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therefore&#44; histopathological evaluation is essential&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Complete excision seems to be the definitive treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The present report describes two cases of ESFA with an exuberant clinical presentation and diagnostic difficulty due to limited access to specialized services&#44; albeit with excellent final results after excision by shaving&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Case 1</span><p id="par0010" class="elsevierStylePara elsevierViewall">A 76-year-old hypertensive diabetic male patient was referred to the dermatology service due to a vegetative lesion around a painful ulcer on the right lateral malleolus that had been noticed in 2018&#46; He denied triggering factors and reported a previous biopsy at an external service diagnosed as verruca vulgaris&#46; Associated with the condition&#44; he had lymphedema of the ipsilateral lower limb&#46; He underwent treatment for the ulcer but showed progression of the vegetative lesion&#46; On examination&#44; there was a hypertrophic scar on the lateral region of the dorsum of the right foot and multiple hardened verrucous pink nodules measuring 9<span class="elsevierStyleHsp" style=""></span>cm in their largest diameter&#44; which coalesced on the lower edge of the scar &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#41;&#46; Dermoscopy showed no findings suggestive of malignancy &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41;&#46; A new biopsy was performed&#44; followed by complete removal of the lesion&#44; by shaving&#44; after histopathological evaluation&#46; The image &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>C&#41; shows the four-month postoperative period&#44; without recurrence&#46; Histopathology disclosed thin cords of cuboidal epithelial cells anastomosed in a network-like fashion in connection with the lower portion of the epidermis &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>A&#41;&#46; A fibrovascular stroma was observed interspersing the epithelial cords &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>B&#41;&#46; The cells that constituted the cords showed ductal differentiation &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#59; findings compatible with ESFA&#46; There was no evidence of malignant transformation&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Case 2</span><p id="par0015" class="elsevierStylePara elsevierViewall">A 61-year-old female diabetic patient was referred to the dermatology service due to the appearance of a vegetative lesion six years previously&#46; She reported that the condition began as papular lesions that developed into a tumor on the dorsum of the right foot&#46; On examination&#44; there was a vegetative lesion measuring approximately 10<span class="elsevierStyleHsp" style=""></span>cm in its largest diameter&#44; well demarcated&#44; with serosanguineous exudate and a foul odor&#44; associated with hardened edema and hyperchromia of the distal third of the limb &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>A&#41;&#46; She denied triggering factors&#46; An incisional biopsy was performed followed by serial shaving of the lesion until its complete excision&#44; and healing by secondary intention &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>B and C&#41;&#44; after histopathological confirmation of ESFA &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a> A and B&#41;&#46; All surgical specimens were sent for pathological analysis&#44; to exclude the possibility of malignant transformation&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">ESFA is a rare benign neoplasm that normally presents as a single&#44; nodular&#44; large asymptomatic plaque&#44; but which can be multiple&#44; coalescent&#44; firm&#44; skin-colored and verrucous in appearance at the margin of an ulceration&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Among the findings of the physical examination&#44; a possible characteristic of the affected region is the &#8220;mossy leg&#8221; aspect&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> a characteristic observed in the reported cases&#46; The lesion has a predilection for distal extremities but can affect other sites&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> The origin is not well defined&#44; but it is associated with the proliferation of adnexal epithelial cells that form ducts&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> which arise from the excretory portion of the eccrine sweat glands&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">ESFA is divided into five types according to morphology&#44; number of lesions and associated factors&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The solitary subtype is the most common&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> represented by the appearance of a verrucous mass or single non-hereditary nodule located on the lower limbs of elderly patients&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> This description seems to fit the patient in the second case report&#44; who had only one lesion on the lower limb&#44; and no association with previous trauma or heredity&#46; The first patient had a chronic ulcer&#44; difficult to heal&#44; was diagnosed with diabetes and lymphedema&#44; suggesting the reactive subtype&#44; which typically affects the acral region and is secondary to a chronic inflammatory or neoplastic lesion&#44; having been previously described in association with ulcers&#44; lymphedema and diabetic foot&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;6</span></a> A specific type of eccrine remodeling or ductal repair&#44; due to repeated damage to eccrine structures&#44; is believed to be the pathogenesis&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;6</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Histopathology is essential for diagnosis&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The formation of thin anastomosed epithelial cords&#44; consisting of benign cuboidal epithelial cells with ductal differentiation&#44; creates a network that connects with the lower portion of the epidermis&#59;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> these cells are basaloid and smaller than the adjacent keratinocytes&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Rich fibrovascular stroma can be observed between the cords&#44; containing plasma cells and ductal structures&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> There may or may not be lumen formation and discrete lymphocytic infiltrate&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Immunohistochemical analysis shows positivity with epithelial membrane antigen&#44;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> carcinoembryonic antigen &#40;CEA&#41;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> and CK19&#44; which identifies ductal differentiation&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Some authors state that malignant transformation may occur in long-standing ESFA&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Areas of malignancy can easily be missed in incisional biopsies&#59; therefore&#44; complete excision is the treatment of choice&#44;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> especially in cases of solitary lesions&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> In the two reported cases&#44; it was decided to perform excision by shaving and regular outpatient monitoring of the lesion bed&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conclusion</span><p id="par0040" class="elsevierStylePara elsevierViewall">The relevance of the cases lies in the rarity of the disease&#44; especially exuberant ones&#46; Both cases showed a delay in the diagnosis&#44; in the first due to a divergent histopathological diagnosis and in the second&#44; due to difficulty in accessing a service capable of carrying out the investigation&#46; Knowledge about the disease and diagnostic possibilities&#44; considering the clinical presentation&#44; helps to guide investigation and treatment more appropriately&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Financial support</span><p id="par0045" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Authors&#8217; contributions</span><p id="par0050" class="elsevierStylePara elsevierViewall">Camila Schlang Cabral da Silveira&#58; Drafting and editing of the manuscript&#59; design and planning of the study&#59; collection&#44; analysis and interpretation of data&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; approval of the final version of the manuscript&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Luiz Felipe Oliveira Santos&#58; Drafting and editing of the manuscript&#59; collection&#44; analysis and interpretation of data&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; approval of the final version of the manuscript&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Marcella Leal Novello D&#8217;Elia&#58; Drafting and editing of the manuscript&#59; design and planning of the study&#59; collection&#44; analysis and interpretation of data&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; approval of the final version of the manuscript&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Daniel Lago Obadia&#58; Drafting and editing of the manuscript&#59; design and planning of the study&#59; collection&#44; analysis and interpretation of data&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; approval of the final version of the manuscript&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conflicts of interest</span><p id="par0070" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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Letter – Dermatopathology
Eccrine syringofibroadenoma: report of two exuberant cases
Camila Schlang Cabral da Silveira
Corresponding author
milsilveira@hotmail.com

Corresponding author.
, Luiz Felipe Oliveira Santos, Marcella Leal Novello D’Elia, Daniel Lago Obadia
Department of Dermatology, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Eccrine syringofibroadenoma &#40;ESFA&#41; is a rare benign adnexal tumor that arises from the excretory portion of the eccrine sweat glands&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> It usually involves distal extremities in middle-aged to elderly patients&#44;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> presenting as solitary or multiple&#44; coalescent&#44; firm&#44; skin-colored verrucous nodules&#44; of variable sizes&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> It is currently classified into five types&#58; solitary lesions&#44; multiple lesions associated with ectodermal dysplasia&#44; lesions without additional cutaneous pathology&#44; nevoid lesions and reactive lesions&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Clinical diagnosis is very difficult and&#44; therefore&#44; histopathological evaluation is essential&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Complete excision seems to be the definitive treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The present report describes two cases of ESFA with an exuberant clinical presentation and diagnostic difficulty due to limited access to specialized services&#44; albeit with excellent final results after excision by shaving&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Case 1</span><p id="par0010" class="elsevierStylePara elsevierViewall">A 76-year-old hypertensive diabetic male patient was referred to the dermatology service due to a vegetative lesion around a painful ulcer on the right lateral malleolus that had been noticed in 2018&#46; He denied triggering factors and reported a previous biopsy at an external service diagnosed as verruca vulgaris&#46; Associated with the condition&#44; he had lymphedema of the ipsilateral lower limb&#46; He underwent treatment for the ulcer but showed progression of the vegetative lesion&#46; On examination&#44; there was a hypertrophic scar on the lateral region of the dorsum of the right foot and multiple hardened verrucous pink nodules measuring 9<span class="elsevierStyleHsp" style=""></span>cm in their largest diameter&#44; which coalesced on the lower edge of the scar &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#41;&#46; Dermoscopy showed no findings suggestive of malignancy &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41;&#46; A new biopsy was performed&#44; followed by complete removal of the lesion&#44; by shaving&#44; after histopathological evaluation&#46; The image &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>C&#41; shows the four-month postoperative period&#44; without recurrence&#46; Histopathology disclosed thin cords of cuboidal epithelial cells anastomosed in a network-like fashion in connection with the lower portion of the epidermis &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>A&#41;&#46; A fibrovascular stroma was observed interspersing the epithelial cords &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>B&#41;&#46; The cells that constituted the cords showed ductal differentiation &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#59; findings compatible with ESFA&#46; There was no evidence of malignant transformation&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Case 2</span><p id="par0015" class="elsevierStylePara elsevierViewall">A 61-year-old female diabetic patient was referred to the dermatology service due to the appearance of a vegetative lesion six years previously&#46; She reported that the condition began as papular lesions that developed into a tumor on the dorsum of the right foot&#46; On examination&#44; there was a vegetative lesion measuring approximately 10<span class="elsevierStyleHsp" style=""></span>cm in its largest diameter&#44; well demarcated&#44; with serosanguineous exudate and a foul odor&#44; associated with hardened edema and hyperchromia of the distal third of the limb &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>A&#41;&#46; She denied triggering factors&#46; An incisional biopsy was performed followed by serial shaving of the lesion until its complete excision&#44; and healing by secondary intention &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Fig&#46; 4</a>B and C&#41;&#44; after histopathological confirmation of ESFA &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Fig&#46; 5</a> A and B&#41;&#46; All surgical specimens were sent for pathological analysis&#44; to exclude the possibility of malignant transformation&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Discussion</span><p id="par0020" class="elsevierStylePara elsevierViewall">ESFA is a rare benign neoplasm that normally presents as a single&#44; nodular&#44; large asymptomatic plaque&#44; but which can be multiple&#44; coalescent&#44; firm&#44; skin-colored and verrucous in appearance at the margin of an ulceration&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Among the findings of the physical examination&#44; a possible characteristic of the affected region is the &#8220;mossy leg&#8221; aspect&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> a characteristic observed in the reported cases&#46; The lesion has a predilection for distal extremities but can affect other sites&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> The origin is not well defined&#44; but it is associated with the proliferation of adnexal epithelial cells that form ducts&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> which arise from the excretory portion of the eccrine sweat glands&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">ESFA is divided into five types according to morphology&#44; number of lesions and associated factors&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> The solitary subtype is the most common&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> represented by the appearance of a verrucous mass or single non-hereditary nodule located on the lower limbs of elderly patients&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> This description seems to fit the patient in the second case report&#44; who had only one lesion on the lower limb&#44; and no association with previous trauma or heredity&#46; The first patient had a chronic ulcer&#44; difficult to heal&#44; was diagnosed with diabetes and lymphedema&#44; suggesting the reactive subtype&#44; which typically affects the acral region and is secondary to a chronic inflammatory or neoplastic lesion&#44; having been previously described in association with ulcers&#44; lymphedema and diabetic foot&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;6</span></a> A specific type of eccrine remodeling or ductal repair&#44; due to repeated damage to eccrine structures&#44; is believed to be the pathogenesis&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;6</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Histopathology is essential for diagnosis&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The formation of thin anastomosed epithelial cords&#44; consisting of benign cuboidal epithelial cells with ductal differentiation&#44; creates a network that connects with the lower portion of the epidermis&#59;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> these cells are basaloid and smaller than the adjacent keratinocytes&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Rich fibrovascular stroma can be observed between the cords&#44; containing plasma cells and ductal structures&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> There may or may not be lumen formation and discrete lymphocytic infiltrate&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> Immunohistochemical analysis shows positivity with epithelial membrane antigen&#44;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> carcinoembryonic antigen &#40;CEA&#41;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> and CK19&#44; which identifies ductal differentiation&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Some authors state that malignant transformation may occur in long-standing ESFA&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Areas of malignancy can easily be missed in incisional biopsies&#59; therefore&#44; complete excision is the treatment of choice&#44;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> especially in cases of solitary lesions&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> In the two reported cases&#44; it was decided to perform excision by shaving and regular outpatient monitoring of the lesion bed&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Conclusion</span><p id="par0040" class="elsevierStylePara elsevierViewall">The relevance of the cases lies in the rarity of the disease&#44; especially exuberant ones&#46; Both cases showed a delay in the diagnosis&#44; in the first due to a divergent histopathological diagnosis and in the second&#44; due to difficulty in accessing a service capable of carrying out the investigation&#46; Knowledge about the disease and diagnostic possibilities&#44; considering the clinical presentation&#44; helps to guide investigation and treatment more appropriately&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Financial support</span><p id="par0045" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Authors&#8217; contributions</span><p id="par0050" class="elsevierStylePara elsevierViewall">Camila Schlang Cabral da Silveira&#58; Drafting and editing of the manuscript&#59; design and planning of the study&#59; collection&#44; analysis and interpretation of data&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; approval of the final version of the manuscript&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Luiz Felipe Oliveira Santos&#58; Drafting and editing of the manuscript&#59; collection&#44; analysis and interpretation of data&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; critical review of the literature&#59; approval of the final version of the manuscript&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Marcella Leal Novello D&#8217;Elia&#58; Drafting and editing of the manuscript&#59; design and planning of the study&#59; collection&#44; analysis and interpretation of data&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; approval of the final version of the manuscript&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Daniel Lago Obadia&#58; Drafting and editing of the manuscript&#59; design and planning of the study&#59; collection&#44; analysis and interpretation of data&#59; intellectual participation in the propaedeutic and&#47;or therapeutic conduct of the studied cases&#59; approval of the final version of the manuscript&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Conflicts of interest</span><p id="par0070" class="elsevierStylePara elsevierViewall">None declared&#46;</p></span></span>"
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Article information
ISSN: 03650596
Original language: English
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