Melanoma: pathogenesis, clinic and histopathology
Keywords:
Melanoma, risk factors, pathogenesis, clinic, diagnosis, histhopathology, prognosticAbstract
Melanoma is the malignant transformation of the melanocyte. It is a highly invasive and often fatal tumor. It accounts for the vast majority of skin cancer deaths, with an estimated of 80% of all skin cancer deaths. Melanoma in its early stages is an eminently curable disease. It is time to increase one’s suspicion of early melanoma. The aim of this paper is to address melanoma epidemiology, etiology, clinical presentation, biopsy methods, prognosis, and diagnosis.
This is a non systematic melanoma review based on scientific papers that have been discussed, in the last 3 years with Dermatology residents and Dermatooncology fellows, at the Grupo de Dermatología of the Instituto Nacional de Cancerología. Most of the articles were selected from the internet by Eduardo Fierro. The medical concepts written in this paper is only responsibility of the authors and it is not the official point of view of the Instituto Nacional de Cancerología.
Author Biographies
Álvaro Enrique Acosta
Médico dermatólogo, dermatólogo oncólogo; coordinador, Clínica de Piel, Instituto Nacional de Cancerología; profesor asociado, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
Eduardo Fierro
Médico dermatólogo, dermatólogo oncólogo; profesor adscrito, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
Victoria Eugenia Velásquez
Médica, residente III año de Dermatología, Facultad de Medicina, Universidad Nacional de Colombia, Bogotá, D.C., Colombia.
Xavier Rueda
Médico dermatólogo, dermatólogo oncólogo, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia
References
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2. Gorbe C, Leiter U. Melanoma epidemiology and trends. Clin Dermatol. 2009;27:3-9.
3. Marks R. Epidemiology of melanoma. Clin Exp Dermatol. 2000;25:459-63.
4. Tsao H, Atkins MB, Sober AJ. Management of cutaneous melanoma. N Engl J Med. 2004;351:998-1012.
5. Thompson JF, Scolyer RA, Kefford RF. Cutaneous melanoma. Lancet. 2005;365:687-701.
6. Desmond RA, Soong SJ. Epidemiology of malignant melanoma. Surg Clin North Am. 2003;83:1-29.
7. Muir CS, Waterhouse J, Mack T, Powell J, Whelan S. Cancer incidence in five continents. Lyon: International Agency for Research on Cancer; 1987.
8. Martínez T, Murillo H. Informe certificados de defunción expedidos en el Instituto Nacional de Cancerología, año 2000. Bogotá: Instituto Nacional de Cancerología; 2001.
9. de Braud F, Khayat D, Kroon BB, Valdagni R, Bruzzi P, Cascinelli N. Malignant melanoma. Crit Rev Oncol Hematol. 2003;47:35-63.
10. Schmid-Wendtner MH, Berking C, Baumert J, Schmidt M, Sander CA, Plewig G, Volkenandt M. Cutaneous melanoma in childhood and adolescence: an analysis of 36 patients. J Am Acad Dermatol. 2002;46:874-9.
11. Huynh PM, Grant-Kels JM, Grin CM. Childhood melanoma: update and treatment. Int J Dermatol. 2005;44:715-23.
12. Flórez A, Cruces M. Melanoma epidemic: true or false? Int J Dermatol. 2004;43:405-7.
13. Daryanani D, Plukker JT, Nap RE, Kuiper H, Hoekstra HJ. Adolescent melanoma: risk factors and long term survival. Eur J Surg Oncol. 2006;32:218-23.
14. Benvenuto-Andrade C, Oseitutu A, Agero AL, Marghoob AA. Cutaneous melanoma: surveillance of patients for recurrence and new primary melanomas. Dermatol Ther. 2005;18:423-35.
15. MacKie RM. Risk factors for the development of primary cutaneous malignant melanoma. Dermatol Clin. 2002;20:597-600.
16. Kanzler MH, Mraz-Gernhard S. Primary cutaneous malignant melanoma and its precursor lesions: diagnostic and therapeutic overview. J Am Acad Dermatol. 2001;45:260-76.
17. Gandini S, Sera F, Cattaruzza MS, Pasquini P, Zanetti R, Masini C, Boyle P, Melchi CF. Review Meta-analysis of risk factors for cutaneous melanoma: III. Family history, actinic damage and phenotypic factors. Eur J Cancer. 2005;41:2040-59.
18. Gandini S, Sera F, Cattaruzza MS, Pasquini P, Abeni D, Boyle P, et al. Review meta-analysis of risk factors for cutaneous melanoma: I. Common and atypical naevi. Eur J Cancer. 2005;41:28-44.
19. Marghoob AA. Congenital melanocytic nevi. Evaluation and management. Dermatol Clin. 2002;20:607-16.
20. Leech SN, Bell H, Leonard N, Jones SL, Geurin D, McKee PH, et al. Neonatal giant congenital nevi with proliferatives nodules a clinicopathologic study and literataure review of neonatal melanoma. Arch Dermatol. 2004;140:83-8.
21. Makkar HS, Frieden IJ. Neurocutaneous melanosis. Semin Cutan Med Surg 2004;23:138-44.
22. Marghoob AA, Dusza S, Oliveria S, Halpern AC. Number of satellite nevi as a correlate for neurocutaneous melanocytosis in patients with large congenital melanocytic nevi. Arch Dermatol. 2004;140:171-5.
23. Schaffer JV, McNiff JM, Bolognia JL. Cerebral mass due to neurocutaneous melanosis: eight years later. Pediatr Dermatol. 2001;18:369-77.
24. Papoo AS. Melanoma in children and adolescents. Eur J Cancer. 2003;39:2652-61.
25. Gallagher RP, Lee TK. Adverse effects of ultraviolet radiation: a brief review. Prog Biophys Mol Biol. 2006;92:119-31.
26. Gandini S, Sera F, Cattaruzza MS, Pasquini P, Picconi O, Boyle P, et al. Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure. Eur J Cancer. 2005;41:45-60.
27. Dennis LK, Beane Freeman LE, VanBeek MJ. Sunscreen use and the risk for melanoma: a quantitative review. Ann Intern Med. 2003;139:966-78.
28. Wagner AJ, Fisher DE. Melanocyte signaling pathways and the etiology of melanoma. Drug Discov Today Dis Mech. 2005;2:179-83.
29. Miller AJ, Mihm MC Jr. Melanoma. N Engl J Med. 2006; 355:51-65.
30. Demierre MF, Sondak VK. Cutaneous melanoma: pathogenesis and rationale for chemoprevention. Crit Rev Oncol Hematol. 2005;53:225-39.
31. Curtin JA, Fridlyand J, Kageshita T, Patel HN, Busam KJ, Kutzner H, et al. Distinct sets of genetic alterations in melanoma. N Engl J Med. 2005;353:2135-47.
32. Chudnovsky Y, Khavari PA, Adams AE. Melanoma genetics and the development of rational therapeutics. J Clin Invest. 2005;115:813-24.
33. Robinson JK, Turrisi R. Skills training to learn discrimination of ABCDE criteria by those at risk of developing melanoma. Arch Dermatol. 2006;142:447-52.
34. Adler MJ, White CR. Amelanotic malignant melanoma. Semin Cutan Med Surg. 1997;16:122-130.
35. Pizzichetta MA, Talamini R, Stanganelli I, Puddu P, Bono R, Argenziano G, et al. Amelanotic/hypomelanotic melanoma: clinical and dermoscopic features. Br J Dermatol. 2004;150:1117-24.
36. Sagabiel R. Clinical presentation. En: Miller SJ, Maloney ME, editors. Cutaneous oncology. Pathology, diagnosis and management. Malden: Blackwell Science; 1998. p.253-61.
37. Sánchez I, Lloret P, Mihm M. Melanoma Maligno. En: Torres V, Camacho FM, Mihm MC, Sober A, Sánchez I, editores. Dermatología práctica ibero-latinoamericana. Atlas, enfermedades sistémicas asociadas y terapéutica. México, D.F.: VicenteTorres Lozada-Nieto Editores, SA de CV.; 2005. p.1359-84.
38. Zalaudek I, Marghoob AA, Scope A, Leinweber B, Ferrara G, Hofmann-Wellenhof R, et al. Three roots of melanoma. Arch Dermatol. 2008;144:1375-9.
39. Phan A, Touzet S, Dalle S, Ronger-Savle S, Balme B, Thomas L. Acral lentiginous melanoma: histopathological prognostic features of 121 cases. Br J Dermatol. 2007;157:311-18.
40. Lateur N, André J. Melanonychia: diagnosis and treatment. Dermatol Ther. 2002;15:131-41.
41. Levit EK, Kagen MH, Scher RK, Grossman M, Altman E. The ABC rule for clinical detection of subungual melanoma. J Am Acad Dermatol. 2000:42:269-74.
42. Skelton HG, Smith KJ. Less common variants of malignant melanoma. Curr Probl Dermatol. 2003:15:197-202.
43. Ries S, Mitsuhashi T, Barr R. Minimal deviation melanoma. Curr Probl Dermatol. 2003;15:203-8.
44. Rapidis AD, Apostolidis C, Georgios V, Valsamis. Primary malignant melanoma of the oral mucosa. J Oral Maxillofac Surg. 2003;61:1132-9.
45. Marghoob AA, Swindle LD., Moricz CZ, Sanchez Negron FA, Slue B, Halpern AC, et al. Instruments and new technologies for the in vivo diagnosis of melanoma. J Am Acad Dermatol. 2003;49:777-97.
46. Moncrieff M, Cotton S, Claridges E, Hall P. Spectrophotometric intracutaneous analyses: a new technique for imaging pigmented skin lesions. Br J Dermatol. 2002;146:448-57.
47. Zaballos P, Carrera C, Puig S, Malvehy J. Criterios dermatoscópicos para el diagnóstico de melanoma. Med Cutan Iber Lat Am. 2004;32:3-17.
48. Tran KT, Wright NA, Cockerell CJ. Biopsy of the pigmented lesion, when and how. J Am Acad Dermatol 2008;59:852-71.
49. Coit D, Andtbacka R, Bichakjian CK, Daud A, Dilawari RA, Dimaio D, Guild V, et al. NCCN Clinical Practice Guidelines in Oncology: Melanoma. Network NCC; 2009.
50. Braun RP, Baran R, Le Gal FA, Dalle S, Ronger S, Pandolf R. Diagnosis and management of nail pigmentations. J Am Acad Dermatol. 2007;56:835-57.
51. Clemente C, Mihm M, Bufalino R, Zurrida S, Collini P, Cascinelli R. Prognostic value of tumor infiltrating lymphocytes in the vertical growth phase of primary cutaneous melanoma. Cancer. 1996:77:1303-10.
52. Torabian S, Kashani-Sabet M. Biomarkers for melanoma. Curr Opin Oncol. 2005;17:167-71.
53. Cohen LM. Lentigo maligna and lentigo maligna melanoma. J Am Acad Dermatol. 1995;33:923-6.
54. Balch CM, Soong SJ, Atkins MB, Buzaid AC, Cascinelli N, Coit DG, et al. An evidence-based staging system for cutaneous melanoma. CA Cancer J Clin. 2004;54:131-49.
55. Sober AJ. Cutaneous melanoma: practical usefulness of the American Joint Committee on Cancer Staging System. Dermatol Ther. 2005;18:407-11.
56. Homsi J, Kashani-Sabet M, Messina JL, Daud A. Cutaneous melanoma: prognostic factors. Cancer Control. 2005;12:223-9.
57. Lachiewicz AM, Berwick M, Wiggins CL, Thomas NE. Survival differences between patients with scalp or neck melanoma and those with melanoma of other sites in the surveillance, epidemiology, and end results (SEER) program. Arch Dermatol. 2008;144:515-21.
58. Montane KT, Elder DE. Factors predictive of metastasis and outcome. En: Miller SJ, Maloney ME, editors. Cutaneous oncology. Pathophysiology, diagnosis, and management. Malden: Blackwell Science; 1998. p.278-89.
59. Balch CM, Wilkerson JA, Murad TM, Soong SJ, Ingalls AL, Maddox WA. The prognostic significance of ulceration of cutaneous melanoma. Cancer. 1980;45:3012-7.
60. Clark WH Jr, Elder DE, Guerry D, Braitman LE, Trock BJ, Schultz D, et al. Model predicting survival in stage I melanoma based on tumor progression. J Natl Cancer Inst. 1989;81:1893-904.
61. Walker MJ, Ronan SG, Han MC, Beattie CW, Das Gupta TK. Interrelationship between histopathologic characteristics of melanoma and estrogen receptor status. Cancer. 1991;68:184-8.
2. Gorbe C, Leiter U. Melanoma epidemiology and trends. Clin Dermatol. 2009;27:3-9.
3. Marks R. Epidemiology of melanoma. Clin Exp Dermatol. 2000;25:459-63.
4. Tsao H, Atkins MB, Sober AJ. Management of cutaneous melanoma. N Engl J Med. 2004;351:998-1012.
5. Thompson JF, Scolyer RA, Kefford RF. Cutaneous melanoma. Lancet. 2005;365:687-701.
6. Desmond RA, Soong SJ. Epidemiology of malignant melanoma. Surg Clin North Am. 2003;83:1-29.
7. Muir CS, Waterhouse J, Mack T, Powell J, Whelan S. Cancer incidence in five continents. Lyon: International Agency for Research on Cancer; 1987.
8. Martínez T, Murillo H. Informe certificados de defunción expedidos en el Instituto Nacional de Cancerología, año 2000. Bogotá: Instituto Nacional de Cancerología; 2001.
9. de Braud F, Khayat D, Kroon BB, Valdagni R, Bruzzi P, Cascinelli N. Malignant melanoma. Crit Rev Oncol Hematol. 2003;47:35-63.
10. Schmid-Wendtner MH, Berking C, Baumert J, Schmidt M, Sander CA, Plewig G, Volkenandt M. Cutaneous melanoma in childhood and adolescence: an analysis of 36 patients. J Am Acad Dermatol. 2002;46:874-9.
11. Huynh PM, Grant-Kels JM, Grin CM. Childhood melanoma: update and treatment. Int J Dermatol. 2005;44:715-23.
12. Flórez A, Cruces M. Melanoma epidemic: true or false? Int J Dermatol. 2004;43:405-7.
13. Daryanani D, Plukker JT, Nap RE, Kuiper H, Hoekstra HJ. Adolescent melanoma: risk factors and long term survival. Eur J Surg Oncol. 2006;32:218-23.
14. Benvenuto-Andrade C, Oseitutu A, Agero AL, Marghoob AA. Cutaneous melanoma: surveillance of patients for recurrence and new primary melanomas. Dermatol Ther. 2005;18:423-35.
15. MacKie RM. Risk factors for the development of primary cutaneous malignant melanoma. Dermatol Clin. 2002;20:597-600.
16. Kanzler MH, Mraz-Gernhard S. Primary cutaneous malignant melanoma and its precursor lesions: diagnostic and therapeutic overview. J Am Acad Dermatol. 2001;45:260-76.
17. Gandini S, Sera F, Cattaruzza MS, Pasquini P, Zanetti R, Masini C, Boyle P, Melchi CF. Review Meta-analysis of risk factors for cutaneous melanoma: III. Family history, actinic damage and phenotypic factors. Eur J Cancer. 2005;41:2040-59.
18. Gandini S, Sera F, Cattaruzza MS, Pasquini P, Abeni D, Boyle P, et al. Review meta-analysis of risk factors for cutaneous melanoma: I. Common and atypical naevi. Eur J Cancer. 2005;41:28-44.
19. Marghoob AA. Congenital melanocytic nevi. Evaluation and management. Dermatol Clin. 2002;20:607-16.
20. Leech SN, Bell H, Leonard N, Jones SL, Geurin D, McKee PH, et al. Neonatal giant congenital nevi with proliferatives nodules a clinicopathologic study and literataure review of neonatal melanoma. Arch Dermatol. 2004;140:83-8.
21. Makkar HS, Frieden IJ. Neurocutaneous melanosis. Semin Cutan Med Surg 2004;23:138-44.
22. Marghoob AA, Dusza S, Oliveria S, Halpern AC. Number of satellite nevi as a correlate for neurocutaneous melanocytosis in patients with large congenital melanocytic nevi. Arch Dermatol. 2004;140:171-5.
23. Schaffer JV, McNiff JM, Bolognia JL. Cerebral mass due to neurocutaneous melanosis: eight years later. Pediatr Dermatol. 2001;18:369-77.
24. Papoo AS. Melanoma in children and adolescents. Eur J Cancer. 2003;39:2652-61.
25. Gallagher RP, Lee TK. Adverse effects of ultraviolet radiation: a brief review. Prog Biophys Mol Biol. 2006;92:119-31.
26. Gandini S, Sera F, Cattaruzza MS, Pasquini P, Picconi O, Boyle P, et al. Meta-analysis of risk factors for cutaneous melanoma: II. Sun exposure. Eur J Cancer. 2005;41:45-60.
27. Dennis LK, Beane Freeman LE, VanBeek MJ. Sunscreen use and the risk for melanoma: a quantitative review. Ann Intern Med. 2003;139:966-78.
28. Wagner AJ, Fisher DE. Melanocyte signaling pathways and the etiology of melanoma. Drug Discov Today Dis Mech. 2005;2:179-83.
29. Miller AJ, Mihm MC Jr. Melanoma. N Engl J Med. 2006; 355:51-65.
30. Demierre MF, Sondak VK. Cutaneous melanoma: pathogenesis and rationale for chemoprevention. Crit Rev Oncol Hematol. 2005;53:225-39.
31. Curtin JA, Fridlyand J, Kageshita T, Patel HN, Busam KJ, Kutzner H, et al. Distinct sets of genetic alterations in melanoma. N Engl J Med. 2005;353:2135-47.
32. Chudnovsky Y, Khavari PA, Adams AE. Melanoma genetics and the development of rational therapeutics. J Clin Invest. 2005;115:813-24.
33. Robinson JK, Turrisi R. Skills training to learn discrimination of ABCDE criteria by those at risk of developing melanoma. Arch Dermatol. 2006;142:447-52.
34. Adler MJ, White CR. Amelanotic malignant melanoma. Semin Cutan Med Surg. 1997;16:122-130.
35. Pizzichetta MA, Talamini R, Stanganelli I, Puddu P, Bono R, Argenziano G, et al. Amelanotic/hypomelanotic melanoma: clinical and dermoscopic features. Br J Dermatol. 2004;150:1117-24.
36. Sagabiel R. Clinical presentation. En: Miller SJ, Maloney ME, editors. Cutaneous oncology. Pathology, diagnosis and management. Malden: Blackwell Science; 1998. p.253-61.
37. Sánchez I, Lloret P, Mihm M. Melanoma Maligno. En: Torres V, Camacho FM, Mihm MC, Sober A, Sánchez I, editores. Dermatología práctica ibero-latinoamericana. Atlas, enfermedades sistémicas asociadas y terapéutica. México, D.F.: VicenteTorres Lozada-Nieto Editores, SA de CV.; 2005. p.1359-84.
38. Zalaudek I, Marghoob AA, Scope A, Leinweber B, Ferrara G, Hofmann-Wellenhof R, et al. Three roots of melanoma. Arch Dermatol. 2008;144:1375-9.
39. Phan A, Touzet S, Dalle S, Ronger-Savle S, Balme B, Thomas L. Acral lentiginous melanoma: histopathological prognostic features of 121 cases. Br J Dermatol. 2007;157:311-18.
40. Lateur N, André J. Melanonychia: diagnosis and treatment. Dermatol Ther. 2002;15:131-41.
41. Levit EK, Kagen MH, Scher RK, Grossman M, Altman E. The ABC rule for clinical detection of subungual melanoma. J Am Acad Dermatol. 2000:42:269-74.
42. Skelton HG, Smith KJ. Less common variants of malignant melanoma. Curr Probl Dermatol. 2003:15:197-202.
43. Ries S, Mitsuhashi T, Barr R. Minimal deviation melanoma. Curr Probl Dermatol. 2003;15:203-8.
44. Rapidis AD, Apostolidis C, Georgios V, Valsamis. Primary malignant melanoma of the oral mucosa. J Oral Maxillofac Surg. 2003;61:1132-9.
45. Marghoob AA, Swindle LD., Moricz CZ, Sanchez Negron FA, Slue B, Halpern AC, et al. Instruments and new technologies for the in vivo diagnosis of melanoma. J Am Acad Dermatol. 2003;49:777-97.
46. Moncrieff M, Cotton S, Claridges E, Hall P. Spectrophotometric intracutaneous analyses: a new technique for imaging pigmented skin lesions. Br J Dermatol. 2002;146:448-57.
47. Zaballos P, Carrera C, Puig S, Malvehy J. Criterios dermatoscópicos para el diagnóstico de melanoma. Med Cutan Iber Lat Am. 2004;32:3-17.
48. Tran KT, Wright NA, Cockerell CJ. Biopsy of the pigmented lesion, when and how. J Am Acad Dermatol 2008;59:852-71.
49. Coit D, Andtbacka R, Bichakjian CK, Daud A, Dilawari RA, Dimaio D, Guild V, et al. NCCN Clinical Practice Guidelines in Oncology: Melanoma. Network NCC; 2009.
50. Braun RP, Baran R, Le Gal FA, Dalle S, Ronger S, Pandolf R. Diagnosis and management of nail pigmentations. J Am Acad Dermatol. 2007;56:835-57.
51. Clemente C, Mihm M, Bufalino R, Zurrida S, Collini P, Cascinelli R. Prognostic value of tumor infiltrating lymphocytes in the vertical growth phase of primary cutaneous melanoma. Cancer. 1996:77:1303-10.
52. Torabian S, Kashani-Sabet M. Biomarkers for melanoma. Curr Opin Oncol. 2005;17:167-71.
53. Cohen LM. Lentigo maligna and lentigo maligna melanoma. J Am Acad Dermatol. 1995;33:923-6.
54. Balch CM, Soong SJ, Atkins MB, Buzaid AC, Cascinelli N, Coit DG, et al. An evidence-based staging system for cutaneous melanoma. CA Cancer J Clin. 2004;54:131-49.
55. Sober AJ. Cutaneous melanoma: practical usefulness of the American Joint Committee on Cancer Staging System. Dermatol Ther. 2005;18:407-11.
56. Homsi J, Kashani-Sabet M, Messina JL, Daud A. Cutaneous melanoma: prognostic factors. Cancer Control. 2005;12:223-9.
57. Lachiewicz AM, Berwick M, Wiggins CL, Thomas NE. Survival differences between patients with scalp or neck melanoma and those with melanoma of other sites in the surveillance, epidemiology, and end results (SEER) program. Arch Dermatol. 2008;144:515-21.
58. Montane KT, Elder DE. Factors predictive of metastasis and outcome. En: Miller SJ, Maloney ME, editors. Cutaneous oncology. Pathophysiology, diagnosis, and management. Malden: Blackwell Science; 1998. p.278-89.
59. Balch CM, Wilkerson JA, Murad TM, Soong SJ, Ingalls AL, Maddox WA. The prognostic significance of ulceration of cutaneous melanoma. Cancer. 1980;45:3012-7.
60. Clark WH Jr, Elder DE, Guerry D, Braitman LE, Trock BJ, Schultz D, et al. Model predicting survival in stage I melanoma based on tumor progression. J Natl Cancer Inst. 1989;81:1893-904.
61. Walker MJ, Ronan SG, Han MC, Beattie CW, Das Gupta TK. Interrelationship between histopathologic characteristics of melanoma and estrogen receptor status. Cancer. 1991;68:184-8.
How to Cite
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Acosta Álvaro E, Fierro E, Velásquez VE, Rueda X. Melanoma: pathogenesis, clinic and histopathology. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 2019 Feb. 12 [cited 2024 Jul. 22];17(2):87-108. Available from: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/156
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How to Cite
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Acosta Álvaro E, Fierro E, Velásquez VE, Rueda X. Melanoma: pathogenesis, clinic and histopathology. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 2019 Feb. 12 [cited 2024 Jul. 22];17(2):87-108. Available from: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/156
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