paginaFinal" => "148" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28274482" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S2468266720300992" "estado" => "S300" "issn" => "24682667" ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sarcoidosis presenting as a proximal phalangeal bony swelling-a case and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A.D. Duckworth" 1 => "A.T. Hill" 2 => "I. Beggs" 3 => "J.T. Patton" 4 => "D.M. Salter" 5 => "D.E. Porter" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11552-009-9207-6" "Revista" => array:6 [ "tituloSerie" => "Hand (N Y)" "fecha" => "2010" "volumen" => "5" "paginaInicial" => "90" "paginaFinal" => "94" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19517195" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sarcoidosis: An unusual presentation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "P. Madureira" 1 => "S. Pimenta" 2 => "H. Cardoso" 3 => "R. Guimarães Cunha" 4 => "L. Costa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.reuma.2016.03.008" "Revista" => array:6 [ "tituloSerie" => "Reumatol Clin" "fecha" => "2017" "volumen" => "13" "paginaInicial" => "227" "paginaFinal" => "229" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27068192" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735743/0000001900000001/v1_202301040853/S2173574322001150/v1_202301040853/en/main.assets" "Apartado" => array:4 [ "identificador" => "5795" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Clinical Rheumatology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735743/0000001900000001/v1_202301040853/S2173574322001150/v1_202301040853/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574322001150?idApp=UINPBA00004M" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 32 | 15 | 47 |
| 2024 September | 96 | 37 | 133 |
| 2024 August | 108 | 48 | 156 |
| 2024 July | 105 | 51 | 156 |
| 2024 June | 116 | 35 | 151 |
| 2024 May | 75 | 25 | 100 |
| 2024 April | 72 | 18 | 90 |
| 2024 March | 76 | 19 | 95 |
| 2024 February | 63 | 33 | 96 |
| 2024 January | 68 | 21 | 89 |
| 2023 December | 64 | 21 | 85 |
| 2023 November | 59 | 38 | 97 |
| 2023 October | 53 | 31 | 84 |
| 2023 September | 99 | 45 | 144 |
| 2023 August | 103 | 19 | 122 |
| 2023 July | 43 | 41 | 84 |
| 2023 March | 7 | 8 | 15 |
Show all
