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Pigmentación negruzca con límites bien definidos en el primer y segundo dedos, con vesícula en el segundo dedo (A).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Sonia Milkova Ivanova, Carlos Daniel Grasa Lozano" "autores" => array:2 [ 0 => array:2 [ "nombre" => "Sonia" "apellidos" => "Milkova Ivanova" ] 1 => array:2 [ "nombre" => "Carlos Daniel" "apellidos" => "Grasa Lozano" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2341287923002016" "doi" => "10.1016/j.anpede.2023.03.015" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287923002016?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1695403323000504?idApp=UINPBA00005H" "url" => "/16954033/0000009900000004/v1_202310020515/S1695403323000504/v1_202310020515/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2341287923002004" "issn" => "23412879" "doi" => "10.1016/j.anpede.2023.02.026" "estado" => "S300" "fechaPublicacion" => "2023-10-01" "aid" => "3423" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "An Pediatr (Barc). 2023;99:285-7" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Paediatrics</span>" "titulo" => "Thymic and pulmonary involvement due to multisystemic Langerhans cell histiocytosis in a 4-month-old boy" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "285" "paginaFinal" => "287" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Afectación tímica y pulmonar por histiocitosis multisistémica de células de Langerhans en un niño de 4 meses" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 566 "Ancho" => 1340 "Tamanyo" => 71454 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0190" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Computed tomography scan of the abdomen in the axial and coronal planes with contrast evinced hepatomegaly with a homogeneous pattern.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Boui Meriem, Zouita Btissam, Lkbir Abidine, Basraoui Dounia, Jalal Hicham" "autores" => array:5 [ 0 => array:2 [ "nombre" => "Boui" "apellidos" => "Meriem" ] 1 => array:2 [ "nombre" => "Zouita" "apellidos" => "Btissam" ] 2 => array:2 [ "nombre" => "Lkbir" "apellidos" => "Abidine" ] 3 => array:2 [ "nombre" => "Basraoui" "apellidos" => "Dounia" ] 4 => array:2 [ "nombre" => "Jalal" "apellidos" => "Hicham" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S1695403323000516" "doi" => "10.1016/j.anpedi.2023.02.012" "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/S1695403323000516?idApp=UINPBA00005H" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287923002004?idApp=UINPBA00005H" "url" => "/23412879/0000009900000004/v1_202310060818/S2341287923002004/v1_202310060818/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2341287923001448" "issn" => "23412879" "doi" => "10.1016/j.anpede.2023.06.013" "estado" => "S300" "fechaPublicacion" => "2023-10-01" "aid" => "3420" "copyright" => "Asociación Española de Pediatría" "documento" => "article" "crossmark" => 1 "subdocumento" => "sco" "cita" => "An Pediatr (Barc). 2023;99:281-2" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Images in Paediatrics</span>" "titulo" => "Bronze baby syndrome or early onset sepsis?" 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Blackish stain with well-defined borders in the first and second toes, with a vesicle in the second toe (A).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A girl aged 13 months with no history of interest presented with 2 blackish cutaneous lesions with a purplish halo in the first and second toe of the right foot, in addition to a vesicle in the second toe (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), which the family believed to be related to contact with a beetle found in the shoe of the patient. She was haemodynamically stable, without vascular or neurologic manifestations or other cutaneous lesions.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">The observed lesions were consistent with those caused by the <span class="elsevierStyleItalic">Blaps lusitanica</span> beetle, of the Coleoptera order and Tenebrionidae family. On account of the limited experience with this type of lesion and the presence of a blister, the patient was discharged home with a prescription for a 1-week course of oral amoxicillin-clavulanic acid, and the pigmentation resolved within 2 weeks.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Similar cases have been described in the Mediterranean region.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1–3</span></a> When threatened, the beetle secretes a dark and malodorous substance rich in carbohydrates and quinines. It usually only stains the skin, and in some instances also causes blisters or dermatitis. The differential diagnosis of acral purpuric skin lesions in children includes traumatic haemorrhage under the stratum corneum, vasospasm, as seen in Raynaud disease or other connective tissue diseases, Janeway lesions characteristic of bacterial endocarditis, cryoglobulinaemia, thromboangiitis obliterans, or acral melanoma. A detailed history-taking and exhaustive physical examination are essential to identify the insect as the cause and avoid performance of additional diagnostic tests.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0020" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2022-11-23" "fechaAceptado" => "2023-03-05" "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" => 2093 "Ancho" => 1874 "Tamanyo" => 291634 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Pigmentation caused by contact with a beetle of the Coleoptera family, from the day of presentation (A) to resolution a few weeks later (D). Blackish stain with well-defined borders in the first and second toes, with a vesicle in the second toe (A).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Exogenous acral pigmentation induced by coleoptera: an underdiagnosed mimic of severe disease" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Álvarez-Salafranca" 1 => "O. Yélamos" 2 => "M. Ramírez-Lluch" 3 => "A. Valero-Torres" 4 => "M. 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Martín-Calvo" ] ] ] ] ] "host" => array:2 [ 0 => array:2 [ "doi" => "10.1111/pde.14856" "Revista" => array:7 [ "tituloSerie" => "Pediatr Dermatol [Internet]" "fecha" => "2021" "volumen" => "38" "numero" => "6" "paginaInicial" => "1594" "paginaFinal" => "1596" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/34779021" "web" => "Medline" ] ] ] ] 1 => array:2 [ "doi" => "10.1111/pde.14856" "WWW" => array:1 [ "link" => "https://doi.org/10.1111/pde.14856" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000009900000004/v1_202310060818/S2341287923002016/v1_202310060818/en/main.assets" "Apartado" => array:4 [ "identificador" => "77701" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in Paediatrics" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000009900000004/v1_202310060818/S2341287923002016/v1_202310060818/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287923002016?idApp=UINPBA00005H" ]
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