<div id="pf1" class="pf w0 h0" data-page-no="1"><div class="pc pc1 w0 h0"><img class="bi x0 y0 w1 h1" alt="" src="https://files.passeidireto.com/75f5f44c-f020-40b0-8bec-4e63b893e22f/bg1.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls6 ws0">REVISIÓN</div><div class="t m0 x2 h3 y2 ff2 fs1 fc0 sc0 ls6">6</div><div class="t m0 x3 h4 y3 ff3 fs2 fc0 sc0 ls6 ws7">Dermatol V<span class="blank _0"></span>enez <span class="ff4 ls0">h</span>Vol.59 <span class="ff4 ls1">h</span>N°2 <span class="ff4 ls2">h</span><span class="ws1">2021</span></div><div class="t m0 x4 h5 y4 ff5 fs3 fc0 sc0 ls6 ws2">Resumen:</div><div class="t m0 x5 h6 y5 ff6 fs1 fc0 sc0 ls6 ws7">La alopecia inducida por andrógenos en individuos genéticamente predispuestos se <span class="blank _1"> </span>denomina</div><div class="t m0 x6 h6 y6 ff6 fs1 fc0 sc0 ls6 ws7">alopecia androgénica. La<span class="blank _0"></span> alopecia androgénica <span class="blank _0"></span>femenina (AAF) <span class="blank _0"></span>es un <span class="blank _0"></span>tipo de alopecia <span class="blank _0"></span>no cicatricial.</div><div class="t m0 x6 h6 y7 ff6 fs1 fc0 sc0 ls6 ws7">La incidencia de <span class="blank _0"></span>AAF tiende <span class="blank _0"></span>a aumentar <span class="blank _0"></span>con la edad. <span class="blank _0"></span>Se ha <span class="blank _0"></span>reconocido que <span class="blank _0"></span>la alopecia a<span class="blank _0"></span>ndrogénica</div><div class="t m0 x6 h6 y8 ff6 fs1 fc0 sc0 ls6 ws7">tiene efectos psicológicos <span class="blank _1"> </span>significativos en los pacientes. <span class="blank _1"> </span>Para las mujeres <span class="blank _1"> </span>afectadas la incapacidad</div><div class="t m0 x6 h6 y9 ff6 fs1 fc0 sc0 ls6 ws7">para peinarse, <span class="blank _1"> </span>insatisfacción <span class="blank _1"> </span>con <span class="blank _1"> </span>su <span class="blank _1"> </span>apariencia <span class="blank _1"> </span>y <span class="blank _1"> </span>ansiedad <span class="blank _1"> </span>por <span class="blank _1"> </span>la continua <span class="blank _1"> </span>pérdida <span class="blank _1"> </span>de <span class="blank _1"> </span>pelo, <span class="blank _1"> </span>son <span class="blank _1"> </span>las</div><div class="t m0 x6 h6 ya ff6 fs1 fc0 sc0 ls6 ws7">principales razones de preocupación. En la actualidad <span class="blank _0"></span>se han realizado varios estudios en cuanto al</div><div class="t m0 x6 h6 yb ff6 fs1 fc0 sc0 ls6 ws7">diagn<span class="blank _1"> </span>ósti<span class="blank _1"> </span>co <span class="blank _2"> </span>de <span class="blank _2"> </span>la <span class="blank _2"> </span>enfer<span class="blank _1"> </span>meda<span class="blank _1"> </span>d, <span class="blank _2"> </span>siend<span class="blank _1"> </span>o <span class="blank _2"> </span>la <span class="blank _2"> </span>trico<span class="blank _1"> </span>scopi<span class="blank _1"> </span>a <span class="blank _2"> </span>una <span class="blank _2"> </span>herra<span class="blank _1"> </span>mien<span class="blank _1"> </span>ta <span class="blank _2"> </span>útil <span class="blank _2"> </span>de <span class="blank _2"> </span>dia<span class="blank _1"> </span>gnós<span class="blank _1"> </span>tico <span class="blank _2"> </span>par<span class="blank _1"> </span>a <span class="blank _2"> </span>la</div><div class="t m0 x6 h6 yc ff6 fs1 fc0 sc0 ls6 ws7">alopecia <span class="blank _1"> </span>androgénica. <span class="blank _2"> </span>Se <span class="blank _1"> </span>ha <span class="blank _1"> </span>evidenciado <span class="blank _2"> </span>mejoría <span class="blank _1"> </span>clínica <span class="blank _2"> </span>con <span class="blank _1"> </span>múltiples <span class="blank _1"> </span>tratamientos <span class="blank _2"> </span>sobre <span class="blank _1"> </span>los <span class="blank _2"> </span>que</div><div class="t m0 x6 h6 yd ff6 fs1 fc0 sc0 ls6 ws7">se hará énfasis en esta revisión.</div><div class="t m0 x7 h6 ye ff7 fs1 fc0 sc0 ls6 ws7">Pala<span class="blank _1"> </span>bras<span class="blank _1"> </span> <span class="blank _2"> </span>clave:<span class="blank _1"> </span> <span class="blank _2"> </span><span class="ff6">alopec<span class="blank _1"> </span>ia <span class="blank _2"> </span>andr<span class="blank _1"> </span>ogén<span class="blank _1"> </span>ica <span class="blank _2"> </span>fem<span class="blank _1"> </span>enin<span class="blank _1"> </span>a, <span class="blank _2"> </span>pérd<span class="blank _1"> </span>ida <span class="blank _2"> </span>de <span class="blank _2"> </span>pel<span class="blank _1"> </span>o, <span class="blank _2"> </span>andr<span class="blank _1"> </span>ógeno<span class="blank _1"> </span>s, <span class="blank _2"> </span>diag<span class="blank _1"> </span>nóst<span class="blank _1"> </span>ico,</span></div><div class="t m0 x6 h6 yf ff6 fs1 fc0 sc0 ls6 ws3">tratamiento.</div><div class="t m0 x6 h5 y10 ff5 fs3 fc0 sc0 ls6 ws7">Female androgenic alopec<span class="blank _0"></span>ia: Diagnostic and therapeutic update</div><div class="t m0 x7 h5 y11 ff5 fs3 fc0 sc0 ls6 ws4">Summary</div><div class="t m0 x8 h6 y12 ff6 fs1 fc0 sc0 ls6 ws7">Androgen-induced <span class="blank _0"></span>alopecia in <span class="blank _0"></span>genetically <span class="blank _0"></span>predisposed <span class="blank _0"></span>individuals <span class="blank _0"></span>is <span class="blank _0"></span>called <span class="blank _0"></span>androgenic <span class="blank _0"></span>alopecia.</div><div class="t m0 x6 h6 y13 ff6 fs1 fc0 sc0 ls6 ws7">Female androgenic alopecia <span class="blank _0"></span>(FAA) is <span class="blank _0"></span>a type <span class="blank _0"></span>of non-scarring alopecia. <span class="blank _0"></span>The incidence <span class="blank _0"></span>of FAA <span class="blank _0"></span>tends to</div><div class="t m0 x6 h6 y14 ff6 fs1 fc0 sc0 ls6 ws7">increas<span class="blank _0"></span>e <span class="blank _0"></span>with<span class="blank _0"></span> <span class="blank _0"></span>age. <span class="blank _3"></span>Androge<span class="blank _0"></span>nic <span class="blank _3"></span>alopecia <span class="blank _3"></span>has <span class="blank _3"></span>been <span class="blank _3"></span>recognized <span class="blank _3"></span>to <span class="blank _3"></span>have <span class="blank _0"></span>signif<span class="blank _0"></span>icant <span class="blank _3"></span>psychol<span class="blank _0"></span>ogical <span class="blank _3"></span>effects</div><div class="t m0 x6 h6 y15 ff6 fs1 fc0 sc0 ls6 ws7">in <span class="blank _3"></span>patients.<span class="blank _0"></span> <span class="blank _3"></span>For <span class="blank _0"></span>affect<span class="blank _0"></span>ed <span class="blank _3"></span>women, <span class="blank _3"></span>the <span class="blank _3"></span>inability<span class="blank _0"></span> <span class="blank _0"></span>to <span class="blank _3"></span>comb <span class="blank _3"></span>their <span class="blank _3"></span>hair, <span class="blank _3"></span>dissatisf<span class="blank _0"></span>actio<span class="blank _0"></span>n <span class="blank _3"></span>with <span class="blank _0"></span>their<span class="blank _0"></span> <span class="blank _3"></span>appearance<span class="blank _0"></span>,</div><div class="t m0 x6 h6 y16 ff6 fs1 fc0 sc0 ls6 ws7">and anxiety about continued hair <span class="blank _1"> </span>loss are the main <span class="blank _1"> </span>reasons for concern. At present, <span class="blank _1"> </span>several studies</div><div class="t m0 x6 h6 y17 ff6 fs1 fc0 sc0 ls6 ws7">have been carried <span class="blank _3"></span>out regarding the diagnosis <span class="blank _0"></span>of the disease, <span class="blank _3"></span>trichoscopy being a useful <span class="blank _0"></span>diagnostic</div><div class="t m0 x6 h6 y18 ff6 fs1 fc0 sc0 ls6 ws7">tool <span class="blank _2"> </span>for <span class="blank _1"> </span>androgeni<span class="blank _1"> </span>c <span class="blank _2"> </span>alopecia. <span class="blank _1"> </span>Clini<span class="blank _1"> </span>cal <span class="blank _2"> </span>improvement <span class="blank _1"> </span>h<span class="blank _1"> </span>as <span class="blank _2"> </span>been <span class="blank _1"> </span>evidenced <span class="blank _2"> </span>with <span class="blank _2"> </span>multiple <span class="blank _2"> </span>treatments,</div><div class="t m0 x6 h6 y19 ff6 fs1 fc0 sc0 ls6 ws7">which will be emphasized in this review.</div><div class="t m0 x5 h6 y1a ff7 fs1 fc0 sc0 ls6 ws5">Keywords:<span class="blank"> </span><span class="ff6 ws7">famale androgenic alopecia, hair loss, androgens, diagnosis, treatment.</span></div><div class="t m0 x9 h7 y1b ff5 fs4 fc0 sc0 ls6 ws7">Nazareth Durán Rondón<span class="fs5 ls3 v1">1</span>, Ruth Jiméne<span class="blank _0"></span>z Pérez<span class="fs5 ls4 v1">1</span>, Cindy Mestre<span class="fs5 ls5 v1">1</span>, Mariangel Rocha Aldana<span class="fs5 ls4 v1">1</span>, </div><div class="t m0 x9 h8 y1c ff5 fs4 fc0 sc0 ls6 ws7">Elda Giansante<span class="fs5 ls3 v1">2</span><span class="v0">.</span></div><div class="t m0 xa h9 y1d ff5 fs6 fc0 sc0 ls6 ws7">Alopecia androgénica femenina: A<span class="blank _3"></span>ctualización</div><div class="t m0 xa h9 y1e ff5 fs6 fc0 sc0 ls6 ws7">diagnóstica y terapéutica.</div><div class="t m0 x3 ha y1f ff8 fs7 fc0 sc0 ls6 ws6">1<span class="ws7 v0">. Residente del 3er año del </span></div><div class="t m0 xb hb y20 ff8 fs7 fc0 sc0 ls6 ws7">Postgrado de Dermatología y </div><div class="t m0 xb hb y21 ff8 fs7 fc0 sc0 ls6 ws7">Si\ufb01lografía. Instituto de </div><div class="t m0 xb hb y22 ff8 fs7 fc0 sc0 ls6 ws7">Biomedicina \u201cDr<span class="blank _3"></span>. Jacinto Convit\u201d. </div><div class="t m0 xb hb y23 ff8 fs7 fc0 sc0 ls6 ws7">Hospital V<span class="blank _3"></span>argas de Caracas. </div><div class="t m0 xb hb y24 ff8 fs7 fc0 sc0 ls6 ws7">Universidad Central de V<span class="blank _3"></span>enezuela.</div><div class="t m0 x3 hb y25 ff8 fs7 fc0 sc0 ls6 ws7">2. Profesora Asistente \u2013 </div><div class="t m0 xb hb y26 ff8 fs7 fc0 sc0 ls6 ws7">Coordinadora de la Pasantía de </div><div class="t m0 xb hb y27 ff8 fs7 fc0 sc0 ls6 ws7">Dermatología Estética y </div><div class="t m0 xb hb y28 ff8 fs7 fc0 sc0 ls6 ws7">Cosmética. Post- Grado de </div><div class="t m0 xb hb y29 ff8 fs7 fc0 sc0 ls6 ws7">Dermatología y Si\ufb01lografía. </div><div class="t m0 xb hb y2a ff8 fs7 fc0 sc0 ls6 ws7">Universidad Central de V<span class="blank _3"></span>enezuela.</div><div class="t m0 x3 hb y2b ff8 fs7 fc0 sc0 ls6 ws7">Autor para correspondencia: </div><div class="t m0 x3 hb y2c ff8 fs7 fc0 sc0 ls6 ws7">Elda Giansante.</div><div class="t m0 x3 hb y2d ff8 fs7 fc0 sc0 ls6 ws7">e-mail: elda.giansante@gmail.com</div><div class="t m0 x3 hb y2e ff8 fs7 fc0 sc0 ls6 ws7">Recibido: 30/06/2021</div><div class="t m0 x3 hb y2f ff8 fs7 fc0 sc0 ls6 ws7">Aceptado: 08/09/2021</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf2" class="pf w0 h0" data-page-no="2"><div class="pc pc2 w0 h0"><img class="bi xc y30 w1 hc" alt="" src="https://files.passeidireto.com/75f5f44c-f020-40b0-8bec-4e63b893e22f/bg2.png"><div class="t m0 xd h2 y31 ff1 fs0 fc0 sc0 ls6 ws7">REVISIÓN </div><div class="t m0 xe h3 y2 ff2 fs1 fc0 sc0 ls6">7</div><div class="t m0 x1 h4 y3 ff3 fs2 fc0 sc0 ls6 ws7">Dermatol V<span class="blank _0"></span>enez <span class="ff4 ls0">h</span>Vol.59 <span class="ff4 ls1">h</span>N°2 <span class="ff4 ls2">h</span><span class="ws1">2021</span></div><div class="t m0 xf h5 y32 ff5 fs3 fc0 sc0 ls6 ws2">Introducción</div><div class="t m0 x10 h6 y33 ff6 fs1 fc0 sc0 ls6 ws7">La alopecia <span class="blank _3"></span>androgénica femenina <span class="blank _3"></span>(AAF) es <span class="blank _3"></span>un tipo de<span class="blank _0"></span> patrón <span class="blank _3"></span>de</div><div class="t m0 x3 h6 y34 ff6 fs1 fc0 sc0 ls6 ws7">alopecia <span class="blank _1"> </span>no <span class="blank _1"> </span>cicatricial, <span class="blank _2"> </span>la <span class="blank _1"> </span>edad <span class="blank _1"> </span>de <span class="blank _1"> </span>inicio <span class="blank _2"> </span>suele <span class="blank _1"> </span>ser <span class="blank _1"> </span>entre <span class="blank _2"> </span>la tercera <span class="blank _2"> </span>y</div><div class="t m0 x3 h6 y35 ff6 fs1 fc0 sc0 ls6 ws7">cuar<span class="blank _1"> </span>ta <span class="blank _4"> </span>déca<span class="blank _1"> </span>da <span class="blank _4"> </span>de <span class="blank _4"> </span>la <span class="blank _4"> </span>vida,<span class="blank _1"> </span> <span class="blank _4"> </span>la <span class="blank _4"> </span>pérdid<span class="blank _1"> </span>a <span class="blank _4"> </span>de <span class="blank _4"> </span>pelo <span class="blank _4"> </span>puede<span class="blank _1"> </span> <span class="blank _4"> </span>inici<span class="blank _1"> </span>ar</div><div class="t m0 x3 h6 y36 ff6 fs1 fc0 sc0 ls6 ws7">inme<span class="blank _1"> </span>dia<span class="blank _1"> </span>tam<span class="blank _1"> </span>ent<span class="blank _1"> </span>e <span class="blank _5"> </span>desp<span class="blank _1"> </span>ués<span class="blank _1"> </span> <span class="blank _5"> </span>de <span class="blank _5"> </span>la <span class="blank _5"> </span>pu<span class="blank _1"> </span>ber<span class="blank _1"> </span>tad<span class="blank _1"> </span> <span class="blank _5"> </span>y <span class="blank _5"> </span>cont<span class="blank _1"> </span>inúa</div><div class="t m0 x3 h6 y37 ff6 fs1 fc0 sc0 ls6 ws7">progresivamente. <span class="blank _1"> </span>Se <span class="blank _2"> </span>caracteriza <span class="blank _2"> </span>por <span class="blank _1"> </span>una <span class="blank _2"> </span>reducción <span class="blank _2"> </span>en <span class="blank _1"> </span>la <span class="blank _2"> </span>densidad</div><div class="t m0 x3 h6 y38 ff6 fs1 fc0 sc0 ls6 ws7">del <span class="blank _6"> </span>pelo<span class="blank _1"> </span> <span class="blank _6"> </span>sobre <span class="blank _6"> </span>la <span class="blank _6"> </span>coron<span class="blank _1"> </span>a <span class="blank _6"> </span>y <span class="blank _7"> </span>el <span class="blank _7"> </span>c<span class="blank _1"> </span>uer<span class="blank _1"> </span>o <span class="blank _7"> </span>ca<span class="blank _1"> </span>bel<span class="blank _1"> </span>lud<span class="blank _1"> </span>o <span class="blank _7"> </span>fr<span class="blank _1"> </span>ont<span class="blank _1"> </span>al. <span class="blank _6"> </span>Los <span class="blank _6"> </span>pelo<span class="blank _1"> </span>s</div><div class="t m0 x3 h6 y39 ff6 fs1 fc0 sc0 ls6 ws7">produc<span class="blank _0"></span>idos <span class="blank _3"></span>por <span class="blank _3"></span>los <span class="blank _0"></span>folícu<span class="blank _0"></span>los <span class="blank _3"></span>afectados<span class="blank _0"></span> <span class="blank _3"></span>se vu<span class="blank _0"></span>elven <span class="blank _3"></span>gradua<span class="blank _0"></span>lmente<span class="blank _0"></span> <span class="blank _0"></span>más</div><div class="t m0 x3 h6 y3a ff6 fs1 fc0 sc0 ls6 ws7">finos <span class="blank _3"></span>y débi<span class="blank _0"></span>les <span class="blank _3"></span>hasta que<span class="blank _0"></span> <span class="blank _0"></span>finalmente <span class="blank _3"></span>estos <span class="blank _3"></span>disminuyen <span class="blank _0"></span>por <span class="blank _3"></span>completo</div><div class="t m0 x3 h6 y3b ff6 fs1 fc0 sc0 ls6 ws7">y dejan <span class="blank _1"> </span>de <span class="blank _1"> </span>producir <span class="blank _1"> </span>pelo. <span class="blank _1"> </span>Puede tener <span class="blank _1"> </span>implicaciones <span class="blank _1"> </span>psicológicas <span class="blank _1"> </span>e</div><div class="t m0 x3 hd y3c ff6 fs1 fc0 sc0 ls6 ws7">influir en la calidad de vida del individuo<span class="fs8 ws8 v1">1,2</span><span class="v0">. </span></div><div class="t m0 x3 h5 y3d ff5 fs3 fc0 sc0 ls6 ws7">Causas de alopecia androgénica femenina</div><div class="t m0 x3 he y3e ff7 fs1 fc0 sc0 ls6 ws7">Factor genético:</div><div class="t m0 xf h6 y3f ff6 fs1 fc0 sc0 ls6 ws7">El <span class="blank _7"> </span>50%<span class="blank _1"> </span> <span class="blank _7"> </span>de <span class="blank _7"> </span>las<span class="blank _1"> </span> <span class="blank _7"> </span>muje<span class="blank _1"> </span>res<span class="blank _1"> </span> <span class="blank _2"> </span>p<span class="blank _1"> </span>res<span class="blank _1"> </span>ent<span class="blank _1"> </span>an <span class="blank _7"> </span>ant<span class="blank _1"> </span>ece<span class="blank _1"> </span>den<span class="blank _1"> </span>tes <span class="blank _7"> </span>f<span class="blank _1"> </span>amil<span class="blank _1"> </span>iar<span class="blank _1"> </span>es <span class="blank _7"> </span>de</div><div class="t m0 x3 h6 y40 ff6 fs1 fc0 sc0 ls6 ws7">alopecia <span class="blank _2"> </span>androgénica<span class="blank _1"> </span> <span class="blank _2"> </span>femenina <span class="blank _2"> </span>(AAF), <span class="blank _2"> </span>puede <span class="blank _2"> </span>trasmitirse <span class="blank _2"> </span>de <span class="blank _2"> </span>forma</div><div class="t m0 x3 h6 y41 ff6 fs1 fc0 sc0 ls6 ws7">autosómica <span class="blank _1"> </span>dominante <span class="blank _2"> </span>con <span class="blank _1"> </span>una <span class="blank _2"> </span>penetrancia <span class="blank _1"> </span>variable, <span class="blank _2"> </span>no <span class="blank _1"> </span>obstante,</div><div class="t m0 x3 h6 y42 ff6 fs1 fc0 sc0 ls6 ws7">su <span class="blank _7"> </span>aus<span class="blank _1"> </span>enc<span class="blank _1"> </span>ia <span class="blank _7"> </span>no <span class="blank _7"> </span>de<span class="blank _1"> </span>sca<span class="blank _1"> </span>rta <span class="blank _7"> </span>qu<span class="blank _1"> </span>e <span class="blank _7"> </span>pue<span class="blank _1"> </span>da <span class="blank _7"> </span>sur<span class="blank _1"> </span>gir<span class="blank _1"> </span> <span class="blank _2"> </span>e<span class="blank _1"> </span>ste<span class="blank _1"> </span> <span class="blank _2"> </span>t<span class="blank _1"> </span>ipo<span class="blank _1"> </span> <span class="blank _2"> </span>d<span class="blank _1"> </span>e <span class="blank _7"> </span>alop<span class="blank _1"> </span>eci<span class="blank _1"> </span>a.</div><div class="t m0 x3 h6 y43 ff6 fs1 fc0 sc0 ls6 ws7">Algu<span class="blank _0"></span>nos <span class="blank _3"></span>inves<span class="blank _0"></span>tiga<span class="blank _0"></span>dore<span class="blank _0"></span>s <span class="blank _3"></span>sospec<span class="blank _0"></span>han <span class="blank _3"></span>que <span class="blank _3"></span>vario<span class="blank _0"></span>s <span class="blank _3"></span>genes <span class="blank _3"></span>juega<span class="blank _0"></span>n <span class="blank _3"></span>un <span class="blank _0"></span>pape<span class="blank _0"></span>l</div><div class="t m0 x3 h6 y44 ff6 fs1 fc0 sc0 ls6 ws7">en <span class="blank _7"> </span>la <span class="blank _7"> </span>AA<span class="blank _1"> </span>F, <span class="blank _7"> </span>se<span class="blank _1"> </span> <span class="blank _7"> </span>han <span class="blank _7"> </span>co<span class="blank _1"> </span>nfi<span class="blank _1"> </span>rma<span class="blank _1"> </span>do <span class="blank _7"> </span>las<span class="blank _1"> </span> <span class="blank _7"> </span>vari<span class="blank _1"> </span>aci<span class="blank _1"> </span>ones<span class="blank _1"> </span> <span class="blank _7"> </span>en <span class="blank _7"> </span>un <span class="blank _7"> </span>so<span class="blank _1"> </span>lo <span class="blank _7"> </span>ge<span class="blank _1"> </span>n <span class="blank _7"> </span>de</div><div class="t m0 x3 h6 y45 ff6 fs1 fc0 sc0 ls6 ws7">rece<span class="blank _1"> </span>pto<span class="blank _1"> </span>res<span class="blank _1"> </span> <span class="blank _4"> </span>d<span class="blank _1"> </span>e <span class="blank _8"> </span>andr<span class="blank _1"> </span>óge<span class="blank _1"> </span>nos<span class="blank _1"> </span> <span class="blank _4"> </span>(<span class="blank _1"> </span>AR)<span class="blank _1"> </span>. <span class="blank _8"> </span>El <span class="blank _8"> </span>rece<span class="blank _1"> </span>pto<span class="blank _1"> </span>r <span class="blank _8"> </span>de <span class="blank _8"> </span>andr<span class="blank _1"> </span>óge<span class="blank _1"> </span>nos</div><div class="t m0 x3 h6 y46 ff6 fs1 fc0 sc0 ls6 ws7">determina <span class="blank _2"> </span>la <span class="blank _2"> </span>sensibilidad <span class="blank _2"> </span>de <span class="blank _1"> </span>las<span class="blank _1"> </span> <span class="blank _2"> </span>células <span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank _2"> </span>los <span class="blank _1"> </span>andró<span class="blank _1"> </span>genos <span class="blank _2"> </span>y <span class="blank _1"> </span>el <span class="blank _2"> </span>gen</div><div class="t m0 x3 h6 y47 ff6 fs1 fc0 sc0 ls6 ws7">AR <span class="blank _3"></span>regula la <span class="blank _3"></span>potencia <span class="blank _0"></span>de <span class="blank _3"></span>los andrógenos <span class="blank _3"></span>disponibles <span class="blank _0"></span>para <span class="blank _3"></span>el folículo</div><div class="t m0 x3 hf y48 ff6 fs1 fc0 sc0 ls6 ws3">piloso<span class="fs8 ws8 v1">3,4</span><span class="v0">.</span></div><div class="t m0 x11 h6 y49 ff6 fs1 fc0 sc0 ls6 ws7">Los <span class="blank"> </span>rec<span class="blank _1"> </span>e<span class="blank _1"> </span>pt<span class="blank _1"> </span>o<span class="blank _1"> </span>r<span class="blank _1"> </span>es<span class="blank _1"> </span> <span class="blank"> </span>de <span class="blank"> </span>and<span class="blank _1"> </span>r<span class="blank _1"> </span>ó<span class="blank _1"> </span>ge<span class="blank _1"> </span>n<span class="blank _1"> </span>o<span class="blank _1"> </span>s<span class="blank _1"> </span> <span class="blank _9"> </span>pe<span class="blank _1"> </span>r<span class="blank _1"> </span>m<span class="blank _1"> </span>it<span class="blank _1"> </span>e<span class="blank _1"> </span>n<span class="blank _1"> </span> <span class="blank _9"> </span>qu<span class="blank _1"> </span>e<span class="blank _1"> </span> <span class="blank _9"> </span>e<span class="blank _1"> </span>l <span class="blank"> </span>cu<span class="blank _1"> </span>er<span class="blank _1"> </span>p<span class="blank _1"> </span>o</div><div class="t m0 x3 h6 y4a ff6 fs1 fc0 sc0 ls6 ws7">re<span class="blank _1"> </span>s<span class="blank _1"> </span>p<span class="blank _1"> </span>on<span class="blank _1"> </span>d<span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank"> </span>a<span class="blank _1"> </span>de<span class="blank _1"> </span>c<span class="blank _1"> </span>u<span class="blank _1"> </span>ad<span class="blank _1"> </span>a<span class="blank _1"> </span>m<span class="blank _1"> </span>en<span class="blank _1"> </span>t<span class="blank _1"> </span>e<span class="blank _1"> </span> <span class="blank"> </span>a<span class="blank _1"> </span> <span class="blank"> </span>l<span class="blank _1"> </span>a <span class="blank"> </span>d<span class="blank _1"> </span>i<span class="blank _1"> </span>h<span class="blank _1"> </span>i<span class="blank _1"> </span>dr<span class="blank _1"> </span>o<span class="blank _1"> </span>t<span class="blank _1"> </span>es<span class="blank _1"> </span>t<span class="blank _1"> </span>o<span class="blank _1"> </span>st<span class="blank _1"> </span>e<span class="blank _1"> </span>r<span class="blank _1"> </span>on<span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank"> </span>y<span class="blank _1"> </span> <span class="blank"> </span>a<span class="blank _1"> </span> <span class="blank"> </span>o<span class="blank _1"> </span>tr<span class="blank _1"> </span>o<span class="blank _1"> </span>s</div><div class="t m0 x3 h6 y4b ff6 fs1 fc0 sc0 ls6 ws7">an<span class="blank _1"> </span>d<span class="blank _1"> </span>r<span class="blank _1"> </span>óg<span class="blank _1"> </span>e<span class="blank _1"> </span>n<span class="blank _1"> </span>os<span class="blank _1"> </span>,<span class="blank _1"> </span> <span class="blank"> </span>se<span class="blank _1"> </span> <span class="blank"> </span>enc<span class="blank _1"> </span>u<span class="blank _1"> </span>e<span class="blank _1"> </span>nt<span class="blank _1"> </span>r<span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank"> </span>loc<span class="blank _1"> </span>a<span class="blank _1"> </span>li<span class="blank _1"> </span>z<span class="blank _1"> </span>a<span class="blank _1"> </span>d<span class="blank _1"> </span>o <span class="blank"> </span>en<span class="blank _1"> </span> <span class="blank"> </span>el<span class="blank _1"> </span> <span class="blank"> </span>cro<span class="blank _1"> </span>m<span class="blank _1"> </span>o<span class="blank _1"> </span>so<span class="blank _1"> </span>m<span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank"> </span>X, <span class="blank"> </span>su</div><div class="t m0 x3 h6 y4c ff6 fs1 fc0 sc0 ls6 ws7">do<span class="blank _1"> </span>m<span class="blank _1"> </span>i<span class="blank _1"> </span>ni<span class="blank _1"> </span>o<span class="blank _1"> </span> <span class="blank _4"> </span>ami<span class="blank _1"> </span>n<span class="blank _1"> </span>ot<span class="blank _1"> </span>e<span class="blank _1"> </span>r<span class="blank _1"> </span>mi<span class="blank _1"> </span>n<span class="blank _1"> </span>a<span class="blank _1"> </span>l<span class="blank _1"> </span> <span class="blank _a"> </span>co<span class="blank _1"> </span>n<span class="blank _1"> </span>t<span class="blank _1"> </span>ie<span class="blank _1"> </span>n<span class="blank _1"> </span>e<span class="blank _1"> </span> <span class="blank _a"> </span>un<span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank _a"> </span>r<span class="blank _1"> </span>eg<span class="blank _1"> </span>i<span class="blank _1"> </span>ó<span class="blank _1"> </span>n<span class="blank _1"> </span> <span class="blank _a"> </span>co<span class="blank _1"> </span>d<span class="blank _1"> </span>i<span class="blank _1"> </span>fi<span class="blank _1"> </span>c<span class="blank _1"> </span>a<span class="blank _1"> </span>da<span class="blank _1"> </span> <span class="blank _a"> </span>p<span class="blank _1"> </span>o<span class="blank _1"> </span>r</div><div class="t m0 x3 h6 y4d ff6 fs1 fc0 sc0 ls6 ws7">se<span class="blank _1"> </span>cu<span class="blank _1"> </span>en<span class="blank _1"> </span>ci<span class="blank _1"> </span>as<span class="blank _1"> </span> <span class="blank _2"> </span>d<span class="blank _1"> </span>e <span class="blank _2"> </span>C<span class="blank _1"> </span>AG<span class="blank _a"> </span>(citosina<span class="blank _1"> </span>-adenina-gu<span class="blank _1"> </span>anina) <span class="blank _2"> </span>relacionada <span class="blank _2"> </span>con <span class="blank _2"> </span>la</div><div class="t m0 x3 h6 y4e ff6 fs1 fc0 sc0 ls6 ws7">tran<span class="blank _1"> </span>scr<span class="blank _1"> </span>ipc<span class="blank _1"> </span>ión <span class="blank _a"> </span>gené<span class="blank _1"> </span>tic<span class="blank _1"> </span>a. <span class="blank _a"> </span>Se <span class="blank _b"> </span>ha <span class="blank _b"> </span>de<span class="blank _1"> </span>mos<span class="blank _1"> </span>tra<span class="blank _1"> </span>do <span class="blank _b"> </span>qu<span class="blank _1"> </span>e <span class="blank _b"> </span>el <span class="blank _b"> </span>n<span class="blank _1"> </span>úme<span class="blank _1"> </span>ro <span class="blank _b"> </span>de</div><div class="t m0 x3 h6 y4f ff6 fs1 fc0 sc0 ls6 ws7">secuencias <span class="blank _1"> </span>varía <span class="blank _1"> </span>en <span class="blank _2"> </span>cada <span class="blank _1"> </span>individuo, <span class="blank _1"> </span>mientras <span class="blank _1"> </span>menor <span class="blank _2"> </span>sea <span class="blank _1"> </span>el <span class="blank _1"> </span>número</div><div class="t m0 x3 h6 y50 ff6 fs1 fc0 sc0 ls6 ws7">de <span class="blank _3"></span>secue<span class="blank _0"></span>ncia<span class="blank _0"></span>s <span class="blank _3"></span>de <span class="blank _3"></span>CAG <span class="blank _0"></span>may<span class="blank _0"></span>or <span class="blank _3"></span>es <span class="blank _3"></span>el <span class="blank _0"></span>ries<span class="blank _0"></span>go <span class="blank _3"></span>de <span class="blank _3"></span>calvic<span class="blank _0"></span>ie <span class="blank _3"></span>y <span class="blank _3"></span>esto <span class="blank _3"></span>determ<span class="blank _0"></span>ina</div><div class="t m0 x3 h6 y51 ff6 fs1 fc0 sc0 ls6 ws7">el aumento <span class="blank _1"> </span>de <span class="blank _1"> </span>la actividad <span class="blank _1"> </span>del <span class="blank _1"> </span>gen AR, <span class="blank _1"> </span>y que <span class="blank _1"> </span>puede <span class="blank _1"> </span>estar presente</div><div class="t m0 x3 hf y52 ff6 fs1 fc0 sc0 ls6 ws7">en la alopecia androgénica masculina y femenina<span class="fs8 ls7 v1">4</span><span class="v0">.</span></div><div class="t m0 x3 he y53 ff7 fs1 fc0 sc0 ls6 ws7">Factor hormonal:</div><div class="t m0 x12 h6 y54 ff6 fs1 fc0 sc0 ls6 ws7">En <span class="blank _2"> </span>las <span class="blank _2"> </span>mujeres <span class="blank _2"> </span>el <span class="blank _1"> </span>hip<span class="blank _1"> </span>erandrogenismo<span class="blank _1"> </span> <span class="blank _2"> </span>se <span class="blank _1"> </span>aso<span class="blank _1"> </span>cia <span class="blank _2"> </span>a <span class="blank _1"> </span>s<span class="blank _1"> </span>índrome <span class="blank _2"> </span>de</div><div class="t m0 x3 h6 y55 ff6 fs1 fc0 sc0 ls6 ws7">ovar<span class="blank _1"> </span>io <span class="blank _2"> </span>po<span class="blank _1"> </span>liq<span class="blank _1"> </span>uís<span class="blank _1"> </span>tico<span class="blank _1"> </span> <span class="blank _2"> </span>y <span class="blank _2"> </span>alt<span class="blank _1"> </span>erac<span class="blank _1"> </span>ión<span class="blank _1"> </span> <span class="blank _2"> </span>de <span class="blank _2"> </span>la <span class="blank _2"> </span>g<span class="blank _1"> </span>lánd<span class="blank _1"> </span>ula<span class="blank _1"> </span> <span class="blank _2"> </span>supr<span class="blank _1"> </span>arr<span class="blank _1"> </span>enal<span class="blank _1"> </span>. <span class="blank _2"> </span>Por<span class="blank _1"> </span> <span class="blank _2"> </span>el</div><div class="t m0 x3 h6 y56 ff6 fs1 fc0 sc0 ls6 ws7">contrario, el <span class="blank _1"> </span>hiperandrogenismo <span class="blank _1"> </span>no <span class="blank _1"> </span>puede <span class="blank _1"> </span>ser <span class="blank _1"> </span>el <span class="blank _1"> </span>único <span class="blank _1"> </span>mecanismo</div><div class="t m0 x3 h6 y57 ff6 fs1 fc0 sc0 ls6 ws7">fisi<span class="blank _1"> </span>opa<span class="blank _1"> </span>tol<span class="blank _1"> </span>ógi<span class="blank _1"> </span>co <span class="blank"> </span>par<span class="blank _1"> </span>a <span class="blank"> </span>desa<span class="blank _1"> </span>rro<span class="blank _1"> </span>lla<span class="blank _1"> </span>r <span class="blank"> </span>AAF <span class="blank"> </span>por<span class="blank _1"> </span>que<span class="blank _1"> </span> <span class="blank"> </span>la <span class="blank"> </span>mayo<span class="blank _1"> </span>ría<span class="blank _1"> </span> <span class="blank"> </span>de <span class="blank"> </span>las</div><div class="t m0 x3 h6 y58 ff6 fs1 fc0 sc0 ls6 ws7">mujeres <span class="blank _2"> </span>no <span class="blank _2"> </span>tienen <span class="blank _2"> </span>concen<span class="blank _1"> </span>traciones<span class="blank _1"> </span> <span class="blank _2"> </span>anormales <span class="blank _2"> </span>ni <span class="blank _2"> </span>muestran <span class="blank _2"> </span>signo<span class="blank _1"> </span>s</div><div class="t m0 x3 h10 y59 ff6 fs1 fc0 sc0 ls6 ws7">de exceso de andrógenos<span class="fs8 ws8 v1">4,5</span><span class="v0">.</span></div><div class="t m0 xf h6 y5a ff6 fs1 fc0 sc0 ls6 ws7">La <span class="blank _7"> </span>test<span class="blank _1"> </span>ost<span class="blank _1"> </span>ero<span class="blank _1"> </span>na <span class="blank _7"> </span>es <span class="blank _7"> </span>prod<span class="blank _1"> </span>uci<span class="blank _1"> </span>da <span class="blank _7"> </span>por<span class="blank _1"> </span> <span class="blank _2"> </span>la<span class="blank _1"> </span>s <span class="blank _7"> </span>célu<span class="blank _1"> </span>las<span class="blank _1"> </span> <span class="blank _2"> </span>in<span class="blank _1"> </span>ter<span class="blank _1"> </span>stic<span class="blank _1"> </span>ial<span class="blank _1"> </span>es <span class="blank _7"> </span>de</div><div class="t m0 x3 h6 y5b ff6 fs1 fc0 sc0 ls6 ws7">Leyd<span class="blank _1"> </span>ig <span class="blank _6"> </span>d<span class="blank _1"> </span>el <span class="blank _6"> </span>te<span class="blank _1"> </span>stí<span class="blank _1"> </span>cul<span class="blank _1"> </span>o, <span class="blank _6"> </span>po<span class="blank _1"> </span>r <span class="blank _6"> </span>la<span class="blank _1"> </span> <span class="blank _6"> </span>and<span class="blank _1"> </span>rost<span class="blank _1"> </span>ene<span class="blank _1"> </span>dio<span class="blank _1"> </span>na <span class="blank _6"> </span>en<span class="blank _1"> </span> <span class="blank _6"> </span>los<span class="blank _1"> </span> <span class="blank _6"> </span>ovar<span class="blank _1"> </span>ios<span class="blank _1"> </span> <span class="blank _6"> </span>y <span class="blank _6"> </span>la</div><div class="t m0 x3 h6 y5c ff6 fs1 fc0 sc0 ls6 ws7">dehi<span class="blank _1"> </span>dro<span class="blank _1"> </span>epi<span class="blank _1"> </span>andr<span class="blank _1"> </span>ost<span class="blank _1"> </span>ero<span class="blank _1"> </span>na <span class="blank _c"> </span>por <span class="blank _c"> </span>las<span class="blank _1"> </span> <span class="blank _c"> </span>glánd<span class="blank _1"> </span>ula<span class="blank _1"> </span>s <span class="blank _c"> </span>supra<span class="blank _1"> </span>rre<span class="blank _1"> </span>nal<span class="blank _1"> </span>es. <span class="blank _c"> </span>La</div><div class="t m0 x3 h6 y5d ff6 fs1 fc0 sc0 ls8 ws7">testosterona <span class="blank _d"> </span>circulante <span class="blank _d"> </span>se <span class="blank _d"> </span>une <span class="blank _d"> </span>a <span class="blank _d"> </span>los <span class="blank _d"> </span>receptores <span class="blank _d"> </span>de <span class="blank _6"> </span>andrógenos</div><div class="t m0 x13 h6 y5e ff6 fs1 fc0 sc0 ls6 ws7">intracelulares<span class="blank _1"> </span> <span class="blank _2"> </span>en <span class="blank _1"> </span>el <span class="blank _2"> </span>bulbo <span class="blank _2"> </span>piloso <span class="blank _2"> </span>y <span class="blank _2"> </span>la <span class="blank _2"> </span>papila <span class="blank _2"> </span>dérmica, <span class="blank _2"> </span>facilitando <span class="blank _2"> </span>la</div><div class="t m0 x13 h11 y5f ff6 fs1 fc0 sc0 ls6 ws7">miniaturización del folículo<span class="fs8 ls9 v1">5</span><span class="fs8 ws8 v1">,6</span><span class="v0">.</span></div><div class="t m0 x14 h6 y60 ff6 fs1 fc0 sc0 ls6 ws7">Los<span class="blank _1"> </span> <span class="blank _2"> </span>d<span class="blank _1"> </span>if<span class="blank _1"> </span>e<span class="blank _1"> </span>re<span class="blank _1"> </span>nt<span class="blank _1"> </span>e<span class="blank _1"> </span>s <span class="blank _2"> </span>p<span class="blank _1"> </span>a<span class="blank _1"> </span>tr<span class="blank _1"> </span>o<span class="blank _1"> </span>ne<span class="blank _1"> </span>s <span class="blank _7"> </span>cl<span class="blank _1"> </span>ín<span class="blank _1"> </span>i<span class="blank _1"> </span>co<span class="blank _1"> </span>s<span class="blank _1"> </span> <span class="blank _2"> </span>en<span class="blank _1"> </span> <span class="blank _2"> </span>l<span class="blank _1"> </span>a <span class="blank _7"> </span>mu<span class="blank _1"> </span>je<span class="blank _1"> </span>r<span class="blank _1"> </span> <span class="blank _2"> </span>co<span class="blank _1"> </span>n<span class="blank _1"> </span> <span class="blank _2"> </span>re<span class="blank _1"> </span>s<span class="blank _1"> </span>pe<span class="blank _1"> </span>c<span class="blank _1"> </span>to<span class="blank _1"> </span> <span class="blank _2"> </span>a<span class="blank _1"> </span>l</div><div class="t m0 x13 h6 y61 ff6 fs1 fc0 sc0 ls6 ws7">ho<span class="blank _1"> </span>m<span class="blank _1"> </span>b<span class="blank _1"> </span>r<span class="blank _1"> </span>e<span class="blank _1"> </span> <span class="blank _d"> </span>s<span class="blank _1"> </span>e<span class="blank _1"> </span> <span class="blank _d"> </span>d<span class="blank _1"> </span>e<span class="blank _1"> </span>b<span class="blank _1"> </span>e<span class="blank _1"> </span>n<span class="blank _1"> </span> <span class="blank _d"> </span>a <span class="blank _9"> </span>la<span class="blank _1"> </span> <span class="blank _d"> </span>d<span class="blank _1"> </span>i<span class="blank _1"> </span>s<span class="blank _1"> </span>t<span class="blank _1"> </span>r<span class="blank _1"> </span>i<span class="blank _1"> </span>b<span class="blank _1"> </span>u<span class="blank _1"> </span>ci<span class="blank _1"> </span>ó<span class="blank _1"> </span>n<span class="blank _1"> </span> <span class="blank _d"> </span>d<span class="blank _1"> </span>e<span class="blank _1"> </span> <span class="blank _d"> </span>l<span class="blank _1"> </span>o<span class="blank _1"> </span>s<span class="blank _1"> </span> <span class="blank _d"> </span>r<span class="blank _1"> </span>e<span class="blank _1"> </span>c<span class="blank _1"> </span>e<span class="blank _1"> </span>pt<span class="blank _1"> </span>o<span class="blank _1"> </span>r<span class="blank _1"> </span>e<span class="blank _1"> </span>s<span class="blank _1"> </span> <span class="blank _d"> </span>p<span class="blank _1"> </span>a<span class="blank _1"> </span>r<span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank _d"> </span>l<span class="blank _1"> </span>a</div><div class="t m0 x13 h6 y62 ff6 fs1 fc0 sc0 ls6 ws7">te<span class="blank _1"> </span>s<span class="blank _1"> </span>t<span class="blank _1"> </span>o<span class="blank _1"> </span>s<span class="blank _1"> </span>t<span class="blank _1"> </span>e<span class="blank _1"> </span>r<span class="blank _1"> </span>o<span class="blank _1"> </span>n<span class="blank _1"> </span>a <span class="blank _8"> </span>e<span class="blank _1"> </span>n <span class="blank _8"> </span>e<span class="blank _1"> </span>l <span class="blank _8"> </span>cu<span class="blank _1"> </span>e<span class="blank _1"> </span>r<span class="blank _1"> </span>o<span class="blank _1"> </span> <span class="blank _8"> </span>ca<span class="blank _1"> </span>b<span class="blank _1"> </span>e<span class="blank _1"> </span>l<span class="blank _1"> </span>l<span class="blank _1"> </span>u<span class="blank _1"> </span>d<span class="blank _1"> </span>o,<span class="blank _1"> </span> <span class="blank _8"> </span>en<span class="blank _1"> </span> <span class="blank _8"> </span>la<span class="blank _1"> </span>s<span class="blank _1"> </span> <span class="blank _8"> </span>mu<span class="blank _1"> </span>j<span class="blank _1"> </span>e<span class="blank _1"> </span>r<span class="blank _1"> </span>e<span class="blank _1"> </span>s<span class="blank _1"> </span> <span class="blank _4"> </span>e<span class="blank _1"> </span>s<span class="blank _1"> </span>t<span class="blank _1"> </span>o<span class="blank _1"> </span>s</div><div class="t m0 x13 h6 y63 ff6 fs1 fc0 sc0 ls6 ws7">re<span class="blank _1"> </span>c<span class="blank _1"> </span>e<span class="blank _1"> </span>p<span class="blank _1"> </span>t<span class="blank _1"> </span>o<span class="blank _1"> </span>r<span class="blank _1"> </span>e<span class="blank _1"> </span>s<span class="blank _1"> </span> <span class="blank _7"> </span>s<span class="blank _1"> </span>o<span class="blank _1"> </span>n<span class="blank _1"> </span> <span class="blank _7"> </span>m<span class="blank _1"> </span>á<span class="blank _1"> </span>s<span class="blank _1"> </span> <span class="blank _7"> </span>b<span class="blank _1"> </span>a<span class="blank _1"> </span>j<span class="blank _1"> </span>o<span class="blank _1"> </span>s<span class="blank _1"> </span> <span class="blank _7"> </span>q<span class="blank _1"> </span>u<span class="blank _1"> </span>e<span class="blank _1"> </span> <span class="blank _7"> </span>e<span class="blank _1"> </span>n<span class="blank _1"> </span> <span class="blank _7"> </span>l<span class="blank _1"> </span>o<span class="blank _1"> </span>s<span class="blank _1"> </span> <span class="blank _7"> </span>f<span class="blank _1"> </span>o<span class="blank _1"> </span>l<span class="blank _1"> </span>í<span class="blank _1"> </span>c<span class="blank _1"> </span>u<span class="blank _1"> </span>lo<span class="blank _1"> </span>s<span class="blank _1"> </span> <span class="blank _6"> </span>ma<span class="blank _1"> </span>s<span class="blank _1"> </span>c<span class="blank _1"> </span>u<span class="blank _1"> </span>l<span class="blank _1"> </span>i<span class="blank _1"> </span>n<span class="blank _1"> </span>o<span class="blank _1"> </span>s<span class="blank _1"> </span>,<span class="blank _1"> </span> <span class="blank _7"> </span>a<span class="blank _1"> </span>s<span class="blank _1"> </span>í</div><div class="t m0 x13 h12 y64 ff6 fs1 fc0 sc0 ls6 ws7">co<span class="blank _1"> </span>m<span class="blank _1"> </span>o<span class="blank _1"> </span> <span class="blank _2"> </span>l<span class="blank _1"> </span>a <span class="blank _7"> </span>en<span class="blank _1"> </span>z<span class="blank _1"> </span>i<span class="blank _1"> </span>ma <span class="blank _2"> </span>5 <span class="blank _2"> </span><span class="ff9 fs3 lsa">a<span class="fs1 lsb">-</span></span>reductas<span class="blank _1"> </span>a <span class="blank _2"> </span>I <span class="blank _2"> </span>y <span class="blank _1"> </span>II<span class="blank _1"> </span> <span class="blank _2"> </span>que <span class="blank _2"> </span>están <span class="blank _2"> </span>reduci<span class="blank _1"> </span>dos <span class="blank _2"> </span>en <span class="blank _2"> </span>los</div><div class="t m0 x13 h6 y65 ff6 fs1 fc0 sc0 ls6 ws7">folí<span class="blank _0"></span>culo<span class="blank _0"></span>s <span class="blank _3"></span>piloso<span class="blank _0"></span>s <span class="blank _3"></span>front<span class="blank _0"></span>ales<span class="blank _0"></span> <span class="blank _3"></span>de l<span class="blank _0"></span>as <span class="blank _3"></span>mujer<span class="blank _3"></span>es. <span class="blank _0"></span>Por<span class="blank _0"></span> <span class="blank _0"></span>otr<span class="blank _0"></span>a <span class="blank _3"></span>parte,<span class="blank _0"></span> <span class="blank _3"></span>la <span class="blank _0"></span>arom<span class="blank _0"></span>atas<span class="blank _0"></span>a</div><div class="t m0 x13 h6 y66 ff6 fs1 fc0 sc0 ls6 ws7">que <span class="blank _3"></span>convierte <span class="blank _0"></span>los <span class="blank _3"></span>andrógenos <span class="blank _0"></span>en <span class="blank _3"></span>estrógenos <span class="blank _0"></span>se <span class="blank _3"></span>encuentra e<span class="blank _0"></span>n <span class="blank _3"></span>mayor</div><div class="t m0 x13 h13 y67 ff6 fs1 fc0 sc0 ls6 ws7">concentración en el folículo piloso frontal en la mujer<span class="fs8 ws8 v1">7,8</span><span class="v0">.</span></div><div class="t m0 x15 h6 y68 ff6 fs1 fc0 sc0 ls6 ws7">En <span class="blank _3"></span>personas predispuestas <span class="blank _3"></span>a <span class="blank _3"></span>la AAF, <span class="blank _3"></span>las conce<span class="blank _0"></span>ntraciones <span class="blank _3"></span>elevadas</div><div class="t m0 x13 h14 y69 ff6 fs1 fc0 sc0 ls6 ws7">de <span class="blank _b"> </span>5 <span class="blank _b"> </span><span class="ff9 fs3 lsc v0">a</span><span class="v0">-redu<span class="blank _1"> </span>cta<span class="blank _1"> </span>sa <span class="blank _b"> </span>en <span class="blank _b"> </span>el <span class="blank _b"> </span>inte<span class="blank _1"> </span>rior<span class="blank _1"> </span> <span class="blank _b"> </span>de <span class="blank _b"> </span>los <span class="blank _b"> </span>folíc<span class="blank _1"> </span>ulo<span class="blank _1"> </span>s <span class="blank _b"> </span>pilo<span class="blank _1"> </span>sos <span class="blank _b"> </span>y <span class="blank _b"> </span>la</span></div><div class="t m0 x13 h6 y6a ff6 fs1 fc0 sc0 ls6 ws7">dihi<span class="blank _1"> </span>dro<span class="blank _1"> </span>tes<span class="blank _1"> </span>tos<span class="blank _1"> </span>tero<span class="blank _1"> </span>na <span class="blank _4"> </span>indu<span class="blank _1"> </span>ce <span class="blank _4"> </span>la <span class="blank _4"> </span>mini<span class="blank _1"> </span>atu<span class="blank _1"> </span>riz<span class="blank _1"> </span>aci<span class="blank _1"> </span>ón <span class="blank _4"> </span>de <span class="blank _4"> </span>folíc<span class="blank _1"> </span>ulo<span class="blank _1"> </span> <span class="blank _a"> </span>p<span class="blank _1"> </span>or</div><div class="t m0 x13 h6 y6b ff6 fs1 fc0 sc0 ls6 ws7">aumento de <span class="blank _0"></span>la apoptosis <span class="blank _0"></span>sobre las <span class="blank _0"></span>células de <span class="blank _0"></span>la papila <span class="blank _0"></span>dérmica, que</div><div class="t m0 x13 h6 y6c ff6 fs1 fc0 sc0 ls6 ws7">se <span class="blank _3"></span>produc<span class="blank _0"></span>e <span class="blank _3"></span>al <span class="blank _3"></span>final <span class="blank _3"></span>de <span class="blank _3"></span>la f<span class="blank _0"></span>ase <span class="blank _3"></span>anág<span class="blank _0"></span>ena,<span class="blank _0"></span> <span class="blank _3"></span>conllev<span class="blank _0"></span>ando<span class="blank _0"></span> <span class="blank _3"></span>la m<span class="blank _0"></span>inia<span class="blank _0"></span>turi<span class="blank _0"></span>zaci<span class="blank _0"></span>ón</div><div class="t m0 x13 h6 y6d ff6 fs1 fc0 sc0 ls6 ws7">y la <span class="blank _1"> </span>pérdida <span class="blank _1"> </span>de <span class="blank _1"> </span>pelo, <span class="blank _1"> </span>es <span class="blank _1"> </span>decir, hay <span class="blank _1"> </span>una <span class="blank _1"> </span>reducción <span class="blank _1"> </span>en <span class="blank _1"> </span>la <span class="blank _1"> </span>duración <span class="blank _1"> </span>de</div><div class="t m0 x13 h13 y6e ff6 fs1 fc0 sc0 ls6 ws7">la fase anágena y la fase telógena aumenta<span class="fs8 ws8 v1">7,8</span><span class="v0">.</span></div><div class="t m0 x13 he y6f ff7 fs1 fc0 sc0 ls6 ws7">Factor inflamatorio:</div><div class="t m0 x14 h6 y70 ff6 fs1 fc0 sc0 ls6 ws7">Var<span class="blank _1"> </span>ios<span class="blank _1"> </span> <span class="blank _2"> </span>dat<span class="blank _1"> </span>os <span class="blank _2"> </span>su<span class="blank _1"> </span>gi<span class="blank _1"> </span>ere<span class="blank _1"> </span>n <span class="blank _2"> </span>que<span class="blank _1"> </span> <span class="blank _2"> </span>la <span class="blank _2"> </span>i<span class="blank _1"> </span>nfl<span class="blank _1"> </span>ama<span class="blank _1"> </span>ció<span class="blank _1"> </span>n <span class="blank _2"> </span>cr<span class="blank _1"> </span>óni<span class="blank _1"> </span>ca <span class="blank _2"> </span>e<span class="blank _1"> </span>n <span class="blank _2"> </span>el <span class="blank _2"> </span>c<span class="blank _1"> </span>uer<span class="blank _1"> </span>o</div><div class="t m0 x13 h6 y71 ff6 fs1 fc0 sc0 ls6 ws7">cabe<span class="blank _1"> </span>llu<span class="blank _1"> </span>do <span class="blank _2"> </span>puede<span class="blank _1"> </span> <span class="blank _1"> </span>p<span class="blank _1"> </span>rom<span class="blank _1"> </span>over<span class="blank _1"> </span> <span class="blank _1"> </span>l<span class="blank _1"> </span>a <span class="blank _1"> </span>p<span class="blank _1"> </span>érd<span class="blank _1"> </span>ida<span class="blank _1"> </span> <span class="blank _1"> </span>de<span class="blank _1"> </span> <span class="blank _1"> </span>pe<span class="blank _1"> </span>lo.<span class="blank _1"> </span> <span class="blank _1"> </span>E<span class="blank _1"> </span>n <span class="blank _1"> </span>l<span class="blank _1"> </span>a <span class="blank _1"> </span>h<span class="blank _1"> </span>ist<span class="blank _1"> </span>olo<span class="blank _1"> </span>gía<span class="blank _1"> </span> <span class="blank _1"> </span>el</div><div class="t m0 x13 h6 y72 ff6 fs1 fc0 sc0 ls6 ws7">pr<span class="blank _1"> </span>oc<span class="blank _1"> </span>e<span class="blank _1"> </span>so<span class="blank _1"> </span> <span class="blank _8"> </span>de<span class="blank _1"> </span> <span class="blank _8"> </span>mi<span class="blank _1"> </span>ni<span class="blank _1"> </span>at<span class="blank _1"> </span>u<span class="blank _1"> </span>ri<span class="blank _1"> </span>za<span class="blank _1"> </span>c<span class="blank _1"> </span>ió<span class="blank _1"> </span>n <span class="blank _8"> </span>e<span class="blank _1"> </span>st<span class="blank _1"> </span>á<span class="blank _1"> </span> <span class="blank _8"> </span>aso<span class="blank _1"> </span>c<span class="blank _1"> </span>ia<span class="blank _1"> </span>do<span class="blank _1"> </span> <span class="blank _8"> </span>co<span class="blank _1"> </span>n<span class="blank _1"> </span> <span class="blank _8"> </span>el <span class="blank _8"> </span>i<span class="blank _1"> </span>nf<span class="blank _1"> </span>i<span class="blank _1"> </span>lt<span class="blank _1"> </span>ra<span class="blank _1"> </span>d<span class="blank _1"> </span>o</div><div class="t m0 x13 h6 y73 ff6 fs1 fc0 sc0 ls6 ws7">li<span class="blank _1"> </span>nf<span class="blank _1"> </span>o<span class="blank _1"> </span>cí<span class="blank _1"> </span>ti<span class="blank _1"> </span>c<span class="blank _1"> </span>o <span class="blank _7"> </span>mi<span class="blank _1"> </span>c<span class="blank _1"> </span>ro<span class="blank _1"> </span>in<span class="blank _1"> </span>f<span class="blank _1"> </span>la<span class="blank _1"> </span>ma<span class="blank _1"> </span>t<span class="blank _1"> </span>or<span class="blank _1"> </span>io<span class="blank _1"> </span> <span class="blank _7"> </span>en<span class="blank _1"> </span> <span class="blank _2"> </span>l<span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank _2"> </span>r<span class="blank _1"> </span>eg<span class="blank _1"> </span>i<span class="blank _1"> </span>ón<span class="blank _1"> </span> <span class="blank _2"> </span>p<span class="blank _1"> </span>e<span class="blank _1"> </span>ri<span class="blank _1"> </span>-i<span class="blank _1"> </span>n<span class="blank _1"> </span>fu<span class="blank _1"> </span>nd<span class="blank _1"> </span>i<span class="blank _1"> </span>bu<span class="blank _1"> </span>l<span class="blank _1"> </span>ar<span class="blank _1"> </span>; <span class="blank _7"> </span>y <span class="blank _7"> </span>l<span class="blank _1"> </span>a</div><div class="t m0 x13 h6 y74 ff6 fs1 fc0 sc0 ls6 ws7">pr<span class="blank _1"> </span>os<span class="blank _1"> </span>t<span class="blank _1"> </span>ag<span class="blank _1"> </span>la<span class="blank _1"> </span>n<span class="blank _1"> </span>di<span class="blank _1"> </span>na<span class="blank _1"> </span> <span class="blank _2"> </span>D2 <span class="blank _2"> </span>(P<span class="blank _1"> </span>G-D2<span class="blank _1"> </span>), <span class="blank _2"> </span>que<span class="blank _1"> </span> <span class="blank _2"> </span>pued<span class="blank _1"> </span>e <span class="blank _2"> </span>inhi<span class="blank _1"> </span>bir <span class="blank _2"> </span>el<span class="blank _1"> </span> <span class="blank _2"> </span>creci<span class="blank _1"> </span>mie<span class="blank _1"> </span>nto <span class="blank _2"> </span>de<span class="blank _1"> </span>l</div><div class="t m0 x13 h6 y75 ff6 fs1 fc0 sc0 ls6 ws7">pelo en los <span class="blank _1"> </span>folículos pilosos <span class="blank _1"> </span>humanos explantados, está <span class="blank _1"> </span>elevada en</div><div class="t m0 x13 h6 y76 ff6 fs1 fc0 sc0 ls6 ws7">el <span class="blank _7"> </span>c<span class="blank _1"> </span>uer<span class="blank _1"> </span>o <span class="blank _7"> </span>c<span class="blank _1"> </span>abe<span class="blank _1"> </span>llud<span class="blank _1"> </span>o <span class="blank _7"> </span>c<span class="blank _1"> </span>alv<span class="blank _1"> </span>o, <span class="blank _6"> </span>pero<span class="blank _1"> </span> <span class="blank _7"> </span>es<span class="blank _1"> </span>te <span class="blank _7"> </span>e<span class="blank _1"> </span>stu<span class="blank _1"> </span>dio<span class="blank _1"> </span> <span class="blank _7"> </span>se<span class="blank _1"> </span> <span class="blank _7"> </span>co<span class="blank _1"> </span>nfir<span class="blank _1"> </span>ma <span class="blank _6"> </span>solo<span class="blank _1"> </span> <span class="blank _7"> </span>en</div><div class="t m0 x13 h15 y77 ff6 fs1 fc0 sc0 ls6 ws3">hombres<span class="fs8 lsd v1">5</span><span class="v0">.</span></div><div class="t m0 x13 he y78 ff7 fs1 fc0 sc0 ls6 ws7">Papel de la microbiota:</div><div class="t m0 x13 h6 y79 ff6 fs1 fc0 sc0 ls6 ws7">En <span class="blank _1"> </span>un <span class="blank _1"> </span>es<span class="blank _1"> </span>tud<span class="blank _1"> </span>io <span class="blank _1"> </span>re<span class="blank _1"> </span>aliz<span class="blank _1"> </span>ado<span class="blank _1"> </span> p<span class="blank _1"> </span>or <span class="blank _1"> </span>Br<span class="blank _1"> </span>yan<span class="blank _1"> </span> S<span class="blank _1"> </span>iu-Y<span class="blank _1"> </span>in <span class="blank _1"> </span>Ho<span class="blank _1"> </span> y<span class="blank _1"> </span> c<span class="blank _1"> </span>ola<span class="blank _1"> </span>bora<span class="blank _1"> </span>dor<span class="blank _1"> </span>es <span class="blank _1"> </span>de<span class="blank _1"> </span>l</div><div class="t m0 x13 h6 y7a ff6 fs1 fc0 sc0 ls6 ws7">Gr<span class="blank _1"> </span>up<span class="blank _1"> </span>o<span class="blank _1"> </span> <span class="blank _6"> </span>d<span class="blank _1"> </span>e <span class="blank _d"> </span>De<span class="blank _1"> </span>r<span class="blank _1"> </span>ma<span class="blank _1"> </span>to<span class="blank _1"> </span>l<span class="blank _1"> </span>og<span class="blank _1"> </span>ía<span class="blank _1"> </span> <span class="blank _d"> </span>Ex<span class="blank _1"> </span>pe<span class="blank _1"> </span>r<span class="blank _1"> </span>im<span class="blank _1"> </span>en<span class="blank _1"> </span>t<span class="blank _1"> </span>al<span class="blank _1"> </span> <span class="blank _6"> </span>d<span class="blank _1"> </span>e<span class="blank _1"> </span>l <span class="blank _d"> </span>In<span class="blank _1"> </span>st<span class="blank _1"> </span>i<span class="blank _1"> </span>tu<span class="blank _1"> </span>t<span class="blank _1"> </span>o <span class="blank _d"> </span>de<span class="blank _1"> </span> <span class="blank _6"> </span>B<span class="blank _1"> </span>i<span class="blank _1"> </span>ol<span class="blank _1"> </span>og<span class="blank _1"> </span>í<span class="blank _1"> </span>a</div><div class="t m0 x13 h6 y7b ff6 fs1 fc0 sc0 ls6 ws7">Mé<span class="blank _1"> </span>di<span class="blank _1"> </span>c<span class="blank _1"> </span>a,<span class="blank _1"> </span> <span class="blank _d"> </span>en<span class="blank _1"> </span> <span class="blank _d"> </span>Si<span class="blank _1"> </span>n<span class="blank _1"> </span>ga<span class="blank _1"> </span>pu<span class="blank _1"> </span>r<span class="blank _1"> </span>, <span class="blank _d"> </span>a<span class="blank _1"> </span>na<span class="blank _1"> </span>l<span class="blank _1"> </span>iz<span class="blank _1"> </span>ar<span class="blank _1"> </span>o<span class="blank _1"> </span>n <span class="blank _d"> </span>l<span class="blank _1"> </span>a <span class="blank _d"> </span>m<span class="blank _1"> </span>ic<span class="blank _1"> </span>r<span class="blank _1"> </span>ob<span class="blank _1"> </span>io<span class="blank _1"> </span>t<span class="blank _1"> </span>a <span class="blank _d"> </span>d<span class="blank _1"> </span>e <span class="blank _d"> </span>l<span class="blank _1"> </span>os<span class="blank _1"> </span> <span class="blank _d"> </span>fo<span class="blank _1"> </span>l<span class="blank _1"> </span>íc<span class="blank _1"> </span>u<span class="blank _1"> </span>lo<span class="blank _1"> </span>s</div><div class="t m0 x13 h6 y7c ff6 fs1 fc0 sc0 ls6 ws7">pilo<span class="blank _1"> </span>sos<span class="blank _1"> </span> d<span class="blank _1"> </span>e p<span class="blank _1"> </span>aci<span class="blank _1"> </span>ente<span class="blank _1"> </span>s <span class="blank _1"> </span>con<span class="blank _1"> </span> pé<span class="blank _1"> </span>rdi<span class="blank _1"> </span>da <span class="blank _1"> </span>de <span class="blank _1"> </span>pel<span class="blank _1"> </span>o <span class="blank _1"> </span>y e<span class="blank _1"> </span>n <span class="blank _1"> </span>paci<span class="blank _1"> </span>ent<span class="blank _1"> </span>es <span class="blank _1"> </span>san<span class="blank _1"> </span>os <span class="blank _1"> </span>en</div><div class="t m0 x13 h6 y7d ff6 fs1 fc0 sc0 ls6 ws7">la<span class="blank _1"> </span> <span class="blank _b"> </span>r<span class="blank _1"> </span>eg<span class="blank _1"> </span>ió<span class="blank _1"> </span>n<span class="blank _1"> </span> <span class="blank _b"> </span>o<span class="blank _1"> </span>cc<span class="blank _1"> </span>ip<span class="blank _1"> </span>i<span class="blank _1"> </span>ta<span class="blank _1"> </span>l <span class="blank _a"> </span>y <span class="blank _a"> </span>de<span class="blank _1"> </span>l<span class="blank _1"> </span> <span class="blank _b"> </span>vé<span class="blank _1"> </span>r<span class="blank _1"> </span>ti<span class="blank _1"> </span>ce<span class="blank _1"> </span>,<span class="blank _1"> </span> <span class="blank _b"> </span>l<span class="blank _1"> </span>ue<span class="blank _1"> </span>go<span class="blank _1"> </span> <span class="blank _b"> </span>s<span class="blank _1"> </span>e<span class="blank _1"> </span> <span class="blank _b"> </span>di<span class="blank _1"> </span>s<span class="blank _1"> </span>ec<span class="blank _1"> </span>c<span class="blank _1"> </span>io<span class="blank _1"> </span>na<span class="blank _1"> </span>r<span class="blank _1"> </span>on<span class="blank _1"> </span> <span class="blank _b"> </span>e<span class="blank _1"> </span>n</div><div class="t m0 x13 h6 y7e ff6 fs1 fc0 sc0 ls6 ws7">comp<span class="blank _1"> </span>art<span class="blank _1"> </span>ime<span class="blank _1"> </span>ntos<span class="blank _1"> </span> medio<span class="blank _1"> </span> e inferio<span class="blank _1"> </span>r. La micr<span class="blank _1"> </span>obi<span class="blank _1"> </span>ota<span class="blank _1"> </span> se caract<span class="blank _1"> </span>eri<span class="blank _1"> </span>zó por</div><div class="t m0 x13 h6 y7f ff6 fs1 fc0 sc0 ls6 ws7">secu<span class="blank _1"> </span>enc<span class="blank _1"> </span>iac<span class="blank _1"> </span>ión <span class="blank _2"> </span>de <span class="blank _2"> </span>16S rRNA, <span class="blank _1"> </span>encontraron <span class="blank _1"> </span>poblaciones <span class="blank _2"> </span>microbianas</div><div class="t m0 x13 h6 y80 ff6 fs1 fc0 sc0 ls6 ws7">dist<span class="blank _1"> </span>int<span class="blank _1"> </span>as <span class="blank _d"> </span>en<span class="blank _1"> </span> <span class="blank _6"> </span>e<span class="blank _1"> </span>l <span class="blank _d"> </span>com<span class="blank _1"> </span>par<span class="blank _1"> </span>tim<span class="blank _1"> </span>ento<span class="blank _1"> </span> <span class="blank _d"> </span>medi<span class="blank _1"> </span>o <span class="blank _d"> </span>e <span class="blank _d"> </span>inf<span class="blank _1"> </span>eri<span class="blank _1"> </span>or <span class="blank _d"> </span>de<span class="blank _1"> </span> <span class="blank _6"> </span>l<span class="blank _1"> </span>os <span class="blank _d"> </span>fo<span class="blank _1"> </span>líc<span class="blank _1"> </span>ulo<span class="blank _1"> </span>s</div><div class="t m0 x13 h6 y81 ff6 fs1 fc0 sc0 ls6 ws7">pilo<span class="blank _1"> </span>sos<span class="blank _1"> </span>. <span class="blank _2"> </span>El<span class="blank _1"> </span> <span class="blank _2"> </span>com<span class="blank _1"> </span>part<span class="blank _1"> </span>ime<span class="blank _1"> </span>nto<span class="blank _1"> </span> <span class="blank _2"> </span>med<span class="blank _1"> </span>io <span class="blank _2"> </span>de<span class="blank _1"> </span>l <span class="blank _2"> </span>pe<span class="blank _1"> </span>lo <span class="blank _2"> </span>f<span class="blank _1"> </span>ue <span class="blank _2"> </span>p<span class="blank _1"> </span>redo<span class="blank _1"> </span>min<span class="blank _1"> </span>ant<span class="blank _1"> </span>e <span class="blank _2"> </span>por</div><div class="t m1 x13 h16 y82 ffa fs9 fc0 sc0 ls6 ws7">Burk<span class="blank _0"></span>hol<span class="blank _0"></span>deri<span class="blank _0"></span>a <span class="blank _3"></span>spp</div><div class="t m0 x16 h6 y82 ff6 fs1 fc0 sc0 ls6 ws7">; <span class="blank _3"></span>se <span class="blank _0"></span>obs<span class="blank _0"></span>ervó<span class="blank _0"></span> <span class="blank _3"></span>mayor <span class="blank _3"></span>diver<span class="blank _0"></span>sida<span class="blank _0"></span>d <span class="blank _3"></span>bacte<span class="blank _0"></span>rian<span class="blank _0"></span>a <span class="blank _3"></span>en <span class="blank _3"></span>la p<span class="blank _0"></span>art<span class="blank _0"></span>e</div><div class="t m0 x13 h6 y83 ff6 fs1 fc0 sc0 ls6 ws7">infe<span class="blank _1"> </span>rio<span class="blank _1"> </span>r <span class="blank _9"> </span>del<span class="blank _1"> </span> <span class="blank _d"> </span>p<span class="blank _1"> </span>elo<span class="blank _1"> </span>. <span class="blank _9"> </span>Los<span class="blank _1"> </span> <span class="blank _d"> </span>f<span class="blank _1"> </span>olí<span class="blank _1"> </span>cul<span class="blank _1"> </span>os <span class="blank _9"> </span>pil<span class="blank _1"> </span>oso<span class="blank _1"> </span>s <span class="blank _9"> </span>occ<span class="blank _1"> </span>ipi<span class="blank _1"> </span>tale<span class="blank _1"> </span>s <span class="blank _9"> </span>y <span class="blank _9"> </span>vér<span class="blank _1"> </span>tic<span class="blank _1"> </span>es <span class="blank _9"> </span>no</div><div class="t m0 x13 h6 y84 ff6 fs1 fc0 sc0 ls6 ws7">mostraron diferencias <span class="blank _3"></span>significativas en <span class="blank _0"></span>los pacientes <span class="blank _3"></span>con pérdida <span class="blank _0"></span>de</div><div class="t m0 x13 h6 y85 ff6 fs1 fc0 sc0 ls6 ws7">pelo, en <span class="blank _1"> </span>vértices <span class="blank _1"> </span>los <span class="blank _1"> </span>pelos se <span class="blank _1"> </span>encontraron <span class="blank _1"> </span>miniaturizados <span class="blank _1"> </span>y alberga</div><div class="t m1 x13 h16 y86 ffa fs9 fc0 sc0 ls6 ws7">Propioniba<span class="blank _1"> </span>cterium <span class="blank _2"> </span>acnes</div><div class="t m0 x17 h6 y86 ff6 fs1 fc0 sc0 ls6 ws7">en <span class="blank _2"> </span>los <span class="blank _2"> </span>compartimentos<span class="blank _1"> </span> <span class="blank _2"> </span>medio <span class="blank _2"> </span>e <span class="blank _1"> </span>i<span class="blank _1"> </span>nferior.</div><div class="t m0 x13 h6 y87 ff6 fs1 fc0 sc0 ls6 ws7">Mien<span class="blank _1"> </span>tra<span class="blank _1"> </span>s <span class="blank"> </span>q<span class="blank _1"> </span>ue <span class="blank _b"> </span>el <span class="blank"> </span>pe<span class="blank _1"> </span>lo <span class="blank _b"> </span>no <span class="blank"> </span>mi<span class="blank _1"> </span>niat<span class="blank _1"> </span>uri<span class="blank _1"> </span>zad<span class="blank _1"> </span>o <span class="blank"> </span>d<span class="blank _1"> </span>e <span class="blank"> </span>o<span class="blank _1"> </span>tra<span class="blank _1"> </span>s <span class="blank _e"> </span>regi<span class="blank _1"> </span>one<span class="blank _1"> </span>s <span class="blank"> </span>e<span class="blank _1"> </span>ra</div><div class="t m0 x13 h6 y88 ff6 fs1 fc0 sc0 ls6 ws7">comparable al sano. El aumento de </div><div class="t m1 x18 h16 y88 ffa fs9 fc0 sc0 ls6 ws7">P. acnes</div><div class="t m0 x19 h6 y88 ff6 fs1 fc0 sc0 ls6 ws7">en los folículos pilosos</div><div class="t m0 x13 h6 y89 ff6 fs1 fc0 sc0 ls6 ws7">mini<span class="blank _1"> </span>atu<span class="blank _1"> </span>riz<span class="blank _1"> </span>ados<span class="blank _1"> </span> <span class="blank _2"> </span>pued<span class="blank _1"> </span>e <span class="blank _2"> </span>est<span class="blank _1"> </span>ar <span class="blank _2"> </span>as<span class="blank _1"> </span>ocia<span class="blank _1"> </span>do <span class="blank _2"> </span>a <span class="blank _2"> </span>la<span class="blank _1"> </span> <span class="blank _2"> </span>resp<span class="blank _1"> </span>uest<span class="blank _1"> </span>a <span class="blank _2"> </span>de <span class="blank _2"> </span>ex<span class="blank _1"> </span>pre<span class="blank _1"> </span>sión</div><div class="t m0 x13 h13 y8a ff6 fs1 fc0 sc0 ls6 ws7">génica en el folículo piloso<span class="fs8 lsd v1">9</span><span class="v0">.</span></div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf3" class="pf w0 h0" data-page-no="3"><div class="pc pc3 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x0 y30 w1 hc" alt="" src="https://files.passeidireto.com/75f5f44c-f020-40b0-8bec-4e63b893e22f/bg3.png"><div class="t m0 x2 h3 y2 ff2 fs1 fc0 sc0 ls6">8</div><div class="t m0 x3 h4 y3 ff3 fs2 fc0 sc0 ls6 ws7">Dermatol V<span class="blank _0"></span>enez <span class="ff4 ls0">h</span>Vol.59 <span class="ff4 ls1">h</span>N°2 <span class="ff4 ls2">h</span><span class="ws1">2021</span></div><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls6 ws7">REVISIÓN </div><div class="t m0 x3 he y8b ff7 fs1 fc0 sc0 ls6 ws9">Clínica</div><div class="t m0 x10 h6 y8c ff6 fs1 fc0 sc0 ls6 ws7">La <span class="blank _3"></span>clínica <span class="blank _0"></span>de <span class="blank _3"></span>las m<span class="blank _0"></span>ujeres <span class="blank _3"></span>con <span class="blank _0"></span>AAF <span class="blank _3"></span>se ca<span class="blank _0"></span>racteriza <span class="blank _3"></span>una <span class="blank _3"></span>fase an<span class="blank _0"></span>ágena</div><div class="t m0 x3 h6 y8d ff6 fs1 fc0 sc0 ls6 ws7">acor<span class="blank _1"> </span>tad<span class="blank _1"> </span>a <span class="blank _2"> </span>y<span class="blank _1"> </span> <span class="blank _2"> </span>la<span class="blank _1"> </span> <span class="blank _2"> </span>min<span class="blank _1"> </span>iat<span class="blank _1"> </span>uri<span class="blank _1"> </span>zaci<span class="blank _1"> </span>ón <span class="blank _7"> </span>de <span class="blank _7"> </span>los <span class="blank _7"> </span>folí<span class="blank _1"> </span>cul<span class="blank _1"> </span>os <span class="blank _7"> </span>pilo<span class="blank _1"> </span>sos<span class="blank _1"> </span> <span class="blank _2"> </span>en<span class="blank _1"> </span> <span class="blank _2"> </span>el<span class="blank _1"> </span> <span class="blank _2"> </span>cue<span class="blank _1"> </span>ro</div><div class="t m0 x3 h6 y8e ff6 fs1 fc0 sc0 ls6 ws7">cabe<span class="blank _1"> </span>llu<span class="blank _1"> </span>do <span class="blank _8"> </span>afect<span class="blank _1"> </span>ado,<span class="blank _1"> </span> <span class="blank _4"> </span>se<span class="blank _1"> </span> <span class="blank _4"> </span>pre<span class="blank _1"> </span>sen<span class="blank _1"> </span>ta <span class="blank _8"> </span>difer<span class="blank _1"> </span>enci<span class="blank _1"> </span>as <span class="blank _8"> </span>impor<span class="blank _1"> </span>tan<span class="blank _1"> </span>tes<span class="blank _1"> </span> <span class="blank _4"> </span>con</div><div class="t m0 x3 h6 y8f ff6 fs1 fc0 sc0 ls6 ws7">respecto <span class="blank _1"> </span>a <span class="blank _2"> </span>la <span class="blank _2"> </span>alopecia <span class="blank _1"> </span>androgénica <span class="blank _2"> </span>masculina, <span class="blank _1"> </span>incluido <span class="blank _2"> </span>el <span class="blank _2"> </span>patrón <span class="blank _1"> </span>y</div><div class="t m0 x3 h17 y90 ff6 fs1 fc0 sc0 ls6 ws7">la densidad en las áreas afectadas<span class="fs8 ls9 v1">1</span><span class="fs8 ws8 v1">0,11</span><span class="v0">.</span></div><div class="t m0 x10 h6 y91 ff6 fs1 fc0 sc0 ls6 ws7">Por <span class="blank _1"> </span>lo <span class="blank _1"> </span>general, <span class="blank _1"> </span>hay <span class="blank _1"> </span>un <span class="blank _1"> </span>patrón <span class="blank _1"> </span>de <span class="blank _1"> </span>pérdida <span class="blank _1"> </span>de <span class="blank _1"> </span>pelo <span class="blank _1"> </span>en <span class="blank _1"> </span>expansión</div><div class="t m0 x3 h6 y92 ff6 fs1 fc0 sc0 ls6 ws7">centrífuga <span class="blank _2"> </span>en <span class="blank _1"> </span>la <span class="blank _2"> </span>mitad <span class="blank _2"> </span>del <span class="blank _2"> </span>cuero <span class="blank _1"> </span>cabelludo <span class="blank _2"> </span>con <span class="blank _2"> </span>preservación <span class="blank _2"> </span>de <span class="blank _1"> </span>la</div><div class="t m0 x3 h18 y93 ff6 fs1 fc0 sc0 ls6 ws7">línea frontal del cuero cabelludo (patrón de Ludwig)<span class="fs8 ls9 wsa v1">12,13</span><span class="v0">. (Figura 1) </span></div><div class="t m0 x12 h6 y94 ff6 fs1 fc0 sc0 ls6 ws7">Las <span class="blank _2"> </span>mujere<span class="blank _1"> </span>s <span class="blank _2"> </span>con <span class="blank _2"> </span>AAF <span class="blank _2"> </span>en <span class="blank _2"> </span>grados <span class="blank _2"> </span>II <span class="blank _2"> </span>y <span class="blank _2"> </span>III <span class="blank _2"> </span>presenta<span class="blank _1"> </span>n <span class="blank _2"> </span>una <span class="blank _2"> </span>serie <span class="blank _2"> </span>de</div><div class="t m0 x3 h6 y95 ff6 fs1 fc0 sc0 ls6 ws7">signos y síntomas:</div><div class="t m0 x12 h6 y96 ff6 fs1 fc0 sc0 ls6 ws7">\u2022 <span class="blank _7"> </span> <span class="blank _7"> </span>A<span class="blank _1"> </span>lop<span class="blank _1"> </span>eci<span class="blank _1"> </span>a <span class="blank _7"> </span>no<span class="blank _1"> </span> <span class="blank _7"> </span>só<span class="blank _1"> </span>lo <span class="blank _7"> </span>e<span class="blank _1"> </span>n <span class="blank _7"> </span>l<span class="blank _1"> </span>a <span class="blank _7"> </span>r<span class="blank _1"> </span>egió<span class="blank _1"> </span>n <span class="blank _7"> </span>f<span class="blank _1"> </span>ron<span class="blank _1"> </span>tove<span class="blank _1"> </span>rti<span class="blank _1"> </span>cal<span class="blank _1"> </span> <span class="blank _7"> </span>sin<span class="blank _1"> </span>o <span class="blank _7"> </span>t<span class="blank _1"> </span>amb<span class="blank _1"> </span>ién <span class="blank _7"> </span> <span class="blank _6"> </span> <span class="blank _7"> </span><span class="fc3 sc0"> </span><span class="blank _7"> </span><span class="fc3 sc0"> </span><span class="blank _7"> </span><span class="fc3 sc0"> </span><span class="blank _6"> </span><span class="fc3 sc0"> </span></div><div class="t m0 x11 h6 y97 ff6 fs1 fc0 sc0 ls6 ws7">regiones temporoparietales y supraauriculares. La AAF grave </div><div class="t m0 x1a h6 y98 ff6 fs1 fc0 sc0 ls6 ws7">a <span class="blank _f"> </span>menu<span class="blank _1"> </span>do <span class="blank _f"> </span>im<span class="blank _1"> </span>pli<span class="blank _1"> </span>ca <span class="blank _f"> </span>re<span class="blank _1"> </span>gión<span class="blank _1"> </span> <span class="blank _f"> </span>pari<span class="blank _1"> </span>eta<span class="blank _1"> </span>l <span class="blank _f"> </span>y <span class="blank _f"> </span>occi<span class="blank _1"> </span>pit<span class="blank _1"> </span>al <span class="blank _f"> </span>co<span class="blank _1"> </span>n <span class="blank _f"> </span> <span class="blank _f"> </span><span class="fc3 sc0"> </span><span class="blank _f"> </span><span class="fc3 sc0"> </span></div><div class="t m0 x1a h19 y99 ff6 fs1 fc0 sc0 ls6 ws7">adelgazamiento difuso del pelo<span class="fs8 ws8 v1">12</span><span class="v0">.</span></div><div class="t m0 x12 h6 y9a ff6 fs1 fc0 sc0 ls6 ws7">\u2022 Es frecuente encontrar alopecia difusa en otras regiones </div><div class="t m0 x1a h19 y9b ff6 fs1 fc0 sc0 ls6 ws7">pilosas como pubis, axilas y cejas<span class="fs8 ws8 v1">12</span><span class="v0">.</span></div><div class="t m0 x12 h6 y9c ff6 fs1 fc0 sc0 ls6 ws7">\u2022 <span class="blank _0"></span>La alopecia comienza <span class="blank _0"></span>a cualquier edad, <span class="blank _0"></span>suele ir precedida <span class="blank _0"></span>de </div><div class="t m0 x1a h6 y9d ff6 fs1 fc0 sc0 ls6 ws7">un <span class="blank _2"> </span>efluvi<span class="blank _1"> </span>o <span class="blank _2"> </span>telógeno<span class="blank _1"> </span> <span class="blank _2"> </span>que <span class="blank _2"> </span>puede <span class="blank _2"> </span>ser <span class="blank _2"> </span>episó<span class="blank _1"> </span>dico <span class="blank _2"> </span>o <span class="blank _2"> </span>persi<span class="blank _1"> </span>stente<span class="blank _1"> </span>. </div><div class="t m0 x1a h6 y9e ff6 fs1 fc0 sc0 ls6 ws7">Sólo<span class="blank _1"> </span> <span class="blank _2"> </span>en <span class="blank _2"> </span>ca<span class="blank _1"> </span>sos<span class="blank _1"> </span> <span class="blank _2"> </span>muy <span class="blank _2"> </span>a<span class="blank _1"> </span>van<span class="blank _1"> </span>zado<span class="blank _1"> </span>s <span class="blank _2"> </span>de<span class="blank _1"> </span> <span class="blank _2"> </span>AAF <span class="blank _2"> </span>pu<span class="blank _1"> </span>ede<span class="blank _1"> </span>n <span class="blank _2"> </span>enc<span class="blank _1"> </span>ont<span class="blank _1"> </span>rar<span class="blank _1"> </span>se </div><div class="t m0 x1a h6 y9f ff6 fs1 fc0 sc0 ls6 ws7">signos de <span class="blank _0"></span>virilización. Las AAF <span class="blank _3"></span>tipo Olsen no suelen <span class="blank _0"></span>presentar </div><div class="t m0 x1a h1a ya0 ff6 fs1 fc0 sc0 ls6 ws3">virilización<span class="fs8 ws8 v1">13</span>.</div><div class="t m0 x12 h6 ya1 ff6 fs1 fc0 sc0 ls6 ws7">\u2022 <span class="blank _3"></span>Un porcentaje elevado de <span class="blank _0"></span>mujeres nota importante <span class="blank _3"></span>seborrea </div><div class="t m0 x1a h1a ya2 ff6 fs1 fc0 sc0 ls6 ws7">en cuero cabelludo, hormigueo, prurito y sensación urente<span class="fs8 ws8 v1">13</span>.</div><div class="t m0 xf h6 ya3 ff6 fs1 fc0 sc0 ls6 ws7">Con <span class="blank _7"> </span>ma<span class="blank _1"> </span>yor<span class="blank _1"> </span> <span class="blank _2"> </span>f<span class="blank _1"> </span>rec<span class="blank _1"> </span>uen<span class="blank _1"> </span>cia <span class="blank _7"> </span>se<span class="blank _1"> </span> <span class="blank _2"> </span>m<span class="blank _1"> </span>ues<span class="blank _1"> </span>tra<span class="blank _1"> </span> <span class="blank _2"> </span>u<span class="blank _1"> </span>na <span class="blank _7"> </span>ac<span class="blank _1"> </span>entu<span class="blank _1"> </span>aci<span class="blank _1"> </span>ón <span class="blank _7"> </span>fr<span class="blank _1"> </span>onta<span class="blank _1"> </span>l <span class="blank _7"> </span>o</div><div class="t m0 x3 h1a ya4 ff6 fs1 fc0 sc0 ls6 ws7">patrón de "árbol de Navidad" (Patrón de Olsen)<span class="fs8 lse wsb v1">11,14</span>. (Figura 2)</div><div class="t m0 x1b h6 ya5 ff6 fs1 fc0 sc0 ls6 ws7">El <span class="blank _2"> </span>ú<span class="blank _1"> </span>lti<span class="blank _1"> </span>mo <span class="blank _7"> </span>patr<span class="blank _1"> </span>ón <span class="blank _7"> </span>ayud<span class="blank _1"> </span>a <span class="blank _2"> </span>a<span class="blank _1"> </span> <span class="blank _2"> </span>dis<span class="blank _1"> </span>tin<span class="blank _1"> </span>gui<span class="blank _1"> </span>r <span class="blank _2"> </span>de<span class="blank _1"> </span> <span class="blank _2"> </span>ot<span class="blank _1"> </span>ras<span class="blank _1"> </span> <span class="blank _2"> </span>con<span class="blank _1"> </span>dic<span class="blank _1"> </span>ion<span class="blank _1"> </span>es <span class="blank _7"> </span>de</div><div class="t m0 x13 h6 ya6 ff6 fs1 fc0 sc0 ls6 ws7">pérdida de pelo, Hamilton <span class="blank _1"> </span>coincidió en que <span class="blank _1"> </span>las mujeres con <span class="blank _1"> </span>patrón</div><div class="t m0 x13 h6 ya7 ff6 fs1 fc0 sc0 ls6 ws7">de <span class="blank _3"></span>pérdid<span class="blank _0"></span>a <span class="blank _3"></span>de <span class="blank _0"></span>pelo<span class="blank _0"></span> <span class="blank _3"></span>generalm<span class="blank _0"></span>ente<span class="blank _0"></span> <span class="blank _3"></span>no d<span class="blank _0"></span>esar<span class="blank _0"></span>rolla<span class="blank _0"></span>n <span class="blank _3"></span>la <span class="blank _3"></span>calvicie<span class="blank _0"></span> <span class="blank _3"></span>de v<span class="blank _0"></span>érti<span class="blank _0"></span>ce</div><div class="t m0 x13 h6 ya8 ff6 fs1 fc0 sc0 ls6 ws7">que <span class="blank _2"> </span>se<span class="blank _1"> </span> <span class="blank _2"> </span>obse<span class="blank _1"> </span>rva <span class="blank _2"> </span>en<span class="blank _1"> </span> <span class="blank _2"> </span>los <span class="blank _2"> </span>ho<span class="blank _1"> </span>mbre<span class="blank _1"> </span>s, <span class="blank _2"> </span>pe<span class="blank _1"> </span>ro <span class="blank _2"> </span>pu<span class="blank _1"> </span>eden<span class="blank _1"> </span> <span class="blank _2"> </span>tene<span class="blank _1"> </span>r <span class="blank _2"> </span>una <span class="blank _2"> </span>re<span class="blank _1"> </span>ces<span class="blank _1"> </span>ión</div><div class="t m0 x13 h6 ya9 ff6 fs1 fc0 sc0 ls6 ws7">bitemporal; <span class="blank _1"> </span>esta <span class="blank _1"> </span>recesión <span class="blank _1"> </span>no <span class="blank _1"> </span>suele <span class="blank _2"> </span>ser la <span class="blank _2"> </span>calvicie, sino <span class="blank _1"> </span>un <span class="blank _2"> </span>pelo más</div><div class="t m0 x13 h1b yaa ff6 fs1 fc0 sc0 ls6 ws7">delgado, más corto y menos denso<span class="fs8 ws8 v1">10,11,14</span><span class="v0">. (Figura 3) </span></div><div class="t m0 x1c h1c yab ffb fs7 fc1 sc0 lsf ws7">Figura 1<span class="ff3">.<span class="blank _0"></span> Escala de densidad del pelo en la línea media de Ludwig.<span class="blank _3"></span></span></div><div class="t m0 x1d h1c yac ffb fs7 fc2 sc0 ls6 ws7">Grado 1: <span class="ff3">adelgazamiento perceptible del pelo en la corona con presrvacion de la linea</span></div><div class="t m0 x1d h1c yad ff3 fs7 fc2 sc0 ls6 ws7">frontal del pelo.</div><div class="t m0 x1d h1c yae ffb fs7 fc2 sc0 ls6 ws7">Grado 2: <span class="ff3">pronunciado adelgazamiento del pelo en la corona.</span></div><div class="t m0 x1d h1c yaf ffb fs7 fc2 sc0 ls6 ws7">Grado 1: <span class="ff3">calvicie total del pelo en la corona </span></div><div class="t m0 x1e h1c yb0 ffb fs7 fc1 sc0 lsf ws7">Figura 2<span class="ff3">.<span class="blank _0"></span> Patrón de árbol de Navidad en alopecia androgénica.<span class="blank _3"></span></span></div><div class="t m0 x1f h1c yb1 ffb fs7 fc1 sc0 lsf ws7">Figura 3<span class="ff3">.<span class="blank _0"></span> Patrón de Hamilton en la alopecia androgénica.<span class="blank _3"></span></span></div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf4" class="pf w0 h0" data-page-no="4"><div class="pc pc4 w0 h0"><img fetchpriority="low" loading="lazy" class="bi xc y30 w2 hc" alt="" src="https://files.passeidireto.com/75f5f44c-f020-40b0-8bec-4e63b893e22f/bg4.png"><div class="t m0 xe h3 y2 ff2 fs1 fc0 sc0 ls6">9</div><div class="t m0 x1 h4 y3 ff3 fs2 fc0 sc0 ls6 ws7">Dermatol V<span class="blank _0"></span>enez <span class="ff4 ls0">h</span>Vol.59 <span class="ff4 ls1">h</span>N°2 <span class="ff4 ls2">h</span><span class="ws1">2021</span></div><div class="t m0 xd h2 y1 ff1 fs0 fc0 sc0 ls6 ws7">REVISIÓN </div><div class="t m0 x12 h6 yb2 ff6 fs1 fc0 sc0 ls6 ws7">Segú<span class="blank _1"> </span>n <span class="blank _2"> </span>un <span class="blank _2"> </span>est<span class="blank _1"> </span>udi<span class="blank _1"> </span>o, <span class="blank _2"> </span>las<span class="blank _1"> </span> <span class="blank _2"> </span>mujer<span class="blank _1"> </span>es <span class="blank _2"> </span>con<span class="blank _1"> </span> <span class="blank _2"> </span>patró<span class="blank _1"> </span>n <span class="blank _2"> </span>de <span class="blank _2"> </span>Lud<span class="blank _1"> </span>wig <span class="blank _2"> </span>pu<span class="blank _1"> </span>eden</div><div class="t m0 x3 h6 yb3 ff6 fs1 fc0 sc0 ls6 ws7">desarrollar <span class="blank _2"> </span>un <span class="blank _2"> </span>patrón <span class="blank _2"> </span>de <span class="blank _1"> </span>Hami<span class="blank _1"> </span>lton <span class="blank _2"> </span>después <span class="blank _2"> </span>de <span class="blank _1"> </span>la<span class="blank _1"> </span> <span class="blank _2"> </span>menopausia. <span class="blank _2"> </span>Sin</div><div class="t m0 x3 h6 yb4 ff6 fs1 fc0 sc0 ls6 ws7">embargo, <span class="blank _2"> </span>en <span class="blank _2"> </span>algunas <span class="blank _2"> </span>mujeres<span class="blank _1"> </span>, <span class="blank _2"> </span>el <span class="blank _1"> </span>a<span class="blank _1"> </span>delgazamie<span class="blank _1"> </span>nto <span class="blank _2"> </span>del <span class="blank _2"> </span>pelo <span class="blank _2"> </span>es <span class="blank _1"> </span>m<span class="blank _1"> </span>ás</div><div class="t m0 x3 h6 yb5 ff6 fs1 fc0 sc0 ls6 ws7">difuso e <span class="blank _1"> </span>involucra <span class="blank _1"> </span>las áreas <span class="blank _1"> </span>parietal y <span class="blank _1"> </span>occipital <span class="blank _1"> </span>del cuero <span class="blank _1"> </span>cabelludo,</div><div class="t m0 x3 h13 yb6 ff6 fs1 fc0 sc0 ls6 ws7">con un patrón de alopecia difusa<span class="fs8 ws8 v1">15</span><span class="v0">.</span></div><div class="t m0 x1c h6 yb7 ff6 fs1 fc0 sc0 ls6 ws7">La <span class="blank _2"> </span>c<span class="blank _1"> </span>lasi<span class="blank _1"> </span>fic<span class="blank _1"> </span>aci<span class="blank _1"> </span>ón <span class="blank _2"> </span>d<span class="blank _1"> </span>el <span class="blank _2"> </span>D<span class="blank _1"> </span>octo<span class="blank _1"> </span>r <span class="blank _2"> </span>Si<span class="blank _1"> </span>ncl<span class="blank _1"> </span>air<span class="blank _1"> </span> <span class="blank _2"> </span>(Co<span class="blank _1"> </span>lli<span class="blank _1"> </span>ns <span class="blank _2"> </span>y<span class="blank _1"> </span> <span class="blank _2"> </span>col<span class="blank _1"> </span>. <span class="blank _2"> </span>20<span class="blank _1"> </span>06; <span class="blank _7"> </span>Yip <span class="blank _2"> </span>y</div><div class="t m0 x3 h17 yb8 ff6 fs1 fc0 sc0 ls6 ws7">Sinclair, 2006)<span class="fs8 ls9 v1">1</span><span class="fs8 ws8 v1">6,17</span><span class="v0">. (Figura 4)</span></div><div class="t m0 x3 h5 yb9 ff5 fs3 fc0 sc0 ls6 ws2">Diagnóstico</div><div class="t m0 x12 h6 yba ff6 fs1 fc0 sc0 ls6 ws7">El diagnóstico de AAF generalmente <span class="blank _1"> </span>se realiza por la clínica <span class="blank _1"> </span>del</div><div class="t m0 x3 h6 ybb ff6 fs1 fc0 sc0 ls6 ws7">paciente. <span class="blank _3"></span>Se <span class="blank _3"></span>recomienda <span class="blank _0"></span>una <span class="blank _3"></span>biopsia <span class="blank _3"></span>del cuero<span class="blank _0"></span> <span class="blank _0"></span>cabelludo <span class="blank _3"></span>para <span class="blank _3"></span>casos</div><div class="t m0 x3 h6 ybc ff6 fs1 fc0 sc0 ls6 ws7">de <span class="blank _1"> </span>diagnóstico <span class="blank _1"> </span>incierto, <span class="blank _1"> </span>pero <span class="blank _1"> </span>también <span class="blank _1"> </span>para <span class="blank _1"> </span>pacientes <span class="blank _1"> </span>muy <span class="blank _1"> </span>jóvenes,</div><div class="t m0 x3 h6 ybd ff6 fs1 fc0 sc0 ls6 ws7">paci<span class="blank _1"> </span>ent<span class="blank _1"> </span>es <span class="blank"> </span>con <span class="blank _9"> </span>AAF<span class="blank _1"> </span> <span class="blank _9"> </span>dif<span class="blank _1"> </span>usa<span class="blank _1"> </span> <span class="blank _9"> </span>y <span class="blank _9"> </span>aq<span class="blank _1"> </span>uell<span class="blank _1"> </span>os <span class="blank"> </span>que <span class="blank _9"> </span>tie<span class="blank _1"> </span>nen<span class="blank _1"> </span> <span class="blank _9"> </span>car<span class="blank _1"> </span>act<span class="blank _1"> </span>erís<span class="blank _1"> </span>tic<span class="blank _1"> </span>as</div><div class="t m0 x3 h6 ybe ff6 fs1 fc0 sc0 ls6 ws7">clínicas <span class="blank _1"> </span>sospechosas <span class="blank _2"> </span>de <span class="blank _1"> </span>las <span class="blank _2"> </span>formas <span class="blank _1"> </span>cicatriciales. <span class="blank _2"> </span>Dado <span class="blank _1"> </span>que <span class="blank _2"> </span>el <span class="blank _1"> </span>cuero</div><div class="t m0 x3 h6 ybf ff6 fs1 fc0 sc0 ls6 ws7">cabellu<span class="blank _1"> </span>do <span class="blank _2"> </span>occipit<span class="blank _1"> </span>al <span class="blank _2"> </span>no <span class="blank _2"> </span>está <span class="blank _2"> </span>bajo <span class="blank _2"> </span>contro<span class="blank _1"> </span>l <span class="blank _2"> </span>de <span class="blank _2"> </span>andrógeno<span class="blank _1"> </span>s <span class="blank _2"> </span>y <span class="blank _2"> </span>no <span class="blank _1"> </span>e<span class="blank _1"> </span>stá</div><div class="t m0 x3 h6 yc0 ff6 fs1 fc0 sc0 ls6 ws7">involucrado en AAF, la mejor <span class="blank _1"> </span>manera de evaluar el adelgazamiento</div><div class="t m0 x3 h6 yc1 ff6 fs1 fc0 sc0 ls6 ws7">del pelo <span class="blank _1"> </span>es separándolo <span class="blank _1"> </span>verticalmente, tanto <span class="blank _1"> </span>en <span class="blank _1"> </span>el cuero <span class="blank _1"> </span>cabelludo</div><div class="t m0 x3 hd yc2 ff6 fs1 fc0 sc0 ls6 ws7">central como occipital, y comparando estas dos áreas<span class="fs8 ls9 wsa v1">10,18</span><span class="v0">.</span></div><div class="t m0 x3 he yc3 ff7 fs1 fc0 sc0 ls6 ws7">Anamnesis: </div><div class="t m0 x10 h6 yc4 ff6 fs1 fc0 sc0 ls6 ws7">Es preciso una anamnesis detallada que recoja la edad de inicio,</div><div class="t m0 x3 h6 yc5 ff6 fs1 fc0 sc0 ls6 ws7">la <span class="blank _b"> </span>d<span class="blank _1"> </span>ura<span class="blank _1"> </span>ció<span class="blank _1"> </span>n <span class="blank _b"> </span>y <span class="blank _a"> </span>la <span class="blank _a"> </span>pro<span class="blank _1"> </span>gres<span class="blank _1"> </span>ión<span class="blank _1"> </span> <span class="blank _b"> </span>de<span class="blank _1"> </span> <span class="blank _b"> </span>la<span class="blank _1"> </span> <span class="blank _b"> </span>pér<span class="blank _1"> </span>did<span class="blank _1"> </span>a <span class="blank _b"> </span>d<span class="blank _1"> </span>e <span class="blank _b"> </span>p<span class="blank _1"> </span>elo,<span class="blank _1"> </span> <span class="blank _b"> </span>po<span class="blank _1"> </span>sib<span class="blank _1"> </span>les</div><div class="t m0 x3 h6 yc6 ff6 fs1 fc0 sc0 ls6 ws7">ante<span class="blank _1"> </span>ced<span class="blank _1"> </span>ent<span class="blank _1"> </span>es <span class="blank _8"> </span>fam<span class="blank _1"> </span>ili<span class="blank _1"> </span>are<span class="blank _1"> </span>s, <span class="blank _8"> </span>en<span class="blank _1"> </span> <span class="blank _8"> </span>mucho<span class="blank _1"> </span>s <span class="blank _8"> </span>cas<span class="blank _1"> </span>os,<span class="blank _1"> </span> <span class="blank _8"> </span>los <span class="blank _8"> </span>ant<span class="blank _1"> </span>ece<span class="blank _1"> </span>den<span class="blank _1"> </span>tes</div><div class="t m0 x3 h6 yc7 ff6 fs1 fc0 sc0 ls6 ws7">famil<span class="blank _0"></span>iare<span class="blank _0"></span>s <span class="blank _3"></span>tienen <span class="blank _3"></span>una <span class="blank _3"></span>respue<span class="blank _0"></span>sta <span class="blank _3"></span>posit<span class="blank _0"></span>iva; <span class="blank _3"></span>si <span class="blank _3"></span>es <span class="blank _3"></span>negativa<span class="blank _0"></span>, <span class="blank _3"></span>AFF <span class="blank _3"></span>no p<span class="blank _0"></span>uede</div><div class="t m0 x3 h1d yc8 ff6 fs1 fc0 sc0 ls6 ws3">excluirse<span class="fs8 ws8 v1">18</span><span class="v0">.</span></div><div class="t m0 xf h6 yc9 ff6 fs1 fc0 sc0 ls6 ws7">Las <span class="blank _10"> </span>paci<span class="blank _1"> </span>ent<span class="blank _1"> </span>es <span class="blank _10"> </span>debe<span class="blank _1"> </span>n <span class="blank _10"> </span>ser <span class="blank _10"> </span>inves<span class="blank _1"> </span>tiga<span class="blank _1"> </span>das<span class="blank _1"> </span> <span class="blank _10"> </span>por <span class="blank _10"> </span>menarq<span class="blank _1"> </span>uia,</div><div class="t m0 x3 h6 yca ff6 fs1 fc0 sc0 ls6 ws7">irreg<span class="blank _0"></span>ulari<span class="blank _0"></span>dades<span class="blank _0"></span> <span class="blank _3"></span>menstrual<span class="blank _0"></span>es, <span class="blank _3"></span>menopa<span class="blank _0"></span>usia,<span class="blank _0"></span> <span class="blank _0"></span>amen<span class="blank _0"></span>orrea<span class="blank _0"></span>, <span class="blank _3"></span>dificult<span class="blank _0"></span>ad <span class="blank _3"></span>para</div><div class="t m0 x3 h6 ycb ff6 fs1 fc0 sc0 ls6 ws7">concebir, signos <span class="blank _1"> </span>de virilización <span class="blank _1"> </span>(hirsutismo, <span class="blank _1"> </span>voz grave, <span class="blank _1"> </span>aumento del</div><div class="t m0 x3 h6 ycc ff6 fs1 fc0 sc0 ls6 ws7">clítoris) <span class="blank _1"> </span>y <span class="blank _2"> </span>acné. <span class="blank _2"> </span>Se <span class="blank _1"> </span>debe <span class="blank _2"> </span>prestar <span class="blank _1"> </span>más <span class="blank _2"> </span>atención <span class="blank _2"> </span>a <span class="blank _1"> </span>los <span class="blank _2"> </span>medicamentos</div><div class="t m0 x3 h6 ycd ff6 fs1 fc0 sc0 ls6 ws7">que <span class="blank _a"> </span>pu<span class="blank _1"> </span>ede<span class="blank _1"> </span>n <span class="blank _a"> </span>ind<span class="blank _1"> </span>ucir<span class="blank _1"> </span> <span class="blank _b"> </span>h<span class="blank _1"> </span>ipe<span class="blank _1"> </span>ran<span class="blank _1"> </span>drog<span class="blank _1"> </span>eni<span class="blank _1"> </span>smo<span class="blank _1"> </span>, <span class="blank _a"> </span>como<span class="blank _1"> </span> <span class="blank _b"> </span>l<span class="blank _1"> </span>os <span class="blank _a"> </span>es<span class="blank _1"> </span>ter<span class="blank _1"> </span>oid<span class="blank _1"> </span>es</div><div class="t m0 x13 h6 yce ff6 fs1 fc0 sc0 ls6 ws7">anab<span class="blank _1"> </span>oli<span class="blank _1"> </span>zan<span class="blank _1"> </span>tes <span class="blank _a"> </span>and<span class="blank _1"> </span>rogé<span class="blank _1"> </span>nic<span class="blank _1"> </span>os,<span class="blank _1"> </span> <span class="blank _b"> </span>los<span class="blank _1"> </span> <span class="blank _b"> </span>pro<span class="blank _1"> </span>and<span class="blank _1"> </span>róg<span class="blank _1"> </span>enos<span class="blank _1"> </span> <span class="blank _b"> </span>si<span class="blank _1"> </span>ntét<span class="blank _1"> </span>ico<span class="blank _1"> </span>s, <span class="blank _b"> </span>l<span class="blank _1"> </span>as</div><div class="t m0 x13 h6 ycf ff6 fs1 fc0 sc0 ls6 ws7">progestinas <span class="blank _2"> </span>y <span class="blank _1"> </span>los <span class="blank _2"> </span>antiepilépticos. <span class="blank _2"> </span>Se <span class="blank _2"> </span>deben <span class="blank _1"> </span>excluir <span class="blank _2"> </span>otras <span class="blank _2"> </span>causas <span class="blank _2"> </span>de</div><div class="t m0 x13 h6 yd0 ff6 fs1 fc0 sc0 ls6 ws7">pérdida <span class="blank _3"></span>de pelo, <span class="blank _3"></span>como <span class="blank _3"></span>deficiencias de <span class="blank _3"></span>hierro, <span class="blank _3"></span>disfunciones <span class="blank _0"></span>tiroideas,</div><div class="t m0 x13 h6 yd1 ff6 fs1 fc0 sc0 ls6 ws7">tratamiento médico, infecciones, dieta<span class="blank _0"></span> deficiente y pérdida <span class="blank _0"></span>de peso</div><div class="t m0 x13 h15 yd2 ff6 fs1 fc0 sc0 ls6 ws3">rápida<span class="fs8 ws8 v1">10,18</span><span class="v0">.</span></div><div class="t m0 x13 he yb8 ff7 fs1 fc0 sc0 ls6 ws7">Examen físico:</div><div class="t m0 x20 h6 yd3 ff6 fs1 fc0 sc0 ls6 ws7">Es <span class="blank _1"> </span>útil <span class="blank _2"> </span>realizar <span class="blank _1"> </span>un <span class="blank _2"> </span>examen <span class="blank _1"> </span>clínico <span class="blank _2"> </span>completo <span class="blank _1"> </span>para <span class="blank _2"> </span>encontrar <span class="blank _1"> </span>otros</div><div class="t m0 x13 h6 yd4 ff6 fs1 fc0 sc0 ls6 ws7">sign<span class="blank _1"> </span>os <span class="blank _d"> </span>de<span class="blank _1"> </span> <span class="blank _6"> </span>hi<span class="blank _1"> </span>per<span class="blank _1"> </span>andr<span class="blank _1"> </span>oge<span class="blank _1"> </span>nis<span class="blank _1"> </span>mo,<span class="blank _1"> </span> <span class="blank _6"> </span>co<span class="blank _1"> </span>mo <span class="blank _d"> </span>el <span class="blank _d"> </span>ac<span class="blank _1"> </span>né <span class="blank _d"> </span>y <span class="blank _d"> </span>el <span class="blank _d"> </span>hir<span class="blank _1"> </span>suti<span class="blank _1"> </span>smo<span class="blank _1"> </span>. <span class="blank _d"> </span>El</div><div class="t m0 x13 h6 yd5 ff6 fs1 fc0 sc0 ls6 ws7">hirsut<span class="blank _0"></span>ismo <span class="blank _3"></span>debe <span class="blank _3"></span>evaluarse <span class="blank _3"></span>en <span class="blank _3"></span>lugares <span class="blank _3"></span>donde <span class="blank _3"></span>típicament<span class="blank _0"></span>e <span class="blank _3"></span>las <span class="blank _0"></span>mujeres</div><div class="t m0 x13 h6 yd6 ff6 fs1 fc0 sc0 ls6 ws7">no <span class="blank _2"> </span>des<span class="blank _1"> </span>arro<span class="blank _1"> </span>lla<span class="blank _1"> </span>n <span class="blank _2"> </span>vell<span class="blank _1"> </span>o <span class="blank _2"> </span>term<span class="blank _1"> </span>ina<span class="blank _1"> </span>l <span class="blank _2"> </span>(car<span class="blank _1"> </span>a, <span class="blank _2"> </span>abd<span class="blank _1"> </span>omen<span class="blank _1"> </span>, <span class="blank _2"> </span>espa<span class="blank _1"> </span>lda<span class="blank _1"> </span> <span class="blank _2"> </span>y <span class="blank _2"> </span>pecho)<span class="blank _1"> </span> <span class="blank _2"> </span>y</div><div class="t m0 x13 h1e yd7 ff6 fs1 fc0 sc0 ls6 ws7">estimarse con la escala Ferryman-Gallwey<span class="fs8 ws8 v1">10</span><span class="v0">. </span></div><div class="t m0 x21 h6 ybd ff6 fs1 fc0 sc0 ls6 ws7">La <span class="blank _3"></span>escal<span class="blank _0"></span>a <span class="blank _3"></span>de <span class="blank _0"></span>Fer<span class="blank _0"></span>rima<span class="blank _0"></span>n-Ga<span class="blank _0"></span>llwe<span class="blank _3"></span>y mo<span class="blank _0"></span>difi<span class="blank _0"></span>cad<span class="blank _0"></span>a <span class="blank _3"></span>evalúa<span class="blank _0"></span> <span class="blank _3"></span>nueve <span class="blank _3"></span>segmen<span class="blank _0"></span>tos</div><div class="t m0 x13 h6 ybe ff6 fs1 fc0 sc0 ls6 ws7">corp<span class="blank _1"> </span>ora<span class="blank _1"> </span>les<span class="blank _1"> </span> <span class="blank"> </span>(labi<span class="blank _1"> </span>o <span class="blank"> </span>supe<span class="blank _1"> </span>rio<span class="blank _1"> </span>r, <span class="blank"> </span>men<span class="blank _1"> </span>tón<span class="blank _1"> </span>, <span class="blank"> </span>braz<span class="blank _1"> </span>os, <span class="blank"> </span>ab<span class="blank _1"> </span>dom<span class="blank _1"> </span>en <span class="blank"> </span>sup<span class="blank _1"> </span>erio<span class="blank _1"> </span>r,</div><div class="t m0 x13 h6 ybf ff6 fs1 fc0 sc0 ls6 ws7">abdomen <span class="blank _1"> </span>inferior, <span class="blank _1"> </span>región <span class="blank _1"> </span>superior <span class="blank _1"> </span>de <span class="blank _2"> </span>la espalda, <span class="blank _1"> </span>región <span class="blank _2"> </span>inferior de</div><div class="t m0 x13 h6 yc0 ff6 fs1 fc0 sc0 ls6 ws7">la <span class="blank _d"> </span>esp<span class="blank _1"> </span>ald<span class="blank _1"> </span>a <span class="blank _d"> </span>y <span class="blank _d"> </span>musl<span class="blank _1"> </span>os)<span class="blank _1"> </span> <span class="blank _6"> </span>e<span class="blank _1"> </span>n <span class="blank _d"> </span>las <span class="blank _d"> </span>qu<span class="blank _1"> </span>e <span class="blank _d"> </span>se <span class="blank _d"> </span>va<span class="blank _1"> </span>lora<span class="blank _1"> </span> <span class="blank _6"> </span>l<span class="blank _1"> </span>a <span class="blank _d"> </span>pre<span class="blank _1"> </span>senc<span class="blank _1"> </span>ia <span class="blank _d"> </span>de<span class="blank _1"> </span> <span class="blank _6"> </span>p<span class="blank _1"> </span>elo</div><div class="t m0 x13 h6 yc1 ff6 fs1 fc0 sc0 ls6 ws7">term<span class="blank _1"> </span>ina<span class="blank _1"> </span>l <span class="blank _d"> </span>s<span class="blank _1"> </span>egún<span class="blank _1"> </span> <span class="blank _d"> </span>la<span class="blank _1"> </span> <span class="blank _d"> </span>si<span class="blank _1"> </span>gui<span class="blank _1"> </span>ente<span class="blank _1"> </span> <span class="blank _d"> </span>es<span class="blank _1"> </span>cal<span class="blank _1"> </span>a: <span class="blank _d"> </span>0<span class="blank _1"> </span> <span class="blank _d"> </span>pu<span class="blank _1"> </span>nto<span class="blank _1"> </span>s <span class="blank _d"> </span>(a<span class="blank _1"> </span>use<span class="blank _1"> </span>nci<span class="blank _1"> </span>a <span class="blank _d"> </span>de<span class="blank _1"> </span> <span class="blank _d"> </span>pe<span class="blank _1"> </span>lo</div><div class="t m0 x13 h6 yc2 ff6 fs1 fc0 sc0 ls6 ws7">terminal<span class="blank _0"></span>), <span class="blank _3"></span>1 pu<span class="blank _0"></span>nto <span class="blank _3"></span>(presencia <span class="blank _3"></span>mínima),<span class="blank _0"></span> <span class="blank _3"></span>2 punt<span class="blank _0"></span>os <span class="blank _3"></span>(mayor <span class="blank _3"></span>a lo <span class="blank _3"></span>habitual<span class="blank _0"></span>,</div><div class="t m0 x13 h6 yd8 ff6 fs1 fc0 sc0 ls6 ws7">pero <span class="blank _0"></span>menor <span class="blank _3"></span>que en <span class="blank _3"></span>varones), 3 <span class="blank _3"></span>puntos (similar <span class="blank _3"></span>a <span class="blank _0"></span>un <span class="blank _0"></span>varón), <span class="blank _3"></span>4 puntos</div><div class="t m0 x13 hd yd9 ff6 fs1 fc0 sc0 ls6 ws7">(mayor a lo habitual para un varón)<span class="fs8 ws8 v1">19</span><span class="v0">.</span></div><div class="t m0 x20 h6 yda ff6 fs1 fc0 sc0 ls6 ws7">La <span class="blank _2"> </span>altera<span class="blank _1"> </span>ción <span class="blank _2"> </span>de <span class="blank _2"> </span>la <span class="blank _2"> </span>ferti<span class="blank _1"> </span>lidad<span class="blank _1"> </span>, <span class="blank _2"> </span>las <span class="blank _2"> </span>irregu<span class="blank _1"> </span>larid<span class="blank _1"> </span>ades <span class="blank _2"> </span>mens<span class="blank _1"> </span>trual<span class="blank _1"> </span>es, <span class="blank _2"> </span>la</div><div class="t m0 x13 h6 ydb ff6 fs1 fc0 sc0 ls6 ws7">amenorrea, <span class="blank _1"> </span>la <span class="blank _2"> </span>hipertricosis, <span class="blank _2"> </span>la <span class="blank _1"> </span>hiperseborrea, <span class="blank _2"> </span>la <span class="blank _1"> </span>obesidad <span class="blank _2"> </span>y <span class="blank _1"> </span>el <span class="blank _2"> </span>acné</div><div class="t m0 x13 h13 ydc ff6 fs1 fc0 sc0 ls6 ws7">severo pueden ser indicativos de ovario poliquístico<span class="fs8 ws8 v1">10</span><span class="v0">.</span></div><div class="t m0 x13 he ydd ff7 fs1 fc0 sc0 ls6 ws7">Examen del cuero cabelludo:</div><div class="t m0 x21 h6 yde ff6 fs1 fc0 sc0 ls6 ws7">Dife<span class="blank _0"></span>ren<span class="blank _0"></span>tes <span class="blank _3"></span>mani<span class="blank _0"></span>obr<span class="blank _0"></span>as <span class="blank _3"></span>aport<span class="blank _0"></span>an <span class="blank _3"></span>infor<span class="blank _0"></span>mac<span class="blank _0"></span>ión <span class="blank _3"></span>sobr<span class="blank _0"></span>e <span class="blank _3"></span>la <span class="blank _3"></span>situaci<span class="blank _0"></span>ón <span class="blank _3"></span>clín<span class="blank _0"></span>ica</div><div class="t m0 x13 h6 ydf ff6 fs1 fc0 sc0 ls6 ws7">del pelo, en las cuales, son las siguientes: </div><div class="t m0 x20 h6 ye0 ff6 fs1 fc0 sc0 ls6 ws7">\u2022 <span class="blank _0"></span> <span class="blank _0"></span>Inspección <span class="blank _3"></span>para evaluar <span class="blank _3"></span>las características <span class="blank _3"></span>macroscópicas: color, </div><div class="t m0 x14 h6 ye1 ff6 fs1 fc0 sc0 ls6 ws7">bril<span class="blank _1"> </span>lo,<span class="blank _1"> </span> <span class="blank"> </span>d<span class="blank _1"> </span>ens<span class="blank _1"> </span>ida<span class="blank _1"> </span>d, <span class="blank _e"> </span>lo<span class="blank _1"> </span>ngi<span class="blank _1"> </span>tud <span class="blank _e"> </span>y<span class="blank _1"> </span> <span class="blank"> </span>f<span class="blank _1"> </span>orm<span class="blank _1"> </span>a <span class="blank _e"> </span>(li<span class="blank _1"> </span>so,<span class="blank _1"> </span> <span class="blank"> </span>r<span class="blank _1"> </span>iza<span class="blank _1"> </span>do,<span class="blank _1"> </span> <span class="blank"> </span>o<span class="blank _1"> </span>ndu<span class="blank _1"> </span>lado<span class="blank _1"> </span>). </div><div class="t m0 x22 h1f ye2 ffb fs7 fc1 sc0 lsf">F<span class="ws7 v0">igura 4<span class="ff3">.<span class="blank _0"></span> Escala Sinclair para la pérdida de pelo de patrón femenino.<span class="blank _3"></span></span></span></div><div class="t m0 x10 h1c ye3 ffb fs7 fc2 sc0 ls10 ws7">Grado <span class="blank _1"> </span>1: <span class="blank _1"> </span><span class="ff3">en <span class="blank _2"> </span>niñas <span class="blank _1"> </span>antes<span class="blank _3"></span></span></div><div class="t m0 x10 h1c ye4 ff3 fs7 fc2 sc0 lsf ws7">de <span class="blank _1"> </span>la <span class="blank _1"> </span>pubertad <span class="blank _1"> </span>y <span class="blank _1"> </span>en <span class="blank _2"> </span>45%<span class="blank _3"></span></div><div class="t m0 x10 h1f ye5 ff3 fs7 fc2 sc0 ls11">d<span class="ws7 v0">e <span class="blank _2"> </span>las <span class="blank _2"> </span>mujeres <span class="blank _7"> </span>mayores<span class="blank _3"></span></span></div><div class="t m0 x10 h1f ye6 ff3 fs7 fc2 sc0 lsf">d<span class="ws7 v0">e 80 años.<span class="blank _0"></span> <span class="blank _3"></span></span></div><div class="t m0 x23 h1c ye7 ffb fs7 fc2 sc0 ls11 ws7">Grado <span class="blank _7"> </span>2: <span class="blank _7"> </span><span class="ff3">ampliación <span class="blank _7"> </span>en <span class="blank _7"> </span>la<span class="blank _3"></span></span></div><div class="t m0 x23 h1c ye8 ff3 fs7 fc2 sc0 ls11 ws7">parte <span class="blank _11"> </span>central <span class="blank _11"> </span>(región<span class="blank _3"></span></div><div class="t m0 x23 h1f ye9 ff3 fs7 fc2 sc0 lsf">i<span class="wsc v0">nterparietal)<span class="blank _3"></span></span></div><div class="t m0 x24 h1c yea ffb fs7 fc2 sc0 ls11 ws7">Grado <span class="blank _7"> </span>3: <span class="blank _7"> </span><span class="ff3">ampliación <span class="blank _7"> </span>en<span class="blank _0"></span></span></div><div class="t m0 x24 h1c yeb ff3 fs7 fc2 sc0 ls11 ws7">la <span class="blank _12"> </span>parte <span class="blank _12"> </span>central <span class="blank _12"> </span>y<span class="blank _3"></span></div><div class="t m0 x24 h1f yec ff3 fs7 fc2 sc0 lsf">a<span class="ws7 v0">delgazamiento del pelo.<span class="blank _3"></span></span></div><div class="t m0 x25 h1c yed ffb fs7 fc2 sc0 lsf ws7">Grado <span class="blank _1"> </span>4: <span class="blank _1"> </span><span class="ff3">alopecia <span class="blank _2"> </span>difusa<span class="blank _3"></span></span></div><div class="t m0 x25 h1c yee ff3 fs7 fc2 sc0 lsf ws7">en la parte alta de la piel<span class="blank _3"></span></div><div class="t m0 x25 h1f yef ff3 fs7 fc2 sc0 lsf">c<span class="wsc v0">abelluda.<span class="blank _3"></span></span></div><div class="t m0 x26 h1c yf0 ffb fs7 fc2 sc0 ls6 ws7">G<span class="blank _1"> </span>r<span class="blank _2"> </span>a<span class="blank _1"> </span>d<span class="blank _1"> </span>o<span class="blank _2"> </span> <span class="blank _11"> </span>5<span class="blank _1"> </span>:<span class="blank _2"> </span> <span class="blank _11"> </span><span class="ff3 wsd">a<span class="blank"> </span>l<span class="blank"> </span>o<span class="blank"> </span>p<span class="blank"> </span>e<span class="blank"> </span>c<span class="blank"> </span>i<span class="blank"> </span>a</span></div><div class="t m0 x26 h1c yf1 ff3 fs7 fc2 sc0 lsf wse">avanzada.<span class="blank _0"></span></div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf5" class="pf w0 h0" data-page-no="5"><div class="pc pc5 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x0 y30 w1 hc" alt="" src="https://files.passeidireto.com/75f5f44c-f020-40b0-8bec-4e63b893e22f/bg5.png"><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls6 ws7">REVISIÓN </div><div class="t m0 x12 h6 y8b ff6 fs1 fc0 sc0 ls6 ws7">\u2022 <span class="blank _2"> </span> <span class="blank _2"> </span> <span class="blank _2"> </span> <span class="blank _2"> </span>Palp<span class="blank _1"> </span>aci<span class="blank _1"> </span>ón <span class="blank _2"> </span>qu<span class="blank _1"> </span>e <span class="blank _2"> </span>per<span class="blank _1"> </span>mit<span class="blank _1"> </span>e <span class="blank _2"> </span>co<span class="blank _1"> </span>noce<span class="blank _1"> </span>r <span class="blank _2"> </span>la<span class="blank _1"> </span> <span class="blank _2"> </span>text<span class="blank _1"> </span>ura<span class="blank _1"> </span> <span class="blank _2"> </span>(ásp<span class="blank _1"> </span>ero<span class="blank _1"> </span>, <span class="blank _2"> </span>sua<span class="blank _1"> </span>ve, </div><div class="t m0 x27 h6 yf2 ff6 fs1 fc0 sc0 ls6 ws7">gras<span class="blank _1"> </span>o, <span class="blank _13"> </span>seco<span class="blank _1"> </span>, <span class="blank _13"> </span>grues<span class="blank _1"> </span>o, <span class="blank _13"> </span>fino<span class="blank _1"> </span>) <span class="blank _13"> </span>y <span class="blank _13"> </span>la <span class="blank _14"> </span>frag<span class="blank _1"> </span>ili<span class="blank _1"> </span>dad<span class="blank _1"> </span>. </div><div class="t m0 x12 h6 yf3 ff6 fs1 fc0 sc0 ls6 ws7">\u2022 <span class="blank _a"> </span> <span class="blank _4"> </span>Pel<span class="blank _1"> </span>liz<span class="blank _1"> </span>cami<span class="blank _1"> </span>ent<span class="blank _1"> </span>o <span class="blank _4"> </span>(sig<span class="blank _1"> </span>no <span class="blank _4"> </span>de <span class="blank _4"> </span>Jacqu<span class="blank _1"> </span>et)<span class="blank _1"> </span>: <span class="blank _4"> </span>cuand<span class="blank _1"> </span>o <span class="blank _4"> </span>no <span class="blank _4"> </span>exist<span class="blank _1"> </span>en </div><div class="t m0 x28 h6 yf4 ff6 fs1 fc0 sc0 ls6 ws7">folículos pilosos el plegado de la piel <span class="blank _0"></span>al pellizcarla es fácil, l</div><div class="t m0 x27 h6 yf5 ff6 fs1 fc0 sc0 ls6 ws7">o que no ocurre si está lleno de folículos.</div><div class="t m0 x12 h6 yf6 ff6 fs1 fc0 sc0 ls6 ws7">\u2022 <span class="blank _4"> </span> <span class="blank _4"> </span>T<span class="blank _1"> </span>rac<span class="blank _1"> </span>ción<span class="blank _1"> </span> <span class="blank _4"> </span>(p<span class="blank _1"> </span>ull <span class="blank _8"> </span>test)<span class="blank _1"> </span>: <span class="blank _4"> </span>d<span class="blank _1"> </span>esde<span class="blank _1"> </span> <span class="blank _4"> </span>la<span class="blank _1"> </span> <span class="blank _4"> </span>bas<span class="blank _1"> </span>e <span class="blank _4"> </span>h<span class="blank _1"> </span>acia<span class="blank _1"> </span> <span class="blank _4"> </span>el<span class="blank _1"> </span> <span class="blank _4"> </span>ext<span class="blank _1"> </span>rem<span class="blank _1"> </span>o </div><div class="t m0 x28 h6 yf7 ff6 fs1 fc0 sc0 ls6 ws7">term<span class="blank _1"> </span>ina<span class="blank _1"> </span>l <span class="blank _2"> </span>d<span class="blank _1"> </span>e <span class="blank _2"> </span>un<span class="blank _1"> </span> <span class="blank _2"> </span>mec<span class="blank _1"> </span>hón<span class="blank _1"> </span> <span class="blank _2"> </span>qu<span class="blank _1"> </span>e <span class="blank _2"> </span>co<span class="blank _1"> </span>nti<span class="blank _1"> </span>ene <span class="blank _7"> </span>25 <span class="blank _2"> </span>a<span class="blank _1"> </span> <span class="blank _2"> </span>50<span class="blank _1"> </span> <span class="blank _2"> </span>pel<span class="blank _1"> </span>os,<span class="blank _1"> </span> <span class="blank _2"> </span>que </div><div class="t m0 x27 h6 yf8 ff6 fs1 fc0 sc0 ls6 ws7">perm<span class="blank _1"> </span>ite<span class="blank _1"> </span> <span class="blank _c"> </span>evalu<span class="blank _1"> </span>ar <span class="blank _c"> </span>una<span class="blank _1"> </span> <span class="blank _c"> </span>pérd<span class="blank _1"> </span>ida <span class="blank _c"> </span>ag<span class="blank _1"> </span>uda <span class="blank _c"> </span>ex<span class="blank _1"> </span>ces<span class="blank _1"> </span>iva <span class="blank _c"> </span>si<span class="blank _1"> </span> <span class="blank _c"> </span>se </div><div class="t m0 x27 h6 yf9 ff6 fs1 fc0 sc0 ls6 ws7">desp<span class="blank _1"> </span>ren<span class="blank _1"> </span>den<span class="blank _1"> </span> <span class="blank"> </span>más <span class="blank"> </span>de <span class="blank"> </span>dos <span class="blank"> </span>o <span class="blank"> </span>tres <span class="blank"> </span>pel<span class="blank _1"> </span>os <span class="blank"> </span>en <span class="blank"> </span>cad<span class="blank _1"> </span>a <span class="blank"> </span>tracc<span class="blank _1"> </span>ión </div><div class="t m0 x27 h6 yfa ff6 fs1 fc0 sc0 ls6 ws7">(sig<span class="blank _1"> </span>no <span class="blank"> </span>de<span class="blank _1"> </span> <span class="blank"> </span>Sabo<span class="blank _1"> </span>rau<span class="blank _1"> </span>d). <span class="blank"> </span>La<span class="blank _1"> </span> <span class="blank"> </span>prue<span class="blank _1"> </span>ba <span class="blank"> </span>de<span class="blank _1"> </span> <span class="blank"> </span>trac<span class="blank _1"> </span>ción<span class="blank _1"> </span> <span class="blank"> </span>pued<span class="blank _1"> </span>e <span class="blank"> </span>ser </div><div class="t m0 x27 h6 yfb ff6 fs1 fc0 sc0 ls6 ws7">positiva en el cuero cabelludo central <span class="blank _0"></span>y en las fases iniciales </div><div class="t m0 x29 h6 yfc ff6 fs1 fc0 sc0 ls6 ws7">de <span class="blank"> </span>AAF, <span class="blank"> </span>mostra<span class="blank _1"> </span>ndo<span class="blank _1"> </span> <span class="blank _9"> </span>raíc<span class="blank _1"> </span>es <span class="blank"> </span>telóg<span class="blank _1"> </span>ena<span class="blank _1"> </span>s. <span class="blank"> </span>Por <span class="blank _9"> </span>lo <span class="blank"> </span>gener<span class="blank _1"> </span>al,<span class="blank _1"> </span> <span class="blank _9"> </span>es </div><div class="t m0 x2a h6 yfd ff6 fs1 fc0 sc0 ls6 ws7">negat<span class="blank _1"> </span>ivo <span class="blank _2"> </span>en <span class="blank _2"> </span>form<span class="blank _1"> </span>as <span class="blank _2"> </span>de <span class="blank _2"> </span>larga<span class="blank _1"> </span> <span class="blank _2"> </span>data <span class="blank _2"> </span>y <span class="blank _2"> </span>la <span class="blank _2"> </span>pérdid<span class="blank _1"> </span>a <span class="blank _2"> </span>del <span class="blank _2"> </span>pelo <span class="blank _2"> </span>no <span class="blank _2"> </span> <span class="blank _2"> </span> </div><div class="t m0 x2a hf yfe ff6 fs1 fc0 sc0 ls6 ws7">afecta el cuero cabelludo de manera difusa<span class="fs8 ws8 v1">20</span><span class="v0">.</span></div><div class="t m0 x3 he yff ff7 fs1 fc0 sc0 ls6 ws9">Tricoscopia:</div><div class="t m0 x2b h6 y100 ff6 fs1 fc0 sc0 ls6 ws7">Es <span class="blank"> </span>una<span class="blank _1"> </span> <span class="blank"> </span>herram<span class="blank _1"> </span>ien<span class="blank _1"> </span>ta <span class="blank"> </span>no <span class="blank"> </span>inv<span class="blank _1"> </span>asi<span class="blank _1"> </span>va <span class="blank"> </span>bas<span class="blank _1"> </span>ada<span class="blank _1"> </span> <span class="blank"> </span>en <span class="blank"> </span>la <span class="blank"> </span>evalu<span class="blank _1"> </span>aci<span class="blank _1"> </span>ón</div><div class="t m0 x3 h6 y101 ff6 fs1 fc0 sc0 ls6 ws7">dermatoscópica <span class="blank _2"> </span>del <span class="blank _2"> </span>cuero <span class="blank _2"> </span>cabelludo, <span class="blank _2"> </span>que <span class="blank _1"> </span>pe<span class="blank _1"> </span>rmite <span class="blank _2"> </span>un <span class="blank _1"> </span>a<span class="blank _1"> </span>umento <span class="blank _2"> </span>de</div><div class="t m0 x3 h6 y102 ff6 fs1 fc0 sc0 ls6 ws7">10 × <span class="blank _1"> </span>para <span class="blank _1"> </span>guiar la <span class="blank _1"> </span>toma de <span class="blank _1"> </span>biopsia. <span class="blank _1"> </span>Un aumento <span class="blank _1"> </span>que <span class="blank _1"> </span>varía de <span class="blank _1"> </span>20 <span class="blank _1"> </span>×</div><div class="t m0 x3 h6 y103 ff6 fs1 fc0 sc0 ls6 ws7">a <span class="blank _2"> </span>70<span class="blank _1"> </span> <span class="blank _2"> </span>× <span class="blank _2"> </span>p<span class="blank _1"> </span>erm<span class="blank _1"> </span>ite<span class="blank _1"> </span> <span class="blank _2"> </span>la <span class="blank _7"> </span>vis<span class="blank _1"> </span>uali<span class="blank _1"> </span>zac<span class="blank _1"> </span>ión<span class="blank _1"> </span> <span class="blank _2"> </span>in <span class="blank _7"> </span>vivo<span class="blank _1"> </span> <span class="blank _2"> </span>de<span class="blank _1"> </span> <span class="blank _2"> </span>la <span class="blank _7"> </span>epid<span class="blank _1"> </span>erm<span class="blank _1"> </span>is <span class="blank _7"> </span>del <span class="blank _7"> </span>cuer<span class="blank _1"> </span>o</div><div class="t m0 x3 h6 y104 ff6 fs1 fc0 sc0 ls6 ws7">cabelludo, los folículos, <span class="blank _1"> </span>los tallos del <span class="blank _1"> </span>pelo y los <span class="blank _1"> </span>patrones vasculares</div><div class="t m0 x3 hf y105 ff6 fs1 fc0 sc0 ls6 ws7">obteniendo así un diagnóstico precoz<span class="fs8 ws8 v1">18</span><span class="v0">.</span></div><div class="t m0 xf h6 y106 ff6 fs1 fc0 sc0 ls6 ws7">El principal signo tricoscópico en la AAF es la presencia de una</div><div class="t m0 x3 h6 y107 ff6 fs1 fc0 sc0 ls6 ws7">variabilidad <span class="blank _1"> </span>del <span class="blank _2"> </span>diámetro <span class="blank _1"> </span>del <span class="blank _2"> </span>pelo <span class="blank _2"> </span>> <span class="blank _1"> </span>20%. <span class="blank _2"> </span>Además, <span class="blank _1"> </span>puede <span class="blank _2"> </span>mostrar</div><div class="t m0 x3 h6 y108 ff6 fs1 fc0 sc0 ls6 ws7">puntos <span class="blank _1"> </span>amarillos <span class="blank _1"> </span>que <span class="blank _2"> </span>son <span class="blank _1"> </span>indicativos <span class="blank _1"> </span>de <span class="blank _1"> </span>folículos <span class="blank _2"> </span>vacíos, <span class="blank _1"> </span>pequeñas</div><div class="t m0 x3 h6 y109 ff6 fs1 fc0 sc0 ls6 ws7">área<span class="blank _1"> </span>s <span class="blank _6"> </span>f<span class="blank _1"> </span>oca<span class="blank _1"> </span>les<span class="blank _1"> </span> <span class="blank _6"> </span>e <span class="blank _d"> </span>hip<span class="blank _1"> </span>erpi<span class="blank _1"> </span>gme<span class="blank _1"> </span>nta<span class="blank _1"> </span>ció<span class="blank _1"> </span>n <span class="blank _6"> </span>p<span class="blank _1"> </span>erif<span class="blank _1"> </span>éri<span class="blank _1"> </span>ca.<span class="blank _1"> </span> <span class="blank _6"> </span>El<span class="blank _1"> </span> <span class="blank _6"> </span>os<span class="blank _1"> </span>tium<span class="blank _1"> </span> <span class="blank _6"> </span>fo<span class="blank _1"> </span>lic<span class="blank _1"> </span>ula<span class="blank _1"> </span>r</div><div class="t m0 x3 h6 y10a ff6 fs1 fc0 sc0 ls6 ws7">genera<span class="blank _0"></span>lmente<span class="blank _0"></span> <span class="blank _3"></span>se co<span class="blank _0"></span>nserva<span class="blank _0"></span>, <span class="blank _3"></span>y es<span class="blank _0"></span>to <span class="blank _3"></span>ayuda <span class="blank _3"></span>en e<span class="blank _0"></span>l <span class="blank _3"></span>diagnóstic<span class="blank _0"></span>o <span class="blank _3"></span>diferencial</div><div class="t m0 x3 h13 y10b ff6 fs1 fc0 sc0 ls6 ws7">de la alopecia cicatricial<span class="fs8 ls9 wsa v1">10,18</span><span class="v0">.</span></div><div class="t m0 xf h6 y10c ff6 fs1 fc0 sc0 ls6 ws7">Rako<span class="blank _1"> </span>wsk<span class="blank _1"> </span>a <span class="blank _7"> </span>et <span class="blank _7"> </span>al<span class="blank _1"> </span> <span class="blank _2"> </span>(<span class="blank _1"> </span>200<span class="blank _1"> </span>9).<span class="blank _1"> </span> <span class="blank _2"> </span>p<span class="blank _1"> </span>lan<span class="blank _1"> </span>tea<span class="blank _1"> </span>ron <span class="blank _7"> </span>cr<span class="blank _1"> </span>ite<span class="blank _1"> </span>rio<span class="blank _1"> </span>s <span class="blank _7"> </span>der<span class="blank _1"> </span>mato<span class="blank _1"> </span>scó<span class="blank _1"> </span>pic<span class="blank _1"> </span>os</div><div class="t m0 x3 h6 y10d ff6 fs1 fc0 sc0 ls6 ws7">mayores <span class="blank _3"></span>y <span class="blank _3"></span>menores <span class="blank _3"></span>para e<span class="blank _0"></span>l <span class="blank _3"></span>diagnóstico <span class="blank _3"></span>de <span class="blank _3"></span>AAF, e<span class="blank _0"></span>l <span class="blank _3"></span>cual s<span class="blank _0"></span>e <span class="blank _3"></span>realiza <span class="blank _3"></span>con</div><div class="t m0 x3 h6 y10e ff6 fs1 fc0 sc0 ls6 ws7">la <span class="blank _d"> </span>pr<span class="blank _1"> </span>ese<span class="blank _1"> </span>ncia<span class="blank _1"> </span> <span class="blank _d"> </span>de <span class="blank _d"> </span>d<span class="blank _1"> </span>os <span class="blank _d"> </span>cr<span class="blank _1"> </span>ite<span class="blank _1"> </span>rios<span class="blank _1"> </span> <span class="blank _d"> </span>pri<span class="blank _1"> </span>nci<span class="blank _1"> </span>pale<span class="blank _1"> </span>s <span class="blank _d"> </span>o <span class="blank _d"> </span>un<span class="blank _1"> </span>o <span class="blank _d"> </span>ma<span class="blank _1"> </span>yor <span class="blank _d"> </span>m<span class="blank _1"> </span>ás <span class="blank _d"> </span>d<span class="blank _1"> </span>os</div><div class="t m0 x3 h13 y10f ff6 fs1 fc0 sc0 ls6 ws7">criterios menores<span class="fs8 ws8 v1">21</span><span class="v0">. (Cuadro 1 y Figura 5) </span></div><div class="t m0 x13 he y8b ff7 fs1 fc0 sc0 ls6 ws9">Biopsia:</div><div class="t m0 x15 h6 y110 ff6 fs1 fc0 sc0 ls6 ws7">Con el <span class="blank _3"></span>advenimiento de la dermatoscopia <span class="blank _3"></span>para el diagnóstico <span class="blank _3"></span>de</div><div class="t m0 x13 h6 y111 ff6 fs1 fc0 sc0 ls6 ws7">AAF de <span class="blank _3"></span>forma no invasiva, <span class="blank _3"></span>la biopsia ha <span class="blank _3"></span>pasado a un <span class="blank _3"></span>segundo plano</div><div class="t m0 x13 h6 y112 ff6 fs1 fc0 sc0 ls6 ws7">y la mi<span class="blank _1"> </span>sma se realiza <span class="blank _1"> </span>en caso <span class="blank _1"> </span>de existir <span class="blank _1"> </span>duda diagnóstica. <span class="blank _1"> </span>Se puede</div><div class="t m0 x13 h6 y113 ff6 fs1 fc0 sc0 ls6 ws7">realizar <span class="blank _2"> </span>una <span class="blank _2"> </span>biopsia <span class="blank _1"> </span>g<span class="blank _1"> </span>uiada <span class="blank _2"> </span>por <span class="blank _1"> </span>de<span class="blank _1"> </span>rmatoscopia <span class="blank _2"> </span>para <span class="blank _2"> </span>seleccionar <span class="blank _2"> </span>el</div><div class="t m0 x13 h6 y114 ff6 fs1 fc0 sc0 ls6 ws7">sitio más significativo, <span class="blank _3"></span>la misma puede ser ú<span class="blank _0"></span>til cuando la <span class="blank _3"></span>evaluación</div><div class="t m0 x13 h6 y115 ff6 fs1 fc0 sc0 ls6 ws7">clínica <span class="blank _2"> </span>no <span class="blank _2"> </span>proporciona <span class="blank _2"> </span>un <span class="blank _2"> </span>diagnóstico <span class="blank _2"> </span>definitivo <span class="blank _2"> </span>y <span class="blank _2"> </span>se <span class="blank _2"> </span>sospecha <span class="blank _2"> </span>de</div><div class="t m0 x13 h6 y116 ff6 fs1 fc0 sc0 ls6 ws7">alope<span class="blank _0"></span>cias <span class="blank _3"></span>cicat<span class="blank _0"></span>rici<span class="blank _0"></span>ales <span class="blank _3"></span>o <span class="blank _3"></span>alopecia<span class="blank _0"></span> <span class="blank _3"></span>areata. <span class="blank _3"></span>Se <span class="blank _3"></span>recomien<span class="blank _0"></span>da <span class="blank _3"></span>realiza<span class="blank _0"></span>rla <span class="blank _3"></span>con</div><div class="t m0 x13 h1a y117 ff6 fs1 fc0 sc0 ls6 ws7">un punch de 4 mm que involucra la dermis<span class="fs8 ls9 wsa v1">10,18</span>.</div><div class="t m0 x14 h6 y118 ff6 fs1 fc0 sc0 ls6 ws7">El <span class="blank _1"> </span>área <span class="blank _2"> </span>preferida <span class="blank _1"> </span>para <span class="blank _2"> </span>realizar <span class="blank _1"> </span>la <span class="blank _2"> </span>toma <span class="blank _2"> </span>de <span class="blank _1"> </span>la <span class="blank _2"> </span>biopsia <span class="blank _1"> </span>es <span class="blank _2"> </span>la <span class="blank _1"> </span>parte</div><div class="t m0 x13 h6 y119 ff6 fs1 fc0 sc0 ls6 ws7">frontovertical del <span class="blank _1"> </span>cuero <span class="blank _1"> </span>cabelludo, <span class="blank _1"> </span>en <span class="blank _1"> </span>un <span class="blank _1"> </span>área <span class="blank _1"> </span>donde <span class="blank _1"> </span>la <span class="blank _1"> </span>pérdida <span class="blank _1"> </span>de</div><div class="t m0 x13 h6 y11a ff6 fs1 fc0 sc0 ls6 ws7">pelo<span class="blank _1"> </span> <span class="blank _2"> </span>sea <span class="blank _2"> </span>evid<span class="blank _1"> </span>ente<span class="blank _1"> </span>. <span class="blank _2"> </span>Es <span class="blank _2"> </span>mejo<span class="blank _1"> </span>r <span class="blank _2"> </span>evit<span class="blank _1"> </span>ar <span class="blank _2"> </span>el <span class="blank _2"> </span>áre<span class="blank _1"> </span>a <span class="blank _2"> </span>bitem<span class="blank _1"> </span>pora<span class="blank _1"> </span>l <span class="blank _2"> </span>ya <span class="blank _2"> </span>que <span class="blank _2"> </span>es<span class="blank _1"> </span>ta</div><div class="t m0 x13 h6 y11b ff6 fs1 fc0 sc0 ls6 ws7">región puede tener pelos miniaturizados en <span class="blank _0"></span>mujeres sin pérdida de</div><div class="t m0 x13 h6 y11c ff6 fs1 fc0 sc0 ls6 ws7">pelo<span class="blank _0"></span>. <span class="blank _3"></span>Seccio<span class="blank _0"></span>nami<span class="blank _0"></span>ent<span class="blank _0"></span>o <span class="blank _3"></span>vertic<span class="blank _0"></span>al <span class="blank _3"></span>y <span class="blank _0"></span>hor<span class="blank _0"></span>izon<span class="blank _0"></span>tal <span class="blank _3"></span>debe<span class="blank _0"></span> <span class="blank _3"></span>ser <span class="blank _3"></span>evaluad<span class="blank _0"></span>o. <span class="blank _3"></span>El <span class="blank _3"></span>corte</div><div class="t m0 x13 h6 y11d ff6 fs1 fc0 sc0 ls6 ws7">tran<span class="blank _1"> </span>sve<span class="blank _1"> </span>rsa<span class="blank _1"> </span>l <span class="blank _a"> </span>es <span class="blank _a"> </span>el<span class="blank _1"> </span> <span class="blank _a"> </span>mét<span class="blank _1"> </span>odo <span class="blank _a"> </span>m<span class="blank _1"> </span>ás <span class="blank _a"> </span>ad<span class="blank _1"> </span>ecua<span class="blank _1"> </span>do <span class="blank _a"> </span>p<span class="blank _1"> </span>ara <span class="blank _a"> </span>o<span class="blank _1"> </span>bten<span class="blank _1"> </span>er <span class="blank _a"> </span>da<span class="blank _1"> </span>tos</div><div class="t m0 x13 h6 y11e ff6 fs1 fc0 sc0 ls6 ws7">diagnó<span class="blank _0"></span>sticos<span class="blank _0"></span>, <span class="blank _3"></span>ya q<span class="blank _0"></span>ue <span class="blank _3"></span>se <span class="blank _0"></span>visual<span class="blank _0"></span>izarán<span class="blank _0"></span> <span class="blank _3"></span>todos <span class="blank _3"></span>los f<span class="blank _0"></span>olícul<span class="blank _0"></span>os. <span class="blank _3"></span>Las <span class="blank _3"></span>secciones</div><div class="t m0 x13 h6 y11f ff6 fs1 fc0 sc0 ls6 ws7">horizonta<span class="blank _1"> </span>les <span class="blank _2"> </span>permiten <span class="blank _2"> </span>evalu<span class="blank _1"> </span>ar <span class="blank _2"> </span>la <span class="blank _2"> </span>cantidad <span class="blank _2"> </span>de <span class="blank _2"> </span>pelos <span class="blank _2"> </span>por <span class="blank _2"> </span>campo <span class="blank _2"> </span>de</div><div class="t m0 x13 h6 y120 ff6 fs1 fc0 sc0 ls6 ws7">visión. <span class="blank _3"></span>En AA<span class="blank _0"></span>F <span class="blank _3"></span>hay un <span class="blank _3"></span>mayor <span class="blank _3"></span>número de <span class="blank _3"></span>pelos <span class="blank _3"></span>miniaturizados <span class="blank _3"></span>(como</div><div class="t m0 x13 h6 y121 ff6 fs1 fc0 sc0 ls6 ws7">vellos). La relación <span class="blank _3"></span>de terminal en los <span class="blank _0"></span>folículos pilosos con <span class="blank _3"></span>forma de</div><div class="t m0 x13 h6 y122 ff6 fs1 fc0 sc0 ls6 ws7">vitela es típicamente <span class="blank _1"> </span><3: 1 en <span class="blank _1"> </span>mujeres con <span class="blank _1"> </span>esta afección contra> <span class="blank _1"> </span>7:</div><div class="t m0 x13 h6 y123 ff6 fs1 fc0 sc0 ls6 ws7">1 <span class="blank _15"> </span>en <span class="blank _15"> </span>el <span class="blank _15"> </span>cu<span class="blank _1"> </span>ero<span class="blank _1"> </span> <span class="blank _15"> </span>cabe<span class="blank _1"> </span>llud<span class="blank _1"> </span>o <span class="blank _15"> </span>nor<span class="blank _1"> </span>mal<span class="blank _1"> </span>. <span class="blank _15"> </span>Otra<span class="blank _1"> </span>s <span class="blank _15"> </span>car<span class="blank _1"> </span>act<span class="blank _1"> </span>erís<span class="blank _1"> </span>tic<span class="blank _1"> </span>as</div><div class="t m0 x13 h6 y124 ff6 fs1 fc0 sc0 ls6 ws7">histopatológicas <span class="blank _2"> </span>típicas <span class="blank _2"> </span>son <span class="blank _1"> </span>un <span class="blank _2"> </span>aumento <span class="blank _2"> </span>de <span class="blank _2"> </span>la <span class="blank _1"> </span>relaci<span class="blank _1"> </span>ón <span class="blank _2"> </span>telógeno <span class="blank _1"> </span>/</div><div class="t m0 x13 h6 y125 ff6 fs1 fc0 sc0 ls6 ws7">anág<span class="blank _1"> </span>eno<span class="blank _1"> </span> <span class="blank _a"> </span>y <span class="blank _a"> </span>u<span class="blank _1"> </span>n <span class="blank _a"> </span>m<span class="blank _1"> </span>ayor<span class="blank _1"> </span> <span class="blank _a"> </span>nú<span class="blank _1"> </span>mer<span class="blank _1"> </span>o <span class="blank _a"> </span>de<span class="blank _1"> </span> <span class="blank _a"> </span>es<span class="blank _1"> </span>tela<span class="blank _1"> </span>s <span class="blank _a"> </span>f<span class="blank _1"> </span>oli<span class="blank _1"> </span>cula<span class="blank _1"> </span>res<span class="blank _1"> </span>. <span class="blank _a"> </span>Pu<span class="blank _1"> </span>ede<span class="blank _1"> </span>n</div><div class="t m0 x13 h6 y126 ff6 fs1 fc0 sc0 ls6 ws7">pres<span class="blank _1"> </span>ent<span class="blank _1"> </span>ars<span class="blank _1"> </span>e <span class="blank"> </span>le<span class="blank _1"> </span>ve <span class="blank"> </span>i<span class="blank _1"> </span>nfl<span class="blank _1"> </span>ama<span class="blank _1"> </span>ció<span class="blank _1"> </span>n <span class="blank"> </span>pe<span class="blank _1"> </span>rif<span class="blank _1"> </span>olic<span class="blank _1"> </span>ula<span class="blank _1"> </span>r <span class="blank"> </span>le<span class="blank _1"> </span>ve <span class="blank _e"> </span>alre<span class="blank _1"> </span>ded<span class="blank _1"> </span>or <span class="blank"> </span>d<span class="blank _1"> </span>e <span class="blank"> </span>l<span class="blank _1"> </span>a</div><div class="t m0 x13 h1a y127 ff6 fs1 fc0 sc0 ls6 ws7">porc<span class="blank _0"></span>ión <span class="blank _3"></span>super<span class="blank _0"></span>ior <span class="blank _3"></span>del <span class="blank _3"></span>folícu<span class="blank _0"></span>lo <span class="blank _3"></span>piloso<span class="blank _0"></span>, <span class="blank _3"></span>así <span class="blank _3"></span>como <span class="blank _3"></span>fibrosis<span class="blank _0"></span> <span class="blank _3"></span>perifoli<span class="blank _0"></span>cula<span class="blank _0"></span>r<span class="fs8 ws8 v1">10,<span class="blank _0"></span>22</span></div><div class="t m0 x2c h6 y127 ff6 fs1 fc0 sc0 ls6">.</div><div class="t m0 x14 h6 y128 ff6 fs1 fc0 sc0 ls6 ws7">La <span class="blank _e"> </span>c<span class="blank _1"> </span>omb<span class="blank _1"> </span>inac<span class="blank _1"> </span>ión<span class="blank _1"> </span> <span class="blank _e"> </span>de<span class="blank _1"> </span> <span class="blank _e"> </span>mét<span class="blank _1"> </span>odo<span class="blank _1"> </span>s <span class="blank _e"> </span>fo<span class="blank _1"> </span>tog<span class="blank _1"> </span>ráfi<span class="blank _1"> </span>cos<span class="blank _1"> </span> <span class="blank _e"> </span>y <span class="blank _e"> </span>l<span class="blank _1"> </span>a <span class="blank _e"> </span>o<span class="blank _1"> </span>rien<span class="blank _1"> </span>tac<span class="blank _1"> </span>ión</div><div class="t m0 x13 h6 y129 ff6 fs1 fc0 sc0 ls6 ws7">tran<span class="blank _1"> </span>sve<span class="blank _1"> </span>rsa<span class="blank _1"> </span>l <span class="blank"> </span>d<span class="blank _1"> </span>e <span class="blank"> </span>l<span class="blank _1"> </span>as <span class="blank _e"> </span>bio<span class="blank _1"> </span>psi<span class="blank _1"> </span>as <span class="blank _e"> </span>de <span class="blank _e"> </span>cue<span class="blank _1"> </span>ro <span class="blank _e"> </span>cabe<span class="blank _1"> </span>llu<span class="blank _1"> </span>do <span class="blank _e"> </span>dem<span class="blank _1"> </span>ues<span class="blank _1"> </span>tran<span class="blank _1"> </span> <span class="blank"> </span>l<span class="blank _1"> </span>a</div><div class="t m0 x13 h6 y12a ff6 fs1 fc0 sc0 ls6 ws7">diversidad <span class="blank _3"></span>de diámetro <span class="blank _3"></span>de los <span class="blank _3"></span>pelos, <span class="blank _3"></span>y esto <span class="blank _3"></span>refleja el <span class="blank _3"></span>signo <span class="blank _3"></span>clínico de</div><div class="t m0 x13 h6 y12b ff6 fs1 fc0 sc0 ls6 ws7">la <span class="blank"> </span>min<span class="blank _1"> </span>iatu<span class="blank _1"> </span>riz<span class="blank _1"> </span>aci<span class="blank _1"> </span>ón <span class="blank"> </span>fol<span class="blank _1"> </span>icu<span class="blank _1"> </span>lar.<span class="blank _1"> </span> <span class="blank"> </span>Este <span class="blank"> </span>da<span class="blank _1"> </span>to <span class="blank"> </span>es <span class="blank"> </span>sól<span class="blank _1"> </span>o <span class="blank"> </span>esta<span class="blank _1"> </span>dís<span class="blank _1"> </span>tic<span class="blank _1"> </span>amen<span class="blank _1"> </span>te</div><div class="t m0 x13 h1a y12c ff6 fs1 fc0 sc0 ls6 ws7">significativo en estados avanzados de AAF patrón Ludwig<span class="fs8 ws8 v1">22</span>.</div><div class="t m0 x13 he y12d ff7 fs1 fc0 sc0 ls6 ws7">Exámenes complementarios:</div><div class="t m0 x2d h6 y12e ff6 fs1 fc0 sc0 ls6 ws7">Hematología <span class="blank _1"> </span>completa, <span class="blank _2"> </span>ferritina <span class="blank _1"> </span>sérica, <span class="blank _1"> </span>hierro, <span class="blank _2"> </span>vitamina <span class="blank _1"> </span>D, <span class="blank _1"> </span>zinc,</div><div class="t m0 x13 h6 y12f ff6 fs1 fc0 sc0 ls6 ws7">prol<span class="blank _1"> </span>act<span class="blank _1"> </span>ina<span class="blank _1"> </span>, <span class="blank _2"> </span>t<span class="blank _1"> </span>esto<span class="blank _1"> </span>ste<span class="blank _1"> </span>ron<span class="blank _1"> </span>a <span class="blank _2"> </span>l<span class="blank _1"> </span>ibr<span class="blank _1"> </span>e <span class="blank _2"> </span>y<span class="blank _1"> </span>/o <span class="blank _7"> </span>tota<span class="blank _1"> </span>l <span class="blank _2"> </span>y<span class="blank _1"> </span> <span class="blank _2"> </span>de<span class="blank _1"> </span>hid<span class="blank _1"> </span>roep<span class="blank _1"> </span>ian<span class="blank _1"> </span>dro<span class="blank _1"> </span>ste<span class="blank _1"> </span>rona</div><div class="t m0 x13 h6 y130 ff6 fs1 fc0 sc0 ls6 ws7">sulfat<span class="blank _0"></span>o <span class="blank _3"></span>(DHEAS). <span class="blank _3"></span>Si <span class="blank _3"></span>se de<span class="blank _0"></span>tecta <span class="blank _3"></span>aument<span class="blank _0"></span>o <span class="blank _3"></span>de D<span class="blank _0"></span>HEAS <span class="blank _3"></span>se <span class="blank _3"></span>debe <span class="blank _0"></span>invest<span class="blank _0"></span>igar</div><div class="t m0 x13 h6 y131 ff6 fs1 fc0 sc0 ls6 ws7">la <span class="blank _3"></span>posible <span class="blank _3"></span>existe<span class="blank _0"></span>ncia <span class="blank _3"></span>de <span class="blank _3"></span>hiperplas<span class="blank _0"></span>ia <span class="blank _3"></span>adrenal <span class="blank _3"></span>congén<span class="blank _0"></span>ita, <span class="blank _3"></span>determ<span class="blank _0"></span>inand<span class="blank _0"></span>o</div><div class="t m0 x13 h1a y132 ff6 fs1 fc0 sc0 ls6 ws7">la <span class="blank _3"></span>17-OH progestero<span class="blank _0"></span>na <span class="blank _3"></span>en la <span class="blank _3"></span>fase <span class="blank _0"></span>folicular <span class="blank _3"></span>del ciclo<span class="fs8 ws8 v1">1<span class="blank _0"></span>9<span class="fs1 ws7 v2">. <span class="blank _3"></span>Las pruebas <span class="blank _3"></span>de</span></span></div><div class="t m0 x13 h6 y133 ff6 fs1 fc0 sc0 ls6 ws7">la <span class="blank _2"> </span>con<span class="blank _1"> </span>cent<span class="blank _1"> </span>rac<span class="blank _1"> </span>ión<span class="blank _1"> </span> <span class="blank _2"> </span>de <span class="blank _2"> </span>andró<span class="blank _1"> </span>gen<span class="blank _1"> </span>os <span class="blank _2"> </span>deb<span class="blank _1"> </span>en <span class="blank _2"> </span>rea<span class="blank _1"> </span>liz<span class="blank _1"> </span>ars<span class="blank _1"> </span>e <span class="blank _2"> </span>dura<span class="blank _1"> </span>nte <span class="blank _2"> </span>la<span class="blank _1"> </span> <span class="blank _2"> </span>fase</div><div class="t m0 x13 h6 y134 ff6 fs1 fc0 sc0 ls6 ws7">foli<span class="blank _1"> </span>cul<span class="blank _1"> </span>ar,<span class="blank _1"> </span> <span class="blank"> </span>entre <span class="blank"> </span>el <span class="blank"> </span>cuar<span class="blank _1"> </span>to <span class="blank"> </span>y <span class="blank"> </span>el <span class="blank"> </span>séptim<span class="blank _1"> </span>o <span class="blank"> </span>día <span class="blank"> </span>del <span class="blank"> </span>ciclo<span class="blank _1"> </span>, <span class="blank"> </span>y <span class="blank"> </span>que <span class="blank"> </span>los</div><div class="t m0 x13 h6 y135 ff6 fs1 fc0 sc0 ls6 ws7">anti<span class="blank _1"> </span>con<span class="blank _1"> </span>cep<span class="blank _1"> </span>tivo<span class="blank _1"> </span>s <span class="blank _9"> </span>or<span class="blank _1"> </span>ales<span class="blank _1"> </span> <span class="blank _9"> </span>debe<span class="blank _1"> </span>n <span class="blank _9"> </span>su<span class="blank _1"> </span>spen<span class="blank _1"> </span>der<span class="blank _1"> </span>se <span class="blank"> </span>durante<span class="blank _1"> </span> <span class="blank _9"> </span>al <span class="blank"> </span>menos <span class="blank _9"> </span>2</div><div class="t m0 x13 h6 y136 ff6 fs1 fc0 sc0 ls6 ws7">mese<span class="blank _1"> </span>s <span class="blank _6"> </span>a<span class="blank _1"> </span>nte<span class="blank _1"> </span>s <span class="blank _6"> </span>d<span class="blank _1"> </span>e <span class="blank _6"> </span>es<span class="blank _1"> </span>ta <span class="blank _d"> </span>pru<span class="blank _1"> </span>eba.<span class="blank _1"> </span> <span class="blank _6"> </span>La<span class="blank _1"> </span> <span class="blank _6"> </span>ec<span class="blank _1"> </span>ogr<span class="blank _1"> </span>afía<span class="blank _1"> </span> <span class="blank _6"> </span>ov<span class="blank _1"> </span>ári<span class="blank _1"> </span>ca <span class="blank _6"> </span>y<span class="blank _1"> </span> <span class="blank _6"> </span>su<span class="blank _1"> </span>pra<span class="blank _1"> </span>rre<span class="blank _1"> </span>nal</div><div class="t m0 x13 h6 y137 ff6 fs1 fc0 sc0 ls6 ws7">podría prescribirse <span class="blank _0"></span>para descartar <span class="blank _3"></span>la presencia de quistes <span class="blank _0"></span>ováricos y</div><div class="t m0 x13 h6 y138 ff6 fs1 fc0 sc0 ls6 ws7">tumo<span class="blank _1"> </span>res<span class="blank _1"> </span> <span class="blank _a"> </span>prod<span class="blank _1"> </span>uct<span class="blank _1"> </span>ore<span class="blank _1"> </span>s <span class="blank _a"> </span>de <span class="blank _a"> </span>an<span class="blank _1"> </span>dró<span class="blank _1"> </span>gen<span class="blank _1"> </span>os <span class="blank _a"> </span>o <span class="blank _a"> </span>h<span class="blank _1"> </span>iper<span class="blank _1"> </span>pla<span class="blank _1"> </span>sia<span class="blank _1"> </span> <span class="blank _b"> </span>c<span class="blank _1"> </span>ong<span class="blank _1"> </span>éni<span class="blank _1"> </span>ta</div><div class="t m0 x13 h6 y139 ff6 fs1 fc0 sc0 ls6 ws7">suprarrenal. Dependiendo de <span class="blank _1"> </span>los resultados, <span class="blank _1"> </span>pueden ser necesarias</div><div class="t m0 x13 h6 y13a ff6 fs1 fc0 sc0 ls6 ws7">más <span class="blank _7"> </span>i<span class="blank _1"> </span>nves<span class="blank _1"> </span>tig<span class="blank _1"> </span>aci<span class="blank _1"> </span>ones<span class="blank _1"> </span> <span class="blank _7"> </span>y <span class="blank _7"> </span>req<span class="blank _1"> </span>urir<span class="blank _1"> </span>á <span class="blank _7"> </span>un <span class="blank _7"> </span>en<span class="blank _1"> </span>foq<span class="blank _1"> </span>ue <span class="blank _7"> </span>in<span class="blank _1"> </span>ter<span class="blank _1"> </span>disc<span class="blank _1"> </span>ipl<span class="blank _1"> </span>ina<span class="blank _1"> </span>rio<span class="blank _1"> </span> <span class="blank _2"> </span>q<span class="blank _1"> </span>ue</div><div class="t m0 x13 h1a y13b ff6 fs1 fc0 sc0 ls6 ws7">involucre a ginecólogos, endocrinólogos y dermatólogos<span class="fs8 ls12 wsf v1">10,18</span>.</div><div class="t m0 x2c h3 y2 ff2 fs1 fc0 sc0 ls6 ws10">10</div><div class="t m0 x3 h4 y3 ff3 fs2 fc0 sc0 ls6 ws7">Dermatol V<span class="blank _0"></span>enez <span class="ff4 ls0">h</span>Vol.59 <span class="ff4 ls1">h</span>N°2 <span class="ff4 ls2">h</span><span class="ws1">2021</span></div><div class="t m0 x2e h20 y13c ff7 fs2 fc0 sc0 ls6 ws7">Criterios Mayores </div><div class="t m0 x12 h21 y13d ff6 fs2 fc0 sc0 ls6 ws7">1.- Más de cuatro amarillos en cuatro </div><div class="t m0 x1a h21 y13e ff6 fs2 fc0 sc0 ls6 ws7">imagenes en el área frantal.</div><div class="t m0 x12 h21 y13f ff6 fs2 fc0 sc0 ls6 ws7">2.- <span class="blank _3"></span>Menor <span class="blank _3"></span>grosor <span class="blank _3"></span>promedio <span class="blank _3"></span>del <span class="blank _0"></span>pelo<span class="blank _0"></span> e<span class="blank _0"></span>n <span class="blank _0"></span> </div><div class="t m0 x1a h21 y140 ff6 fs2 fc0 sc0 ls6 ws7">el área frontal en comparación con </div><div class="t m0 x1a h21 y141 ff6 fs2 fc0 sc0 ls6 ws7">el área occipital.</div><div class="t m0 x12 h21 y142 ff6 fs2 fc0 sc0 ls6 ws7">3.- </div><div class="t m0 x1a h6 y143 ff6 fs1 fc0 sc0 ls6 ws3">><span class="fs2 ws7">10% <span class="blank _3"></span>delos <span class="blank _0"></span>pelos <span class="blank _3"></span>finos <span class="blank _3"></span>(< <span class="blank _3"></span>0.3 mm<span class="blank _0"></span>) </span></div><div class="t m0 x1a h21 y144 ff6 fs2 fc0 sc0 ls6 ws7">en el área frontal.</div><div class="t m0 x2f h20 y145 ff7 fs2 fc0 sc0 ls6 ws7">Criterios Menores </div><div class="t m0 x30 h21 y146 ff6 fs2 fc0 sc0 ls6 ws7">1.- <span class="blank _0"></span>Aumento <span class="blank _0"></span>de <span class="blank _0"></span>la pro<span class="blank _0"></span>porción <span class="blank _0"></span>frontal <span class="blank _0"></span>a </div><div class="t m0 x31 h21 y147 ff6 fs2 fc0 sc0 ls6 ws7">occipital <span class="blank _1"> </span>de <span class="blank _2"> </span>unidades <span class="blank _1"> </span>pilosebáceas </div><div class="t m0 x31 h21 y148 ff6 fs2 fc0 sc0 ls6 ws7">de un solo pelo.</div><div class="t m0 x30 h21 y149 ff6 fs2 fc0 sc0 ls6 ws7">2.- Vellos.</div><div class="t m0 x30 h21 y14a ff6 fs2 fc0 sc0 ls6 ws7">3.- Decoloración perifolicular.</div><div class="t m0 x12 h1c y14b ffb fs7 fc1 sc0 lsf ws7">Cuadro 1:<span class="blank"> </span><span class="ff3">Críterios dermatoscópicos en alopecia androgénica femenina<span class="blank _0"></span></span></div><div class="t m0 x32 h1c y14c ffb fs7 fc1 sc0 lsf ws7">Figura 5<span class="ff3">.<span class="blank _0"></span> Se muestra a) Miniaturización del pelo >20% b)Puntos amarillos.<span class="blank _0"></span></span></div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf6" class="pf w0 h0" data-page-no="6"><div class="pc pc6 w0 h0"><img fetchpriority="low" loading="lazy" class="bi xc y30 w1 hc" alt="" src="https://files.passeidireto.com/75f5f44c-f020-40b0-8bec-4e63b893e22f/bg6.png"><div class="t m0 x3 he y14d ff7 fs1 fc0 sc0 ls6 ws7">Diagnóstico diferencial:</div><div class="t m0 x33 h6 y14e ff6 fs1 fc0 sc0 ls6 ws7">Pued<span class="blank _1"> </span>en <span class="blank _16"> </span>pres<span class="blank _1"> </span>ent<span class="blank _1"> </span>ars<span class="blank _1"> </span>e <span class="blank _16"> </span>múlti<span class="blank _1"> </span>ple<span class="blank _1"> </span>s <span class="blank _16"> </span>trast<span class="blank _1"> </span>orno<span class="blank _1"> </span>s <span class="blank _16"> </span>del <span class="blank _16"> </span>pelo<span class="blank _1"> </span> <span class="blank _16"> </span>con</div><div class="t m0 x3 h6 y14f ff6 fs1 fc0 sc0 ls6 ws7">cara<span class="blank _0"></span>cte<span class="blank _0"></span>ríst<span class="blank _3"></span>icas <span class="blank _3"></span>clínic<span class="blank _0"></span>as <span class="blank _3"></span>que <span class="blank _3"></span>se <span class="blank _3"></span>asemej<span class="blank _0"></span>an <span class="blank _3"></span>a <span class="blank _3"></span>AAF. <span class="blank _3"></span>La <span class="blank _3"></span>AAF <span class="blank _3"></span>puede <span class="blank _3"></span>coexi<span class="blank _0"></span>sti<span class="blank _0"></span>r</div><div class="t m0 x3 h6 y150 ff6 fs1 fc0 sc0 ls6 ws7">con <span class="blank _3"></span>otros trastornos. <span class="blank _3"></span>Entre <span class="blank _0"></span>los <span class="blank _3"></span>principales diagnóstico<span class="blank _0"></span>s <span class="blank _0"></span>diferenciales</div><div class="t m0 x3 h6 y151 ff6 fs1 fc0 sc0 ls6 ws7">enco<span class="blank _1"> </span>ntr<span class="blank _1"> </span>amo<span class="blank _1"> </span>s: <span class="blank _4"> </span>efluv<span class="blank _1"> </span>io <span class="blank _4"> </span>teló<span class="blank _1"> </span>gen<span class="blank _1"> </span>o <span class="blank _a"> </span>(<span class="blank _1"> </span>ET)<span class="blank _1"> </span>, <span class="blank _a"> </span>al<span class="blank _1"> </span>ope<span class="blank _1"> </span>cia<span class="blank _1"> </span> <span class="blank _a"> </span>ar<span class="blank _1"> </span>eat<span class="blank _1"> </span>a <span class="blank _a"> </span>di<span class="blank _1"> </span>fus<span class="blank _1"> </span>a <span class="blank _a"> </span>o</div><div class="t m0 x3 h6 y152 ff6 fs1 fc0 sc0 ls6 ws7">incógnita <span class="blank _1"> </span>(AA) <span class="blank _1"> </span>y <span class="blank _1"> </span>alopecias <span class="blank _1"> </span>cicatriciales <span class="blank _1"> </span>que <span class="blank _2"> </span>pueden estar <span class="blank _1"> </span>presentes</div><div class="t m0 x3 h6 y153 ff6 fs1 fc0 sc0 ls6 ws7">en <span class="blank _2"> </span>una <span class="blank _1"> </span>d<span class="blank _1"> </span>istribución <span class="blank _2"> </span>de <span class="blank _2"> </span>AAF <span class="blank _2"> </span>alopecia <span class="blank _2"> </span>fibrosante <span class="blank _2"> </span>en <span class="blank _2"> </span>distribución <span class="blank _2"> </span>de</div><div class="t m0 x3 h1e y154 ff6 fs1 fc0 sc0 ls6 ws7">patrones (AFDP) pérdida del pelo con patrón cicatricial (PCPC)<span class="fs8 ls9 wsa v1">18,20</span><span class="v0">.</span></div><div class="t m0 x3 h5 y155 ff5 fs3 fc0 sc0 ls6 ws2">T<span class="blank _3"></span>ratamiento</div><div class="t m0 x12 h6 y156 ff6 fs1 fc0 sc0 ls6 ws7">La <span class="blank _0"></span>alopecia <span class="blank _3"></span>androgénica femenina <span class="blank _3"></span>es uno <span class="blank _3"></span>de los <span class="blank _3"></span>problemas más</div><div class="t m0 x3 h6 y157 ff6 fs1 fc0 sc0 ls6 ws7">comp<span class="blank _1"> </span>lej<span class="blank _1"> </span>os <span class="blank _c"> </span>de <span class="blank _16"> </span>tr<span class="blank _1"> </span>ata<span class="blank _1"> </span>r <span class="blank _16"> </span>en<span class="blank _1"> </span> <span class="blank _16"> </span>de<span class="blank _1"> </span>rmat<span class="blank _1"> </span>olo<span class="blank _1"> </span>gía<span class="blank _1"> </span>. <span class="blank _16"> </span>Us<span class="blank _1"> </span>ual<span class="blank _1"> </span>men<span class="blank _1"> </span>te <span class="blank _16"> </span>n<span class="blank _1"> </span>o <span class="blank _16"> </span>ha<span class="blank _1"> </span>y</div><div class="t m0 x3 h6 y158 ff6 fs1 fc0 sc0 ls6 ws7">trat<span class="blank _1"> </span>ami<span class="blank _1"> </span>ent<span class="blank _1"> </span>o <span class="blank _2"> </span>c<span class="blank _1"> </span>ura<span class="blank _1"> </span>tiv<span class="blank _1"> </span>o <span class="blank _7"> </span>defi<span class="blank _1"> </span>nit<span class="blank _1"> </span>ivo <span class="blank _7"> </span>pa<span class="blank _1"> </span>ra <span class="blank _7"> </span>est<span class="blank _1"> </span>a <span class="blank _2"> </span>a<span class="blank _1"> </span>fec<span class="blank _1"> </span>ció<span class="blank _1"> </span>n, <span class="blank _7"> </span>la <span class="blank _7"> </span>AAF<span class="blank _1"> </span> <span class="blank _2"> </span>e<span class="blank _1"> </span>s <span class="blank _7"> </span>una</div><div class="t m0 x3 h6 y159 ff6 fs1 fc0 sc0 ls6 ws7">enfermedad <span class="blank _1"> </span>lentamente <span class="blank _2"> </span>progresiva <span class="blank _1"> </span>y <span class="blank _2"> </span>el <span class="blank _1"> </span>objetivo <span class="blank _2"> </span>de <span class="blank _1"> </span>la <span class="blank _2"> </span>terapia <span class="blank _1"> </span>será</div><div class="t m0 x3 h6 y15a ff6 fs1 fc0 sc0 ls6 ws7">dete<span class="blank _1"> </span>ner<span class="blank _1"> </span> <span class="blank _10"> </span>la <span class="blank _10"> </span>progre<span class="blank _1"> </span>sió<span class="blank _1"> </span>n <span class="blank _10"> </span>e <span class="blank _10"> </span>induc<span class="blank _1"> </span>ir <span class="blank _10"> </span>el <span class="blank _10"> </span>crec<span class="blank _1"> </span>imi<span class="blank _1"> </span>ent<span class="blank _1"> </span>o <span class="blank _10"> </span>de <span class="blank _10"> </span>pelo</div><div class="t m0 x3 h6 y15b ff6 fs1 fc0 sc0 ls6 ws7">cosm<span class="blank _1"> </span>éti<span class="blank _1"> </span>cam<span class="blank _1"> </span>ent<span class="blank _1"> </span>e <span class="blank"> </span>acept<span class="blank _1"> </span>abl<span class="blank _1"> </span>e. <span class="blank"> </span>Actu<span class="blank _1"> </span>alm<span class="blank _1"> </span>ent<span class="blank _1"> </span>e <span class="blank"> </span>han <span class="blank"> </span>apar<span class="blank _1"> </span>ecid<span class="blank _1"> </span>o <span class="blank"> </span>nuev<span class="blank _1"> </span>as</div><div class="t m0 x3 h6 y15c ff6 fs1 fc0 sc0 ls6 ws7">conduc<span class="blank _0"></span>tas <span class="blank _3"></span>terapéuti<span class="blank _0"></span>cas <span class="blank _3"></span>en <span class="blank _0"></span>el <span class="blank _3"></span>manejo <span class="blank _3"></span>de <span class="blank _0"></span>la <span class="blank _3"></span>alopecia <span class="blank _3"></span>androgé<span class="blank _0"></span>nica <span class="blank _3"></span>que</div><div class="t m0 x3 h6 y15d ff6 fs1 fc0 sc0 ls6 ws7">han <span class="blank _6"> </span>bri<span class="blank _1"> </span>ndad<span class="blank _1"> </span>o <span class="blank _7"> </span>u<span class="blank _1"> </span>na <span class="blank _6"> </span>evol<span class="blank _1"> </span>uci<span class="blank _1"> </span>ón <span class="blank _6"> </span>sati<span class="blank _1"> </span>sfa<span class="blank _1"> </span>ctor<span class="blank _1"> </span>ia <span class="blank _6"> </span>en <span class="blank _7"> </span>e<span class="blank _1"> </span>l <span class="blank _7"> </span>m<span class="blank _1"> </span>ane<span class="blank _1"> </span>jo <span class="blank _6"> </span>de <span class="blank _7"> </span>e<span class="blank _1"> </span>sto<span class="blank _1"> </span>s</div><div class="t m0 x3 h6 y15e ff6 fs1 fc0 sc0 ls6 ws7">paci<span class="blank _1"> </span>ent<span class="blank _1"> </span>es.<span class="blank _1"> </span> <span class="blank _7"> </span>S<span class="blank _1"> </span>in <span class="blank _6"> </span>e<span class="blank _1"> </span>mbar<span class="blank _1"> </span>go,<span class="blank _1"> </span> <span class="blank _6"> </span>es <span class="blank _6"> </span>ese<span class="blank _1"> </span>nci<span class="blank _1"> </span>al <span class="blank _6"> </span>di<span class="blank _1"> </span>scu<span class="blank _1"> </span>tir <span class="blank _6"> </span>c<span class="blank _1"> </span>on <span class="blank _6"> </span>el<span class="blank _1"> </span> <span class="blank _7"> </span>p<span class="blank _1"> </span>aci<span class="blank _1"> </span>ent<span class="blank _1"> </span>e <span class="blank _6"> </span>sus</div><div class="t m0 x3 h6 y15f ff6 fs1 fc0 sc0 ls6 ws7">expe<span class="blank _1"> </span>cta<span class="blank _1"> </span>tiv<span class="blank _1"> </span>as, <span class="blank _4"> </span>la<span class="blank _1"> </span>s <span class="blank _4"> </span>opci<span class="blank _1"> </span>one<span class="blank _1"> </span>s <span class="blank _4"> </span>ter<span class="blank _1"> </span>apéu<span class="blank _1"> </span>tic<span class="blank _1"> </span>as,<span class="blank _1"> </span> <span class="blank _a"> </span>s<span class="blank _1"> </span>us <span class="blank _4"> </span>co<span class="blank _1"> </span>stos<span class="blank _1"> </span> <span class="blank _4"> </span>y <span class="blank _4"> </span>efect<span class="blank _1"> </span>os</div><div class="t m0 x3 h6 y160 ff6 fs1 fc0 sc0 ls6 ws7">secu<span class="blank _1"> </span>nda<span class="blank _1"> </span>rio<span class="blank _1"> </span>s, <span class="blank _a"> </span>y <span class="blank _a"> </span>la <span class="blank _a"> </span>imp<span class="blank _1"> </span>ort<span class="blank _1"> </span>anci<span class="blank _1"> </span>a <span class="blank _a"> </span>del<span class="blank _1"> </span> <span class="blank _b"> </span>us<span class="blank _1"> </span>o <span class="blank _a"> </span>y <span class="blank _b"> </span>l<span class="blank _1"> </span>a <span class="blank _a"> </span>adhe<span class="blank _1"> </span>ren<span class="blank _1"> </span>cia<span class="blank _1"> </span> <span class="blank _b"> </span>a <span class="blank _a"> </span>lo<span class="blank _1"> </span>s</div><div class="t m0 x3 h6 y161 ff6 fs1 fc0 sc0 ls6 ws7">tratamientos. <span class="blank _1"> </span>No <span class="blank _2"> </span>obstante, <span class="blank _1"> </span>los <span class="blank _2"> </span>medicamentos <span class="blank _1"> </span>orales <span class="blank _1"> </span>y <span class="blank _2"> </span>tópicos <span class="blank _1"> </span>son</div><div class="t m0 x3 h6 y162 ff6 fs1 fc0 sc0 ls6 ws7">efectiv<span class="blank _0"></span>os <span class="blank _3"></span>para <span class="blank _3"></span>mantener <span class="blank _3"></span>solo <span class="blank _3"></span>el p<span class="blank _0"></span>elo <span class="blank _3"></span>existente<span class="blank _0"></span>, <span class="blank _3"></span>pero <span class="blank _0"></span>no <span class="blank _3"></span>tienen <span class="blank _3"></span>efecto</div><div class="t m0 x3 h22 y163 ff6 fs1 fc0 sc0 ls6 ws7">significativo sobre la restauración del pelo<span class="fs8 ls9 v1">1</span><span class="fs8 v1">0, 23<span class="fs1 v2">.</span></span></div><div class="t m0 x12 h6 y164 ff6 fs1 fc0 sc0 ls6 ws7">De <span class="blank _2"> </span>m<span class="blank _1"> </span>ane<span class="blank _1"> </span>ra <span class="blank _2"> </span>d<span class="blank _1"> </span>idá<span class="blank _1"> </span>cti<span class="blank _1"> </span>ca <span class="blank _2"> </span>s<span class="blank _1"> </span>e <span class="blank _2"> </span>d<span class="blank _1"> </span>ivid<span class="blank _1"> </span>e <span class="blank _2"> </span>e<span class="blank _1"> </span>l <span class="blank _2"> </span>tr<span class="blank _1"> </span>ata<span class="blank _1"> </span>mie<span class="blank _1"> </span>nto <span class="blank _7"> </span>de <span class="blank _2"> </span>l<span class="blank _1"> </span>a <span class="blank _2"> </span>s<span class="blank _1"> </span>igui<span class="blank _1"> </span>ent<span class="blank _1"> </span>e</div><div class="t m0 x3 h6 y165 ff6 fs1 fc0 sc0 ls6 ws7">forma: tópico, oral, antiandrogénico, intradérmico y otras terapias.</div><div class="t m0 x3 h5 y166 ff5 fs3 fc0 sc0 ls6 ws7">T<span class="blank _3"></span>ratamiento tópico </div><div class="t m0 x3 he y167 ff7 fs1 fc0 sc0 ls6 ws7">Minoxidil tópico:</div><div class="t m0 x10 h6 y168 ff6 fs1 fc0 sc0 ls6 ws7">El <span class="blank _1"> </span>minoxidil <span class="blank _1"> </span>tópico <span class="blank _1"> </span>es <span class="blank _1"> </span>el <span class="blank _2"> </span>tratamiento de <span class="blank _2"> </span>primera línea <span class="blank _1"> </span>para <span class="blank _2"> </span>AAF</div><div class="t m0 x3 h6 y169 ff6 fs1 fc0 sc0 ls6 ws7">aprobado por la FDA. Es un <span class="blank _0"></span>bloqueador de los canales de potasio <span class="blank _0"></span>y</div><div class="t m0 x3 h6 y16a ff6 fs1 fc0 sc0 ls6 ws7">un efecto <span class="blank _1"> </span>secundario <span class="blank _1"> </span>es el <span class="blank _1"> </span>aumento <span class="blank _1"> </span>en la <span class="blank _1"> </span>regeneración <span class="blank _1"> </span>del <span class="blank _1"> </span>pelo. El</div><div class="t m0 x3 h6 y16b ff6 fs1 fc0 sc0 ls6 ws7">meca<span class="blank _1"> </span>nis<span class="blank _1"> </span>mo <span class="blank _e"> </span>exa<span class="blank _1"> </span>cto<span class="blank _1"> </span> <span class="blank"> </span>de<span class="blank _1"> </span> <span class="blank"> </span>ac<span class="blank _1"> </span>ció<span class="blank _1"> </span>n <span class="blank"> </span>s<span class="blank _1"> </span>e <span class="blank"> </span>d<span class="blank _1"> </span>esco<span class="blank _1"> </span>noc<span class="blank _1"> </span>e, <span class="blank _e"> </span>alg<span class="blank _1"> </span>una<span class="blank _1"> </span>s <span class="blank"> </span>h<span class="blank _1"> </span>ipót<span class="blank _1"> </span>esi<span class="blank _1"> </span>s</div><div class="t m0 x3 h6 y16c ff6 fs1 fc0 sc0 ls6 ws7">incluyen <span class="blank _3"></span>aumento <span class="blank _0"></span>de <span class="blank _3"></span>la irrigación<span class="blank _0"></span> <span class="blank _0"></span>sanguínea <span class="blank _3"></span>y <span class="blank _0"></span>efectos <span class="blank _3"></span>proliferativos,</div><div class="t m0 x3 h6 y16d ff6 fs1 fc0 sc0 ls6 ws7">anti<span class="blank _1"> </span>and<span class="blank _1"> </span>rog<span class="blank _1"> </span>énic<span class="blank _1"> </span>os <span class="blank _16"> </span>y <span class="blank _16"> </span>antii<span class="blank _1"> </span>nfla<span class="blank _1"> </span>mat<span class="blank _1"> </span>ori<span class="blank _1"> </span>os. <span class="blank _16"> </span>El <span class="blank _16"> </span>mino<span class="blank _1"> </span>xidi<span class="blank _1"> </span>l <span class="blank _16"> </span>facil<span class="blank _1"> </span>ita<span class="blank _1"> </span> <span class="blank _16"> </span>la</div><div class="t m0 x3 h6 y16e ff6 fs1 fc0 sc0 ls6 ws7">prolongación de <span class="blank _1"> </span>la fase <span class="blank _1"> </span>anágena del <span class="blank _1"> </span>folículo <span class="blank _1"> </span>piloso y <span class="blank _1"> </span>la ampliación</div><div class="t m0 x3 h6 y16f ff6 fs1 fc0 sc0 ls6 ws7">de los <span class="blank _3"></span>folículos miniaturizados, alcanzando <span class="blank _0"></span>la transformación <span class="blank _3"></span>de los</div><div class="t m0 x3 h6 y170 ff6 fs1 fc0 sc0 ls6 ws7">folí<span class="blank _1"> </span>cul<span class="blank _1"> </span>os <span class="blank _17"> </span>capi<span class="blank _1"> </span>lar<span class="blank _1"> </span>es <span class="blank _17"> </span>mini<span class="blank _1"> </span>atu<span class="blank _1"> </span>riz<span class="blank _1"> </span>ados<span class="blank _1"> </span> <span class="blank _17"> </span>en <span class="blank _17"> </span>folícu<span class="blank _1"> </span>los<span class="blank _1"> </span> <span class="blank _17"> </span>capila<span class="blank _1"> </span>res</div><div class="t m0 x3 h23 y171 ff6 fs1 fc0 sc0 ls6 ws3">terminales<span class="fs8 lse wsb v1">10,23,24</span><span class="v0">.</span></div><div class="t m0 xb h6 y172 ff6 fs1 fc0 sc0 ls6 ws7">Se <span class="blank _0"></span>encuentra <span class="blank _3"></span>disponible en <span class="blank _3"></span>soluciones al <span class="blank _3"></span>2%, 5% <span class="blank _3"></span>y espuma <span class="blank _3"></span>al 5%,</div><div class="t m0 x3 h6 y173 ff6 fs1 fc0 sc0 ls6 ws7">la <span class="blank _3"></span>aplicación <span class="blank _3"></span>de <span class="blank _3"></span>minoxidil <span class="blank _3"></span>al <span class="blank _3"></span>2% dos<span class="blank _0"></span> <span class="blank _3"></span>veces <span class="blank _0"></span>al <span class="blank _3"></span>día <span class="blank _0"></span>muestr<span class="blank _0"></span>a <span class="blank _3"></span>una e<span class="blank _0"></span>ficacia</div><div class="t m0 x3 h6 y174 ff6 fs1 fc0 sc0 ls6 ws7">similar <span class="blank _3"></span>a l<span class="blank _0"></span>a <span class="blank _3"></span>solución d<span class="blank _0"></span>e <span class="blank _3"></span>minoxidil <span class="blank _0"></span>al <span class="blank _3"></span>5% o <span class="blank _3"></span>la <span class="blank _0"></span>espuma <span class="blank _3"></span>aplicada <span class="blank _3"></span>una vez</div><div class="t m0 x3 h6 y175 ff6 fs1 fc0 sc0 ls6 ws7">al <span class="blank _3"></span>día. El <span class="blank _3"></span>minoxidil tópico <span class="blank _3"></span>se <span class="blank _3"></span>debe aplicar <span class="blank _3"></span>como 1 <span class="blank _3"></span>ml <span class="blank _0"></span>de <span class="blank _3"></span>solución con</div><div class="t m0 x3 h6 y176 ff6 fs1 fc0 sc0 ls6 ws7">una pipeta <span class="blank _3"></span>directamente sobre el <span class="blank _0"></span>cuero cabelludo <span class="blank _3"></span>seco, no necesita</div><div class="t m0 x3 h6 y177 ff6 fs1 fc0 sc0 ls6 ws7">masaje y <span class="blank _3"></span>es recomendable <span class="blank _3"></span>aplicarlo 2 <span class="blank _0"></span>horas <span class="blank _0"></span>antes <span class="blank _0"></span>de acostarse <span class="blank _3"></span>para</div><div class="t m0 x13 h6 y178 ff6 fs1 fc0 sc0 ls6 ws7">permitir el <span class="blank _3"></span>secado adecuado <span class="blank _0"></span>del <span class="blank _0"></span>pelo y <span class="blank _3"></span>evitar que <span class="blank _0"></span>se extienda <span class="blank _3"></span>por la</div><div class="t m0 x13 h6 y179 ff6 fs1 fc0 sc0 ls6 ws7">cara <span class="blank _1"> </span>durante <span class="blank _1"> </span>el <span class="blank _1"> </span>sueño. <span class="blank _1"> </span>Su <span class="blank _2"> </span>eficacia se <span class="blank _2"> </span>pudo observar <span class="blank _2"> </span>después de <span class="blank _2"> </span>6-</div><div class="t m0 x13 h6 y17a ff6 fs1 fc0 sc0 ls6 ws7">12 <span class="blank _2"> </span>meses <span class="blank _1"> </span>de <span class="blank _2"> </span>tratamiento. <span class="blank _1"> </span>Se <span class="blank _2"> </span>debe <span class="blank _2"> </span>informar <span class="blank _1"> </span>a <span class="blank _2"> </span>los <span class="blank _2"> </span>pacientes <span class="blank _1"> </span>acerca</div><div class="t m0 x13 h6 y17b ff6 fs1 fc0 sc0 ls6 ws7">de <span class="blank _3"></span>un <span class="blank _3"></span>aument<span class="blank _0"></span>o <span class="blank _3"></span>trans<span class="blank _0"></span>itor<span class="blank _0"></span>io <span class="blank _3"></span>en <span class="blank _3"></span>la <span class="blank _3"></span>pérdid<span class="blank _0"></span>a <span class="blank _3"></span>de <span class="blank _3"></span>pelo <span class="blank _3"></span>en <span class="blank _0"></span>tel<span class="blank _0"></span>ógen<span class="blank _3"></span>o du<span class="blank _3"></span>rante</div><div class="t m0 x13 h6 y17c ff6 fs1 fc0 sc0 ls6 ws7">los primeros <span class="blank _0"></span>meses de tratamiento. <span class="blank _3"></span>Si se interrumpe el <span class="blank _0"></span>tratamiento,</div><div class="t m0 x13 h6 y17d ff6 fs1 fc0 sc0 ls6 ws7">se <span class="blank _1"> </span>produce <span class="blank _2"> </span>una <span class="blank _1"> </span>regresión <span class="blank _1"> </span>clínica <span class="blank _2"> </span>dentro <span class="blank _1"> </span>de <span class="blank _1"> </span>los <span class="blank _2"> </span>6 <span class="blank _1"> </span>meses <span class="blank _2"> </span>y <span class="blank _1"> </span>el <span class="blank _1"> </span>grado</div><div class="t m0 x13 h6 y17e ff6 fs1 fc0 sc0 ls6 ws7">de <span class="blank _7"> </span>alop<span class="blank _1"> </span>eci<span class="blank _1"> </span>a <span class="blank _2"> </span>v<span class="blank _1"> </span>olv<span class="blank _1"> </span>erá<span class="blank _1"> </span> <span class="blank _2"> </span>a <span class="blank _7"> </span>su <span class="blank _7"> </span>est<span class="blank _1"> </span>ado<span class="blank _1"> </span> <span class="blank _2"> </span>in<span class="blank _1"> </span>ici<span class="blank _1"> </span>al. <span class="blank _7"> </span>El <span class="blank _7"> </span>efe<span class="blank _1"> </span>cto<span class="blank _1"> </span> <span class="blank _2"> </span>se<span class="blank _1"> </span>cun<span class="blank _1"> </span>dar<span class="blank _1"> </span>io <span class="blank _7"> </span>más</div><div class="t m0 x13 h6 y17f ff6 fs1 fc0 sc0 ls6 ws7">desag<span class="blank _1"> </span>radabl<span class="blank _1"> </span>e <span class="blank _2"> </span>en <span class="blank _2"> </span>las <span class="blank _2"> </span>mujere<span class="blank _1"> </span>s <span class="blank _2"> </span>es <span class="blank _2"> </span>la <span class="blank _2"> </span>hipertr<span class="blank _1"> </span>icosi<span class="blank _1"> </span>s, <span class="blank _2"> </span>puede<span class="blank _1"> </span> <span class="blank _2"> </span>producir<span class="blank _1"> </span>se</div><div class="t m0 x13 h6 y180 ff6 fs1 fc0 sc0 ls6 ws7">derm<span class="blank _1"> </span>ati<span class="blank _1"> </span>tis<span class="blank _1"> </span> <span class="blank"> </span>de <span class="blank _e"> </span>con<span class="blank _1"> </span>tac<span class="blank _1"> </span>to <span class="blank"> </span>i<span class="blank _1"> </span>rri<span class="blank _1"> </span>tant<span class="blank _1"> </span>e <span class="blank"> </span>o<span class="blank _1"> </span> <span class="blank"> </span>alé<span class="blank _1"> </span>rgi<span class="blank _1"> </span>ca,<span class="blank _1"> </span> <span class="blank"> </span>rel<span class="blank _1"> </span>aci<span class="blank _1"> </span>onad<span class="blank _1"> </span>a <span class="blank"> </span>c<span class="blank _1"> </span>on <span class="blank"> </span>e<span class="blank _1"> </span>l</div><div class="t m0 x13 h1a y181 ff6 fs1 fc0 sc0 ls6 ws7">vehículo de solución de propilenglicol<span class="fs8 ws8 v1">10,23,24</span>.</div><div class="t m0 x13 he y182 ff7 fs1 fc0 sc0 ls6 ws9">Ketoconazol:</div><div class="t m0 x15 h6 y183 ff6 fs1 fc0 sc0 ls6 ws7">Es <span class="blank _3"></span>un <span class="blank _0"></span>medic<span class="blank _0"></span>ament<span class="blank _0"></span>o <span class="blank _3"></span>antimicóti<span class="blank _0"></span>co <span class="blank _3"></span>utilizad<span class="blank _0"></span>o <span class="blank _3"></span>para <span class="blank _3"></span>tratar <span class="blank _3"></span>la <span class="blank _0"></span>derma<span class="blank _0"></span>titis</div><div class="t m0 x13 h6 y184 ff6 fs1 fc0 sc0 ls6 ws7">sebo<span class="blank _1"> </span>rre<span class="blank _1"> </span>ica<span class="blank _1"> </span>. <span class="blank _8"> </span>En<span class="blank _1"> </span> <span class="blank _8"> </span>AAF<span class="blank _1"> </span>, <span class="blank _8"> </span>el<span class="blank _1"> </span> <span class="blank _8"> </span>cha<span class="blank _1"> </span>mpú<span class="blank _1"> </span> <span class="blank _8"> </span>ha <span class="blank _8"> </span>d<span class="blank _1"> </span>emo<span class="blank _1"> </span>stra<span class="blank _1"> </span>do <span class="blank _8"> </span>s<span class="blank _1"> </span>u <span class="blank _8"> </span>ut<span class="blank _1"> </span>ili<span class="blank _1"> </span>dad<span class="blank _1"> </span>,</div><div class="t m0 x13 h6 y185 ff6 fs1 fc0 sc0 ls6 ws7">especia<span class="blank _0"></span>lmente <span class="blank _3"></span>si <span class="blank _3"></span>se u<span class="blank _0"></span>sa <span class="blank _3"></span>en c<span class="blank _0"></span>ombinac<span class="blank _0"></span>ión <span class="blank _3"></span>con <span class="blank _3"></span>otros <span class="blank _0"></span>tratam<span class="blank _0"></span>ientos.<span class="blank _0"></span> <span class="blank _3"></span>Este</div><div class="t m0 x13 h6 y186 ff6 fs1 fc0 sc0 ls6 ws7">efec<span class="blank _1"> </span>to <span class="blank _9"> </span>pod<span class="blank _1"> </span>ría <span class="blank _9"> </span>deb<span class="blank _1"> </span>ers<span class="blank _1"> </span>e <span class="blank _d"> </span>a <span class="blank _9"> </span>su <span class="blank _9"> </span>pod<span class="blank _1"> </span>er <span class="blank _9"> </span>anti<span class="blank _1"> </span>inf<span class="blank _1"> </span>lama<span class="blank _1"> </span>tor<span class="blank _1"> </span>io,<span class="blank _1"> </span> <span class="blank _d"> </span>qu<span class="blank _1"> </span>e <span class="blank _d"> </span>r<span class="blank _1"> </span>educ<span class="blank _1"> </span>e</div><div class="t m1 x13 h16 y187 ffa fs9 fc0 sc0 ls6 ws7">Malassezia </div><div class="t m0 x34 h6 y187 ff6 fs1 fc0 sc0 ls6 ws7">y <span class="blank _2"> </span>a <span class="blank _1"> </span>su <span class="blank _2"> </span>capacid<span class="blank _1"> </span>ad <span class="blank _2"> </span>para <span class="blank _2"> </span>disminuir <span class="blank _2"> </span>la <span class="blank _2"> </span>dihidrotestosterona</div><div class="t m0 x13 h6 y188 ff6 fs1 fc0 sc0 ls6 ws7">en <span class="blank _a"> </span>l<span class="blank _1"> </span>a <span class="blank _a"> </span>p<span class="blank _1"> </span>iel<span class="blank _1"> </span> <span class="blank _a"> </span>qu<span class="blank _1"> </span>e <span class="blank _a"> </span>ac<span class="blank _1"> </span>túa<span class="blank _1"> </span> <span class="blank _a"> </span>co<span class="blank _1"> </span>mo <span class="blank _a"> </span>u<span class="blank _1"> </span>n <span class="blank _a"> </span>a<span class="blank _1"> </span>nta<span class="blank _1"> </span>gon<span class="blank _1"> </span>ista<span class="blank _1"> </span> <span class="blank _a"> </span>de<span class="blank _1"> </span>l <span class="blank _a"> </span>r<span class="blank _1"> </span>ecep<span class="blank _1"> </span>tor<span class="blank _1"> </span> <span class="blank _a"> </span>de</div><div class="t m0 x13 h6 y189 ff6 fs1 fc0 sc0 ls6 ws7">andr<span class="blank _1"> </span>óge<span class="blank _1"> </span>nos<span class="blank _1"> </span>. <span class="blank _d"> </span>S<span class="blank _1"> </span>e <span class="blank _d"> </span>r<span class="blank _1"> </span>eco<span class="blank _1"> </span>mie<span class="blank _1"> </span>nda <span class="blank _9"> </span>en <span class="blank _9"> </span>muj<span class="blank _1"> </span>ere<span class="blank _1"> </span>s <span class="blank _d"> </span>c<span class="blank _1"> </span>on <span class="blank _9"> </span>AAF<span class="blank _1"> </span> <span class="blank _d"> </span>as<span class="blank _1"> </span>oci<span class="blank _1"> </span>ada <span class="blank _9"> </span>con</div><div class="t m0 x13 h1a y18a ff6 fs1 fc0 sc0 ls6 ws7">dermatitis seborreica o sebopsoriasis<span class="fs8 ws8 v1">10</span>.</div><div class="t m0 x13 he y18b ff7 fs1 fc0 sc0 ls6 ws7">Cetirizina: </div><div class="t m0 x2d h6 y18c ff6 fs1 fc0 sc0 ls6 ws7">Es <span class="blank _7"> </span>u<span class="blank _1"> </span>n <span class="blank _7"> </span>a<span class="blank _1"> </span>ntag<span class="blank _1"> </span>oni<span class="blank _1"> </span>sta<span class="blank _1"> </span> <span class="blank _7"> </span>del<span class="blank _1"> </span> <span class="blank _7"> </span>re<span class="blank _1"> </span>cept<span class="blank _1"> </span>or <span class="blank _6"> </span>de <span class="blank _7"> </span>h<span class="blank _1"> </span>ist<span class="blank _1"> </span>ami<span class="blank _1"> </span>na <span class="blank _7"> </span>H<span class="blank _1"> </span>1 <span class="blank _7"> </span>d<span class="blank _1"> </span>e <span class="blank _7"> </span>se<span class="blank _1"> </span>gun<span class="blank _1"> </span>da</div><div class="t m0 x13 h6 y18d ff6 fs1 fc0 sc0 ls6 ws7">generación, seguro <span class="blank _3"></span>y selectivo, a<span class="blank _0"></span>mpliamente utilizado <span class="blank _3"></span>en la práctica</div><div class="t m0 x13 h6 y18e ff6 fs1 fc0 sc0 ls6 ws7">diar<span class="blank _1"> </span>ia. <span class="blank _2"> </span>Alg<span class="blank _1"> </span>unas<span class="blank _1"> </span> <span class="blank _2"> </span>invest<span class="blank _1"> </span>igac<span class="blank _1"> </span>ione<span class="blank _1"> </span>s <span class="blank _2"> </span>repor<span class="blank _1"> </span>tan <span class="blank _2"> </span>que<span class="blank _1"> </span> <span class="blank _2"> </span>la <span class="blank _2"> </span>cetir<span class="blank _1"> </span>izin<span class="blank _1"> </span>a <span class="blank _2"> </span>provo<span class="blank _1"> </span>ca</div><div class="t m0 x13 h6 y18f ff6 fs1 fc0 sc0 ls6 ws7">una <span class="blank _8"> </span>reduc<span class="blank _1"> </span>ció<span class="blank _1"> </span>n <span class="blank _4"> </span>s<span class="blank _1"> </span>ign<span class="blank _1"> </span>ific<span class="blank _1"> </span>ati<span class="blank _1"> </span>va <span class="blank _8"> </span>tanto<span class="blank _1"> </span> <span class="blank _4"> </span>en <span class="blank _8"> </span>el <span class="blank _4"> </span>i<span class="blank _1"> </span>nfil<span class="blank _1"> </span>tra<span class="blank _1"> </span>do <span class="blank _8"> </span>de <span class="blank _4"> </span>cé<span class="blank _1"> </span>lula<span class="blank _1"> </span>s</div><div class="t m0 x13 h6 y190 ff6 fs1 fc0 sc0 ls6 ws7">inflamatorias como en la producción de prostaglandina D2 (PGD2).</div><div class="t m0 x13 h1a y191 ff6 fs1 fc0 sc0 ls6 ws7">Su indicación es tópica al 1% (1 aplicación / diaria ¼ 1ml / día)<span class="fs8 ws8 v1">25</span>.</div><div class="t m0 x13 h6 y192 ff6 fs1 fc0 sc0 ls6 ws7">Según <span class="blank _1"> </span>informes <span class="blank _1"> </span>sobre <span class="blank _2"> </span>el efecto <span class="blank _2"> </span>de <span class="blank _1"> </span>varios <span class="blank _1"> </span>tipos <span class="blank _1"> </span>de <span class="blank _2"> </span>prostaglandinas</div><div class="t m0 x13 h6 y193 ff6 fs1 fc0 sc0 ls6 ws7">en el <span class="blank _1"> </span>ciclo <span class="blank _1"> </span>del <span class="blank _1"> </span>folículo <span class="blank _1"> </span>piloso, <span class="blank _1"> </span>se ha <span class="blank _1"> </span>demostrado <span class="blank _1"> </span>que <span class="blank _1"> </span>los <span class="blank _1"> </span>tipos E <span class="blank _1"> </span>y <span class="blank _1"> </span>F</div><div class="t m0 x13 h6 y194 ff6 fs1 fc0 sc0 ls6 ws7">(PGE <span class="blank _2"> </span>y <span class="blank _2"> </span>PGF <span class="blank _2"> </span>a) <span class="blank _1"> </span>e<span class="blank _1"> </span>stimulan<span class="blank _1"> </span> <span class="blank _2"> </span>el <span class="blank _1"> </span>c<span class="blank _1"> </span>recimien<span class="blank _1"> </span>to <span class="blank _2"> </span>del <span class="blank _2"> </span>pelo, <span class="blank _2"> </span>mientras <span class="blank _2"> </span>que <span class="blank _2"> </span>los</div><div class="t m0 x13 h6 y195 ff6 fs1 fc0 sc0 ls6 ws7">tipos <span class="blank _1"> </span>D <span class="blank _1"> </span>(en <span class="blank _2"> </span>particular <span class="blank _1"> </span>PGD2) <span class="blank _1"> </span>favorecen <span class="blank _1"> </span>la <span class="blank _2"> </span>progresión de <span class="blank _2"> </span>la <span class="blank _1"> </span>calvicie.</div><div class="t m0 x13 h6 y196 ff6 fs1 fc0 sc0 ls6 ws7">De <span class="blank _6"> </span>hec<span class="blank _1"> </span>ho, <span class="blank _6"> </span>PG<span class="blank _1"> </span>D2 <span class="blank _6"> </span>inh<span class="blank _1"> </span>ibe <span class="blank _6"> </span>el<span class="blank _1"> </span> <span class="blank _7"> </span>cr<span class="blank _1"> </span>eci<span class="blank _1"> </span>mie<span class="blank _1"> </span>nto <span class="blank _6"> </span>de<span class="blank _1"> </span>l <span class="blank _7"> </span>p<span class="blank _1"> </span>elo<span class="blank _1"> </span>, <span class="blank _6"> </span>favo<span class="blank _1"> </span>rec<span class="blank _1"> </span>iend<span class="blank _1"> </span>o <span class="blank _6"> </span>la</div><div class="t m0 x13 h1a y197 ff6 fs1 fc0 sc0 ls6 ws3">miniaturización<span class="fs8 ws8 v1">25</span>.</div><div class="t m0 x13 h5 y198 ff5 fs3 fc0 sc0 ls6 ws7">T<span class="blank _3"></span>ratamiento oral</div><div class="t m0 x13 he y199 ff7 fs1 fc0 sc0 ls6 ws7">Minoxidil oral:</div><div class="t m0 x14 h6 y19a ff6 fs1 fc0 sc0 ls6 ws7">El <span class="blank _b"> </span>min<span class="blank _1"> </span>oxi<span class="blank _1"> </span>dil<span class="blank _1"> </span> <span class="blank _e"> </span>e<span class="blank _1"> </span>s <span class="blank _b"> </span>un <span class="blank _b"> </span>de<span class="blank _1"> </span>riv<span class="blank _1"> </span>ado <span class="blank _b"> </span>de<span class="blank _1"> </span> <span class="blank _e"> </span>p<span class="blank _1"> </span>ipe<span class="blank _1"> </span>rid<span class="blank _1"> </span>ino<span class="blank _1"> </span>piri<span class="blank _1"> </span>mid<span class="blank _1"> </span>ina<span class="blank _1"> </span> <span class="blank _e"> </span>y<span class="blank _1"> </span> <span class="blank _e"> </span>u<span class="blank _1"> </span>n</div><div class="t m0 x13 h6 y19b ff6 fs1 fc0 sc0 ls6 ws7">vasodilatador que <span class="blank _3"></span>se usa <span class="blank _3"></span>por vía oral <span class="blank _3"></span>para la <span class="blank _3"></span>hipertensión. En <span class="blank _0"></span>AAF el</div><div class="t m0 x13 h6 y19c ff6 fs1 fc0 sc0 ls6 ws7">minoxidil oral <span class="blank _0"></span>se usa <span class="blank _0"></span>en dosis <span class="blank _0"></span>mucho más <span class="blank _0"></span>bajas que <span class="blank _0"></span>las que <span class="blank _0"></span>se usan</div><div class="t m0 x13 h6 y19d ff6 fs1 fc0 sc0 ls6 ws7">para tratar <span class="blank _0"></span>la presión <span class="blank _3"></span>arterial alta, las dosis <span class="blank _3"></span>varían de 0.25 <span class="blank _0"></span>a 2.5 <span class="blank _0"></span>mg /</div><div class="t m0 x13 h6 y19e ff6 fs1 fc0 sc0 ls6 ws7">día. <span class="blank _3"></span>Los pacientes <span class="blank _3"></span>se consideran<span class="blank _0"></span> <span class="blank _0"></span>elegibles <span class="blank _3"></span>para el <span class="blank _3"></span>minoxidil <span class="blank _0"></span>oral <span class="blank _3"></span>si su</div><div class="t m0 x13 h6 y19f ff6 fs1 fc0 sc0 ls6 ws7">pérdida de <span class="blank _1"> </span>pelo <span class="blank _1"> </span>no <span class="blank _1"> </span>responde <span class="blank _1"> </span>al <span class="blank _1"> </span>minoxidil tópico <span class="blank _1"> </span>o <span class="blank _1"> </span>si <span class="blank _1"> </span>no <span class="blank _1"> </span>lo <span class="blank _1"> </span>toleran.</div><div class="t m0 x13 h6 y1a0 ff6 fs1 fc0 sc0 ls6 ws7">Puede causar <span class="blank _1"> </span>una <span class="blank _1"> </span>reducción <span class="blank _1"> </span>significativa en <span class="blank _1"> </span>la <span class="blank _1"> </span>presión <span class="blank _1"> </span>arterial si <span class="blank _1"> </span>se</div><div class="t m0 x13 h6 y1a1 ff6 fs1 fc0 sc0 ls6 ws7">admi<span class="blank _1"> </span>nis<span class="blank _1"> </span>tra<span class="blank _1"> </span> <span class="blank _18"> </span>con <span class="blank _18"> </span>o<span class="blank _1"> </span>tro<span class="blank _1"> </span>s <span class="blank _18"> </span>tra<span class="blank _1"> </span>tam<span class="blank _1"> </span>ien<span class="blank _1"> </span>tos<span class="blank _1"> </span> <span class="blank _5"> </span>a<span class="blank _1"> </span>nti<span class="blank _1"> </span>hip<span class="blank _1"> </span>ert<span class="blank _1"> </span>ensi<span class="blank _1"> </span>vos<span class="blank _1"> </span> <span class="blank _18"> </span>e</div><div class="t m0 x13 h13 y1a2 ff6 fs1 fc0 sc0 ls6 ws3">hipertricosis<span class="fs8 ws8 v1">10,26-28</span><span class="v0">.</span></div><div class="t m0 x35 h3 y2 ff2 fs1 fc0 sc0 ls6 ws10">1<span class="blank _3"></span>1</div><div class="t m0 x1 h4 y3 ff3 fs2 fc0 sc0 ls6 ws7">Dermatol V<span class="blank _0"></span>enez <span class="ff4 ls0">h</span>Vol.59 <span class="ff4 ls1">h</span>N°2 <span class="ff4 ls2">h</span><span class="ws1">2021</span></div><div class="t m0 xd h2 y1 ff1 fs0 fc0 sc0 ls6 ws7">REVISIÓN </div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf7" class="pf w0 h0" data-page-no="7"><div class="pc pc7 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x0 y30 w1 hc" alt="" src="https://files.passeidireto.com/75f5f44c-f020-40b0-8bec-4e63b893e22f/bg7.png"><div class="t m0 x2c h3 y2 ff2 fs1 fc0 sc0 ls6 ws10">12</div><div class="t m0 x3 h4 y3 ff3 fs2 fc0 sc0 ls6 ws7">Dermatol V<span class="blank _0"></span>enez <span class="ff4 ls0">h</span>Vol.59 <span class="ff4 ls1">h</span>N°2 <span class="ff4 ls2">h</span><span class="ws1">2021</span></div><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls6 ws7">REVISIÓN </div><div class="t m0 xf h6 y8b ff6 fs1 fc0 sc0 ls6 ws7">Se <span class="blank _9"> </span>dem<span class="blank _1"> </span>ostr<span class="blank _1"> </span>ó <span class="blank _9"> </span>en <span class="blank _9"> </span>un <span class="blank _9"> </span>estu<span class="blank _1"> </span>dio<span class="blank _1"> </span> <span class="blank _d"> </span>p<span class="blank _1"> </span>rosp<span class="blank _1"> </span>ect<span class="blank _1"> </span>ivo<span class="blank _1"> </span> <span class="blank _d"> </span>au<span class="blank _1"> </span>str<span class="blank _1"> </span>ali<span class="blank _1"> </span>ano <span class="blank _9"> </span>que<span class="blank _1"> </span> <span class="blank _d"> </span>l<span class="blank _1"> </span>a</div><div class="t m0 x3 h6 y1a3 ff6 fs1 fc0 sc0 ls6 ws7">combinación el <span class="blank _1"> </span>minoxidil <span class="blank _1"> </span>oral <span class="blank _1"> </span>0,25 mg/día <span class="blank _1"> </span>más <span class="blank _1"> </span>espironolactona <span class="blank _1"> </span>25</div><div class="t m0 x3 h6 y1a4 ff6 fs1 fc0 sc0 ls6 ws7">mg es eficaz para reducir la gravedad de la pérdida del pelo a los 6</div><div class="t m0 x3 h6 y1a5 ff6 fs1 fc0 sc0 ls6 ws7">y <span class="blank _2"> </span>12 <span class="blank _2"> </span>m<span class="blank _1"> </span>ese<span class="blank _1"> </span>s. <span class="blank _2"> </span>Se<span class="blank _1"> </span> <span class="blank _2"> </span>agr<span class="blank _1"> </span>egó<span class="blank _1"> </span> <span class="blank _2"> </span>espi<span class="blank _1"> </span>ron<span class="blank _1"> </span>ola<span class="blank _1"> </span>cton<span class="blank _1"> </span>a <span class="blank _2"> </span>pa<span class="blank _1"> </span>ra <span class="blank _2"> </span>re<span class="blank _1"> </span>duc<span class="blank _1"> </span>ir <span class="blank _2"> </span>e<span class="blank _1"> </span>l <span class="blank _2"> </span>rie<span class="blank _1"> </span>sgo<span class="blank _1"> </span> <span class="blank _2"> </span>de</div><div class="t m0 x3 h1a y1a6 ff6 fs1 fc0 sc0 ls6 ws7">edema y aumentar la respuesta al tratamiento<span class="fs8 ls9 wsa v1">10,26-28</span>.</div><div class="t m0 x3 h5 y1a7 ff5 fs3 fc0 sc0 ls6 ws7">T<span class="blank _3"></span>ratamiento antiandrogénico </div><div class="t m0 x3 he y1a8 ff7 fs1 fc0 sc0 ls6 ws7">Tratamientos moduladores de hormonas:</div><div class="t m0 x10 h6 y1a9 ff6 fs1 fc0 sc0 ls6 ws7">Los <span class="blank _3"></span>tratamientos <span class="blank _3"></span>moduladores <span class="blank _3"></span>de hormon<span class="blank _0"></span>as <span class="blank _3"></span>utilizados <span class="blank _0"></span>para <span class="blank _3"></span>AAF</div><div class="t m0 x3 h6 y1aa ff6 fs1 fc0 sc0 ls6 ws7">cont<span class="blank _1"> </span>ien<span class="blank _1"> </span>en <span class="blank _2"> </span>an<span class="blank _1"> </span>tag<span class="blank _1"> </span>onis<span class="blank _1"> </span>tas<span class="blank _1"> </span> <span class="blank _2"> </span>de <span class="blank _2"> </span>los<span class="blank _1"> </span> <span class="blank _2"> </span>rece<span class="blank _1"> </span>pto<span class="blank _1"> </span>res <span class="blank _2"> </span>de<span class="blank _1"> </span> <span class="blank _2"> </span>anti<span class="blank _1"> </span>and<span class="blank _1"> </span>róg<span class="blank _1"> </span>eno,<span class="blank _1"> </span> <span class="blank _2"> </span>que</div><div class="t m0 x3 h6 y1ab ff6 fs1 fc0 sc0 ls6 ws7">impi<span class="blank _1"> </span>den <span class="blank _2"> </span>la <span class="blank _2"> </span>uni<span class="blank _1"> </span>ón <span class="blank _2"> </span>de <span class="blank _2"> </span>la <span class="blank _2"> </span>test<span class="blank _1"> </span>oste<span class="blank _1"> </span>rona <span class="blank _2"> </span>y <span class="blank _2"> </span>la <span class="blank _2"> </span>dih<span class="blank _1"> </span>idrot<span class="blank _1"> </span>esto<span class="blank _1"> </span>ster<span class="blank _1"> </span>ona <span class="blank _2"> </span>a <span class="blank _2"> </span>su</div><div class="t m0 x3 h6 y1ac ff6 fs1 fc0 sc0 ls6 ws7">receptor, y <span class="blank _3"></span>antiandrógenos reales, que <span class="blank _3"></span>alteran los andrógenos <span class="blank _3"></span>en el</div><div class="t m0 x3 h24 y1ad ff6 fs1 fc0 sc0 ls6 ws7">folí<span class="blank _1"> </span>cul<span class="blank _1"> </span>o <span class="blank _19"> </span>pilo<span class="blank _1"> </span>so.<span class="blank _1"> </span> <span class="blank _f"> </span>L<span class="blank _1"> </span>os <span class="blank _19"> </span>inh<span class="blank _1"> </span>ibi<span class="blank _1"> </span>dore<span class="blank _1"> </span>s <span class="blank _19"> </span>de <span class="blank _19"> </span>5-<span class="ff9 fsa ls13 v0">a</span><span class="v0">-<span class="blank _1"> </span>red<span class="blank _1"> </span>ucta<span class="blank _1"> </span>sa <span class="blank _19"> </span>o <span class="blank _19"> </span>los</span></div><div class="t m0 x3 h6 y1ae ff6 fs1 fc0 sc0 ls6 ws7">antiandrógenos <span class="blank _2"> </span>están <span class="blank _1"> </span>prohibido<span class="blank _1"> </span>s <span class="blank _2"> </span>en <span class="blank _1"> </span>embarazadas. <span class="blank _2"> </span>Debe <span class="blank _2"> </span>indicarse</div><div class="t m0 x3 h6 y1af ff6 fs1 fc0 sc0 ls6 ws7">anticoncepción <span class="blank _1"> </span>estricta <span class="blank _1"> </span>durante, <span class="blank _2"> </span>y <span class="blank _1"> </span>al <span class="blank _1"> </span>menos, <span class="blank _2"> </span>30 días <span class="blank _2"> </span>después <span class="blank _1"> </span>de <span class="blank _1"> </span>la</div><div class="t m0 x3 h6 y1b0 ff6 fs1 fc0 sc0 ls6 ws7">inte<span class="blank _1"> </span>rru<span class="blank _1"> </span>pci<span class="blank _1"> </span>ón <span class="blank _16"> </span>d<span class="blank _1"> </span>e <span class="blank _16"> </span>es<span class="blank _1"> </span>tos<span class="blank _1"> </span> <span class="blank _16"> </span>med<span class="blank _1"> </span>ica<span class="blank _1"> </span>men<span class="blank _1"> </span>tos.<span class="blank _1"> </span> <span class="blank _16"> </span>Su<span class="blank _1"> </span> <span class="blank _16"> </span>adm<span class="blank _1"> </span>ini<span class="blank _1"> </span>stra<span class="blank _1"> </span>ció<span class="blank _1"> </span>n <span class="blank _16"> </span>es</div><div class="t m0 x3 h6 y1b1 ff6 fs1 fc0 sc0 ls6 ws7">acon<span class="blank _1"> </span>sej<span class="blank _1"> </span>abl<span class="blank _1"> </span>e, <span class="blank _7"> </span>e<span class="blank _1"> </span>n <span class="blank _7"> </span>as<span class="blank _1"> </span>oci<span class="blank _1"> </span>ació<span class="blank _1"> </span>n <span class="blank _7"> </span>c<span class="blank _1"> </span>on <span class="blank _7"> </span>m<span class="blank _1"> </span>inox<span class="blank _1"> </span>idi<span class="blank _1"> </span>l, <span class="blank _7"> </span>e<span class="blank _1"> </span>n <span class="blank _7"> </span>c<span class="blank _1"> </span>asos<span class="blank _1"> </span> <span class="blank _7"> </span>de <span class="blank _6"> </span>resp<span class="blank _1"> </span>ues<span class="blank _1"> </span>ta</div><div class="t m0 x3 h1a y1b2 ff6 fs1 fc0 sc0 ls6 ws7">inadec<span class="blank _0"></span>uada <span class="blank _3"></span>a <span class="blank _3"></span>este <span class="blank _0"></span>último<span class="blank _0"></span> <span class="blank _3"></span>o en <span class="blank _3"></span>pacien<span class="blank _0"></span>tes <span class="blank _3"></span>con <span class="blank _3"></span>hiperandro<span class="blank _0"></span>genism<span class="blank _0"></span>o<span class="fs8 ws8 v1">10,2<span class="blank _0"></span>3<span class="fs1 v2">.</span></span></div><div class="t m0 x3 he y1b3 ff7 fs1 fc0 sc0 ls6 ws9">Finasterida:</div><div class="t m0 x12 h6 y1b4 ff6 fs1 fc0 sc0 ls6 ws7">La <span class="blank _2"> </span>fin<span class="blank _1"> </span>ast<span class="blank _1"> </span>eri<span class="blank _1"> </span>da <span class="blank _2"> </span>es<span class="blank _1"> </span> <span class="blank _2"> </span>un <span class="blank _2"> </span>inhi<span class="blank _1"> </span>bid<span class="blank _1"> </span>or <span class="blank _2"> </span>de<span class="blank _1"> </span> <span class="blank _2"> </span>la <span class="blank _2"> </span>5-<span class="ff9 fsa ls14">a</span>-<span class="blank _1"> </span>redu<span class="blank _1"> </span>cta<span class="blank _1"> </span>sa <span class="blank _2"> </span>ti<span class="blank _1"> </span>po <span class="blank _2"> </span>II<span class="blank _1"> </span> <span class="blank _2"> </span>que</div><div class="t m0 x3 h6 y1b5 ff6 fs1 fc0 sc0 ls6 ws7">bloq<span class="blank _1"> </span>uea<span class="blank _1"> </span> <span class="blank"> </span>la <span class="blank"> </span>con<span class="blank _1"> </span>ver<span class="blank _1"> </span>sió<span class="blank _1"> </span>n <span class="blank"> </span>de <span class="blank"> </span>te<span class="blank _1"> </span>stos<span class="blank _1"> </span>ter<span class="blank _1"> </span>ona<span class="blank _1"> </span> <span class="blank"> </span>en <span class="blank"> </span>dih<span class="blank _1"> </span>idr<span class="blank _1"> </span>otes<span class="blank _1"> </span>tos<span class="blank _1"> </span>ter<span class="blank _1"> </span>ona,</div><div class="t m0 x3 h6 y1b6 ff6 fs1 fc0 sc0 ls6 ws7">deti<span class="blank _1"> </span>ene<span class="blank _1"> </span> <span class="blank _8"> </span>la <span class="blank _8"> </span>pé<span class="blank _1"> </span>rdid<span class="blank _1"> </span>a <span class="blank _8"> </span>de<span class="blank _1"> </span>l <span class="blank _8"> </span>pel<span class="blank _1"> </span>o <span class="blank _8"> </span>y <span class="blank _8"> </span>au<span class="blank _1"> </span>ment<span class="blank _1"> </span>a <span class="blank _8"> </span>el<span class="blank _1"> </span> <span class="blank _8"> </span>crec<span class="blank _1"> </span>imi<span class="blank _1"> </span>ento<span class="blank _1"> </span>. <span class="blank _8"> </span>Ha</div><div class="t m0 x3 h6 y1b7 ff6 fs1 fc0 sc0 ls6 ws7">demo<span class="blank _1"> </span>str<span class="blank _1"> </span>ado<span class="blank _1"> </span> <span class="blank _d"> </span>su <span class="blank _9"> </span>efic<span class="blank _1"> </span>aci<span class="blank _1"> </span>a <span class="blank _d"> </span>t<span class="blank _1"> </span>anto<span class="blank _1"> </span> <span class="blank _d"> </span>en<span class="blank _1"> </span> <span class="blank _d"> </span>pac<span class="blank _1"> </span>ien<span class="blank _1"> </span>tes<span class="blank _1"> </span> <span class="blank _d"> </span>nor<span class="blank _1"> </span>moa<span class="blank _1"> </span>ndro<span class="blank _1"> </span>gén<span class="blank _1"> </span>ico<span class="blank _1"> </span>s</div><div class="t m0 x3 h6 y1b8 ff6 fs1 fc0 sc0 ls6 ws7">como<span class="blank _1"> </span> <span class="blank _6"> </span>en <span class="blank _d"> </span>paci<span class="blank _1"> </span>ent<span class="blank _1"> </span>es <span class="blank _6"> </span>h<span class="blank _1"> </span>ipe<span class="blank _1"> </span>rand<span class="blank _1"> </span>rog<span class="blank _1"> </span>éni<span class="blank _1"> </span>cos <span class="blank _d"> </span>en <span class="blank _6"> </span>al<span class="blank _1"> </span>gun<span class="blank _1"> </span>os <span class="blank _6"> </span>e<span class="blank _1"> </span>stu<span class="blank _1"> </span>dio<span class="blank _1"> </span>s <span class="blank _6"> </span>qu<span class="blank _1"> </span>e</div><div class="t m0 x3 h6 y1b9 ff6 fs1 fc0 sc0 ls6 ws7">utilizan <span class="blank _3"></span>dosis <span class="blank _3"></span>más a<span class="blank _0"></span>ltas <span class="blank _3"></span>(2.5\u20135 <span class="blank _3"></span>mg por <span class="blank _3"></span>día), <span class="blank _3"></span>al m<span class="blank _0"></span>enos <span class="blank _3"></span>de 6<span class="blank _0"></span> <span class="blank _0"></span>a <span class="blank _3"></span>12 me<span class="blank _0"></span>ses</div><div class="t m0 x3 h6 y1ba ff6 fs1 fc0 sc0 ls6 ws7">de <span class="blank _3"></span>tratami<span class="blank _0"></span>ento<span class="blank _0"></span> <span class="blank _3"></span>para <span class="blank _3"></span>lograr <span class="blank _3"></span>el <span class="blank _3"></span>crecimie<span class="blank _0"></span>nto <span class="blank _3"></span>del <span class="blank _3"></span>pelo. <span class="blank _3"></span>Los <span class="blank _3"></span>pacient<span class="blank _0"></span>es <span class="blank _3"></span>que</div><div class="t m0 x3 h6 y1bb ff6 fs1 fc0 sc0 ls6 ws7">resp<span class="blank _1"> </span>ond<span class="blank _1"> </span>en <span class="blank _e"> </span>deb<span class="blank _1"> </span>en <span class="blank _e"> </span>con<span class="blank _1"> </span>tin<span class="blank _1"> </span>uar<span class="blank _1"> </span> <span class="blank"> </span>el<span class="blank _1"> </span> <span class="blank"> </span>t<span class="blank _1"> </span>rata<span class="blank _1"> </span>mie<span class="blank _1"> </span>nto<span class="blank _1"> </span> <span class="blank"> </span>pa<span class="blank _1"> </span>ra <span class="blank _e"> </span>man<span class="blank _1"> </span>ten<span class="blank _1"> </span>er <span class="blank _e"> </span>los</div><div class="t m0 x3 h6 y1bc ff6 fs1 fc0 sc0 ls6 ws7">resultados <span class="blank _3"></span>obtenidos. <span class="blank _3"></span>Además <span class="blank _3"></span>del <span class="blank _0"></span>efecto <span class="blank _3"></span>teratogénico, <span class="blank _3"></span>la <span class="blank _3"></span>finasterida</div><div class="t m0 x3 h6 y1bd ff6 fs1 fc0 sc0 ls6 ws7">se <span class="blank _7"> </span>ha <span class="blank _7"> </span>as<span class="blank _1"> </span>ocia<span class="blank _1"> </span>do <span class="blank _7"> </span>co<span class="blank _1"> </span>n <span class="blank _7"> </span>tumo<span class="blank _1"> </span>res<span class="blank _1"> </span> <span class="blank _2"> </span>m<span class="blank _1"> </span>ali<span class="blank _1"> </span>gnos<span class="blank _1"> </span> <span class="blank _2"> </span>m<span class="blank _1"> </span>edi<span class="blank _1"> </span>ado<span class="blank _1"> </span>s <span class="blank _7"> </span>por <span class="blank _7"> </span>es<span class="blank _1"> </span>tróg<span class="blank _1"> </span>eno<span class="blank _1"> </span>s</div><div class="t m0 x3 h6 y1be ff6 fs1 fc0 sc0 ls6 ws7">como<span class="blank _1"> </span> <span class="blank _6"> </span>el <span class="blank _d"> </span>cánc<span class="blank _1"> </span>er <span class="blank _6"> </span>d<span class="blank _1"> </span>e <span class="blank _6"> </span>ma<span class="blank _1"> </span>ma,<span class="blank _1"> </span> <span class="blank _6"> </span>ya <span class="blank _6"> </span>q<span class="blank _1"> </span>ue <span class="blank _6"> </span>p<span class="blank _1"> </span>ued<span class="blank _1"> </span>e <span class="blank _6"> </span>ge<span class="blank _1"> </span>nera<span class="blank _1"> </span>r <span class="blank _6"> </span>un<span class="blank _1"> </span> <span class="blank _6"> </span>exc<span class="blank _1"> </span>eso<span class="blank _1"> </span> <span class="blank _6"> </span>de</div><div class="t m0 x3 h6 y1bf ff6 fs1 fc0 sc0 ls6 ws7">estr<span class="blank _1"> </span>óge<span class="blank _1"> </span>nos<span class="blank _1"> </span>. <span class="blank _6"> </span>P<span class="blank _1"> </span>or <span class="blank _d"> </span>lo<span class="blank _1"> </span> <span class="blank _6"> </span>ta<span class="blank _1"> </span>nto<span class="blank _1"> </span>, <span class="blank _d"> </span>no <span class="blank _d"> </span>se <span class="blank _d"> </span>deb<span class="blank _1"> </span>e <span class="blank _d"> </span>pres<span class="blank _1"> </span>cri<span class="blank _1"> </span>bir<span class="blank _1"> </span> <span class="blank _6"> </span>f<span class="blank _1"> </span>inas<span class="blank _1"> </span>ter<span class="blank _1"> </span>ida<span class="blank _1"> </span> <span class="blank _6"> </span>si<span class="blank _1"> </span> <span class="blank _6"> </span>l<span class="blank _1"> </span>a</div><div class="t m0 x3 h6 y1c0 ff6 fs1 fc0 sc0 ls6 ws7">paci<span class="blank _1"> </span>ent<span class="blank _1"> </span>e <span class="blank"> </span>tiene <span class="blank"> </span>antece<span class="blank _1"> </span>den<span class="blank _1"> </span>tes<span class="blank _1"> </span> <span class="blank _9"> </span>fam<span class="blank _1"> </span>ili<span class="blank _1"> </span>ares<span class="blank _1"> </span> <span class="blank _9"> </span>de<span class="blank _1"> </span> <span class="blank _9"> </span>cán<span class="blank _1"> </span>cer <span class="blank"> </span>de <span class="blank _9"> </span>se<span class="blank _1"> </span>no. <span class="blank"> </span>Los</div><div class="t m0 x3 h6 y1c1 ff6 fs1 fc0 sc0 ls6 ws7">efec<span class="blank _1"> </span>tos<span class="blank _1"> </span> <span class="blank _2"> </span>se<span class="blank _1"> </span>cun<span class="blank _1"> </span>dar<span class="blank _1"> </span>ios<span class="blank _1"> </span> <span class="blank _2"> </span>qu<span class="blank _1"> </span>e <span class="blank _2"> </span>s<span class="blank _1"> </span>e <span class="blank _7"> </span>evid<span class="blank _1"> </span>enc<span class="blank _1"> </span>ian <span class="blank _7"> </span>son<span class="blank _1"> </span> <span class="blank _2"> </span>l<span class="blank _1"> </span>a <span class="blank _2"> </span>c<span class="blank _1"> </span>efa<span class="blank _1"> </span>lea<span class="blank _1"> </span>, <span class="blank _2"> </span>d<span class="blank _1"> </span>epr<span class="blank _1"> </span>esió<span class="blank _1"> </span>n,</div><div class="t m0 x3 h1a y1c2 ff6 fs1 fc0 sc0 ls6 ws7">náuseas y disminución de la libido<span class="fs8 ws8 v1">29</span>.</div><div class="t m0 x3 he y1c3 ff7 fs1 fc0 sc0 ls6 ws9">Dutasteride:</div><div class="t m0 x10 h6 y1c4 ff6 fs1 fc0 sc0 ls6 ws7">Es un <span class="blank _1"> </span>inhibidor <span class="blank _1"> </span>de la <span class="blank _1"> </span>5-<span class="ffc ws10">\u03b1</span>-reductasa <span class="blank _1"> </span>tipos I <span class="blank _1"> </span>y <span class="blank _1"> </span>II. Se <span class="blank _1"> </span>ha <span class="blank _1"> </span>informado</div><div class="t m0 x3 h6 y1c5 ff6 fs1 fc0 sc0 ls6 ws7">el <span class="blank _3"></span>éxito en <span class="blank _3"></span>el tratamiento <span class="blank _3"></span>de la <span class="blank _3"></span>AAF <span class="blank _3"></span>en dosis <span class="blank _3"></span>que varían <span class="blank _3"></span>de 0.25 <span class="blank _3"></span>a <span class="blank _3"></span>0.5</div><div class="t m0 x3 h6 y1c6 ff6 fs1 fc0 sc0 ls6 ws7">mg <span class="blank _2"> </span>/ <span class="blank _1"> </span>día. <span class="blank _2"> </span>Es <span class="blank _2"> </span>bien <span class="blank _2"> </span>tolerado, <span class="blank _2"> </span>pero <span class="blank _2"> </span>debido <span class="blank _1"> </span>a <span class="blank _2"> </span>su <span class="blank _2"> </span>larga <span class="blank _2"> </span>vida <span class="blank _2"> </span>media, <span class="blank _1"> </span>l<span class="blank _1"> </span>as</div><div class="t m0 x3 h6 y1c7 ff6 fs1 fc0 sc0 ls6 ws7">muje<span class="blank _1"> </span>res<span class="blank _1"> </span> <span class="blank _4"> </span>e<span class="blank _1"> </span>n <span class="blank _8"> </span>edad<span class="blank _1"> </span> <span class="blank _4"> </span>f<span class="blank _1"> </span>ért<span class="blank _1"> </span>il <span class="blank _8"> </span>debe<span class="blank _1"> </span>n <span class="blank _8"> </span>cont<span class="blank _1"> </span>inua<span class="blank _1"> </span>r <span class="blank _8"> </span>util<span class="blank _1"> </span>iza<span class="blank _1"> </span>ndo <span class="blank _8"> </span>mét<span class="blank _1"> </span>odo<span class="blank _1"> </span>s</div><div class="t m0 x3 h6 y1c8 ff6 fs1 fc0 sc0 ls6 ws7">anticonceptivos <span class="blank _1"> </span>efectivos <span class="blank _1"> </span>durante al <span class="blank _1"> </span>menos <span class="blank _1"> </span>6 <span class="blank _1"> </span>meses <span class="blank _1"> </span>después <span class="blank _1"> </span>de <span class="blank _1"> </span>la</div><div class="t m0 x3 h1a y1c9 ff6 fs1 fc0 sc0 ls6 ws3">interrupción<span class="fs8 ws8 v1">10</span>.</div><div class="t m0 x13 he y1ca ff7 fs1 fc0 sc0 ls6 ws9">Espironolactona:</div><div class="t m0 x20 h6 y1cb ff6 fs1 fc0 sc0 ls6 ws7">La <span class="blank _3"></span>espironolactona <span class="blank _3"></span>es un <span class="blank _3"></span>diurético <span class="blank _3"></span>ahorrador d<span class="blank _0"></span>e <span class="blank _3"></span>potasio utiliz<span class="blank _0"></span>ado</div><div class="t m0 x13 h6 y1cc ff6 fs1 fc0 sc0 ls6 ws7">para<span class="blank _1"> </span> <span class="blank _4"> </span>el<span class="blank _1"> </span> <span class="blank _4"> </span>tr<span class="blank _1"> </span>atam<span class="blank _1"> </span>ien<span class="blank _1"> </span>to <span class="blank _8"> </span>de <span class="blank _4"> </span>la<span class="blank _1"> </span> <span class="blank _4"> </span>hip<span class="blank _1"> </span>ert<span class="blank _1"> </span>ens<span class="blank _1"> </span>ión<span class="blank _1"> </span>, <span class="blank _4"> </span>hi<span class="blank _1"> </span>per<span class="blank _1"> </span>ald<span class="blank _1"> </span>oste<span class="blank _1"> </span>ron<span class="blank _1"> </span>ism<span class="blank _1"> </span>o,</div><div class="t m0 x13 h6 y1cd ff6 fs1 fc0 sc0 ls6 ws7">insuficiencia cardíaca <span class="blank _1"> </span>y <span class="blank _1"> </span>también <span class="blank _1"> </span>está <span class="blank _1"> </span>aprobado <span class="blank _1"> </span>para <span class="blank _1"> </span>el <span class="blank _1"> </span>tratamiento</div><div class="t m0 x13 h6 y1ce ff6 fs1 fc0 sc0 ls6 ws7">del <span class="blank _7"> </span>hir<span class="blank _1"> </span>sut<span class="blank _1"> </span>ism<span class="blank _1"> </span>o. <span class="blank _7"> </span>Los <span class="blank _7"> </span>mec<span class="blank _1"> </span>ani<span class="blank _1"> </span>smo<span class="blank _1"> </span>s <span class="blank _2"> </span>d<span class="blank _1"> </span>e <span class="blank _7"> </span>acci<span class="blank _1"> </span>ón <span class="blank _7"> </span>de <span class="blank _7"> </span>la <span class="blank _7"> </span>espi<span class="blank _1"> </span>ron<span class="blank _1"> </span>ola<span class="blank _1"> </span>cto<span class="blank _1"> </span>na</div><div class="t m0 x13 h6 y1cf ff6 fs1 fc0 sc0 ls6 ws7">están mediados por el <span class="blank _1"> </span>antagonista directo de <span class="blank _1"> </span>la aldosterona en <span class="blank _1"> </span>los</div><div class="t m0 x13 h6 y1d0 ff6 fs1 fc0 sc0 ls6 ws7">rece<span class="blank _1"> </span>pto<span class="blank _1"> </span>res<span class="blank _1"> </span> <span class="blank _8"> </span>de<span class="blank _1"> </span> <span class="blank _8"> </span>a<span class="blank _1"> </span>ndr<span class="blank _1"> </span>ógen<span class="blank _1"> </span>os <span class="blank _1a"> </span>y <span class="blank _8"> </span>a<span class="blank _1"> </span> <span class="blank _8"> </span>t<span class="blank _1"> </span>rav<span class="blank _1"> </span>és <span class="blank _1a"> </span>de <span class="blank _1a"> </span>la <span class="blank _8"> </span>r<span class="blank _1"> </span>educ<span class="blank _1"> </span>ció<span class="blank _1"> </span>n <span class="blank _1a"> </span>del</div><div class="t m0 x13 h6 y1d1 ff6 fs1 fc0 sc0 ls6 ws7">hiperandrogenismo y <span class="blank _3"></span>la inflamación sistémica. Esta <span class="blank _3"></span>molécula inhibe</div><div class="t m0 x13 h6 y1d2 ff6 fs1 fc0 sc0 ls6 ws7">parcialmente <span class="blank _2"> </span>la <span class="blank _1"> </span>este<span class="blank _1"> </span>roidogénesis <span class="blank _2"> </span>ovárica <span class="blank _1"> </span>y<span class="blank _1"> </span> <span class="blank _2"> </span>suprarrenal, <span class="blank _1"> </span>bloquea <span class="blank _2"> </span>la</div><div class="t m0 x13 h6 y1d3 ff6 fs1 fc0 sc0 ls6 ws3">5-<span class="ffc ws10">\u03b1</span><span class="ws7">-reduct<span class="blank _0"></span>asa <span class="blank _3"></span>y la <span class="blank _3"></span>17-hidroxie<span class="blank _0"></span>steroide <span class="blank _3"></span>deshidrogenas<span class="blank _0"></span>a <span class="blank _3"></span>en el <span class="blank _3"></span>ovárico</span></div><div class="t m0 x13 h6 y1d4 ff6 fs1 fc0 sc0 ls6 ws7">y <span class="blank _3"></span>suprarrenal, acti<span class="blank _0"></span>va <span class="blank _3"></span>la aromatasa <span class="blank _3"></span>y <span class="blank _0"></span>aumenta <span class="blank _3"></span>la globul<span class="blank _0"></span>ina <span class="blank _3"></span>fijadora de</div><div class="t m0 x13 h1b y1d5 ff6 fs1 fc0 sc0 ls6 ws7">hormonas sexuales (SHBG)<span class="fs8 ws8 v1">10</span><span class="v0">.</span></div><div class="t m0 x36 h6 y1d6 ff6 fs1 fc0 sc0 ls6 ws7">La dosis inicial <span class="blank _1"> </span>suele ser <span class="blank _1"> </span>de 50 mg <span class="blank _1"> </span>por día <span class="blank _1"> </span>durante 1 mes, <span class="blank _1"> </span>luego</div><div class="t m0 x13 h6 y1d7 ff6 fs1 fc0 sc0 ls6 ws7">de <span class="blank _2"> </span>100 <span class="blank _2"> </span>a <span class="blank _2"> </span>200 <span class="blank _2"> </span>mg <span class="blank _2"> </span>/ <span class="blank _1"> </span>d<span class="blank _1"> </span>ía. <span class="blank _2"> </span>Debe <span class="blank _2"> </span>conti<span class="blank _1"> </span>nuarse<span class="blank _1"> </span> <span class="blank _2"> </span>durante <span class="blank _2"> </span>al <span class="blank _2"> </span>menos<span class="blank _1"> </span> <span class="blank _2"> </span>6 <span class="blank _1"> </span>a<span class="blank _1"> </span> <span class="blank _2"> </span>9</div><div class="t m0 x13 h6 y1d8 ff6 fs1 fc0 sc0 ls6 ws7">meses <span class="blank _3"></span>para <span class="blank _3"></span>evaluar <span class="blank _0"></span>su <span class="blank _3"></span>eficacia. <span class="blank _3"></span>La esp<span class="blank _0"></span>ironolacto<span class="blank _0"></span>na <span class="blank _3"></span>es una<span class="blank _0"></span> <span class="blank _3"></span>alternativa</div><div class="t m0 x13 h6 y1d9 ff6 fs1 fc0 sc0 ls6 ws7">válida a la finasterida en pacientes que muestran AAF asociada con</div><div class="t m0 x13 h25 y1da ff6 fs1 fc0 sc0 ls6 ws7">hirsutismo o acné<span class="fs8 ws8 v1">10</span><span class="v0">.</span></div><div class="t m0 x13 he y1db ff7 fs1 fc0 sc0 ls6 ws7">Acetato de ciproterona:</div><div class="t m0 x15 h6 y1dc ff6 fs1 fc0 sc0 ls6 ws7">El <span class="blank _1"> </span>acetato <span class="blank _2"> </span>de ciproterona <span class="blank _2"> </span>(CPA) <span class="blank _1"> </span>es <span class="blank _1"> </span>un <span class="blank _2"> </span>antiandrógeno <span class="blank _1"> </span>que <span class="blank _1"> </span>actúa</div><div class="t m0 x13 h6 y1dd ff6 fs1 fc0 sc0 ls6 ws7">bloq<span class="blank _1"> </span>uea<span class="blank _1"> </span>ndo<span class="blank _1"> </span> <span class="blank _d"> </span>l<span class="blank _1"> </span>os <span class="blank"> </span>recepto<span class="blank _1"> </span>res<span class="blank _1"> </span> <span class="blank _9"> </span>de <span class="blank _9"> </span>and<span class="blank _1"> </span>róg<span class="blank _1"> </span>enos<span class="blank _1"> </span> <span class="blank _9"> </span>y <span class="blank _9"> </span>dism<span class="blank _1"> </span>inu<span class="blank _1"> </span>yen<span class="blank _1"> </span>do <span class="blank _9"> </span>las</div><div class="t m0 x13 h6 y1de ff6 fs1 fc0 sc0 ls6 ws7">concentracio<span class="blank _0"></span>nes <span class="blank _3"></span>de tes<span class="blank _0"></span>tosterona <span class="blank _3"></span>al <span class="blank _0"></span>suprimir <span class="blank _3"></span>la <span class="blank _3"></span>hormona <span class="blank _0"></span>luteinizante</div><div class="t m0 x13 h6 y1df ff6 fs1 fc0 sc0 ls6 ws7">y <span class="blank _7"> </span>la<span class="blank _1"> </span> <span class="blank _7"> </span>li<span class="blank _1"> </span>ber<span class="blank _1"> </span>ació<span class="blank _1"> </span>n <span class="blank _7"> </span>d<span class="blank _1"> </span>e <span class="blank _7"> </span>l<span class="blank _1"> </span>a <span class="blank _7"> </span>ho<span class="blank _1"> </span>rmo<span class="blank _1"> </span>na <span class="blank _6"> </span>foli<span class="blank _1"> </span>cul<span class="blank _1"> </span>oest<span class="blank _1"> </span>imu<span class="blank _1"> </span>lan<span class="blank _1"> </span>te.<span class="blank _1"> </span> <span class="blank _7"> </span>Su <span class="blank _6"> </span>efic<span class="blank _1"> </span>aci<span class="blank _1"> </span>a <span class="blank _7"> </span>e<span class="blank _1"> </span>s</div><div class="t m0 x13 h6 y1e0 ff6 fs1 fc0 sc0 ls6 ws7">similar <span class="blank _3"></span>a <span class="blank _0"></span>la <span class="blank _3"></span>espironolactona. <span class="blank _3"></span>El <span class="blank _3"></span>CPA se<span class="blank _0"></span> <span class="blank _3"></span>prescribe <span class="blank _3"></span>en combi<span class="blank _0"></span>nación <span class="blank _3"></span>con</div><div class="t m0 x13 h1e y1e1 ff6 fs1 fc0 sc0 ls6 ws7">un estrógeno en las píldoras anticonceptivas orales<span class="fs8 ws8 v1">10</span><span class="v0">. </span></div><div class="t m0 x15 h6 y1e2 ff6 fs1 fc0 sc0 ls6 ws7">La <span class="blank _1"> </span>dosis <span class="blank _1"> </span>en <span class="blank _1"> </span>AAF <span class="blank _2"> </span>en mujeres <span class="blank _2"> </span>premenopáusicas son <span class="blank _1"> </span>100 <span class="blank _2"> </span>mg / <span class="blank _2"> </span>día</div><div class="t m0 x13 h6 y1e3 ff6 fs1 fc0 sc0 ls6 ws7">en <span class="blank _1"> </span>los <span class="blank _1"> </span>días <span class="blank _1"> </span>5\u201315 <span class="blank _1"> </span>del <span class="blank _2"> </span>ciclo menstrual <span class="blank _2"> </span>junto con <span class="blank _1"> </span>etinilestradiol <span class="blank _2"> </span>50 <span class="ffc ws10">\u03bc</span>g</div><div class="t m0 x13 h6 y1e4 ff6 fs1 fc0 sc0 ls6 ws7">en los <span class="blank _1"> </span>días <span class="blank _1"> </span>5\u201325, <span class="blank _1"> </span>o 50 <span class="blank _1"> </span>mg <span class="blank _1"> </span>/ <span class="blank _1"> </span>día en <span class="blank _1"> </span>los <span class="blank _1"> </span>días <span class="blank _1"> </span>1\u201310 y <span class="blank _1"> </span>etinilestradiol <span class="blank _1"> </span>35</div><div class="t m0 x13 h6 y1e5 ffc fs1 fc0 sc0 ls6 ws10">\u03bc<span class="ff6 ws7">g <span class="blank _3"></span>los días <span class="blank _3"></span>1\u201321. <span class="blank _0"></span>Las <span class="blank _3"></span>mujeres posme<span class="blank _0"></span>nopáusicas <span class="blank _3"></span>pueden ser <span class="blank _3"></span>tratadas</span></div><div class="t m0 x13 h6 y1e6 ff6 fs1 fc0 sc0 ls6 ws7">con 50 mg <span class="blank _3"></span>diarios. Los efectos secundarios incluyen <span class="blank _3"></span>irregularidades</div><div class="t m0 x13 h6 y1e7 ff6 fs1 fc0 sc0 ls6 ws7">en <span class="blank _2"> </span>el <span class="blank _1"> </span>ciclo <span class="blank _2"> </span>menstrual, <span class="blank _2"> </span>aumento <span class="blank _1"> </span>de <span class="blank _2"> </span>peso, <span class="blank _1"> </span>sensibili<span class="blank _1"> </span>dad <span class="blank _1"> </span>en <span class="blank _2"> </span>los <span class="blank _2"> </span>senos,</div><div class="t m0 x13 h6 y1e8 ff6 fs1 fc0 sc0 ls6 ws7">disminución de la <span class="blank _0"></span>libido, depresión y <span class="blank _0"></span>náuseas. No debe <span class="blank _0"></span>prescribirse</div><div class="t m0 x13 h6 y1e9 ff6 fs1 fc0 sc0 ls6 ws7">a pacientes <span class="blank _0"></span>con enfermedades <span class="blank _3"></span>hepáticas. Existe un mayor <span class="blank _3"></span>riesgo de</div><div class="t m0 x13 h6 y1ea ff6 fs1 fc0 sc0 ls6 ws7">tromboembolismo <span class="blank _0"></span>venoso <span class="blank _3"></span>en pacientes <span class="blank _3"></span>que toman <span class="blank _3"></span>anticonceptivos</div><div class="t m0 x13 h6 y1eb ff6 fs1 fc0 sc0 ls6 ws7">orales <span class="blank _2"> </span>que <span class="blank _2"> </span>contienen <span class="blank _2"> </span>estrógenos, <span class="blank _2"> </span>que <span class="blank _2"> </span>luego <span class="blank _2"> </span>pueden <span class="blank _2"> </span>aumentar <span class="blank _2"> </span>en</div><div class="t m0 x13 h1b y1ec ff6 fs1 fc0 sc0 ls6 ws7">pacientes que toman anticonceptivos de CPA<span class="fs8 ws8 v1">10,18</span><span class="v0">.</span></div><div class="t m0 x13 he y1ed ff7 fs1 fc0 sc0 ls6 ws9">Flutamida:</div><div class="t m0 x20 h6 y1ee ff6 fs1 fc0 sc0 ls6 ws7">La <span class="blank _3"></span>fluta<span class="blank _0"></span>mida<span class="blank _0"></span> <span class="blank _3"></span>antago<span class="blank _0"></span>niza<span class="blank _0"></span> <span class="blank _3"></span>el <span class="blank _0"></span>rece<span class="blank _0"></span>ptor<span class="blank _3"></span> al <span class="blank _3"></span>que <span class="blank _3"></span>se <span class="blank _3"></span>une <span class="blank _3"></span>a <span class="blank _0"></span>la <span class="blank _3"></span>testo<span class="blank _0"></span>ster<span class="blank _3"></span>ona</div><div class="t m0 x13 h6 y1ef ff6 fs1 fc0 sc0 ls6 ws7">y la dihidrotestosterona. <span class="blank _1"> </span>Se administra a <span class="blank _1"> </span>dosis que varían <span class="blank _1"> </span>de 62.5 a</div><div class="t m0 x13 h6 y1f0 ff6 fs1 fc0 sc0 ls6 ws7">250 mg diarios <span class="blank _1"> </span>para AAF. Aunque ha <span class="blank _1"> </span>demostrado ser más <span class="blank _1"> </span>eficiente</div><div class="t m0 x13 h6 y1f1 ff6 fs1 fc0 sc0 ls6 ws7">que <span class="blank _d"> </span>la <span class="blank _d"> </span>fin<span class="blank _1"> </span>aste<span class="blank _1"> </span>rid<span class="blank _1"> </span>a <span class="blank _6"> </span>y<span class="blank _1"> </span> <span class="blank _6"> </span>la <span class="blank _d"> </span>esp<span class="blank _1"> </span>iro<span class="blank _1"> </span>nola<span class="blank _1"> </span>cto<span class="blank _1"> </span>na <span class="blank _d"> </span>en <span class="blank _6"> </span>A<span class="blank _1"> </span>AF,<span class="blank _1"> </span> <span class="blank _6"> </span>no<span class="blank _1"> </span> <span class="blank _6"> </span>se<span class="blank _1"> </span> <span class="blank _6"> </span>pre<span class="blank _1"> </span>scr<span class="blank _1"> </span>ibe</div><div class="t m0 x13 h6 y1f2 ff6 fs1 fc0 sc0 ls6 ws7">regu<span class="blank _1"> </span>larm<span class="blank _1"> </span>ente<span class="blank _1"> </span> <span class="blank _2"> </span>debido<span class="blank _1"> </span> <span class="blank _2"> </span>al <span class="blank _2"> </span>riesg<span class="blank _1"> </span>o <span class="blank _2"> </span>de <span class="blank _2"> </span>hepat<span class="blank _1"> </span>otox<span class="blank _1"> </span>icid<span class="blank _1"> </span>ad <span class="blank _2"> </span>e <span class="blank _2"> </span>insu<span class="blank _1"> </span>fici<span class="blank _1"> </span>enci<span class="blank _1"> </span>a</div><div class="t m0 x13 h6 y1f3 ff6 fs1 fc0 sc0 ls6 ws7">hepá<span class="blank _1"> </span>tic<span class="blank _1"> </span>a. <span class="blank _d"> </span>S<span class="blank _1"> </span>e <span class="blank _d"> </span>de<span class="blank _1"> </span>be <span class="blank _d"> </span>s<span class="blank _1"> </span>oli<span class="blank _1"> </span>cit<span class="blank _1"> </span>ar <span class="blank _d"> </span>c<span class="blank _1"> </span>ontr<span class="blank _1"> </span>ol <span class="blank _d"> </span>d<span class="blank _1"> </span>e <span class="blank _d"> </span>la<span class="blank _1"> </span>s <span class="blank _d"> </span>t<span class="blank _1"> </span>rans<span class="blank _1"> </span>ami<span class="blank _1"> </span>nas<span class="blank _1"> </span>as <span class="blank _d"> </span>s<span class="blank _1"> </span>éric<span class="blank _1"> </span>as</div><div class="t m0 x13 h6 y1f4 ff6 fs1 fc0 sc0 ls6 ws7">mens<span class="blank _1"> </span>ualm<span class="blank _1"> </span>ent<span class="blank _1"> </span>e <span class="blank _2"> </span>dura<span class="blank _1"> </span>nte <span class="blank _2"> </span>los<span class="blank _1"> </span> <span class="blank _2"> </span>prime<span class="blank _1"> </span>ros <span class="blank _2"> </span>4 <span class="blank _2"> </span>mes<span class="blank _1"> </span>es <span class="blank _2"> </span>y <span class="blank _2"> </span>peri<span class="blank _1"> </span>ódi<span class="blank _1"> </span>came<span class="blank _1"> </span>nte <span class="blank _2"> </span>a</div><div class="t m0 x13 h6 y1f5 ff6 fs1 fc0 sc0 ls6 ws7">part<span class="blank _1"> </span>ir <span class="blank _2"> </span>d<span class="blank _1"> </span>e <span class="blank _2"> </span>en<span class="blank _1"> </span>ton<span class="blank _1"> </span>ces.<span class="blank _1"> </span> <span class="blank _2"> </span>Ent<span class="blank _1"> </span>re <span class="blank _2"> </span>l<span class="blank _1"> </span>os <span class="blank _2"> </span>e<span class="blank _1"> </span>fect<span class="blank _1"> </span>os <span class="blank _2"> </span>s<span class="blank _1"> </span>ecu<span class="blank _1"> </span>nda<span class="blank _1"> </span>rios<span class="blank _1"> </span> <span class="blank _2"> </span>se <span class="blank _2"> </span>e<span class="blank _1"> </span>ncu<span class="blank _1"> </span>ent<span class="blank _1"> </span>ra <span class="blank _2"> </span>la</div><div class="t m0 x13 h1a y1f6 ff6 fs1 fc0 sc0 ls6 ws7">disminución de la libido<span class="fs8 ws8 v1">10</span><span class="v0">.</span></div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf8" class="pf w0 h0" data-page-no="8"><div class="pc pc8 w0 h0"><img fetchpriority="low" loading="lazy" class="bi xc y30 w1 hc" alt="" src="https://files.passeidireto.com/75f5f44c-f020-40b0-8bec-4e63b893e22f/bg8.png"><div class="t m0 x35 h3 y2 ff2 fs1 fc0 sc0 ls6 ws10">13</div><div class="t m0 x1 h4 y3 ff3 fs2 fc0 sc0 ls6 ws7">Dermatol V<span class="blank _0"></span>enez <span class="ff4 ls0">h</span>Vol.59 <span class="ff4 ls1">h</span>N°2 <span class="ff4 ls2">h</span><span class="ws1">2021</span></div><div class="t m0 xd h2 y1 ff1 fs0 fc0 sc0 ls6 ws7">REVISIÓN </div><div class="t m0 x3 he y1f7 ff7 fs1 fc0 sc0 ls6 ws7">Bicalutamida: </div><div class="t m0 x10 h6 y1f8 ff6 fs1 fc0 sc0 ls6 ws7">Es <span class="blank _1"> </span>un antiandrógeno <span class="blank _1"> </span>no <span class="blank _1"> </span>esteroideo <span class="blank _1"> </span>de <span class="blank _1"> </span>primera <span class="blank _1"> </span>generación <span class="blank _1"> </span>que</div><div class="t m0 x3 h6 y1f9 ff6 fs1 fc0 sc0 ls6 ws7">bloquea <span class="blank _2"> </span>el <span class="blank _2"> </span>receptor <span class="blank _1"> </span>d<span class="blank _1"> </span>e <span class="blank _2"> </span>andrógenos <span class="blank _2"> </span>de <span class="blank _1"> </span>forma <span class="blank _2"> </span>selectiva, <span class="blank _2"> </span>con <span class="blank _2"> </span>mejor</div><div class="t m0 x3 h6 y1fa ff6 fs1 fc0 sc0 ls6 ws7">perfil de <span class="blank _3"></span>seguridad que la <span class="blank _3"></span>flutamida. Esta indicado <span class="blank _3"></span>en pacientes con</div><div class="t m0 x3 h6 y1fb ff6 fs1 fc0 sc0 ls6 ws7">hirs<span class="blank _1"> </span>uti<span class="blank _1"> </span>smo<span class="blank _1"> </span> <span class="blank _1a"> </span>o <span class="blank _16"> </span>en <span class="blank _16"> </span>pacie<span class="blank _1"> </span>nte<span class="blank _1"> </span>s <span class="blank _1a"> </span>c<span class="blank _1"> </span>on <span class="blank _16"> </span>mani<span class="blank _1"> </span>fes<span class="blank _1"> </span>tac<span class="blank _1"> </span>ione<span class="blank _1"> </span>s <span class="blank _16"> </span>clíni<span class="blank _1"> </span>cas<span class="blank _1"> </span> <span class="blank _1a"> </span>de</div><div class="t m0 x3 h6 y1fc ff6 fs1 fc0 sc0 ls6 ws7">hipe<span class="blank _1"> </span>ran<span class="blank _1"> </span>dro<span class="blank _1"> </span>geni<span class="blank _1"> </span>smo<span class="blank _1"> </span> <span class="blank _6"> </span>(s<span class="blank _1"> </span>ebor<span class="blank _1"> </span>rea<span class="blank _1"> </span>, <span class="blank _6"> </span>el<span class="blank _1"> </span> <span class="blank _6"> </span>ac<span class="blank _1"> </span>né <span class="blank _6"> </span>y<span class="blank _1"> </span> <span class="blank _6"> </span>el<span class="blank _1"> </span> <span class="blank _6"> </span>hir<span class="blank _1"> </span>sut<span class="blank _1"> </span>ism<span class="blank _1"> </span>o). <span class="blank _d"> </span>La <span class="blank _6"> </span>d<span class="blank _1"> </span>osi<span class="blank _1"> </span>s</div><div class="t m0 x3 h6 y1fd ff6 fs1 fc0 sc0 ls6 ws7">reco<span class="blank _0"></span>menda<span class="blank _0"></span>da <span class="blank _3"></span>es <span class="blank _3"></span>de 5<span class="blank _0"></span>0 <span class="blank _3"></span>mg <span class="blank _0"></span>diar<span class="blank _0"></span>ios <span class="blank _3"></span>en <span class="blank _3"></span>monoter<span class="blank _0"></span>apia<span class="blank _0"></span> <span class="blank _3"></span>y en<span class="blank _0"></span> <span class="blank _3"></span>combinac<span class="blank _0"></span>ión</div><div class="t m0 x3 h26 y1fe ff6 fs1 fc0 sc0 ls6 ws7">con otros tratamientos 50 mg 2 veces por semana<span class="fs8 ls9 v1">3</span><span class="fs8 ws8 v1">0,31</span>.</div><div class="t m0 x3 h6 y1ff ff6 fs1 fc0 sc0 ls6 ws7">La <span class="blank"> </span>bical<span class="blank _1"> </span>uta<span class="blank _1"> </span>mida<span class="blank _1"> </span> <span class="blank"> </span>parece<span class="blank _1"> </span> <span class="blank"> </span>tener <span class="blank"> </span>un <span class="blank"> </span>perfil<span class="blank _1"> </span> <span class="blank _9"> </span>de<span class="blank _1"> </span> <span class="blank _9"> </span>se<span class="blank _1"> </span>guri<span class="blank _1"> </span>dad<span class="blank _1"> </span> <span class="blank"> </span>favorab<span class="blank _1"> </span>le</div><div class="t m0 x3 h6 y200 ff6 fs1 fc0 sc0 ls6 ws7">cuando se usa para tratar <span class="blank _0"></span>la AAF, incluso en combinación con <span class="blank _0"></span>otros</div><div class="t m0 x3 h6 y201 ff6 fs1 fc0 sc0 ls6 ws7">tratamientos, <span class="blank _0"></span>como <span class="blank _0"></span>el <span class="blank _0"></span>minoxidil <span class="blank _3"></span>oral y <span class="blank _3"></span>la espironolactona. <span class="blank _3"></span>Puede ser</div><div class="t m0 x3 h6 y202 ff6 fs1 fc0 sc0 ls6 ws7">útil <span class="blank _3"></span>para <span class="blank _3"></span>disminuir <span class="blank _3"></span>el ries<span class="blank _0"></span>go <span class="blank _3"></span>de hi<span class="blank _0"></span>pertricosi<span class="blank _0"></span>s, <span class="blank _3"></span>que e<span class="blank _0"></span>s <span class="blank _3"></span>el efec<span class="blank _0"></span>to <span class="blank _3"></span>adverso</div><div class="t m0 x3 h1a y203 ff6 fs1 fc0 sc0 ls6 ws7">más frecuente del minoxidil oral<span class="fs8 ls9 wsa v1">30,31</span>.</div><div class="t m0 x3 h5 y204 ff5 fs3 fc0 sc0 ls6 ws7">T<span class="blank _3"></span>ratamiento intradérmico</div><div class="t m0 x3 he y205 ff7 fs1 fc0 sc0 ls6 ws7">Plasma rico en plaquetas:</div><div class="t m0 x10 h6 y206 ff6 fs1 fc0 sc0 ls6 ws7">El plas<span class="blank _1"> </span>ma ric<span class="blank _1"> </span>o en plaqu<span class="blank _1"> </span>eta<span class="blank _1"> </span>s (PRP<span class="blank _1"> </span>), es una pre<span class="blank _1"> </span>par<span class="blank _1"> </span>aci<span class="blank _1"> </span>ón autó<span class="blank _1"> </span>log<span class="blank _1"> </span>a</div><div class="t m0 x3 h6 y207 ff6 fs1 fc0 sc0 ls6 ws7">de <span class="blank _2"> </span>plaq<span class="blank _1"> </span>ue<span class="blank _1"> </span>ta<span class="blank _1"> </span>s <span class="blank _1"> </span>e<span class="blank _1"> </span>n <span class="blank _1"> </span>p<span class="blank _1"> </span>la<span class="blank _1"> </span>sma<span class="blank _1"> </span> <span class="blank _1"> </span>co<span class="blank _1"> </span>nc<span class="blank _1"> </span>en<span class="blank _1"> </span>tr<span class="blank _1"> </span>ad<span class="blank _1"> </span>o. <span class="blank _2"> </span>La <span class="blank _1"> </span>té<span class="blank _1"> </span>cn<span class="blank _1"> </span>ic<span class="blank _1"> </span>a <span class="blank _1"> </span>a<span class="blank _1"> </span>ct<span class="blank _1"> </span>ual<span class="blank _1"> </span> <span class="blank _1"> </span>me<span class="blank _1"> </span>di<span class="blank _1"> </span>an<span class="blank _1"> </span>te</div><div class="t m0 x3 h6 y208 ff6 fs1 fc0 sc0 ls6 ws7">la c<span class="blank _1"> </span>ua<span class="blank _1"> </span>l se<span class="blank _1"> </span> pre<span class="blank _1"> </span>pa<span class="blank _1"> </span>ra<span class="blank _1"> </span> el PR<span class="blank _1"> </span>P pr<span class="blank _1"> </span>op<span class="blank _1"> </span>or<span class="blank _1"> </span>ci<span class="blank _1"> </span>on<span class="blank _1"> </span>a un<span class="blank _1"> </span> enr<span class="blank _1"> </span>iq<span class="blank _1"> </span>ue<span class="blank _1"> </span>cim<span class="blank _1"> </span>ie<span class="blank _1"> </span>nt<span class="blank _1"> </span>o de<span class="blank _1"> </span>l 30<span class="blank _1"> </span>0</div><div class="t m0 x3 h6 y209 ff6 fs1 fc0 sc0 ls6 ws7">al<span class="blank _1"> </span> <span class="blank _8"> </span>70<span class="blank _1"> </span>0%<span class="blank _1"> </span> <span class="blank _8"> </span>(g<span class="blank _1"> </span>e<span class="blank _1"> </span>ne<span class="blank _1"> </span>r<span class="blank _1"> </span>a<span class="blank _1"> </span>lm<span class="blank _1"> </span>e<span class="blank _1"> </span>n<span class="blank _1"> </span>te<span class="blank _1"> </span> <span class="blank _8"> </span>má<span class="blank _1"> </span>s<span class="blank _1"> </span> <span class="blank _4"> </span>d<span class="blank _1"> </span>e<span class="blank _1"> </span> <span class="blank _4"> </span>1<span class="blank _1"> </span> <span class="blank _8"> </span>00<span class="blank _1"> </span>0<span class="blank _1"> </span> <span class="blank _4"> </span>0<span class="blank _1"> </span>0<span class="blank _1"> </span>0 <span class="blank _8"> </span>de<span class="blank _1"> </span> <span class="blank _8"> </span>pl<span class="blank _1"> </span>a<span class="blank _1"> </span>qu<span class="blank _1"> </span>e<span class="blank _1"> </span>t<span class="blank _1"> </span>as<span class="blank _1"> </span>/</div><div class="t m0 x3 h1a y20a ff6 fs1 fc0 sc0 ls6 ws11">mic<span class="blank"> </span>r<span class="blank"> </span>o<span class="blank"> </span>l<span class="blank"> </span>i<span class="blank"> </span>t<span class="blank"> </span>r<span class="blank"> </span>o<span class="blank"> </span>)<span class="blank"> </span><span class="fs8 ws7 v1">10, 32</span>.</div><div class="t m0 x10 h6 y20b ff6 fs1 fc0 sc0 ls6 ws7">Las <span class="blank"> </span>molécu<span class="blank _1"> </span>las<span class="blank _1"> </span> <span class="blank _d"> </span>b<span class="blank _1"> </span>ioa<span class="blank _1"> </span>cti<span class="blank _1"> </span>vas <span class="blank"> </span>presen<span class="blank _1"> </span>tes<span class="blank _1"> </span> <span class="blank _d"> </span>e<span class="blank _1"> </span>n <span class="blank _9"> </span>el <span class="blank"> </span>PRP <span class="blank _d"> </span>p<span class="blank _1"> </span>rom<span class="blank _1"> </span>uev<span class="blank _1"> </span>en <span class="blank _9"> </span>4</div><div class="t m0 x3 h6 y20c ff6 fs1 fc0 sc0 ls6 ws7">acciones principales en el entorno <span class="blank _1"> </span>local de la administración, como</div><div class="t m0 x3 h6 y20d ff6 fs1 fc0 sc0 ls6 ws7">son <span class="blank _3"></span>la <span class="blank _3"></span>proliferac<span class="blank _0"></span>ión, <span class="blank _3"></span>migrac<span class="blank _0"></span>ión, <span class="blank _3"></span>difere<span class="blank _0"></span>nciaci<span class="blank _0"></span>ón <span class="blank _3"></span>celular <span class="blank _3"></span>y <span class="blank _3"></span>angiogéne<span class="blank _0"></span>sis.</div><div class="t m0 x3 h6 y20e ff6 fs1 fc0 sc0 ls6 ws7">Varias <span class="blank _3"></span>citocinas, <span class="blank _0"></span>quimiocinas <span class="blank _3"></span>y fac<span class="blank _0"></span>tores <span class="blank _3"></span>de crecimien<span class="blank _0"></span>to <span class="blank _3"></span>participan en</div><div class="t m0 x3 h6 y20f ff6 fs1 fc0 sc0 ls6 ws7">la regulación <span class="blank _1"> </span>de la <span class="blank _1"> </span>morfogénesis <span class="blank _1"> </span>del pelo <span class="blank _1"> </span>y el <span class="blank _1"> </span>ciclo <span class="blank _1"> </span>del crecimiento</div><div class="t m0 x3 h6 y210 ff6 fs1 fc0 sc0 ls6 ws7">del <span class="blank"> </span>pelo<span class="blank _1"> </span>. <span class="blank"> </span>El <span class="blank"> </span>factor<span class="blank _1"> </span> <span class="blank"> </span>de <span class="blank _9"> </span>cr<span class="blank _1"> </span>ecim<span class="blank _1"> </span>ien<span class="blank _1"> </span>to <span class="blank"> </span>(TGF<span class="blank _1"> </span>) <span class="blank"> </span>prese<span class="blank _1"> </span>nte <span class="blank"> </span>en <span class="blank"> </span>PRP <span class="blank"> </span>está</div><div class="t m0 x3 h6 y211 ff6 fs1 fc0 sc0 ls6 ws7">involucrado en la restauración del pelo en la AAF. Estos factores <span class="blank _1"> </span>de</div><div class="t m0 x3 h6 y212 ff6 fs1 fc0 sc0 ls6 ws7">crec<span class="blank _1"> </span>imi<span class="blank _1"> </span>ent<span class="blank _1"> </span>o <span class="blank _d"> </span>pue<span class="blank _1"> </span>den<span class="blank _1"> </span> <span class="blank _d"> </span>est<span class="blank _1"> </span>imu<span class="blank _1"> </span>lar <span class="blank _d"> </span>l<span class="blank _1"> </span>as <span class="blank _d"> </span>c<span class="blank _1"> </span>élu<span class="blank _1"> </span>las <span class="blank _d"> </span>m<span class="blank _1"> </span>adr<span class="blank _1"> </span>e <span class="blank _d"> </span>ub<span class="blank _1"> </span>icad<span class="blank _1"> </span>as <span class="blank _d"> </span>e<span class="blank _1"> </span>n <span class="blank _d"> </span>la</div><div class="t m0 x3 h6 y213 ff6 fs1 fc0 sc0 ls6 ws7">región <span class="blank _1"> </span>abultada <span class="blank _1"> </span>de <span class="blank _1"> </span>la <span class="blank _2"> </span>papila dérmica <span class="blank _2"> </span>que a <span class="blank _2"> </span>su vez <span class="blank _2"> </span>puede activarse</div><div class="t m0 x3 h6 y214 ff6 fs1 fc0 sc0 ls6 ws7">la <span class="blank _a"> </span>fa<span class="blank _1"> </span>se <span class="blank _a"> </span>p<span class="blank _1"> </span>rol<span class="blank _1"> </span>ife<span class="blank _1"> </span>rati<span class="blank _1"> </span>va <span class="blank _a"> </span>d<span class="blank _1"> </span>el <span class="blank _a"> </span>c<span class="blank _1"> </span>iclo<span class="blank _1"> </span> <span class="blank _a"> </span>del<span class="blank _1"> </span> <span class="blank _a"> </span>pel<span class="blank _1"> </span>o <span class="blank _a"> </span>y <span class="blank _a"> </span>e<span class="blank _1"> </span>s <span class="blank _a"> </span>res<span class="blank _1"> </span>pon<span class="blank _1"> </span>sab<span class="blank _1"> </span>le <span class="blank _a"> </span>de<span class="blank _1"> </span>l</div><div class="t m0 x3 h1a y215 ff6 fs1 fc0 sc0 ls6 ws7">crecimiento de la unidad folicular<span class="fs8 ls9 wsa v1">33,34</span>.</div><div class="t m0 x10 h6 y216 ff6 fs1 fc0 sc0 ls6 ws7">Finalmente, gracias <span class="blank _1"> </span>a la <span class="blank _1"> </span>supresión de <span class="blank _1"> </span>las citocinas <span class="blank _1"> </span>inflamatorias,</div><div class="t m0 x3 h6 y217 ff6 fs1 fc0 sc0 ls6 ws7">el <span class="blank"> </span>PRP <span class="blank"> </span>apa<span class="blank _1"> </span>rec<span class="blank _1"> </span>e <span class="blank"> </span>como<span class="blank _1"> </span> <span class="blank"> </span>un <span class="blank"> </span>poten<span class="blank _1"> </span>te <span class="blank"> </span>agen<span class="blank _1"> </span>te <span class="blank"> </span>ant<span class="blank _1"> </span>iin<span class="blank _1"> </span>flam<span class="blank _1"> </span>ato<span class="blank _1"> </span>rio<span class="blank _1"> </span>. <span class="blank"> </span>Los</div><div class="t m0 x3 h6 y218 ff6 fs1 fc0 sc0 ls6 ws7">prin<span class="blank _1"> </span>cip<span class="blank _1"> </span>ale<span class="blank _1"> </span>s <span class="blank _2"> </span>ef<span class="blank _1"> </span>ect<span class="blank _1"> </span>os <span class="blank _7"> </span>secu<span class="blank _1"> </span>nda<span class="blank _1"> </span>rios<span class="blank _1"> </span> <span class="blank _2"> </span>de<span class="blank _1"> </span> <span class="blank _2"> </span>est<span class="blank _1"> </span>a <span class="blank _2"> </span>t<span class="blank _1"> </span>écn<span class="blank _1"> </span>ica <span class="blank _7"> </span>se <span class="blank _2"> </span>a<span class="blank _1"> </span>soc<span class="blank _1"> </span>ia <span class="blank _2"> </span>d<span class="blank _1"> </span>olo<span class="blank _1"> </span>r <span class="blank _2"> </span>y</div><div class="t m0 x3 h6 y219 ff6 fs1 fc0 sc0 ls6 ws7">edema transitorio después <span class="blank _3"></span>del tratamiento y sensibilidad, <span class="blank _0"></span>tricodinia</div><div class="t m0 x3 h1a y21a ff6 fs1 fc0 sc0 ls6 ws7">persiste<span class="blank _0"></span>nte, <span class="blank _3"></span>efluvio <span class="blank _3"></span>telógeno, <span class="blank _3"></span>infeccion<span class="blank _0"></span>es <span class="blank _3"></span>secundarias <span class="blank _3"></span>y <span class="blank _0"></span>cicatr<span class="blank _0"></span>ices<span class="fs8 ws8 v1">34,35<span class="blank _0"></span><span class="fs1 v2">.</span></span></div><div class="t m0 x10 h6 y21b ff6 fs1 fc0 sc0 ls6 ws7">La <span class="blank _1"> </span>frecuencia de <span class="blank _1"> </span>las <span class="blank _1"> </span>sesiones <span class="blank _1"> </span>varía <span class="blank _1"> </span>de <span class="blank _1"> </span>dos <span class="blank _1"> </span>a <span class="blank _1"> </span>cinco <span class="blank _1"> </span>tratamientos,</div><div class="t m0 x3 h6 y21c ff6 fs1 fc0 sc0 ls6 ws7">con <span class="blank _9"> </span>un <span class="blank _d"> </span>in<span class="blank _1"> </span>ter<span class="blank _1"> </span>valo<span class="blank _1"> </span> <span class="blank _d"> </span>de <span class="blank _9"> </span>una <span class="blank _d"> </span>s<span class="blank _1"> </span>ema<span class="blank _1"> </span>na <span class="blank _d"> </span>a<span class="blank _1"> </span> <span class="blank _d"> </span>12 <span class="blank _d"> </span>s<span class="blank _1"> </span>ema<span class="blank _1"> </span>nas.<span class="blank _1"> </span> <span class="blank _d"> </span>Gen<span class="blank _1"> </span>til<span class="blank _1"> </span>e <span class="blank _d"> </span>y <span class="blank _d"> </span>c<span class="blank _1"> </span>ols<span class="blank _1"> </span>,</div><div class="t m0 x3 h6 y21d ff6 fs1 fc0 sc0 ls6 ws7">reportan <span class="blank _1"> </span>una <span class="blank _2"> </span>mejoría <span class="blank _2"> </span>clínica <span class="blank _1"> </span>después <span class="blank _2"> </span>de <span class="blank _1"> </span>la <span class="blank _2"> </span>tercera <span class="blank _2"> </span>sesión. <span class="blank _1"> </span>Aunque</div><div class="t m0 x3 h6 y21e ff6 fs1 fc0 sc0 ls6 ws7">se <span class="blank"> </span>neces<span class="blank _1"> </span>ita<span class="blank _1"> </span>n <span class="blank"> </span>más <span class="blank"> </span>estudi<span class="blank _1"> </span>os <span class="blank"> </span>para<span class="blank _1"> </span> <span class="blank"> </span>confir<span class="blank _1"> </span>mar <span class="blank"> </span>su <span class="blank"> </span>efica<span class="blank _1"> </span>cia<span class="blank _1"> </span> <span class="blank"> </span>y <span class="blank _d"> </span>d<span class="blank _1"> </span>efi<span class="blank _1"> </span>nir</div><div class="t m0 x3 h6 y21f ff6 fs1 fc0 sc0 ls6 ws7">prot<span class="blank _1"> </span>oco<span class="blank _1"> </span>los<span class="blank _1"> </span> <span class="blank _1a"> </span>estan<span class="blank _1"> </span>dar<span class="blank _1"> </span>izad<span class="blank _1"> </span>os <span class="blank _1a"> </span>pa<span class="blank _1"> </span>ra <span class="blank _1a"> </span>tra<span class="blank _1"> </span>tami<span class="blank _1"> </span>ent<span class="blank _1"> </span>os,<span class="blank _1"> </span> <span class="blank _1a"> </span>el <span class="blank _1a"> </span>PRP <span class="blank _1a"> </span>pue<span class="blank _1"> </span>de</div><div class="t m0 x3 h6 y220 ff6 fs1 fc0 sc0 ls6 ws7">repr<span class="blank _1"> </span>ese<span class="blank _1"> </span>nta<span class="blank _1"> </span>r <span class="blank _4"> </span>una<span class="blank _1"> </span> <span class="blank _4"> </span>opc<span class="blank _1"> </span>ión<span class="blank _1"> </span> <span class="blank _4"> </span>viab<span class="blank _1"> </span>le <span class="blank _4"> </span>e<span class="blank _1"> </span>n <span class="blank _4"> </span>pa<span class="blank _1"> </span>cie<span class="blank _1"> </span>ntes<span class="blank _1"> </span> <span class="blank _4"> </span>en <span class="blank _4"> </span>l<span class="blank _1"> </span>os <span class="blank _4"> </span>q<span class="blank _1"> </span>ue <span class="blank _4"> </span>lo<span class="blank _1"> </span>s</div><div class="t m0 x3 h1a y221 ff6 fs1 fc0 sc0 ls6 ws7">tratamientos estándar no producen resultados satisfactorios<span class="fs8 ws8 v1">35</span>.</div><div class="t m0 x13 he y1f7 ff7 fs1 fc0 sc0 ls6 ws9">Dutasteride:</div><div class="t m0 x14 h6 y222 ff6 fs1 fc0 sc0 ls6 ws7">En <span class="blank _2"> </span>el <span class="blank _2"> </span>año <span class="blank _2"> </span>2009<span class="blank _1"> </span>, <span class="blank _2"> </span>Abdal<span class="blank _1"> </span>lah <span class="blank _2"> </span>y <span class="blank _2"> </span>cols,<span class="blank _1"> </span> <span class="blank _2"> </span>public<span class="blank _1"> </span>aron <span class="blank _2"> </span>un <span class="blank _2"> </span>pri<span class="blank _1"> </span>mer <span class="blank _2"> </span>ens<span class="blank _1"> </span>ayo</div><div class="t m0 x13 h6 y223 ff6 fs1 fc0 sc0 ls6 ws7">clín<span class="blank _1"> </span>ico<span class="blank _1"> </span> <span class="blank"> </span>para<span class="blank _1"> </span> <span class="blank"> </span>eval<span class="blank _1"> </span>uar<span class="blank _1"> </span> <span class="blank"> </span>la <span class="blank"> </span>ef<span class="blank _1"> </span>ica<span class="blank _1"> </span>cia <span class="blank"> </span>y<span class="blank _1"> </span> <span class="blank"> </span>la <span class="blank"> </span>se<span class="blank _1"> </span>guri<span class="blank _1"> </span>dad<span class="blank _1"> </span> <span class="blank"> </span>de <span class="blank"> </span>la<span class="blank _1"> </span> <span class="blank"> </span>inye<span class="blank _1"> </span>cci<span class="blank _1"> </span>ón</div><div class="t m0 x13 h6 y224 ff6 fs1 fc0 sc0 ls6 ws7">intradérmica <span class="blank _1"> </span>de <span class="blank _1"> </span>una <span class="blank _1"> </span>solución <span class="blank _1"> </span>de <span class="blank _1"> </span>dutasteride <span class="blank _1"> </span>al <span class="blank _1"> </span>0,05% <span class="blank _1"> </span>en <span class="blank _1"> </span>pacientes</div><div class="t m0 x13 h1a y225 ff6 fs1 fc0 sc0 ls6 ws7">con AAF masculina<span class="fs8 ws8 v1">36</span>.</div><div class="t m0 x36 h6 y226 ff6 fs1 fc0 sc0 ls6 ws7">Moftah y cols, realizaron un ensayo <span class="blank _0"></span>clínico en 126 pacientes con</div><div class="t m0 x13 h6 y227 ff6 fs1 fc0 sc0 ls6 ws7">AAF <span class="blank _2"> </span>en <span class="blank _2"> </span>el <span class="blank _2"> </span>que <span class="blank _2"> </span>comparab<span class="blank _1"> </span>an <span class="blank _2"> </span>la <span class="blank _2"> </span>eficacia<span class="blank _1"> </span> <span class="blank _2"> </span>de <span class="blank _2"> </span>2ml <span class="blank _2"> </span>de <span class="blank _1"> </span>u<span class="blank _1"> </span>na <span class="blank _2"> </span>solució<span class="blank _1"> </span>n <span class="blank _2"> </span>de</div><div class="t m0 x13 h6 y228 ff6 fs1 fc0 sc0 ls6 ws7">dutasteride al <span class="blank _1"> </span>0,05% <span class="blank _1"> </span>con <span class="blank _1"> </span>dexpantenol, <span class="blank _1"> </span>biotina <span class="blank _1"> </span>y <span class="blank _1"> </span>piridoxina <span class="blank _1"> </span>frente <span class="blank _1"> </span>a</div><div class="t m0 x13 h6 y229 ff6 fs1 fc0 sc0 ls6 ws7">inye<span class="blank _1"> </span>cci<span class="blank _1"> </span>one<span class="blank _1"> </span>s <span class="blank"> </span>de <span class="blank"> </span>su<span class="blank _1"> </span>ero<span class="blank _1"> </span> <span class="blank"> </span>fisi<span class="blank _1"> </span>ológ<span class="blank _1"> </span>ico<span class="blank _1"> </span>. <span class="blank"> </span>Se <span class="blank"> </span>re<span class="blank _1"> </span>ali<span class="blank _1"> </span>zar<span class="blank _1"> </span>on <span class="blank"> </span>12<span class="blank _1"> </span> <span class="blank"> </span>sesi<span class="blank _1"> </span>ones<span class="blank _1"> </span> <span class="blank"> </span>de</div><div class="t m0 x13 h6 y22a ff6 fs1 fc0 sc0 ls6 ws7">meso<span class="blank _1"> </span>ter<span class="blank _1"> </span>api<span class="blank _1"> </span>a <span class="blank _6"> </span>du<span class="blank _1"> </span>rant<span class="blank _1"> </span>e <span class="blank _6"> </span>un<span class="blank _1"> </span> <span class="blank _6"> </span>pla<span class="blank _1"> </span>zo <span class="blank _6"> </span>de<span class="blank _1"> </span> <span class="blank _6"> </span>16 <span class="blank _6"> </span>s<span class="blank _1"> </span>ema<span class="blank _1"> </span>nas<span class="blank _1"> </span>. <span class="blank _6"> </span>Se<span class="blank _1"> </span> <span class="blank _6"> </span>cons<span class="blank _1"> </span>tat<span class="blank _1"> </span>ó <span class="blank _6"> </span>un<span class="blank _1"> </span>a</div><div class="t m0 x13 h6 y22b ff6 fs1 fc0 sc0 ls6 ws7">mejoría <span class="blank _1"> </span>en <span class="blank _2"> </span>el <span class="blank _1"> </span>62,8% <span class="blank _1"> </span>de <span class="blank _2"> </span>las <span class="blank _1"> </span>pacientes <span class="blank _2"> </span>que <span class="blank _1"> </span>recibieron <span class="blank _1"> </span>la <span class="blank _2"> </span>solución <span class="blank _1"> </span>de</div><div class="t m0 x13 h13 y22c ff6 fs1 fc0 sc0 ls6 ws7">dutasteride con respecto al 17,5% del grupo control<span class="fs8 ws8 v1">37</span><span class="v0">.</span></div><div class="t m0 x14 h6 y22d ff6 fs1 fc0 sc0 ls6 ws7">El <span class="blank _2"> </span>dutasteride <span class="blank _1"> </span>inhibe <span class="blank _2"> </span>las <span class="blank _2"> </span>isoenzimas <span class="blank _2"> </span>1 <span class="blank _1"> </span>y <span class="blank _2"> </span>2 <span class="blank _2"> </span>de <span class="blank _2"> </span>la <span class="blank _1"> </span>5-<span class="ff9 ls15">a</span><span class="ws3">-reductasa,</span></div><div class="t m0 x13 h6 y22e ff6 fs1 fc0 sc0 ls6 ws7">dismin<span class="blank _0"></span>uye <span class="blank _3"></span>la <span class="blank _0"></span>dihidr<span class="blank _0"></span>otesto<span class="blank _0"></span>steron<span class="blank _0"></span>a <span class="blank _3"></span>sérica <span class="blank _3"></span>un 9<span class="blank _0"></span>0%. <span class="blank _3"></span>Su <span class="blank _0"></span>larga<span class="blank _0"></span> <span class="blank _0"></span>vida <span class="blank _3"></span>media,</div><div class="t m0 x13 h6 y22f ff6 fs1 fc0 sc0 ls6 ws7">aproximadamente <span class="blank _0"></span>4-5 semanas, <span class="blank _3"></span>permite espaciar <span class="blank _3"></span>más las <span class="blank _3"></span>pautas de</div><div class="t m0 x13 h6 y230 ff6 fs1 fc0 sc0 ls6 ws7">tratamiento. Por <span class="blank _1"> </span>al <span class="blank _1"> </span>menos <span class="blank _1"> </span>una <span class="blank _1"> </span>semana, <span class="blank _1"> </span>en <span class="blank _1"> </span>las <span class="blank _1"> </span>que <span class="blank _1"> </span>se <span class="blank _1"> </span>administraba</div><div class="t m0 x13 h6 y231 ff6 fs1 fc0 sc0 ls6 ws7">2 ml <span class="blank _3"></span>de solución <span class="blank _0"></span>en <span class="blank _0"></span>cada sesión. <span class="blank _3"></span>El 92,9% <span class="blank _0"></span>de los <span class="blank _3"></span>pacientes refirieron</div><div class="t m0 x13 h19 y232 ff6 fs1 fc0 sc0 ls6 ws7">mejoría en la densidad capilar<span class="fs8 ls9 wsa v1">37,38</span>.</div><div class="t m0 x14 h6 y233 ff6 fs1 fc0 sc0 ls6 ws7">Las <span class="blank _6"> </span>m<span class="blank _1"> </span>icr<span class="blank _1"> </span>oin<span class="blank _1"> </span>yecc<span class="blank _1"> </span>ion<span class="blank _1"> </span>es <span class="blank _6"> </span>d<span class="blank _1"> </span>e <span class="blank _6"> </span>dut<span class="blank _1"> </span>ast<span class="blank _1"> </span>erid<span class="blank _1"> </span>e <span class="blank _6"> </span>se<span class="blank _1"> </span> <span class="blank _6"> </span>mues<span class="blank _1"> </span>tra<span class="blank _1"> </span>n <span class="blank _6"> </span>co<span class="blank _1"> </span>mo <span class="blank _6"> </span>un<span class="blank _1"> </span>a</div><div class="t m0 x13 h6 y234 ff6 fs1 fc0 sc0 ls6 ws7">alternativa segura <span class="blank _0"></span>y potencialmente <span class="blank _0"></span>efectiva en el <span class="blank _3"></span>tratamiento de la</div><div class="t m0 x13 h6 y235 ff6 fs1 fc0 sc0 ls6 ws7">AAF,<span class="blank _1"> </span> <span class="blank _2"> </span>que<span class="blank _1"> </span> <span class="blank _2"> </span>pro<span class="blank _1"> </span>babl<span class="blank _1"> </span>eme<span class="blank _1"> </span>nte<span class="blank _1"> </span> <span class="blank _2"> </span>verá<span class="blank _1"> </span> <span class="blank _2"> </span>inc<span class="blank _1"> </span>rem<span class="blank _1"> </span>ent<span class="blank _1"> </span>ado <span class="blank _2"> </span>s<span class="blank _1"> </span>u <span class="blank _2"> </span>us<span class="blank _1"> </span>o <span class="blank _2"> </span>en<span class="blank _1"> </span> <span class="blank _2"> </span>el <span class="blank _2"> </span>fu<span class="blank _1"> </span>tur<span class="blank _1"> </span>o,</div><div class="t m0 x13 h6 y236 ff6 fs1 fc0 sc0 ls6 ws7">espe<span class="blank _1"> </span>cia<span class="blank _1"> </span>lme<span class="blank _1"> </span>nte<span class="blank _1"> </span> <span class="blank _a"> </span>en<span class="blank _1"> </span> <span class="blank _a"> </span>p<span class="blank _1"> </span>aci<span class="blank _1"> </span>ente<span class="blank _1"> </span>s <span class="blank _4"> </span>que <span class="blank _4"> </span>no <span class="blank _4"> </span>dese<span class="blank _1"> </span>en <span class="blank _4"> </span>lle<span class="blank _1"> </span>var<span class="blank _1"> </span> <span class="blank _a"> </span>ac<span class="blank _1"> </span>abo<span class="blank _1"> </span> <span class="blank _a"> </span>u<span class="blank _1"> </span>n</div><div class="t m0 x13 h13 y237 ff6 fs1 fc0 sc0 ls6 ws7">tratamiento oral o como una terapia complementaria al mismo<span class="fs8 ls12 wsf v1">38,39</span><span class="v0">.</span></div><div class="t m0 x13 h5 y238 ff5 fs3 fc0 sc0 ls6 ws7">Otras terapias</div><div class="t m0 x13 he y239 ff7 fs1 fc0 sc0 ls6 ws7">Terapia de luz:</div><div class="t m0 x2d h6 y23a ff6 fs1 fc0 sc0 ls6 ws7">El <span class="blank _1"> </span>mecanismo <span class="blank _1"> </span>de <span class="blank _1"> </span>la <span class="blank _1"> </span>terapia <span class="blank _1"> </span>con <span class="blank _2"> </span>luz láser <span class="blank _1"> </span>de <span class="blank _1"> </span>bajo <span class="blank _2"> </span>nivel (LLLT) <span class="blank _1"> </span>es</div><div class="t m0 x13 h6 y23b ff6 fs1 fc0 sc0 ls6 ws7">una <span class="blank _3"></span>nueva <span class="blank _3"></span>técni<span class="blank _0"></span>ca <span class="blank _3"></span>para <span class="blank _3"></span>estimu<span class="blank _0"></span>lar <span class="blank _3"></span>el <span class="blank _3"></span>crecimie<span class="blank _0"></span>nto <span class="blank _3"></span>del <span class="blank _3"></span>pelo <span class="blank _3"></span>en <span class="blank _3"></span>hombres</div><div class="t m0 x13 h6 y23c ff6 fs1 fc0 sc0 ls6 ws7">y <span class="blank _9"> </span>muje<span class="blank _1"> </span>res<span class="blank _1"> </span>. <span class="blank _9"> </span>Se <span class="blank _9"> </span>pre<span class="blank _1"> </span>sum<span class="blank _1"> </span>e <span class="blank _9"> </span>que <span class="blank"> </span>la <span class="blank _d"> </span>lu<span class="blank _1"> </span>z <span class="blank _9"> </span>mej<span class="blank _1"> </span>ora <span class="blank"> </span>las <span class="blank _d"> </span>v<span class="blank _1"> </span>ías<span class="blank _1"> </span> <span class="blank _d"> </span>r<span class="blank _1"> </span>esp<span class="blank _1"> </span>irat<span class="blank _1"> </span>ori<span class="blank _1"> </span>as</div><div class="t m0 x13 h6 y23d ff6 fs1 fc0 sc0 ls6 ws7">mito<span class="blank _1"> </span>con<span class="blank _1"> </span>dri<span class="blank _1"> </span>ales<span class="blank _1"> </span>, <span class="blank _9"> </span>act<span class="blank _1"> </span>ivi<span class="blank _1"> </span>dad <span class="blank"> </span>y <span class="blank _d"> </span>prod<span class="blank _1"> </span>ucc<span class="blank _1"> </span>ión<span class="blank _1"> </span> <span class="blank _d"> </span>d<span class="blank _1"> </span>e <span class="blank _9"> </span>aden<span class="blank _1"> </span>osi<span class="blank _1"> </span>na <span class="blank _9"> </span>tri<span class="blank _1"> </span>fos<span class="blank _1"> </span>fat<span class="blank _1"> </span>o.</div><div class="t m0 x13 h6 y23e ff6 fs1 fc0 sc0 ls6 ws7">Además, <span class="blank _2"> </span>estim<span class="blank _1"> </span>ula <span class="blank _2"> </span>la <span class="blank _2"> </span>reentrada <span class="blank _2"> </span>en <span class="blank _2"> </span>la <span class="blank _2"> </span>fase <span class="blank _2"> </span>anágena <span class="blank _2"> </span>en <span class="blank _2"> </span>los <span class="blank _2"> </span>folícul<span class="blank _1"> </span>os</div><div class="t m0 x13 h6 y23f ff6 fs1 fc0 sc0 ls6 ws7">pilos<span class="blank _0"></span>os <span class="blank _3"></span>telógen<span class="blank _0"></span>os, <span class="blank _3"></span>prolon<span class="blank _0"></span>ga <span class="blank _3"></span>la <span class="blank _3"></span>duración <span class="blank _3"></span>de <span class="blank _3"></span>la <span class="blank _0"></span>fase <span class="blank _3"></span>anáge<span class="blank _0"></span>na, <span class="blank _3"></span>aument<span class="blank _0"></span>a</div><div class="t m0 x13 h6 y240 ff6 fs1 fc0 sc0 ls6 ws7">las tasas <span class="blank _0"></span>de proliferación <span class="blank _0"></span>en los <span class="blank _0"></span>folículos pilosos <span class="blank _0"></span>anágenos activos <span class="blank _0"></span>y</div><div class="t m0 x13 h25 y241 ff6 fs1 fc0 sc0 ls6 ws7">previene el desarrollo catágeno prematuro<span class="fs8 ws8 v1">10</span><span class="v0">.</span></div><div class="t m0 x36 h6 y242 ff6 fs1 fc0 sc0 ls6 ws7">Se <span class="blank _2"> </span>e<span class="blank _1"> </span>ncu<span class="blank _1"> </span>entr<span class="blank _1"> </span>an <span class="blank _7"> </span>much<span class="blank _1"> </span>os <span class="blank _7"> </span>disp<span class="blank _1"> </span>osi<span class="blank _1"> </span>tivo<span class="blank _1"> </span>s <span class="blank _2"> </span>d<span class="blank _1"> </span>ise<span class="blank _1"> </span>ñado<span class="blank _1"> </span>s, <span class="blank _7"> </span>como<span class="blank _1"> </span> <span class="blank _2"> </span>cep<span class="blank _1"> </span>ill<span class="blank _1"> </span>os,</div><div class="t m0 x13 h6 y243 ff6 fs1 fc0 sc0 ls6 ws7">pein<span class="blank _1"> </span>es,<span class="blank _1"> </span> <span class="blank _4"> </span>c<span class="blank _1"> </span>apu<span class="blank _1"> </span>cha<span class="blank _1"> </span>s <span class="blank _8"> </span>y <span class="blank _4"> </span>c<span class="blank _1"> </span>asco<span class="blank _1"> </span>s. <span class="blank _8"> </span>La <span class="blank _8"> </span>FDA <span class="blank _8"> </span>ha <span class="blank _8"> </span>apr<span class="blank _1"> </span>obad<span class="blank _1"> </span>o <span class="blank _8"> </span>dife<span class="blank _1"> </span>rent<span class="blank _1"> </span>es</div><div class="t m0 x13 h6 y244 ff6 fs1 fc0 sc0 ls6 ws7">disp<span class="blank _1"> </span>osi<span class="blank _1"> </span>tiv<span class="blank _1"> </span>os <span class="blank _d"> </span>LLL<span class="blank _1"> </span>T <span class="blank _6"> </span>p<span class="blank _1"> </span>ara<span class="blank _1"> </span> <span class="blank _6"> </span>su<span class="blank _1"> </span> <span class="blank _6"> </span>u<span class="blank _1"> </span>so <span class="blank _d"> </span>en <span class="blank _d"> </span>AAF<span class="blank _1"> </span>, <span class="blank _d"> </span>por <span class="blank _d"> </span>lo<span class="blank _1"> </span> <span class="blank _6"> </span>ge<span class="blank _1"> </span>ner<span class="blank _1"> </span>al,<span class="blank _1"> </span> <span class="blank _6"> </span>so<span class="blank _1"> </span>n <span class="blank _d"> </span>bien</div><div class="t m0 x13 h6 y245 ff6 fs1 fc0 sc0 ls6 ws7">tole<span class="blank _1"> </span>rad<span class="blank _1"> </span>os.<span class="blank _1"> </span> <span class="blank _7"> </span>L<span class="blank _1"> </span>os <span class="blank _6"> </span>efe<span class="blank _1"> </span>cto<span class="blank _1"> </span>s <span class="blank _7"> </span>s<span class="blank _1"> </span>ecu<span class="blank _1"> </span>nda<span class="blank _1"> </span>rio<span class="blank _1"> </span>s <span class="blank _7"> </span>i<span class="blank _1"> </span>ncl<span class="blank _1"> </span>uye<span class="blank _1"> </span>n <span class="blank _6"> </span>sequ<span class="blank _1"> </span>eda<span class="blank _1"> </span>d <span class="blank _6"> </span>del <span class="blank _6"> </span>cue<span class="blank _1"> </span>ro</div><div class="t m0 x13 h27 y246 ff6 fs1 fc0 sc0 ls6 ws7">cabelludo, prurito, sensibilidad y una sensación de calor<span class="fs8 ws8 v1">10</span><span class="v0">.</span></div><div class="t m0 x2d h6 y247 ff6 fs1 fc0 sc0 ls6 ws7">Los <span class="blank _1"> </span>resultados <span class="blank _2"> </span>obtenidos <span class="blank _1"> </span>por <span class="blank _1"> </span>Faghihi <span class="blank _2"> </span>G <span class="blank _1"> </span>y <span class="blank _2"> </span>cols, <span class="blank _1"> </span>muestran <span class="blank _1"> </span>cómo</div><div class="t m0 x13 h6 y248 ff6 fs1 fc0 sc0 ls6 ws7">está<span class="blank _1"> </span> <span class="blank"> </span>técnic<span class="blank _1"> </span>a <span class="blank"> </span>puede <span class="blank"> </span>estim<span class="blank _1"> </span>ula<span class="blank _1"> </span>r <span class="blank"> </span>el <span class="blank _9"> </span>cre<span class="blank _1"> </span>cim<span class="blank _1"> </span>ien<span class="blank _1"> </span>to <span class="blank"> </span>del <span class="blank"> </span>pelo <span class="blank"> </span>tanto<span class="blank _1"> </span> <span class="blank _9"> </span>en</div><div class="t m0 x13 h6 y249 ff6 fs1 fc0 sc0 ls6 ws7">homb<span class="blank _1"> </span>res<span class="blank _1"> </span> <span class="blank _2"> </span>c<span class="blank _1"> </span>omo <span class="blank _7"> </span>en<span class="blank _1"> </span> <span class="blank _2"> </span>mu<span class="blank _1"> </span>jer<span class="blank _1"> </span>es <span class="blank _7"> </span>con<span class="blank _1"> </span> <span class="blank _2"> </span>al<span class="blank _1"> </span>ope<span class="blank _1"> </span>cia<span class="blank _1"> </span> <span class="blank _2"> </span>an<span class="blank _1"> </span>dro<span class="blank _1"> </span>gén<span class="blank _1"> </span>ica.<span class="blank _1"> </span> <span class="blank _2"> </span>D<span class="blank _1"> </span>ado <span class="blank _7"> </span>qu<span class="blank _1"> </span>e</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pf9" class="pf w0 h0" data-page-no="9"><div class="pc pc9 w0 h0"><img fetchpriority="low" loading="lazy" class="bi x0 y30 w1 hc" alt="" src="https://files.passeidireto.com/75f5f44c-f020-40b0-8bec-4e63b893e22f/bg9.png"><div class="t m0 x2c h3 y2 ff2 fs1 fc0 sc0 ls6 ws10">14</div><div class="t m0 x3 h4 y3 ff3 fs2 fc0 sc0 ls6 ws7">Dermatol V<span class="blank _0"></span>enez <span class="ff4 ls0">h</span>Vol.59 <span class="ff4 ls1">h</span>N°2 <span class="ff4 ls2">h</span><span class="ws1">2021</span></div><div class="t m0 x1 h2 y1 ff1 fs0 fc0 sc0 ls6 ws7">REVISIÓN </div><div class="t m0 x3 h6 y8b ff6 fs1 fc0 sc0 ls6 ws7">tanto <span class="blank _1"> </span>la <span class="blank _1"> </span>regeneración <span class="blank _1"> </span>reconstructiva <span class="blank _1"> </span>que <span class="blank _1"> </span>se <span class="blank _1"> </span>produce <span class="blank _1"> </span>en <span class="blank _1"> </span>el <span class="blank _1"> </span>proceso</div><div class="t m0 x3 h6 y24a ff6 fs1 fc0 sc0 ls6 ws7">de <span class="blank _2"> </span>cicatriza<span class="blank _1"> </span>ción <span class="blank _2"> </span>de <span class="blank _2"> </span>heridas<span class="blank _1"> </span> <span class="blank _2"> </span>como <span class="blank _2"> </span>la <span class="blank _2"> </span>regeneración<span class="blank _1"> </span> <span class="blank _2"> </span>fisiológic<span class="blank _1"> </span>a <span class="blank _2"> </span>en <span class="blank _2"> </span>el</div><div class="t m0 x3 h6 y24b ff6 fs1 fc0 sc0 ls6 ws7">ciclo <span class="blank _2"> </span>de <span class="blank _2"> </span>crecim<span class="blank _1"> </span>iento <span class="blank _2"> </span>del <span class="blank _2"> </span>pelo <span class="blank _2"> </span>requ<span class="blank _1"> </span>ieren <span class="blank _2"> </span>la <span class="blank _2"> </span>prolif<span class="blank _1"> </span>eración<span class="blank _1"> </span> <span class="blank _2"> </span>celular, <span class="blank _2"> </span>es</div><div class="t m0 x3 h6 y24c ff6 fs1 fc0 sc0 ls6 ws7">posi<span class="blank _1"> </span>ble <span class="blank _2"> </span>que<span class="blank _1"> </span> <span class="blank _2"> </span>el <span class="blank _2"> </span>efecto<span class="blank _1"> </span> <span class="blank _2"> </span>estimu<span class="blank _1"> </span>lant<span class="blank _1"> </span>e <span class="blank _2"> </span>de <span class="blank _2"> </span>la <span class="blank _2"> </span>luz <span class="blank _2"> </span>de <span class="blank _2"> </span>baj<span class="blank _1"> </span>o <span class="blank _2"> </span>nivel<span class="blank _1"> </span> <span class="blank _2"> </span>sobre<span class="blank _1"> </span> <span class="blank _2"> </span>el</div><div class="t m0 x3 h25 y24d ff6 fs1 fc0 sc0 ls6 ws7">crecimiento del pelo se pueda lograr de forma directa <span class="blank _0"></span>o indirecta<span class="fs8 ws8 v1">24</span><span class="v0">.</span></div><div class="t m0 x3 he y24e ff7 fs1 fc0 sc0 ls6 ws7">Microneedling o microagujas:</div><div class="t m0 xb h6 y24f ff6 fs1 fc0 sc0 ls6 ws7">Se <span class="blank _3"></span>ha <span class="blank _0"></span>demostr<span class="blank _0"></span>ado <span class="blank _3"></span>que <span class="blank _3"></span>esta <span class="blank _0"></span>terapi<span class="blank _0"></span>a <span class="blank _3"></span>mejora <span class="blank _3"></span>el c<span class="blank _0"></span>recimi<span class="blank _0"></span>ento <span class="blank _3"></span>del <span class="blank _3"></span>pelo</div><div class="t m0 x3 h6 y250 ff6 fs1 fc0 sc0 ls6 ws7">medi<span class="blank _1"> </span>ant<span class="blank _1"> </span>e <span class="blank _7"> </span>la <span class="blank _7"> </span>e<span class="blank _1"> </span>stim<span class="blank _1"> </span>ula<span class="blank _1"> </span>ció<span class="blank _1"> </span>n <span class="blank _7"> </span>de <span class="blank _7"> </span>la<span class="blank _1"> </span> <span class="blank _7"> </span>piel<span class="blank _1"> </span>, <span class="blank _7"> </span>pa<span class="blank _1"> </span>pila<span class="blank _1"> </span> <span class="blank _7"> </span>y <span class="blank _7"> </span>cél<span class="blank _1"> </span>ulas<span class="blank _1"> </span> <span class="blank _7"> </span>mad<span class="blank _1"> </span>re <span class="blank _7"> </span>y <span class="blank _7"> </span>un</div><div class="t m0 x3 h6 y251 ff6 fs1 fc0 sc0 ls6 ws7">aumento <span class="blank _0"></span>en el <span class="blank _3"></span>suministro de <span class="blank _3"></span>sangre a <span class="blank _3"></span>los folículos <span class="blank _0"></span>pilosos, debido <span class="blank _3"></span>a</div><div class="t m0 x3 h6 y252 ff6 fs1 fc0 sc0 ls6 ws7">su capacidad para mejorar <span class="blank _1"> </span>la producción del factor <span class="blank _1"> </span>de crecimiento,</div><div class="t m0 x3 h6 y253 ff6 fs1 fc0 sc0 ls6 ws7">faci<span class="blank _1"> </span>lit<span class="blank _1"> </span>ar <span class="blank _2"> </span>e<span class="blank _1"> </span>l <span class="blank _2"> </span>des<span class="blank _1"> </span>arr<span class="blank _1"> </span>oll<span class="blank _1"> </span>o <span class="blank _2"> </span>del<span class="blank _1"> </span> <span class="blank _2"> </span>fol<span class="blank _1"> </span>ícu<span class="blank _1"> </span>lo <span class="blank _2"> </span>p<span class="blank _1"> </span>ilos<span class="blank _1"> </span>o <span class="blank _2"> </span>y <span class="blank _2"> </span>c<span class="blank _1"> </span>rea<span class="blank _1"> </span>r <span class="blank _2"> </span>mic<span class="blank _1"> </span>roc<span class="blank _1"> </span>ana<span class="blank _1"> </span>les <span class="blank _2"> </span>q<span class="blank _1"> </span>ue</div><div class="t m0 x3 h6 y254 ff6 fs1 fc0 sc0 ls6 ws7">perm<span class="blank _1"> </span>ite<span class="blank _1"> </span>n <span class="blank _e"> </span>e<span class="blank _1"> </span>l <span class="blank _e"> </span>s<span class="blank _1"> </span>umi<span class="blank _1"> </span>nist<span class="blank _1"> </span>ro <span class="blank _b"> </span>tra<span class="blank _1"> </span>nsdé<span class="blank _1"> </span>rmi<span class="blank _1"> </span>co <span class="blank _b"> </span>de <span class="blank _b"> </span>medi<span class="blank _1"> </span>cam<span class="blank _1"> </span>ent<span class="blank _1"> </span>os, <span class="blank _b"> </span>com<span class="blank _1"> </span>o</div><div class="t m0 x3 h6 y255 ff6 fs1 fc0 sc0 ls6 ws7">mino<span class="blank _1"> </span>xid<span class="blank _1"> </span>il <span class="blank _7"> </span>o <span class="blank _7"> </span>P<span class="blank _1"> </span>RP, <span class="blank _7"> </span>a<span class="blank _1"> </span> <span class="blank _2"> </span>t<span class="blank _1"> </span>rav<span class="blank _1"> </span>és <span class="blank _7"> </span>de<span class="blank _1"> </span>l <span class="blank _7"> </span>est<span class="blank _1"> </span>rat<span class="blank _1"> </span>o <span class="blank _7"> </span>cór<span class="blank _1"> </span>neo<span class="blank _1"> </span>. <span class="blank _7"> </span>Se <span class="blank _7"> </span>ha<span class="blank _1"> </span> <span class="blank _7"> </span>plan<span class="blank _1"> </span>tea<span class="blank _1"> </span>do <span class="blank _7"> </span>la</div><div class="t m0 x3 h6 y256 ff6 fs1 fc0 sc0 ls6 ws7">hipó<span class="blank _1"> </span>tes<span class="blank _1"> </span>is <span class="blank _1a"> </span>de<span class="blank _1"> </span> <span class="blank _1a"> </span>que <span class="blank _1a"> </span>la<span class="blank _1"> </span> <span class="blank _1a"> </span>micro<span class="blank _1"> </span>les<span class="blank _1"> </span>ión<span class="blank _1"> </span> <span class="blank _1a"> </span>que <span class="blank _1a"> </span>se<span class="blank _1"> </span> <span class="blank _1a"> </span>produ<span class="blank _1"> </span>jo <span class="blank _1a"> </span>me<span class="blank _1"> </span>dia<span class="blank _1"> </span>nte</div><div class="t m0 x3 h6 y257 ff6 fs1 fc0 sc0 ls6 ws7">micr<span class="blank _1"> </span>oag<span class="blank _1"> </span>uja<span class="blank _1"> </span>s <span class="blank _9"> </span>pod<span class="blank _1"> </span>ría <span class="blank"> </span>ayudar<span class="blank _1"> </span> <span class="blank _d"> </span>a<span class="blank _1"> </span>l <span class="blank _9"> </span>rec<span class="blank _1"> </span>lut<span class="blank _1"> </span>amie<span class="blank _1"> </span>nto<span class="blank _1"> </span> <span class="blank _9"> </span>de <span class="blank _9"> </span>los<span class="blank _1"> </span> <span class="blank _d"> </span>f<span class="blank _1"> </span>act<span class="blank _1"> </span>ore<span class="blank _1"> </span>s <span class="blank _9"> </span>de</div><div class="t m0 x3 h27 y258 ff6 fs1 fc0 sc0 ls6 ws3">crecimiento<span class="fs8 ws8 v1">40</span><span class="v0">.</span></div><div class="t m0 x10 h6 y259 ff6 fs1 fc0 sc0 ls6 ws7">Autores recomiendan el tratamiento con <span class="blank _1"> </span>microagujas tres veces</div><div class="t m0 x3 h6 y25a ff6 fs1 fc0 sc0 ls6 ws7">al <span class="blank _1"> </span>mes, <span class="blank _1"> </span>durante <span class="blank _1"> </span>al <span class="blank _2"> </span>menos 6 <span class="blank _2"> </span>meses. Starace <span class="blank _2"> </span>y col, <span class="blank _2"> </span>en su <span class="blank _2"> </span>experiencia</div><div class="t m0 x3 h6 y25b ff6 fs1 fc0 sc0 ls6 ws7">conf<span class="blank _1"> </span>irm<span class="blank _1"> </span>an <span class="blank _2"> </span>u<span class="blank _1"> </span>na <span class="blank _2"> </span>me<span class="blank _1"> </span>jor<span class="blank _1"> </span>a <span class="blank _2"> </span>tra<span class="blank _1"> </span>s <span class="blank _2"> </span>el<span class="blank _1"> </span> <span class="blank _2"> </span>uso <span class="blank _2"> </span>d<span class="blank _1"> </span>e <span class="blank _2"> </span>mi<span class="blank _1"> </span>cron<span class="blank _1"> </span>eed<span class="blank _1"> </span>lin<span class="blank _1"> </span>g <span class="blank _2"> </span>en <span class="blank _2"> </span>d<span class="blank _1"> </span>os <span class="blank _2"> </span>t<span class="blank _1"> </span>ipos</div><div class="t m0 x3 h6 y25c ff6 fs1 fc0 sc0 ls6 ws7">diferentes <span class="blank _2"> </span>de <span class="blank _1"> </span>pacientes: <span class="blank _2"> </span>aquellos <span class="blank _1"> </span>que <span class="blank _2"> </span>quieren <span class="blank _2"> </span>tener <span class="blank _1"> </span>una <span class="blank _2"> </span>respuesta</div><div class="t m0 x3 h6 y25d ff6 fs1 fc0 sc0 ls6 ws7">rápi<span class="blank _1"> </span>da <span class="blank _2"> </span>a<span class="blank _1"> </span> <span class="blank _2"> </span>la<span class="blank _1"> </span> <span class="blank _2"> </span>ter<span class="blank _1"> </span>api<span class="blank _1"> </span>a <span class="blank _2"> </span>y <span class="blank _2"> </span>a<span class="blank _1"> </span>que<span class="blank _1"> </span>llo<span class="blank _1"> </span>s <span class="blank _2"> </span>qu<span class="blank _1"> </span>e <span class="blank _2"> </span>no<span class="blank _1"> </span> <span class="blank _2"> </span>han<span class="blank _1"> </span> <span class="blank _2"> </span>obt<span class="blank _1"> </span>eni<span class="blank _1"> </span>do <span class="blank _2"> </span>u<span class="blank _1"> </span>n <span class="blank _2"> </span>re<span class="blank _1"> </span>sul<span class="blank _1"> </span>tad<span class="blank _1"> </span>o</div><div class="t m0 x3 h6 y25e ff6 fs1 fc0 sc0 ls6 ws7">sati<span class="blank _0"></span>sfact<span class="blank _0"></span>orio<span class="blank _0"></span> <span class="blank _3"></span>con <span class="blank _0"></span>trat<span class="blank _0"></span>amie<span class="blank _0"></span>ntos<span class="blank _0"></span> <span class="blank _3"></span>previos.<span class="blank _0"></span> <span class="blank _3"></span>Se r<span class="blank _0"></span>ecom<span class="blank _0"></span>iend<span class="blank _0"></span>a <span class="blank _3"></span>a l<span class="blank _0"></span>os <span class="blank _3"></span>pacien<span class="blank _0"></span>tes</div><div class="t m0 x3 h6 y25f ff6 fs1 fc0 sc0 ls6 ws7">que reanuden <span class="blank _1"> </span>la <span class="blank _1"> </span>aplicación <span class="blank _1"> </span>de <span class="blank _1"> </span>tratamientos <span class="blank _1"> </span>tópicos <span class="blank _1"> </span>después <span class="blank _1"> </span>de 24</div><div class="t m0 x3 h6 y260 ff6 fs1 fc0 sc0 ls6 ws7">horas. <span class="blank _0"></span>Los efectos <span class="blank _3"></span>secundarios informados <span class="blank _3"></span>son dolor <span class="blank _3"></span>o molestias en</div><div class="t m0 x3 h19 y261 ff6 fs1 fc0 sc0 ls6 ws7">el sitio de tratamiento, hemorragias, infecciones y adenopatías<span class="fs8 ls9 wsa v1">10,40</span>.</div><div class="t m0 x3 h5 y262 ff5 fs3 fc0 sc0 ls6 ws2">Conclusión</div><div class="t m0 xb h6 y263 ff6 fs1 fc0 sc0 ls6 ws7">La alopecia <span class="blank _3"></span>androgénica femenina (AAF) <span class="blank _0"></span>es una <span class="blank _3"></span>forma común de</div><div class="t m0 x3 h6 y264 ff6 fs1 fc0 sc0 ls6 ws7">alop<span class="blank _1"> </span>eci<span class="blank _1"> </span>a <span class="blank _b"> </span>no<span class="blank _1"> </span> <span class="blank _b"> </span>cic<span class="blank _1"> </span>atr<span class="blank _1"> </span>ici<span class="blank _1"> </span>al <span class="blank _b"> </span>c<span class="blank _1"> </span>on <span class="blank _b"> </span>u<span class="blank _1"> </span>na <span class="blank _b"> </span>a<span class="blank _1"> </span>mpl<span class="blank _1"> </span>ia <span class="blank _b"> </span>i<span class="blank _1"> </span>nci<span class="blank _1"> </span>denc<span class="blank _1"> </span>ia <span class="blank _b"> </span>e<span class="blank _1"> </span>n <span class="blank _b"> </span>mu<span class="blank _1"> </span>jer<span class="blank _1"> </span>es</div><div class="t m0 x3 h6 y265 ff6 fs1 fc0 sc0 ls6 ws7">prem<span class="blank _0"></span>enop<span class="blank _0"></span>aúsi<span class="blank _0"></span>cas.<span class="blank _0"></span> <span class="blank _3"></span>Clínicam<span class="blank _0"></span>ente<span class="blank _0"></span> <span class="blank _3"></span>se c<span class="blank _0"></span>ara<span class="blank _0"></span>cter<span class="blank _0"></span>iza <span class="blank _3"></span>por <span class="blank _3"></span>el <span class="blank _3"></span>adelgaz<span class="blank _0"></span>amie<span class="blank _0"></span>nto</div><div class="t m0 x3 h6 y266 ff6 fs1 fc0 sc0 ls6 ws7">del <span class="blank _7"> </span>pel<span class="blank _1"> </span>o <span class="blank _2"> </span>en<span class="blank _1"> </span> <span class="blank _2"> </span>el<span class="blank _1"> </span> <span class="blank _2"> </span>cue<span class="blank _1"> </span>ro <span class="blank _7"> </span>cabe<span class="blank _1"> </span>llu<span class="blank _1"> </span>do <span class="blank _2"> </span>c<span class="blank _1"> </span>ent<span class="blank _1"> </span>ral <span class="blank _7"> </span>e <span class="blank _2"> </span>hi<span class="blank _1"> </span>sto<span class="blank _1"> </span>lóg<span class="blank _1"> </span>ica<span class="blank _1"> </span>ment<span class="blank _1"> </span>e <span class="blank _2"> </span>p<span class="blank _1"> </span>or <span class="blank _2"> </span>l<span class="blank _1"> </span>a</div><div class="t m0 x3 h6 y267 ff6 fs1 fc0 sc0 ls6 ws7">miniaturización <span class="blank _3"></span>de los <span class="blank _3"></span>folículos pilosos <span class="blank _3"></span>y <span class="blank _0"></span>un <span class="blank _3"></span>mayor número <span class="blank _3"></span>de pelos</div><div class="t m0 x3 h6 y268 ff6 fs1 fc0 sc0 ls6 ws7">telógenos en la zona afectada.</div><div class="t m0 x10 h6 y269 ff6 fs1 fc0 sc0 ls6 ws7">La <span class="blank _1"> </span>tricoscopia <span class="blank _1"> </span>es <span class="blank _1"> </span>una <span class="blank _2"> </span>herramienta de <span class="blank _2"> </span>diagnóstico útil <span class="blank _2"> </span>para este</div><div class="t m0 x3 h6 y26a ff6 fs1 fc0 sc0 ls6 ws7">tipo de <span class="blank _0"></span>alopecia y <span class="blank _3"></span>siempre se debe evaluar <span class="blank _3"></span>la línea frontal del <span class="blank _3"></span>cuero</div><div class="t m0 x3 h6 y26b ff6 fs1 fc0 sc0 ls6 ws7">cabe<span class="blank _1"> </span>llu<span class="blank _1"> </span>do <span class="blank _b"> </span>y<span class="blank _1"> </span> <span class="blank _b"> </span>el <span class="blank _b"> </span>ár<span class="blank _1"> </span>ea <span class="blank _b"> </span>d<span class="blank _1"> </span>el <span class="blank _b"> </span>ve<span class="blank _1"> </span>rte<span class="blank _1"> </span>x <span class="blank _b"> </span>en <span class="blank _b"> </span>p<span class="blank _1"> </span>aci<span class="blank _1"> </span>ent<span class="blank _1"> </span>es <span class="blank _b"> </span>qu<span class="blank _1"> </span>e <span class="blank _b"> </span>cu<span class="blank _1"> </span>rse<span class="blank _1"> </span>n <span class="blank _b"> </span>con</div><div class="t m0 x3 h6 y26c ff6 fs1 fc0 sc0 ls6 ws7">adelgazamiento <span class="blank _1"> </span>del <span class="blank _1"> </span>pelo, <span class="blank _1"> </span>principalmente <span class="blank _1"> </span>si <span class="blank _1"> </span>se <span class="blank _1"> </span>asocia <span class="blank _1"> </span>con <span class="blank _1"> </span>prurito <span class="blank _2"> </span>o</div><div class="t m0 x3 h6 y26d ff6 fs1 fc0 sc0 ls6 ws7">tricodinia. Además, <span class="blank _0"></span>en casos <span class="blank _0"></span>dudosos, se <span class="blank _0"></span>puede recurrir <span class="blank _3"></span>a la biopsia</div><div class="t m0 x3 h6 y26e ff6 fs1 fc0 sc0 ls6 ws7">guiada por tricoscopia para un diagnóstico definitivo.</div><div class="t m0 xf h6 y26f ff6 fs1 fc0 sc0 ls6 ws7">Exis<span class="blank _1"> </span>ten<span class="blank _1"> </span> <span class="blank _10"> </span>múlt<span class="blank _1"> </span>ipl<span class="blank _1"> </span>es <span class="blank _10"> </span>tra<span class="blank _1"> </span>tam<span class="blank _1"> </span>ien<span class="blank _1"> </span>tos<span class="blank _1"> </span> <span class="blank _10"> </span>como <span class="blank _10"> </span>l<span class="blank _1"> </span>os <span class="blank _10"> </span>men<span class="blank _1"> </span>cio<span class="blank _1"> </span>nad<span class="blank _1"> </span>os</div><div class="t m0 x3 h6 y270 ff6 fs1 fc0 sc0 ls6 ws7">anteriormente <span class="blank _1"> </span>en <span class="blank _1"> </span>este <span class="blank _1"> </span>artículo, con <span class="blank _1"> </span>excelentes <span class="blank _1"> </span>efectos <span class="blank _1"> </span>favorables <span class="blank _1"> </span>y</div><div class="t m0 x3 h6 y271 ff6 fs1 fc0 sc0 ls6 ws7">mejoría clínica satisfactoria en pacientes con este tipo de alopecia. </div><div class="t m0 xf h6 y272 ff6 fs1 fc0 sc0 ls6 ws7">El <span class="blank _9"> </span>obj<span class="blank _1"> </span>eti<span class="blank _1"> </span>vo <span class="blank _9"> </span>de <span class="blank _9"> </span>es<span class="blank _1"> </span>te <span class="blank _9"> </span>art<span class="blank _1"> </span>ícu<span class="blank _1"> </span>lo <span class="blank _9"> </span>ha <span class="blank _9"> </span>si<span class="blank _1"> </span>do <span class="blank _9"> </span>rea<span class="blank _1"> </span>liz<span class="blank _1"> </span>ar <span class="blank _9"> </span>una<span class="blank _1"> </span> <span class="blank _d"> </span>r<span class="blank _1"> </span>evi<span class="blank _1"> </span>sió<span class="blank _1"> </span>n <span class="blank _9"> </span>y</div><div class="t m0 x13 h6 y273 ff6 fs1 fc0 sc0 ls6 ws7">actu<span class="blank _1"> </span>ali<span class="blank _1"> </span>zac<span class="blank _1"> </span>ión <span class="blank _b"> </span>s<span class="blank _1"> </span>obr<span class="blank _1"> </span>e <span class="blank _b"> </span>alo<span class="blank _1"> </span>pec<span class="blank _1"> </span>ia <span class="blank _b"> </span>a<span class="blank _1"> </span>ndro<span class="blank _1"> </span>gén<span class="blank _1"> </span>ica<span class="blank _1"> </span>, <span class="blank _b"> </span>tem<span class="blank _1"> </span>a <span class="blank _b"> </span>ta<span class="blank _1"> </span>n <span class="blank _b"> </span>amp<span class="blank _1"> </span>lio<span class="blank _1"> </span> <span class="blank _b"> </span>e</div><div class="t m0 x13 h6 y274 ff6 fs1 fc0 sc0 ls6 ws7">interesante, <span class="blank _0"></span>para cr<span class="blank _0"></span>ear así <span class="blank _3"></span>un aporte <span class="blank _3"></span>a la <span class="blank _3"></span>dermatología venezolana <span class="blank _0"></span>y</div><div class="t m0 x13 h28 y275 ff6 fs1 fc0 sc0 ls6 ws7">su literatura<span class="ffd fc4 v0">\uf06c</span></div><div class="t m0 x13 h5 y276 ff5 fs3 fc0 sc0 ls6 ws2">Ref<span class="blank _0"></span>erencias</div><div class="t m0 x1b h29 y277 ff6 fs7 fc0 sc0 ls6">T</div><div class="t m0 x1e h29 y278 ff6 fs7 fc0 sc0 ls6 ws7">a<span class="blank _3"></span>wf<span class="blank _3"></span>i<span class="blank _0"></span>k<span class="blank _3"></span> <span class="blank _3"></span>SS<span class="blank _3"></span>,<span class="blank _3"></span> <span class="blank _3"></span>So<span class="blank _3"></span>r<span class="blank _0"></span>o<span class="blank _3"></span>ur<span class="blank _3"></span> <span class="blank _3"></span>O<span class="blank _3"></span>A,<span class="blank _3"></span> <span class="blank _3"></span>A<span class="blank _3"></span>la<span class="blank _3"></span>r<span class="blank _0"></span>i<span class="blank _3"></span>ny<span class="blank _3"></span> <span class="blank _3"></span>A<span class="blank _3"></span>F,<span class="blank _3"></span> </div><div class="t m2 x37 h2a y277 ffa fsb fc0 sc0 ls6">e</div><div class="t m2 x38 h2a y278 ffa fsb fc0 sc0 ls6 ws7">t<span class="blank _3"></span> <span class="blank _3"></span>al</div><div class="t m0 x39 h29 y277 ff6 fs7 fc0 sc0 ls6">.</div><div class="t m0 x3a h29 y278 ff6 fs7 fc0 sc0 ls6 ws7"> <span class="blank _3"></span>W<span class="blank _3"></span>hi<span class="blank _3"></span>t<span class="blank _3"></span>e <span class="blank _3"></span>a<span class="blank _3"></span>n<span class="blank _0"></span>d<span class="blank _3"></span> <span class="blank _3"></span>ye<span class="blank _3"></span>l<span class="blank _3"></span>lo<span class="blank _3"></span>w<span class="blank _0"></span> <span class="blank _3"></span>d<span class="blank _3"></span>ot<span class="blank _3"></span>s<span class="blank _3"></span> <span class="blank _3"></span>as<span class="blank _3"></span> <span class="blank _3"></span>n<span class="blank _3"></span>ew<span class="blank _3"></span> <span class="blank _3"></span>t<span class="blank _3"></span>ri<span class="blank _3"></span>c<span class="blank _0"></span>h<span class="blank _3"></span>os<span class="blank _3"></span>c<span class="blank _0"></span>o<span class="blank _3"></span>pi<span class="blank _3"></span>c<span class="blank _1b"></span>1</div><div class="t m0 x1b h29 y279 ff6 fs7 fc0 sc0 ls6">s</div><div class="t m0 x1e h29 y27a ff6 fs7 fc0 sc0 ls6 ws7">i<span class="blank _0"></span>g<span class="blank _0"></span>n<span class="blank _0"></span>s<span class="blank _0"></span> <span class="blank _1"> </span>of<span class="blank _3"></span> <span class="blank _2"> </span>s<span class="blank _3"></span>ev<span class="blank _3"></span>er<span class="blank _3"></span>e <span class="blank _1"> </span>f<span class="blank _0"></span>e<span class="blank _0"></span>m<span class="blank _0"></span>a<span class="blank _0"></span>l<span class="blank _0"></span>e<span class="blank _0"></span> <span class="blank _1"> </span>an<span class="blank _3"></span>dr<span class="blank _3"></span>og<span class="blank _3"></span>en<span class="blank _3"></span>et<span class="blank _3"></span>ic<span class="blank _3"></span> <span class="blank _2"> </span>a<span class="blank _3"></span>lo<span class="blank _3"></span>pe<span class="blank _3"></span>ci<span class="blank _3"></span>a <span class="blank _1"> </span>in<span class="blank _3"></span> <span class="blank _1"> </span>da<span class="blank _3"></span>rk<span class="blank _3"></span> <span class="blank _2"> </span>s<span class="blank _0"></span>k<span class="blank _0"></span>i<span class="blank _3"></span>n <span class="blank _1"> </span>ph<span class="blank _3"></span>ot<span class="blank _3"></span>ot<span class="blank _3"></span>yp<span class="blank _3"></span>es<span class="blank _3"></span>. <span class="blank _1"> </span>I<span class="blank _0"></span>n<span class="blank _0"></span>t<span class="blank _0"></span> <span class="blank _1"> </span> <span class="blank _2"> </span>J</div><div class="t m0 x1b h29 y27b ff6 fs7 fc0 sc0 ls6 ws7">D<span class="blank _3"></span>er<span class="blank _3"></span>m<span class="blank _0"></span>a<span class="blank _3"></span>to<span class="blank _3"></span>l<span class="blank _0"></span>.<span class="blank _3"></span> 2<span class="blank _3"></span>0<span class="blank _0"></span>1<span class="blank _3"></span>8;<span class="blank _3"></span> 5<span class="blank _3"></span>7<span class="blank _3"></span>:1<span class="blank _3"></span>2<span class="blank _0"></span>2<span class="blank _3"></span>1-<span class="blank _3"></span>1<span class="blank _0"></span>2<span class="blank _3"></span>28<span class="blank _3"></span>.<span class="blank _0"></span> </div><div class="t m0 x1b h29 y27c ff6 fs7 fc0 sc0 ls6 ws7">S<span class="blank _3"></span>al<span class="blank _3"></span>m<span class="blank _3"></span>an<span class="blank _3"></span> <span class="blank _3"></span>K<span class="blank _3"></span>E<span class="blank _0"></span>,<span class="blank _3"></span> <span class="blank _3"></span>A<span class="blank _0"></span>l<span class="blank _3"></span>tu<span class="blank _3"></span>n<span class="blank _3"></span>ay<span class="blank _3"></span> <span class="blank _3"></span>I<span class="blank _3"></span>K<span class="blank _0"></span>,<span class="blank _3"></span> <span class="blank _3"></span>K<span class="blank _0"></span>u<span class="blank _3"></span>cu<span class="blank _3"></span>k<span class="blank _3"></span>un<span class="blank _3"></span>a<span class="blank _3"></span>l <span class="blank _1c"></span>N<span class="blank _3"></span>A,<span class="blank _3"></span> </div><div class="t m2 x3a h2a y27d ffa fsb fc0 sc0 ls6 ws7">e<span class="blank _3"></span>t <span class="blank _1c"></span>a<span class="blank _3"></span>l</div><div class="t m0 x3b h29 y27d ff6 fs7 fc0 sc0 ls6 ws7">.<span class="blank _3"></span> <span class="blank _3"></span>F<span class="blank _0"></span>r<span class="blank _3"></span>eq<span class="blank _3"></span>u<span class="blank _3"></span>en<span class="blank _3"></span>c<span class="blank _3"></span>y,<span class="blank _3"></span> <span class="blank _1c"></span>se<span class="blank _3"></span>v<span class="blank _3"></span>er<span class="blank _3"></span>i<span class="blank _3"></span>ty<span class="blank _3"></span> <span class="blank _1c"></span>an<span class="blank _3"></span>d<span class="blank _3"></span> <span class="blank _3"></span>r<span class="blank _0"></span>e<span class="blank _3"></span>la<span class="blank _3"></span>t<span class="blank _3"></span>ed<span class="blank _3"></span> <span class="blank _1c"></span>fa<span class="blank _3"></span>c<span class="blank _3"></span>to<span class="blank _3"></span>r<span class="blank _3"></span>s<span class="blank _1b"></span>2</div><div class="t m0 x1b h29 y27e ff6 fs7 fc0 sc0 ls6 ws7">o<span class="blank _3"></span>f <span class="blank _1c"></span>an<span class="blank _3"></span>dr<span class="blank _3"></span>o<span class="blank _3"></span>ge<span class="blank _3"></span>n<span class="blank _0"></span>e<span class="blank _3"></span>ti<span class="blank _3"></span>c<span class="blank _0"></span> <span class="blank _3"></span>a<span class="blank _0"></span>l<span class="blank _3"></span>op<span class="blank _3"></span>e<span class="blank _0"></span>c<span class="blank _3"></span>ia<span class="blank _3"></span> <span class="blank _3"></span>in<span class="blank _3"></span> <span class="blank _3"></span>de<span class="blank _3"></span>r<span class="blank _3"></span>ma<span class="blank _3"></span>t<span class="blank _0"></span>o<span class="blank _3"></span>lo<span class="blank _3"></span>g<span class="blank _0"></span>y<span class="blank _3"></span> <span class="blank _0"></span>o<span class="blank _3"></span>ut<span class="blank _3"></span>p<span class="blank _0"></span>a<span class="blank _3"></span>ti<span class="blank _3"></span>e<span class="blank _0"></span>n<span class="blank _3"></span>t <span class="blank _1c"></span>cl<span class="blank _3"></span>i<span class="blank _0"></span>n<span class="blank _3"></span>ic<span class="blank _3"></span>: <span class="blank _1c"></span>ho<span class="blank _3"></span>s<span class="blank _3"></span>pi<span class="blank _3"></span>t<span class="blank _0"></span>a<span class="blank _3"></span>l-<span class="blank _3"></span>b<span class="blank _0"></span>a<span class="blank _3"></span>se<span class="blank _3"></span>d<span class="blank _0"></span> <span class="blank _3"></span>c<span class="blank _0"></span>r<span class="blank _3"></span>os<span class="blank _3"></span>s-</div><div class="t m0 x1b h29 y27f ff6 fs7 fc0 sc0 ls6">s</div><div class="t m0 x3c h29 y280 ff6 fs7 fc0 sc0 ls6 ws7">e<span class="blank _3"></span>ct<span class="blank _3"></span>i<span class="blank _0"></span>o<span class="blank _3"></span>na<span class="blank _3"></span>l<span class="blank _0"></span> <span class="blank _3"></span>st<span class="blank _3"></span>u<span class="blank _0"></span>d<span class="blank _3"></span>y <span class="blank _3"></span>in<span class="blank _3"></span> <span class="blank _3"></span>Tu<span class="blank _3"></span>r<span class="blank _0"></span>k<span class="blank _3"></span>ey<span class="blank _3"></span>.<span class="blank _0"></span> <span class="blank _3"></span>An<span class="blank _3"></span> <span class="blank _0"></span>B<span class="blank _3"></span>ra<span class="blank _3"></span>s<span class="blank _0"></span> <span class="blank _3"></span>De<span class="blank _3"></span>r<span class="blank _0"></span>m<span class="blank _3"></span>at<span class="blank _3"></span>o<span class="blank _0"></span>l<span class="blank _3"></span>. <span class="blank _3"></span>2<span class="blank _0"></span>0<span class="blank _3"></span>17<span class="blank _3"></span>; <span class="blank _3"></span>9<span class="blank _3"></span>2:<span class="blank _3"></span>3<span class="blank _0"></span>5<span class="blank _3"></span>-4<span class="blank _3"></span>0<span class="blank _0"></span>.<span class="blank _3"></span> </div><div class="t m0 x1b h29 y281 ff6 fs7 fc0 sc0 ls6">M</div><div class="t m0 x3d h29 y282 ff6 fs7 fc0 sc0 ls6 ws7">y<span class="blank _3"></span>so<span class="blank _1c"></span>re<span class="blank _3"></span> <span class="blank _1c"></span>V,<span class="blank _3"></span> <span class="blank _1c"></span>Pa<span class="blank _3"></span>r<span class="blank _3"></span>th<span class="blank _1c"></span>as<span class="blank _3"></span>a<span class="blank _3"></span>ra<span class="blank _1c"></span>dh<span class="blank _3"></span>i<span class="blank _3"></span> <span class="blank _3"></span>A<span class="blank _0"></span>,<span class="blank _3"></span> <span class="blank _3"></span>K<span class="blank _3"></span>ha<span class="blank _3"></span>r<span class="blank _3"></span>ka<span class="blank _1c"></span>r <span class="blank _1c"></span>R<span class="blank _3"></span>, </div><div class="t m2 x39 h2a y283 ffa fsb fc0 sc0 ls6">e</div><div class="t m2 x3e h2a y284 ffa fsb fc0 sc0 ls6 ws7">t<span class="blank _3"></span> <span class="blank _3"></span>a<span class="blank _3"></span>l.</div><div class="t m0 x3f h29 y283 ff6 fs7 fc0 sc0 ls6">E</div><div class="t m0 x40 h29 y284 ff6 fs7 fc0 sc0 ls6 ws7">x<span class="blank _3"></span>pe<span class="blank _1c"></span>rt<span class="blank _3"></span> <span class="blank _1c"></span>co<span class="blank _3"></span>n<span class="blank _3"></span>se<span class="blank _1c"></span>ns<span class="blank _3"></span>u<span class="blank _3"></span>s <span class="blank _1c"></span>o<span class="blank _3"></span>n <span class="blank _1c"></span>t<span class="blank _3"></span>he<span class="blank _1c"></span> <span class="blank _3"></span>ma<span class="blank _1c"></span>na<span class="blank _3"></span>g<span class="blank _3"></span>em<span class="blank _1c"></span>en<span class="blank _3"></span>t<span class="blank _1b"></span>3</div><div class="t m0 x1b h29 y285 ff6 fs7 fc0 sc0 ls6">o</div><div class="t m0 x1e h29 y286 ff6 fs7 fc0 sc0 ls6 ws7">f<span class="blank _3"></span> a<span class="blank _3"></span>n<span class="blank _0"></span>d<span class="blank _3"></span>ro<span class="blank _3"></span>g<span class="blank _0"></span>e<span class="blank _3"></span>ne<span class="blank _3"></span>t<span class="blank _0"></span>i<span class="blank _3"></span>c <span class="blank _3"></span>a<span class="blank _0"></span>l<span class="blank _3"></span>op<span class="blank _3"></span>ec<span class="blank _3"></span>i<span class="blank _3"></span>a <span class="blank _3"></span>i<span class="blank _0"></span>n<span class="blank _3"></span> I<span class="blank _3"></span>n<span class="blank _0"></span>d<span class="blank _3"></span>ia<span class="blank _3"></span>.<span class="blank _0"></span> <span class="blank _3"></span>In<span class="blank _3"></span>t<span class="blank _0"></span> <span class="blank _3"></span>J <span class="blank _3"></span>T<span class="blank _0"></span>r<span class="blank _3"></span>ic<span class="blank _3"></span>h<span class="blank _0"></span>o<span class="blank _3"></span>l.<span class="blank _3"></span> <span class="blank _0"></span>2<span class="blank _3"></span>01<span class="blank _3"></span>9;<span class="blank _3"></span> <span class="blank _3"></span>11<span class="blank _3"></span>:<span class="blank _0"></span>1<span class="blank _3"></span>01<span class="blank _3"></span>-<span class="blank _0"></span>1<span class="blank _3"></span>06<span class="blank _3"></span>.</div><div class="t m0 x1b h29 y287 ff6 fs7 fc0 sc0 ls6 ws7">G<span class="blank _3"></span>ue<span class="blank _3"></span>r<span class="blank _0"></span>r<span class="blank _3"></span>a A<span class="blank _3"></span>,<span class="blank _3"></span> Go<span class="blank _3"></span>n<span class="blank _0"></span>z<span class="blank _3"></span>ál<span class="blank _3"></span>e<span class="blank _0"></span>z<span class="blank _3"></span>-G<span class="blank _3"></span>u<span class="blank _0"></span>e<span class="blank _3"></span>rr<span class="blank _3"></span>a<span class="blank _0"></span> E<span class="blank _3"></span>, <span class="blank _0"></span>B<span class="blank _3"></span>or<span class="blank _3"></span>r<span class="blank _0"></span>á<span class="blank _3"></span>s J<span class="blank _3"></span>.<span class="blank _3"></span> Al<span class="blank _3"></span>o<span class="blank _3"></span>pe<span class="blank _3"></span>ci<span class="blank _3"></span>a<span class="blank _3"></span> an<span class="blank _3"></span>d<span class="blank _3"></span>ro<span class="blank _3"></span>g<span class="blank _0"></span>é<span class="blank _3"></span>ni<span class="blank _3"></span>c<span class="blank _0"></span>a<span class="blank _3"></span> fe<span class="blank _3"></span>m<span class="blank _3"></span>en<span class="blank _3"></span>in<span class="blank _3"></span>a<span class="blank _3"></span>: n<span class="blank _3"></span>u<span class="blank _3"></span>ev<span class="blank _3"></span>o<span class="blank _0"></span>s<span class="blank _1b"></span>4</div><div class="t m0 x1b h29 y288 ff6 fs7 fc0 sc0 ls6">f</div><div class="t m0 x3c h29 y289 ff6 fs7 fc0 sc0 ls6 ws7">a<span class="blank _0"></span>c<span class="blank _0"></span>t<span class="blank _0"></span>o<span class="blank _0"></span>r<span class="blank _3"></span>es<span class="blank _0"></span> <span class="blank _2"> </span>f<span class="blank _0"></span>i<span class="blank _0"></span>s<span class="blank _0"></span>i<span class="blank _0"></span>o<span class="blank _0"></span>p<span class="blank _0"></span>a<span class="blank _0"></span>t<span class="blank _0"></span>o<span class="blank _3"></span>ló<span class="blank _3"></span>gi<span class="blank _0"></span>c<span class="blank _3"></span>os<span class="blank _0"></span> <span class="blank _2"> </span>y <span class="blank _1"> </span>fu<span class="blank _3"></span>tu<span class="blank _3"></span>ra<span class="blank _0"></span>s<span class="blank _3"></span> <span class="blank _7"> </span>t<span class="blank _0"></span>e<span class="blank _0"></span>n<span class="blank _0"></span>d<span class="blank _0"></span>e<span class="blank _0"></span>n<span class="blank _0"></span>c<span class="blank _3"></span>ia<span class="blank _0"></span>s<span class="blank _0"></span> <span class="blank _2"> </span>p<span class="blank _0"></span>a<span class="blank _0"></span>r<span class="blank _0"></span>a<span class="blank _0"></span> <span class="blank _2"> </span>un<span class="blank _3"></span> <span class="blank _2"> </span>ab<span class="blank _3"></span>or<span class="blank _3"></span>da<span class="blank _3"></span>je<span class="blank _3"></span> <span class="blank _2"> </span>cl<span class="blank _0"></span>í<span class="blank _3"></span>ni<span class="blank _0"></span>c<span class="blank _3"></span>o <span class="blank _2"> </span>má<span class="blank _3"></span>s</div><div class="t m0 x1b h29 y28a ff6 fs7 fc0 sc0 ls6 ws7">i<span class="blank _3"></span>nt<span class="blank _3"></span>e<span class="blank _0"></span>g<span class="blank _3"></span>ra<span class="blank _3"></span>l<span class="blank _0"></span>.<span class="blank _3"></span> M<span class="blank _3"></span>á<span class="blank _0"></span>s<span class="blank _3"></span> D<span class="blank _3"></span>er<span class="blank _3"></span>m<span class="blank _3"></span>at<span class="blank _3"></span>o<span class="blank _0"></span>l<span class="blank _3"></span>. <span class="blank _3"></span>2<span class="blank _0"></span>0<span class="blank _3"></span>16<span class="blank _3"></span>;<span class="blank _0"></span> <span class="blank _3"></span>26<span class="blank _3"></span>:<span class="blank _0"></span>2<span class="blank _3"></span>5-<span class="blank _3"></span>3<span class="blank _0"></span>6<span class="blank _3"></span>.</div><div class="t m0 x1b h29 y28b ff6 fs7 fc0 sc0 ls6">A</div><div class="t m0 x1e h29 y28c ff6 fs7 fc0 sc0 ls6 ws7">t<span class="blank _0"></span>a<span class="blank _3"></span>na<span class="blank _3"></span>sk<span class="blank _3"></span>ov<span class="blank _3"></span>a-<span class="blank _3"></span>Me<span class="blank _3"></span>s<span class="blank _0"></span>i<span class="blank _0"></span>n<span class="blank _3"></span>ko<span class="blank _3"></span>vs<span class="blank _3"></span>ka<span class="blank _3"></span> <span class="blank _1"> </span>N<span class="blank _0"></span>,<span class="blank _3"></span> <span class="blank _1"> </span>Be<span class="blank _3"></span>rg<span class="blank _3"></span>f<span class="blank _0"></span>e<span class="blank _0"></span>l<span class="blank _3"></span>d WF<span class="blank _3"></span>.<span class="blank _0"></span> Ha<span class="blank _3"></span>ir<span class="blank _3"></span>:<span class="blank _0"></span> Wh<span class="blank _3"></span>at<span class="blank _3"></span> is<span class="blank _3"></span> <span class="blank _1"> </span>n<span class="blank _0"></span>e<span class="blank _0"></span>w<span class="blank _3"></span> <span class="blank _1"> </span>in<span class="blank _3"></span> di<span class="blank _3"></span>ag<span class="blank _3"></span>no<span class="blank _3"></span>si<span class="blank _3"></span>s<span class="blank _0"></span> an<span class="blank _3"></span>d<span class="blank _1b"></span>5</div><div class="t m0 x1b h29 y28d ff6 fs7 fc0 sc0 ls6 ws7">m<span class="blank _0"></span>a<span class="blank _0"></span>n<span class="blank _0"></span>a<span class="blank _0"></span>g<span class="blank _3"></span>em<span class="blank _0"></span>e<span class="blank _3"></span>nt<span class="blank _0"></span>?<span class="blank _3"></span> <span class="blank"> </span>F<span class="blank _3"></span>em<span class="blank _3"></span>al<span class="blank _3"></span>e <span class="blank _6"> </span>p<span class="blank _0"></span>a<span class="blank _3"></span>tt<span class="blank _3"></span>er<span class="blank _0"></span>n<span class="blank _3"></span> <span class="blank"> </span>h<span class="blank _3"></span>ai<span class="blank _3"></span>r <span class="blank _7"> </span>lo<span class="blank _3"></span>ss<span class="blank _0"></span> <span class="blank _6"> </span>up<span class="blank _3"></span>da<span class="blank _3"></span>te<span class="blank _3"></span>: <span class="blank _6"> </span>di<span class="blank _3"></span>ag<span class="blank _3"></span>no<span class="blank _3"></span>si<span class="blank _3"></span>s <span class="blank _6"> </span>a<span class="blank _0"></span>n<span class="blank _0"></span>d<span class="blank _3"></span> <span class="blank"> </span>t<span class="blank _3"></span>re<span class="blank _3"></span>at<span class="blank _3"></span>me<span class="blank _3"></span>nt<span class="blank _3"></span>.</div><div class="t m0 x1b h29 y28e ff6 fs7 fc0 sc0 ls6 ws7">D<span class="blank _3"></span>er<span class="blank _3"></span>m<span class="blank _0"></span>a<span class="blank _3"></span>to<span class="blank _3"></span>l<span class="blank _0"></span> <span class="blank _3"></span>Cl<span class="blank _3"></span>in<span class="blank _3"></span>.<span class="blank _3"></span> 2<span class="blank _3"></span>0<span class="blank _0"></span>1<span class="blank _3"></span>3;<span class="blank _3"></span> <span class="blank _0"></span>3<span class="blank _3"></span>1:<span class="blank _3"></span>1<span class="blank _0"></span>1<span class="blank _3"></span>9\u2013<span class="blank _3"></span>1<span class="blank _0"></span>2<span class="blank _3"></span>7</div><div class="t m0 x1b h29 y28f ff6 fs7 fc0 sc0 ls6">R</div><div class="t m0 x1e h29 y290 ff6 fs7 fc0 sc0 ls6 ws7">a<span class="blank _3"></span>mo<span class="blank _3"></span>s<span class="blank _0"></span> <span class="blank _3"></span>PM<span class="blank _3"></span>,<span class="blank _0"></span> <span class="blank _3"></span>Mi<span class="blank _3"></span>o<span class="blank _0"></span>t<span class="blank _3"></span> H<span class="blank _3"></span>A<span class="blank _3"></span>. <span class="blank _3"></span>F<span class="blank _0"></span>e<span class="blank _3"></span>ma<span class="blank _3"></span>l<span class="blank _0"></span>e<span class="blank _3"></span> P<span class="blank _3"></span>a<span class="blank _0"></span>t<span class="blank _3"></span>te<span class="blank _3"></span>r<span class="blank _0"></span>n<span class="blank _3"></span> H<span class="blank _3"></span>a<span class="blank _3"></span>ir<span class="blank _3"></span> <span class="blank _0"></span>L<span class="blank _3"></span>os<span class="blank _3"></span>s<span class="blank _0"></span>:<span class="blank _3"></span> a<span class="blank _3"></span> <span class="blank _3"></span>cl<span class="blank _3"></span>i<span class="blank _0"></span>n<span class="blank _3"></span>ic<span class="blank _3"></span>al<span class="blank _3"></span> <span class="blank _3"></span>an<span class="blank _3"></span>d<span class="blank _3"></span> p<span class="blank _3"></span>a<span class="blank _0"></span>t<span class="blank _3"></span>ho<span class="blank _3"></span>p<span class="blank _0"></span>h<span class="blank _3"></span>ys<span class="blank _3"></span>i<span class="blank _0"></span>o<span class="blank _3"></span>lo<span class="blank _3"></span>g<span class="blank _0"></span>i<span class="blank _3"></span>ca<span class="blank _3"></span>l<span class="blank _1b"></span>6</div><div class="t m0 x1b h29 y291 ff6 fs7 fc0 sc0 ls6 ws7">r<span class="blank _3"></span>ev<span class="blank _3"></span>i<span class="blank _0"></span>e<span class="blank _3"></span>w.<span class="blank _3"></span> <span class="blank _0"></span>A<span class="blank _3"></span>n <span class="blank _3"></span>B<span class="blank _0"></span>r<span class="blank _3"></span>as<span class="blank _3"></span> D<span class="blank _3"></span>e<span class="blank _3"></span>rm<span class="blank _3"></span>a<span class="blank _0"></span>t<span class="blank _3"></span>ol<span class="blank _3"></span>.<span class="blank _0"></span> <span class="blank _3"></span>20<span class="blank _3"></span>1<span class="blank _0"></span>5<span class="blank _3"></span>; <span class="blank _3"></span>9<span class="blank _0"></span>0<span class="blank _3"></span>:5<span class="blank _3"></span>2<span class="blank _0"></span>9<span class="blank _3"></span>-5<span class="blank _3"></span>4<span class="blank _0"></span>3<span class="blank _3"></span>.</div><div class="t m0 x1b h29 y292 ff6 fs7 fc0 sc0 ls6 ws7">B<span class="blank _0"></span>r<span class="blank _0"></span>o<span class="blank _0"></span>u<span class="blank _0"></span>g<span class="blank _3"></span>h <span class="blank _2"> </span>K<span class="blank _3"></span>, <span class="blank _2"> </span>T<span class="blank _3"></span>or<span class="blank _0"></span>g<span class="blank _3"></span>er<span class="blank _3"></span>so<span class="blank _0"></span>n<span class="blank _3"></span> <span class="blank _2"> </span>R.<span class="blank _3"></span> <span class="blank _2"> </span>Ho<span class="blank _3"></span>rm<span class="blank _0"></span>o<span class="blank _3"></span>na<span class="blank _0"></span>l<span class="blank _3"></span> <span class="blank _2"> </span>th<span class="blank _3"></span>er<span class="blank _3"></span>ap<span class="blank _0"></span>y<span class="blank _3"></span> <span class="blank _2"> </span>in<span class="blank _3"></span> <span class="blank _2"> </span>fe<span class="blank _3"></span>ma<span class="blank _0"></span>l<span class="blank _3"></span>e <span class="blank _2"> </span>p<span class="blank _3"></span>at<span class="blank _0"></span>t<span class="blank _3"></span>er<span class="blank _3"></span>n <span class="blank _2"> </span>h<span class="blank _3"></span>ai<span class="blank _0"></span>r<span class="blank _3"></span> <span class="blank _2"> </span>lo<span class="blank _3"></span>ss<span class="blank _0"></span>.<span class="blank _3"></span> <span class="blank _2"> </span>In<span class="blank _3"></span>t <span class="blank _2"> </span>J<span class="blank _1b"></span>7</div><div class="t m0 x1b h29 y293 ff6 fs7 fc0 sc0 ls6 ws7">W<span class="blank _3"></span>om<span class="blank _3"></span>e<span class="blank _0"></span>n<span class="blank _3"></span>s <span class="blank _3"></span>D<span class="blank _0"></span>e<span class="blank _3"></span>rm<span class="blank _3"></span>at<span class="blank _3"></span>o<span class="blank _3"></span>l.<span class="blank _3"></span> <span class="blank _0"></span>2<span class="blank _3"></span>01<span class="blank _3"></span>7<span class="blank _0"></span>;<span class="blank _3"></span>3:<span class="blank _3"></span> <span class="blank _0"></span>5<span class="blank _3"></span>3\u2013<span class="blank _3"></span>5<span class="blank _0"></span>7<span class="blank _3"></span>.</div><div class="t m0 x1b h29 y294 ff6 fs7 fc0 sc0 ls6 ws7">G<span class="blank _0"></span>u<span class="blank _3"></span>zm<span class="blank _3"></span>án<span class="blank _3"></span>-S<span class="blank _3"></span>án<span class="blank _3"></span>c<span class="blank _0"></span>h<span class="blank _3"></span>ez<span class="blank _3"></span> <span class="blank _1"> </span>D<span class="blank _0"></span>.<span class="blank _0"></span> Al<span class="blank _3"></span>o<span class="blank _0"></span>p<span class="blank _0"></span>e<span class="blank _3"></span>ci<span class="blank _3"></span>a a<span class="blank _3"></span>nd<span class="blank _3"></span>ro<span class="blank _3"></span>gé<span class="blank _3"></span>ni<span class="blank _3"></span>c<span class="blank _0"></span>a<span class="blank _3"></span>. R<span class="blank _0"></span>e<span class="blank _0"></span>v<span class="blank _3"></span> <span class="blank _1"> </span>Me<span class="blank _3"></span>x<span class="blank _0"></span> De<span class="blank _3"></span>rm<span class="blank _3"></span>a<span class="blank _0"></span>t<span class="blank _3"></span>ol<span class="blank _3"></span>. 2<span class="blank _0"></span>0<span class="blank _3"></span>15<span class="blank _3"></span>; 5<span class="blank _0"></span>9<span class="blank _3"></span>:3<span class="blank _3"></span>87<span class="blank _3"></span>-<span class="blank _1b"></span>8</div><div class="t m0 x1b h29 y295 ff6 fs7 fc0 sc0 ls6 ws12">3<span class="blank _3"></span>94<span class="blank _3"></span>.</div><div class="t m0 x1b h29 y296 ff6 fs7 fc0 sc0 ls6 ws7">H<span class="blank _3"></span>o <span class="blank _3"></span>B,<span class="blank _3"></span> <span class="blank _0"></span>P<span class="blank _3"></span>ei<span class="blank _3"></span> E<span class="blank _3"></span>,<span class="blank _3"></span> C<span class="blank _3"></span>hu<span class="blank _3"></span> <span class="blank _3"></span>C,<span class="blank _3"></span> e<span class="blank _3"></span>t<span class="blank _3"></span> a<span class="blank _3"></span>l.<span class="blank _3"></span> <span class="blank _0"></span>M<span class="blank _3"></span>ic<span class="blank _3"></span>r<span class="blank _0"></span>o<span class="blank _3"></span>bi<span class="blank _3"></span>o<span class="blank _0"></span>m<span class="blank _3"></span>e <span class="blank _3"></span>in<span class="blank _3"></span> <span class="blank _0"></span>t<span class="blank _3"></span>he<span class="blank _3"></span> <span class="blank _0"></span>h<span class="blank _3"></span>ai<span class="blank _3"></span>r <span class="blank _3"></span>f<span class="blank _3"></span>ol<span class="blank _3"></span>li<span class="blank _3"></span>c<span class="blank _3"></span>le<span class="blank _3"></span> o<span class="blank _3"></span>f<span class="blank _3"></span> a<span class="blank _3"></span>nd<span class="blank _3"></span>r<span class="blank _3"></span>og<span class="blank _3"></span>e<span class="blank _0"></span>n<span class="blank _3"></span>et<span class="blank _3"></span>i<span class="blank _0"></span>c<span class="blank _3"></span> a<span class="blank _3"></span>lo<span class="blank _3"></span>p<span class="blank _3"></span>ec<span class="blank _3"></span>i<span class="blank _0"></span>a<span class="blank _1b"></span>9</div><div class="t m0 x1b h29 y297 ff6 fs7 fc0 sc0 ls6 ws7">p<span class="blank _3"></span>at<span class="blank _3"></span>i<span class="blank _0"></span>e<span class="blank _3"></span>nt<span class="blank _3"></span>s<span class="blank _0"></span>.<span class="blank _3"></span> P<span class="blank _3"></span>L<span class="blank _0"></span>o<span class="blank _3"></span>S <span class="blank _3"></span>ON<span class="blank _3"></span>E<span class="blank _3"></span>. <span class="blank _3"></span>2<span class="blank _0"></span>0<span class="blank _3"></span>19<span class="blank _3"></span>;<span class="blank _0"></span> <span class="blank _3"></span>14<span class="blank _3"></span>:<span class="blank _0"></span>1<span class="blank _3"></span>-1<span class="blank _3"></span>7<span class="blank _0"></span>.</div><div class="t m0 x1b h29 y298 ff6 fs7 fc0 sc0 ls6 ws7">S<span class="blank _3"></span>ta<span class="blank _3"></span>r<span class="blank _0"></span>a<span class="blank _3"></span>ce<span class="blank _3"></span> M,<span class="blank _3"></span> Or<span class="blank _3"></span>l<span class="blank _0"></span>a<span class="blank _3"></span>nd<span class="blank _3"></span>o<span class="blank _0"></span> G,<span class="blank _3"></span> Al<span class="blank _3"></span>e<span class="blank _3"></span>ss<span class="blank _3"></span>a<span class="blank _0"></span>n<span class="blank _3"></span>dr<span class="blank _3"></span>i<span class="blank _0"></span>n<span class="blank _3"></span>i A<span class="blank _3"></span>, </div><div class="t m2 x41 h2a y299 ffa fsb fc0 sc0 ls6 ws7">e<span class="blank _3"></span>t a<span class="blank _3"></span>l.<span class="blank _3"></span> </div><div class="t m0 x42 h29 y299 ff6 fs7 fc0 sc0 ls6 ws7">F<span class="blank _3"></span>em<span class="blank _3"></span>a<span class="blank _0"></span>l<span class="blank _3"></span>e A<span class="blank _3"></span>nd<span class="blank _3"></span>r<span class="blank _0"></span>o<span class="blank _3"></span>ge<span class="blank _3"></span>n<span class="blank _0"></span>e<span class="blank _3"></span>ti<span class="blank _3"></span>c<span class="blank _0"></span> Al<span class="blank _3"></span>o<span class="blank _3"></span>pe<span class="blank _3"></span>c<span class="blank _0"></span>i<span class="blank _3"></span>a:<span class="blank _3"></span> An<span class="blank _1b"></span>1<span class="blank _3"></span>0</div><div class="t m0 x1b h29 y29a ff6 fs7 fc0 sc0 ls6 ws7">U<span class="blank _3"></span>pd<span class="blank _3"></span>a<span class="blank _0"></span>t<span class="blank _3"></span>e <span class="blank _3"></span>o<span class="blank _0"></span>n<span class="blank _3"></span> D<span class="blank _3"></span>i<span class="blank _0"></span>a<span class="blank _3"></span>gn<span class="blank _3"></span>os<span class="blank _3"></span>i<span class="blank _3"></span>s <span class="blank _3"></span>a<span class="blank _0"></span>n<span class="blank _3"></span>d <span class="blank _3"></span>M<span class="blank _0"></span>a<span class="blank _3"></span>na<span class="blank _3"></span>g<span class="blank _0"></span>e<span class="blank _3"></span>me<span class="blank _3"></span>n<span class="blank _0"></span>t<span class="blank _3"></span>. <span class="blank _3"></span>A<span class="blank _0"></span>m<span class="blank _3"></span> J<span class="blank _3"></span> <span class="blank _0"></span>C<span class="blank _3"></span>li<span class="blank _3"></span>n<span class="blank _0"></span> <span class="blank _3"></span>De<span class="blank _3"></span>rm<span class="blank _3"></span>a<span class="blank _3"></span>to<span class="blank _3"></span>l<span class="blank _0"></span>.<span class="blank _3"></span> 2<span class="blank _3"></span>0<span class="blank _0"></span>1<span class="blank _3"></span>9;<span class="blank _3"></span> <span class="blank _0"></span>2<span class="blank _3"></span>1:<span class="blank _3"></span> <span class="blank _0"></span>6<span class="blank _3"></span>9\u2013<span class="blank _3"></span>8<span class="blank _0"></span>4<span class="blank _3"></span>.</div><div class="t m0 x1b h29 y29b ff6 fs7 fc0 sc0 ls6 ws7">C<span class="blank _3"></span>ar<span class="blank _3"></span>mi<span class="blank _3"></span>na<span class="blank _3"></span> E,<span class="blank _3"></span> Az<span class="blank _3"></span>zi<span class="blank _3"></span>z<span class="blank _3"></span> <span class="blank _1"> </span>R,<span class="blank _3"></span> Be<span class="blank _3"></span>r<span class="blank _0"></span>g<span class="blank _0"></span>f<span class="blank _3"></span>el<span class="blank _3"></span>d W<span class="blank _3"></span>, </div><div class="t m2 x37 h2a y29c ffa fsb fc0 sc0 ls6 ws7">e<span class="blank _3"></span>t a<span class="blank _0"></span>l<span class="blank _3"></span>. </div><div class="t m0 x3e h29 y29c ff6 fs7 fc0 sc0 ls6 ws7">F<span class="blank _3"></span>em<span class="blank _3"></span>al<span class="blank _3"></span>e P<span class="blank _3"></span>at<span class="blank _3"></span>t<span class="blank _0"></span>e<span class="blank _3"></span>rn<span class="blank _3"></span> <span class="blank _1"> </span>H<span class="blank _3"></span>ai<span class="blank _3"></span>r L<span class="blank _3"></span>os<span class="blank _3"></span>s a<span class="blank _3"></span>nd<span class="blank _3"></span> An<span class="blank _3"></span>dr<span class="blank _3"></span>o<span class="blank _0"></span>g<span class="blank _3"></span>en<span class="blank _1b"></span>1<span class="blank _3"></span>1</div><div class="t m0 x1b h29 y29d ff6 fs7 fc0 sc0 ls6 ws7">E<span class="blank _0"></span>x<span class="blank _0"></span>c<span class="blank _0"></span>e<span class="blank _0"></span>s<span class="blank _3"></span>s:<span class="blank _0"></span> <span class="blank _d"> </span>A <span class="blank _6"> </span>Re<span class="blank _3"></span>po<span class="blank _3"></span>rt<span class="blank _3"></span> <span class="blank"> </span>F<span class="blank _3"></span>ro<span class="blank _3"></span>m <span class="blank _d"> </span>t<span class="blank _0"></span>h<span class="blank _0"></span>e<span class="blank _3"></span> <span class="blank"> </span>M<span class="blank _3"></span>ul<span class="blank _3"></span>ti<span class="blank _0"></span>d<span class="blank _3"></span>is<span class="blank _0"></span>c<span class="blank _3"></span>ip<span class="blank _0"></span>l<span class="blank _3"></span>in<span class="blank _0"></span>a<span class="blank _3"></span>ry<span class="blank _3"></span> <span class="blank"> </span>A<span class="blank _3"></span>nd<span class="blank _0"></span>r<span class="blank _3"></span>og<span class="blank _3"></span>en<span class="blank _0"></span> <span class="blank _d"> </span>Ex<span class="blank _3"></span>ce<span class="blank _3"></span>ss<span class="blank _3"></span> <span class="blank"> </span>a<span class="blank _3"></span>nd<span class="blank _3"></span> <span class="blank"> </span>P<span class="blank _3"></span>CO<span class="blank _3"></span>S</div><div class="t m0 x1b h29 y29e ff6 fs7 fc0 sc0 ls6 ws7">C<span class="blank _3"></span>om<span class="blank _3"></span>m<span class="blank _0"></span>i<span class="blank _3"></span>tt<span class="blank _3"></span>e<span class="blank _0"></span>e<span class="blank _3"></span>. <span class="blank _3"></span>J <span class="blank _3"></span>C<span class="blank _3"></span>li<span class="blank _3"></span>n<span class="blank _0"></span> <span class="blank _3"></span>En<span class="blank _3"></span>d<span class="blank _0"></span>o<span class="blank _3"></span>cr<span class="blank _3"></span>i<span class="blank _0"></span>n<span class="blank _3"></span>ol<span class="blank _3"></span> <span class="blank _0"></span>M<span class="blank _3"></span>et<span class="blank _3"></span>a<span class="blank _0"></span>b<span class="blank _3"></span>. <span class="blank _3"></span>2<span class="blank _0"></span>0<span class="blank _3"></span>19<span class="blank _3"></span>;<span class="blank _0"></span> <span class="blank _3"></span>10<span class="blank _3"></span>4:<span class="blank _3"></span>2<span class="blank _3"></span>87<span class="blank _3"></span>5<span class="blank _0"></span>-<span class="blank _3"></span>28<span class="blank _3"></span>9<span class="blank _0"></span>1<span class="blank _3"></span>. </div><div class="t m0 x1b h29 y29f ff6 fs7 fc0 sc0 ls6 ws7">L<span class="blank _3"></span>ud<span class="blank _3"></span>w<span class="blank _3"></span>ig<span class="blank _3"></span> <span class="blank _1c"></span>E.<span class="blank _3"></span> <span class="blank _1c"></span>Cl<span class="blank _3"></span>a<span class="blank _3"></span>ss<span class="blank _3"></span>i<span class="blank _3"></span>fi<span class="blank _3"></span>c<span class="blank _3"></span>at<span class="blank _3"></span>i<span class="blank _3"></span>on<span class="blank _3"></span> <span class="blank _1c"></span>of<span class="blank _3"></span> <span class="blank _1c"></span>th<span class="blank _3"></span>e<span class="blank _3"></span> <span class="blank _3"></span>ty<span class="blank _1c"></span>pe<span class="blank _3"></span>s<span class="blank _3"></span> <span class="blank _3"></span>of<span class="blank _1c"></span> <span class="blank _3"></span>an<span class="blank _3"></span>d<span class="blank _3"></span>ro<span class="blank _3"></span>g<span class="blank _3"></span>en<span class="blank _1c"></span>et<span class="blank _3"></span>i<span class="blank _3"></span>c <span class="blank _1c"></span>a<span class="blank _3"></span>lo<span class="blank _3"></span>p<span class="blank _3"></span>ec<span class="blank _3"></span>i<span class="blank _3"></span>a <span class="blank _1c"></span>(<span class="blank _3"></span>co<span class="blank _3"></span>m<span class="blank _3"></span>mo<span class="blank _3"></span>n<span class="blank _3"></span> <span class="blank _3"></span>ba<span class="blank _1c"></span>ld<span class="blank _3"></span>n<span class="blank _3"></span>es<span class="blank _3"></span>s<span class="blank _3"></span>)<span class="blank _1b"></span>12</div><div class="t m0 x1b h29 y2a0 ff6 fs7 fc0 sc0 ls6 ws7">o<span class="blank _3"></span>cu<span class="blank _3"></span>r<span class="blank _0"></span>r<span class="blank _3"></span>in<span class="blank _3"></span>g<span class="blank _0"></span> <span class="blank _3"></span>in<span class="blank _3"></span> <span class="blank _0"></span>t<span class="blank _3"></span>he<span class="blank _3"></span> <span class="blank _0"></span>f<span class="blank _3"></span>em<span class="blank _3"></span>al<span class="blank _3"></span>e<span class="blank _3"></span> s<span class="blank _3"></span>e<span class="blank _0"></span>x<span class="blank _3"></span>. <span class="blank _3"></span>B<span class="blank _0"></span>r<span class="blank _3"></span> J<span class="blank _3"></span> <span class="blank _0"></span>D<span class="blank _3"></span>er<span class="blank _3"></span>m<span class="blank _0"></span>a<span class="blank _3"></span>to<span class="blank _3"></span>l<span class="blank _0"></span>.<span class="blank _3"></span> 1<span class="blank _3"></span>9<span class="blank _0"></span>7<span class="blank _3"></span>7;<span class="blank _3"></span> 9<span class="blank _3"></span>7<span class="blank _3"></span>:2<span class="blank _3"></span>4<span class="blank _0"></span>7<span class="blank _3"></span>-2<span class="blank _3"></span>5<span class="blank _0"></span>4<span class="blank _3"></span>.</div><div class="t m0 x1b h29 y2a1 ff6 fs7 fc0 sc0 ls6 ws7">H<span class="blank _3"></span>ar<span class="blank _3"></span>r<span class="blank _0"></span>i<span class="blank _3"></span>es<span class="blank _3"></span> M<span class="blank _3"></span>,<span class="blank _0"></span> T<span class="blank _3"></span>o<span class="blank _3"></span>st<span class="blank _3"></span>i<span class="blank _0"></span> A<span class="blank _3"></span>,<span class="blank _3"></span> B<span class="blank _3"></span>er<span class="blank _3"></span>g<span class="blank _0"></span>f<span class="blank _3"></span>el<span class="blank _3"></span>d<span class="blank _0"></span> <span class="blank _0"></span>E<span class="blank _3"></span>N,<span class="blank _3"></span> </div><div class="t m2 x43 h2a y2a2 ffa fsb fc0 sc0 ls6 ws7">e<span class="blank _3"></span>t <span class="blank _3"></span>al<span class="blank _3"></span>.<span class="blank _3"></span> </div><div class="t m0 x3a h29 y2a2 ff6 fs7 fc0 sc0 ls6 ws7">T<span class="blank _3"></span>ow<span class="blank _3"></span>a<span class="blank _0"></span>r<span class="blank _3"></span>ds<span class="blank _3"></span> a<span class="blank _3"></span> c<span class="blank _3"></span>o<span class="blank _0"></span>n<span class="blank _3"></span>se<span class="blank _3"></span>n<span class="blank _0"></span>s<span class="blank _3"></span>us<span class="blank _3"></span> o<span class="blank _3"></span>n<span class="blank _0"></span> h<span class="blank _3"></span>o<span class="blank _3"></span>w <span class="blank _3"></span>to<span class="blank _3"></span> d<span class="blank _3"></span>i<span class="blank _3"></span>ag<span class="blank _3"></span>no<span class="blank _3"></span>s<span class="blank _3"></span>e<span class="blank _1b"></span>13</div><div class="t m0 x1b h29 y2a3 ff6 fs7 fc0 sc0 ls6 ws7">a<span class="blank _3"></span>nd<span class="blank _3"></span> q<span class="blank _3"></span>ua<span class="blank _3"></span>n<span class="blank _0"></span>t<span class="blank _3"></span>if<span class="blank _3"></span>y<span class="blank _0"></span> f<span class="blank _3"></span>e<span class="blank _0"></span>m<span class="blank _3"></span>al<span class="blank _3"></span>e <span class="blank _3"></span>pa<span class="blank _3"></span>t<span class="blank _0"></span>t<span class="blank _3"></span>er<span class="blank _3"></span>n<span class="blank _0"></span> h<span class="blank _3"></span>ai<span class="blank _3"></span>r<span class="blank _3"></span> l<span class="blank _0"></span>o<span class="blank _3"></span>ss<span class="blank _3"></span>:<span class="blank _0"></span> t<span class="blank _3"></span>he<span class="blank _3"></span> "<span class="blank _3"></span>Se<span class="blank _3"></span>v<span class="blank _3"></span>er<span class="blank _3"></span>i<span class="blank _0"></span>t<span class="blank _3"></span>y <span class="blank _0"></span>I<span class="blank _3"></span>nd<span class="blank _3"></span>e<span class="blank _0"></span>x<span class="blank _3"></span> of<span class="blank _3"></span> f<span class="blank _3"></span>e<span class="blank _0"></span>m<span class="blank _3"></span>al<span class="blank _3"></span>e <span class="blank _3"></span>pa<span class="blank _3"></span>t<span class="blank _0"></span>t<span class="blank _3"></span>er<span class="blank _3"></span>n<span class="blank _0"></span> h<span class="blank _3"></span>ai<span class="blank _3"></span>r</div><div class="t m0 x1b h29 y2a4 ff6 fs7 fc0 sc0 ls6 ws7">l<span class="blank _3"></span>os<span class="blank _3"></span>s<span class="blank _0"></span> <span class="blank _3"></span>(F<span class="blank _3"></span>P<span class="blank _0"></span>H<span class="blank _3"></span>L-<span class="blank _3"></span>SI<span class="blank _3"></span>)<span class="blank _3"></span> "<span class="blank _3"></span>.<span class="blank _0"></span> <span class="blank _3"></span>J <span class="blank _3"></span>E<span class="blank _0"></span>u<span class="blank _3"></span>r <span class="blank _3"></span>A<span class="blank _0"></span>c<span class="blank _3"></span>ad<span class="blank _3"></span> <span class="blank _0"></span>D<span class="blank _3"></span>er<span class="blank _3"></span>m<span class="blank _0"></span>a<span class="blank _3"></span>to<span class="blank _3"></span>l<span class="blank _0"></span> <span class="blank _3"></span>Ve<span class="blank _3"></span>n<span class="blank _0"></span>e<span class="blank _3"></span>re<span class="blank _3"></span>o<span class="blank _0"></span>l<span class="blank _3"></span>. <span class="blank _3"></span>20<span class="blank _3"></span>1<span class="blank _3"></span>6;<span class="blank _3"></span> <span class="blank _0"></span>3<span class="blank _3"></span>0:<span class="blank _3"></span> <span class="blank _0"></span>6<span class="blank _3"></span>67<span class="blank _3"></span>\u2013<span class="blank _0"></span>6<span class="blank _3"></span>76<span class="blank _3"></span>.</div><div class="t m0 x1b h29 y2a5 ff6 fs7 fc0 sc0 ls6 ws7">O<span class="blank _3"></span>ls<span class="blank _3"></span>e<span class="blank _0"></span>n<span class="blank _3"></span> E<span class="blank _3"></span>A<span class="blank _3"></span>. <span class="blank _1c"></span>Th<span class="blank _3"></span>e <span class="blank _1c"></span>mi<span class="blank _3"></span>d<span class="blank _3"></span>li<span class="blank _3"></span>ne<span class="blank _3"></span> <span class="blank _3"></span>p<span class="blank _0"></span>a<span class="blank _3"></span>rt<span class="blank _3"></span>:<span class="blank _0"></span> <span class="blank _3"></span>a<span class="blank _0"></span>n<span class="blank _3"></span> i<span class="blank _3"></span>m<span class="blank _3"></span>po<span class="blank _3"></span>r<span class="blank _0"></span>t<span class="blank _3"></span>an<span class="blank _3"></span>t<span class="blank _0"></span> <span class="blank _3"></span>p<span class="blank _0"></span>h<span class="blank _3"></span>ys<span class="blank _3"></span>i<span class="blank _0"></span>c<span class="blank _3"></span>al<span class="blank _3"></span> <span class="blank _3"></span>cl<span class="blank _3"></span>u<span class="blank _0"></span>e<span class="blank _3"></span> <span class="blank _0"></span>t<span class="blank _3"></span>o <span class="blank _3"></span>t<span class="blank _3"></span>he<span class="blank _3"></span> <span class="blank _3"></span>cl<span class="blank _3"></span>i<span class="blank _0"></span>n<span class="blank _3"></span>ic<span class="blank _3"></span>a<span class="blank _0"></span>l<span class="blank _3"></span> <span class="blank _0"></span>d<span class="blank _3"></span>ia<span class="blank _3"></span>g<span class="blank _0"></span>n<span class="blank _3"></span>os<span class="blank _3"></span>i<span class="blank _0"></span>s<span class="blank _3"></span> <span class="blank _0"></span>o<span class="blank _3"></span>f<span class="blank _1b"></span>14</div><div class="t m0 x1b h29 y2a6 ff6 fs7 fc0 sc0 ls6 ws7">a<span class="blank _3"></span>nd<span class="blank _3"></span>r<span class="blank _0"></span>o<span class="blank _3"></span>ge<span class="blank _3"></span>n<span class="blank _0"></span>e<span class="blank _3"></span>ti<span class="blank _3"></span>c<span class="blank _0"></span> <span class="blank _3"></span>al<span class="blank _3"></span>o<span class="blank _0"></span>p<span class="blank _3"></span>ec<span class="blank _3"></span>ia<span class="blank _3"></span> <span class="blank _3"></span>in<span class="blank _3"></span> <span class="blank _0"></span>w<span class="blank _3"></span>om<span class="blank _3"></span>e<span class="blank _0"></span>n<span class="blank _3"></span>. <span class="blank _3"></span>J<span class="blank _0"></span> <span class="blank _3"></span>Am<span class="blank _3"></span> <span class="blank _0"></span>A<span class="blank _3"></span>ca<span class="blank _3"></span>d<span class="blank _0"></span> <span class="blank _3"></span>De<span class="blank _3"></span>r<span class="blank _0"></span>m<span class="blank _3"></span>at<span class="blank _3"></span>o<span class="blank _0"></span>l<span class="blank _3"></span>. <span class="blank _3"></span>19<span class="blank _3"></span>9<span class="blank _3"></span>9;<span class="blank _3"></span> <span class="blank _0"></span>4<span class="blank _3"></span>0:<span class="blank _3"></span>1<span class="blank _0"></span>0<span class="blank _3"></span>6-<span class="blank _3"></span>9<span class="blank _0"></span>.</div><div class="t m0 x44 h29 y2a7 ff6 fs7 fc0 sc0 ls6 ws7">H<span class="blank _3"></span>er<span class="blank _3"></span>s<span class="blank _0"></span>k<span class="blank _3"></span>ov<span class="blank _3"></span>i<span class="blank _0"></span>t<span class="blank _3"></span>z <span class="blank _3"></span>I<span class="blank _3"></span>, <span class="blank _3"></span>T<span class="blank _3"></span>os<span class="blank _3"></span>t<span class="blank _0"></span>i<span class="blank _3"></span> A<span class="blank _3"></span>.<span class="blank _3"></span> \u201c<span class="blank _3"></span>F<span class="blank _3"></span>em<span class="blank _3"></span>al<span class="blank _3"></span>e<span class="blank _3"></span> p<span class="blank _3"></span>a<span class="blank _3"></span>tt<span class="blank _3"></span>e<span class="blank _0"></span>r<span class="blank _3"></span>n <span class="blank _3"></span>h<span class="blank _3"></span>ai<span class="blank _3"></span>r<span class="blank _0"></span> <span class="blank _3"></span>lo<span class="blank _3"></span>s<span class="blank _3"></span>s.<span class="blank _3"></span>\u201d<span class="blank _0"></span> <span class="blank _3"></span>In<span class="blank _3"></span>t<span class="blank _3"></span> J<span class="blank _3"></span> <span class="blank _3"></span>En<span class="blank _3"></span>d<span class="blank _3"></span>oc<span class="blank _3"></span>r<span class="blank _0"></span>i<span class="blank _3"></span>no<span class="blank _3"></span>l<span class="blank _0"></span> <span class="blank _3"></span>Me<span class="blank _3"></span>t<span class="blank _3"></span>ab<span class="blank _3"></span>.<span class="blank _0"></span> <span class="blank _3"></span>20<span class="blank _3"></span>1<span class="blank _3"></span>3;<span class="blank _3"></span> <span class="blank _3"></span>11<span class="blank _3"></span>:<span class="blank _1b"></span>1<span class="blank _3"></span>5</div><div class="t m0 x1b h29 y2a8 ff6 fs7 fc0 sc0 ls6 ws7">9<span class="blank _3"></span>86<span class="blank _3"></span>0<span class="blank _0"></span>-<span class="blank _3"></span>68<span class="blank _3"></span>.<span class="blank _0"></span> </div><div class="t m0 x1b h29 y2a9 ff6 fs7 fc0 sc0 ls6 ws7">Y<span class="blank _3"></span>ip<span class="blank _3"></span> Y,<span class="blank _3"></span> Si<span class="blank _3"></span>n<span class="blank _0"></span>c<span class="blank _3"></span>la<span class="blank _3"></span>ir<span class="blank _3"></span> RD<span class="blank _3"></span>.<span class="blank _3"></span> <span class="blank _1"> </span>A<span class="blank _0"></span>n<span class="blank _3"></span>ti<span class="blank _3"></span>a<span class="blank _0"></span>n<span class="blank _3"></span>dr<span class="blank _3"></span>o<span class="blank _0"></span>g<span class="blank _3"></span>en<span class="blank _3"></span> th<span class="blank _3"></span>e<span class="blank _0"></span>r<span class="blank _3"></span>ap<span class="blank _3"></span>y f<span class="blank _3"></span>or<span class="blank _3"></span> a<span class="blank _0"></span>n<span class="blank _3"></span>dr<span class="blank _3"></span>og<span class="blank _3"></span>e<span class="blank _3"></span>ne<span class="blank _3"></span>t<span class="blank _0"></span>i<span class="blank _3"></span>c a<span class="blank _3"></span>lo<span class="blank _3"></span>p<span class="blank _0"></span>e<span class="blank _3"></span>ci<span class="blank _3"></span>a<span class="blank _0"></span>.<span class="blank _3"></span> <span class="blank _1"> </span>E<span class="blank _0"></span>x<span class="blank _3"></span>pe<span class="blank _3"></span>rt<span class="blank _3"></span> Re<span class="blank _3"></span>v<span class="blank _1b"></span>1<span class="blank _3"></span>6</div><div class="t m0 x1b h29 y2aa ff6 fs7 fc0 sc0 ls6 ws7">D<span class="blank _3"></span>er<span class="blank _3"></span>m<span class="blank _0"></span>a<span class="blank _3"></span>to<span class="blank _3"></span>l<span class="blank _0"></span>.<span class="blank _3"></span> 2<span class="blank _3"></span>0<span class="blank _0"></span>0<span class="blank _3"></span>6;<span class="blank _3"></span> 1<span class="blank _3"></span>:<span class="blank _3"></span>26<span class="blank _3"></span>1<span class="blank _0"></span>\u2013<span class="blank _3"></span>26<span class="blank _3"></span>9<span class="blank _0"></span>.</div><div class="t m0 x1b h29 y2ab ff6 fs7 fc0 sc0 ls6 ws7">G<span class="blank _3"></span>uz<span class="blank _3"></span>m<span class="blank _0"></span>á<span class="blank _3"></span>n-<span class="blank _3"></span>S<span class="blank _0"></span>á<span class="blank _3"></span>nc<span class="blank _3"></span>he<span class="blank _3"></span>z<span class="blank _3"></span> DA<span class="blank _3"></span>.<span class="blank _3"></span> Al<span class="blank _3"></span>o<span class="blank _3"></span>pe<span class="blank _3"></span>c<span class="blank _0"></span>i<span class="blank _3"></span>a a<span class="blank _3"></span>n<span class="blank _3"></span>dr<span class="blank _3"></span>o<span class="blank _0"></span>g<span class="blank _3"></span>én<span class="blank _3"></span>i<span class="blank _0"></span>c<span class="blank _3"></span>a.<span class="blank _3"></span> D<span class="blank _3"></span>er<span class="blank _3"></span>m<span class="blank _0"></span>a<span class="blank _3"></span>to<span class="blank _3"></span>l<span class="blank _0"></span> R<span class="blank _3"></span>ev<span class="blank _3"></span> M<span class="blank _3"></span>ex<span class="blank _3"></span>.<span class="blank _3"></span> 20<span class="blank _3"></span>1<span class="blank _3"></span>5;<span class="blank _3"></span> 5<span class="blank _3"></span>9:<span class="blank _3"></span>3<span class="blank _0"></span>8<span class="blank _3"></span>7-<span class="blank _1b"></span>1<span class="blank _3"></span>7</div><div class="t m0 x1b h29 y2ac ff6 fs7 fc0 sc0 ls6 ws12">3<span class="blank _3"></span>94<span class="blank _3"></span>.</div><div class="t m0 x1b h29 y2ad ff6 fs7 fc0 sc0 ls6 ws7">G<span class="blank _3"></span>ue<span class="blank _3"></span>r<span class="blank _0"></span>r<span class="blank _3"></span>a-<span class="blank _3"></span>T<span class="blank _0"></span>a<span class="blank _3"></span>pi<span class="blank _3"></span>a<span class="blank _0"></span> A<span class="blank _3"></span>,<span class="blank _0"></span> G<span class="blank _3"></span>o<span class="blank _3"></span>nz<span class="blank _3"></span>ál<span class="blank _3"></span>e<span class="blank _3"></span>z-<span class="blank _3"></span>G<span class="blank _0"></span>u<span class="blank _3"></span>er<span class="blank _3"></span>r<span class="blank _0"></span>a<span class="blank _3"></span> E<span class="blank _0"></span>.<span class="blank _3"></span> A<span class="blank _3"></span>lo<span class="blank _3"></span>p<span class="blank _0"></span>e<span class="blank _3"></span>ci<span class="blank _3"></span>a<span class="blank _0"></span> d<span class="blank _3"></span>e<span class="blank _0"></span> P<span class="blank _3"></span>a<span class="blank _3"></span>tr<span class="blank _3"></span>ón<span class="blank _3"></span> F<span class="blank _3"></span>e<span class="blank _3"></span>me<span class="blank _3"></span>ni<span class="blank _3"></span>n<span class="blank _3"></span>o.<span class="blank _3"></span> R<span class="blank _3"></span>ev<span class="blank _3"></span>.<span class="blank _3"></span> C<span class="blank _0"></span>h<span class="blank _3"></span>il<span class="blank _3"></span>e<span class="blank _0"></span>n<span class="blank _3"></span>a<span class="blank _1b"></span>18</div><div class="t m0 x1b h29 y2ae ff6 fs7 fc0 sc0 ls6 ws7">D<span class="blank _3"></span>er<span class="blank _3"></span>m<span class="blank _0"></span>a<span class="blank _3"></span>to<span class="blank _3"></span>l<span class="blank _0"></span>.<span class="blank _3"></span> 2<span class="blank _3"></span>0<span class="blank _0"></span>0<span class="blank _3"></span>9;<span class="blank _3"></span> 2<span class="blank _3"></span>5<span class="blank _3"></span>:3<span class="blank _3"></span>2<span class="blank _0"></span>4<span class="blank _3"></span>-3<span class="blank _3"></span>3<span class="blank _0"></span>2<span class="blank _3"></span>.</div><div class="t m0 x1b h29 y2af ff6 fs7 fc0 sc0 ls6 ws7">J<span class="blank _0"></span>i<span class="blank _0"></span>m<span class="blank _0"></span>é<span class="blank _0"></span>n<span class="blank _0"></span>e<span class="blank _3"></span>z <span class="blank _7"> </span>JS<span class="blank _3"></span>, <span class="blank _7"> </span>E<span class="blank _0"></span>s<span class="blank _0"></span>c<span class="blank _0"></span>a<span class="blank _0"></span>l<span class="blank _0"></span>o<span class="blank _0"></span>n<span class="blank _3"></span>a <span class="blank _7"> </span>A,<span class="blank _3"></span> <span class="blank _6"> </span>D<span class="blank _0"></span>i<span class="blank _0"></span>e<span class="blank _0"></span>z<span class="blank _0"></span>,<span class="blank _0"></span> <span class="blank _7"> </span>A.<span class="blank _3"></span> <span class="blank _6"> </span>E<span class="blank _0"></span>l<span class="blank _0"></span> <span class="blank _7"> </span>ov<span class="blank _3"></span>ar<span class="blank _3"></span>io<span class="blank _3"></span> <span class="blank _6"> </span>p<span class="blank _0"></span>o<span class="blank _0"></span>l<span class="blank _0"></span>i<span class="blank _0"></span>q<span class="blank _0"></span>u<span class="blank _0"></span>í<span class="blank _0"></span>s<span class="blank _3"></span>ti<span class="blank _0"></span>c<span class="blank _3"></span>o <span class="blank _7"> </span>y <span class="blank _7"> </span>l<span class="blank _0"></span>a<span class="blank _0"></span>s<span class="blank _0"></span> <span class="blank _7"> </span>en<span class="blank _3"></span>fe<span class="blank _3"></span>rm<span class="blank _3"></span>ed<span class="blank _3"></span>ad<span class="blank _3"></span>es<span class="blank _1b"></span>1<span class="blank _3"></span>9</div><div class="t m0 x1b h29 y2b0 ff6 fs7 fc0 sc0 ls6 ws7">d<span class="blank _3"></span>er<span class="blank _3"></span>m<span class="blank _0"></span>a<span class="blank _3"></span>to<span class="blank _3"></span>l<span class="blank _0"></span>ó<span class="blank _3"></span>gi<span class="blank _3"></span>c<span class="blank _0"></span>a<span class="blank _3"></span>s.<span class="blank _3"></span> M<span class="blank _3"></span>á<span class="blank _3"></span>s <span class="blank _3"></span>D<span class="blank _0"></span>e<span class="blank _3"></span>rm<span class="blank _3"></span>a<span class="blank _0"></span>t<span class="blank _3"></span>ol<span class="blank _3"></span>.<span class="blank _0"></span> <span class="blank _3"></span>20<span class="blank _3"></span>1<span class="blank _0"></span>7<span class="blank _3"></span>; <span class="blank _3"></span>2<span class="blank _0"></span>8<span class="blank _3"></span>:4<span class="blank _3"></span>-<span class="blank _0"></span>1<span class="blank _3"></span>4.</div><div class="t m0 x1b h29 y2b1 ff6 fs7 fc0 sc0 ls6 ws7">K<span class="blank _3"></span>ib<span class="blank _3"></span>a<span class="blank _3"></span>r <span class="blank _1c"></span>M<span class="blank _3"></span>, <span class="blank _1c"></span>A<span class="blank _3"></span>kt<span class="blank _3"></span>a<span class="blank _3"></span>n <span class="blank _1c"></span>S<span class="blank _3"></span>, <span class="blank _1c"></span>B<span class="blank _3"></span>il<span class="blank _3"></span>g<span class="blank _3"></span>in<span class="blank _3"></span> <span class="blank _1c"></span>M.<span class="blank _3"></span> <span class="blank _1c"></span>Sc<span class="blank _3"></span>a<span class="blank _3"></span>lp<span class="blank _3"></span> <span class="blank _1c"></span>de<span class="blank _3"></span>r<span class="blank _3"></span>ma<span class="blank _3"></span>t<span class="blank _3"></span>os<span class="blank _3"></span>c<span class="blank _3"></span>op<span class="blank _1c"></span>ic<span class="blank _3"></span> <span class="blank _3"></span>f<span class="blank _3"></span>in<span class="blank _1c"></span>di<span class="blank _3"></span>n<span class="blank _3"></span>gs<span class="blank _3"></span> <span class="blank _1c"></span>in<span class="blank _3"></span> <span class="blank _3"></span>a<span class="blank _3"></span>nd<span class="blank _1c"></span>ro<span class="blank _3"></span>g<span class="blank _3"></span>en<span class="blank _3"></span>e<span class="blank _3"></span>ti<span class="blank _3"></span>c<span class="blank _3"></span> <span class="blank _3"></span>a<span class="blank _0"></span>l<span class="blank _3"></span>op<span class="blank _1c"></span>ec<span class="blank _3"></span>i<span class="blank _3"></span>a<span class="blank _1b"></span>20</div><div class="t m0 x1b h29 y2b2 ff6 fs7 fc0 sc0 ls6 ws7">a<span class="blank _3"></span>nd<span class="blank _3"></span> <span class="blank _0"></span>t<span class="blank _3"></span>he<span class="blank _3"></span>i<span class="blank _0"></span>r<span class="blank _3"></span> r<span class="blank _3"></span>e<span class="blank _0"></span>l<span class="blank _3"></span>at<span class="blank _3"></span>i<span class="blank _0"></span>o<span class="blank _3"></span>ns<span class="blank _3"></span> w<span class="blank _3"></span>i<span class="blank _3"></span>th<span class="blank _3"></span> <span class="blank _0"></span>d<span class="blank _3"></span>is<span class="blank _3"></span>e<span class="blank _0"></span>a<span class="blank _3"></span>se<span class="blank _3"></span> <span class="blank _0"></span>s<span class="blank _3"></span>ev<span class="blank _3"></span>e<span class="blank _0"></span>r<span class="blank _3"></span>it<span class="blank _3"></span>y<span class="blank _0"></span>.<span class="blank _3"></span> A<span class="blank _3"></span>n<span class="blank _0"></span>n<span class="blank _3"></span> D<span class="blank _3"></span>er<span class="blank _3"></span>m<span class="blank _3"></span>at<span class="blank _3"></span>o<span class="blank _0"></span>l<span class="blank _3"></span>. <span class="blank _3"></span>2<span class="blank _0"></span>0<span class="blank _3"></span>14<span class="blank _3"></span>;<span class="blank _0"></span> <span class="blank _3"></span>26<span class="blank _3"></span>:<span class="blank _0"></span>4<span class="blank _3"></span>78<span class="blank _3"></span>-<span class="blank _0"></span>4<span class="blank _3"></span>84<span class="blank _3"></span>.<span class="blank _0"></span> </div><div class="t m0 x1b h29 y2b3 ff6 fs7 fc0 sc0 ls6 ws7">R<span class="blank _0"></span>a<span class="blank _0"></span>k<span class="blank _0"></span>o<span class="blank _0"></span>w<span class="blank _3"></span>sk<span class="blank _0"></span>a<span class="blank _3"></span> <span class="blank _1"> </span>A,<span class="blank _3"></span> <span class="blank _1"> </span>Sl<span class="blank _3"></span>ow<span class="blank _3"></span>in<span class="blank _3"></span>sk<span class="blank _3"></span>a M,<span class="blank _3"></span> <span class="blank _1"> </span>K<span class="blank _0"></span>o<span class="blank _0"></span>w<span class="blank _0"></span>a<span class="blank _0"></span>l<span class="blank _0"></span>s<span class="blank _3"></span>ka<span class="blank _0"></span>-<span class="blank _3"></span>Ol<span class="blank _0"></span>e<span class="blank _3"></span>dz<span class="blank _0"></span>k<span class="blank _3"></span>a E,<span class="blank _3"></span> </div><div class="t m2 x45 h2a y2b4 ffa fsb fc0 sc0 ls6 ws7">e<span class="blank _0"></span>t<span class="blank _0"></span> al<span class="blank _3"></span>. </div><div class="t m0 x46 h29 y2b4 ff6 fs7 fc0 sc0 ls6 ws7">D<span class="blank _0"></span>e<span class="blank _0"></span>r<span class="blank _0"></span>m<span class="blank _0"></span>o<span class="blank _3"></span>sc<span class="blank _0"></span>o<span class="blank _3"></span>py<span class="blank _0"></span> in<span class="blank _3"></span> <span class="blank _1"> </span>fe<span class="blank _3"></span>ma<span class="blank _3"></span>le<span class="blank _1b"></span>2<span class="blank _3"></span>1</div><div class="t m0 x1b h29 y2b5 ff6 fs7 fc0 sc0 ls6 ws7">a<span class="blank _3"></span>nd<span class="blank _3"></span>r<span class="blank _3"></span>og<span class="blank _3"></span>e<span class="blank _0"></span>n<span class="blank _3"></span>ic<span class="blank _3"></span> <span class="blank _1c"></span>al<span class="blank _3"></span>o<span class="blank _0"></span>p<span class="blank _3"></span>ec<span class="blank _3"></span>i<span class="blank _3"></span>a:<span class="blank _3"></span> <span class="blank _3"></span>M<span class="blank _3"></span>et<span class="blank _3"></span>h<span class="blank _3"></span>od<span class="blank _3"></span> <span class="blank _3"></span>s<span class="blank _3"></span>ta<span class="blank _3"></span>n<span class="blank _3"></span>da<span class="blank _3"></span>r<span class="blank _0"></span>d<span class="blank _3"></span>iz<span class="blank _3"></span>a<span class="blank _3"></span>ti<span class="blank _3"></span>o<span class="blank _3"></span>n <span class="blank _1c"></span>a<span class="blank _0"></span>n<span class="blank _3"></span>d <span class="blank _1c"></span>d<span class="blank _0"></span>i<span class="blank _3"></span>ag<span class="blank _3"></span>n<span class="blank _3"></span>os<span class="blank _3"></span>t<span class="blank _3"></span>ic<span class="blank _3"></span> <span class="blank _3"></span>c<span class="blank _3"></span>ri<span class="blank _3"></span>t<span class="blank _0"></span>e<span class="blank _3"></span>ri<span class="blank _3"></span>a<span class="blank _3"></span>. <span class="blank _1c"></span>I<span class="blank _0"></span>n<span class="blank _3"></span>t <span class="blank _1c"></span>J<span class="blank _3"></span> <span class="blank _3"></span>Tr<span class="blank _3"></span>i<span class="blank _3"></span>ch<span class="blank _3"></span>o<span class="blank _3"></span>l.</div><div class="t m0 x1b h29 y2b6 ff6 fs7 fc0 sc0 ls6 ws7">2<span class="blank _3"></span>00<span class="blank _3"></span>9<span class="blank _0"></span>;<span class="blank _3"></span> 1<span class="blank _3"></span>:<span class="blank _0"></span>1<span class="blank _3"></span>23<span class="blank _3"></span>-3<span class="blank _3"></span>0<span class="blank _3"></span>.</div><div class="t m0 x1b h29 y2b7 ff6 fs7 fc0 sc0 ls6 ws7">C<span class="blank _0"></span>a<span class="blank _0"></span>m<span class="blank _0"></span>a<span class="blank _0"></span>c<span class="blank _3"></span>ho<span class="blank _0"></span> <span class="blank _1"> </span>F.<span class="blank _3"></span> <span class="blank _1"> </span>Al<span class="blank _3"></span>op<span class="blank _3"></span>ec<span class="blank _3"></span>ia<span class="blank _3"></span> <span class="blank _2"> </span>A<span class="blank _3"></span>nd<span class="blank _3"></span>ro<span class="blank _3"></span>ge<span class="blank _3"></span>né<span class="blank _0"></span>t<span class="blank _3"></span>ic<span class="blank _0"></span>a<span class="blank _3"></span> <span class="blank _2"> </span>F<span class="blank _3"></span>em<span class="blank _0"></span>e<span class="blank _3"></span>ni<span class="blank _0"></span>n<span class="blank _3"></span>a.<span class="blank _3"></span> <span class="blank _2"> </span>E<span class="blank _3"></span>ti<span class="blank _0"></span>o<span class="blank _3"></span>lo<span class="blank _0"></span>g<span class="blank _3"></span>ía<span class="blank _3"></span> <span class="blank _2"> </span>y<span class="blank _3"></span> <span class="blank _2"> </span>d<span class="blank _3"></span>ia<span class="blank _0"></span>g<span class="blank _3"></span>nó<span class="blank _0"></span>s<span class="blank _3"></span>ti<span class="blank _0"></span>c<span class="blank _3"></span>o.<span class="blank _3"></span> <span class="blank _2"> </span>R<span class="blank _3"></span>ev<span class="blank _0"></span>.<span class="blank _1b"></span>2<span class="blank _3"></span>2</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div> <div id="pfa" class="pf w0 h0" data-page-no="a"><div class="pc pca w0 h0"><img fetchpriority="low" loading="lazy" class="bi xc y30 w1 hc" alt="" src="https://files.passeidireto.com/75f5f44c-f020-40b0-8bec-4e63b893e22f/bga.png"><div class="t m0 x35 h3 y2 ff2 fs1 fc0 sc0 ls6 ws10">15</div><div class="t m0 x1 h4 y3 ff3 fs2 fc0 sc0 ls6 ws7">Dermatol V<span class="blank _0"></span>enez <span class="ff4 ls0">h</span>Vol.59 <span class="ff4 ls1">h</span>N°2 <span class="ff4 ls2">h</span><span class="ws1">2021</span></div><div class="t m0 xd h2 y1 ff1 fs0 fc0 sc0 ls6 ws7">REVISIÓN </div><div class="t m0 x47 h29 y2b8 ff6 fs7 fc0 sc0 ls6 ws7">C<span class="blank _3"></span>hi<span class="blank _3"></span>l<span class="blank _0"></span>e<span class="blank _3"></span>na<span class="blank _3"></span> <span class="blank _0"></span>D<span class="blank _3"></span>er<span class="blank _3"></span>ma<span class="blank _3"></span>t<span class="blank _3"></span>ol<span class="blank _3"></span>.<span class="blank _0"></span> <span class="blank _3"></span>20<span class="blank _3"></span>1<span class="blank _0"></span>2<span class="blank _3"></span>; <span class="blank _3"></span>2<span class="blank _0"></span>8<span class="blank _3"></span>: <span class="blank _3"></span>2<span class="blank _0"></span>4<span class="blank _3"></span>0-<span class="blank _3"></span>2<span class="blank _0"></span>6<span class="blank _3"></span>9.</div><div class="t m0 x47 h29 y2b9 ff6 fs7 fc0 sc0 ls6 ws7">V<span class="blank _3"></span>añ<span class="blank _3"></span>ó<span class="blank _0"></span> S<span class="blank _3"></span>,<span class="blank _0"></span> S<span class="blank _3"></span>a<span class="blank _0"></span>c<span class="blank _3"></span>ed<span class="blank _3"></span>a<span class="blank _0"></span> D<span class="blank _3"></span>.<span class="blank _0"></span> A<span class="blank _3"></span>lo<span class="blank _3"></span>p<span class="blank _3"></span>ec<span class="blank _3"></span>i<span class="blank _0"></span>a<span class="blank _3"></span> a<span class="blank _0"></span>n<span class="blank _3"></span>dr<span class="blank _3"></span>o<span class="blank _0"></span>g<span class="blank _3"></span>én<span class="blank _3"></span>i<span class="blank _0"></span>c<span class="blank _3"></span>a.<span class="blank _3"></span> E<span class="blank _3"></span>n <span class="blank _3"></span>Va<span class="blank _3"></span>ñ<span class="blank _0"></span>ó<span class="blank _3"></span> S,<span class="blank _3"></span> J<span class="blank _3"></span>a<span class="blank _0"></span>é<span class="blank _3"></span>n <span class="blank _0"></span>P<span class="blank _3"></span>, <span class="blank _0"></span>d<span class="blank _3"></span>ir<span class="blank _3"></span>e<span class="blank _0"></span>c<span class="blank _3"></span>to<span class="blank _3"></span>r<span class="blank _0"></span>e<span class="blank _3"></span>s.<span class="blank _3"></span> M<span class="blank _3"></span>an<span class="blank _3"></span>u<span class="blank _3"></span>al<span class="blank _1b"></span>2<span class="blank _3"></span>3</div><div class="t m0 x47 h29 y2ba ff6 fs7 fc0 sc0 ls6">p</div><div class="t m0 x2b h29 y2bb ff6 fs7 fc0 sc0 ls6 ws7">r<span class="blank _0"></span>á<span class="blank _0"></span>c<span class="blank _0"></span>t<span class="blank _0"></span>i<span class="blank _3"></span>co<span class="blank _0"></span> <span class="blank _2"> </span>de<span class="blank _3"></span> <span class="blank _7"> </span>tr<span class="blank _3"></span>ic<span class="blank _3"></span>ol<span class="blank _3"></span>og<span class="blank _3"></span>ía<span class="blank _3"></span> <span class="blank _7"> </span>#<span class="blank _0"></span>T<span class="blank _0"></span>r<span class="blank _3"></span>ic<span class="blank _0"></span>o<span class="blank _3"></span>HR<span class="blank _0"></span>C<span class="blank _3"></span>. <span class="blank _2"> </span>1e<span class="blank _3"></span>ra<span class="blank _3"></span> <span class="blank _7"> </span>ed<span class="blank _3"></span>ic<span class="blank _3"></span>ió<span class="blank _3"></span>n.<span class="blank _3"></span> <span class="blank _7"> </span>M<span class="blank _0"></span>a<span class="blank _0"></span>d<span class="blank _0"></span>r<span class="blank _3"></span>id<span class="blank _3"></span>: <span class="blank _2"> </span>Cu<span class="blank _3"></span>qu<span class="blank _3"></span>er<span class="blank _3"></span>el<span class="blank _3"></span>la<span class="blank _3"></span> <span class="blank _7"> </span>me<span class="blank _3"></span>di<span class="blank _3"></span>ca<span class="blank _3"></span>l</div><div class="t m0 x47 h29 y2bc ff6 fs7 fc0 sc0 ls6">c</div><div class="t m0 x2b h29 y2bd ff6 fs7 fc0 sc0 ls6 ws7">o<span class="blank _3"></span>mm<span class="blank _3"></span>n<span class="blank _0"></span>i<span class="blank _3"></span>ca<span class="blank _3"></span>t<span class="blank _0"></span>i<span class="blank _3"></span>on<span class="blank _3"></span>s;<span class="blank _3"></span> <span class="blank _3"></span>20<span class="blank _3"></span>2<span class="blank _0"></span>0<span class="blank _3"></span>. <span class="blank _3"></span>P<span class="blank _0"></span> <span class="blank _3"></span>24<span class="blank _3"></span>-<span class="blank _0"></span>6<span class="blank _3"></span>5.</div><div class="t m0 x47 h29 y2be ff6 fs7 fc0 sc0 ls6 ws7">F<span class="blank _3"></span>ag<span class="blank _3"></span>h<span class="blank _0"></span>i<span class="blank _3"></span>hi<span class="blank _3"></span> G<span class="blank _0"></span>,<span class="blank _3"></span> Mo<span class="blank _3"></span>z<span class="blank _3"></span>af<span class="blank _3"></span>a<span class="blank _0"></span>r<span class="blank _3"></span>po<span class="blank _3"></span>o<span class="blank _0"></span>r<span class="blank _3"></span> S,<span class="blank _3"></span> A<span class="blank _3"></span>si<span class="blank _3"></span>l<span class="blank _0"></span>i<span class="blank _3"></span>an<span class="blank _3"></span> A<span class="blank _0"></span>,<span class="blank _3"></span> </div><div class="t m2 x48 h2a y2bf ffa fsb fc0 sc0 ls6 ws7">e<span class="blank _3"></span>t a<span class="blank _3"></span>l<span class="blank _3"></span>. </div><div class="t m0 x49 h29 y2bf ff6 fs7 fc0 sc0 ls6 ws7">T<span class="blank _3"></span>he<span class="blank _3"></span> e<span class="blank _0"></span>f<span class="blank _3"></span>fe<span class="blank _3"></span>c<span class="blank _0"></span>t<span class="blank _3"></span>iv<span class="blank _3"></span>e<span class="blank _0"></span>n<span class="blank _3"></span>es<span class="blank _3"></span>s<span class="blank _0"></span> o<span class="blank _3"></span>f <span class="blank _0"></span>a<span class="blank _3"></span>dd<span class="blank _3"></span>in<span class="blank _3"></span>g<span class="blank _3"></span> lo<span class="blank _3"></span>w<span class="blank _3"></span>-l<span class="blank _3"></span>e<span class="blank _0"></span>v<span class="blank _3"></span>el<span class="blank _1b"></span>2<span class="blank _3"></span>4</div><div class="t m0 x47 h29 y2c0 ff6 fs7 fc0 sc0 ls6 ws7">l<span class="blank _0"></span>i<span class="blank _0"></span>g<span class="blank _0"></span>h<span class="blank _0"></span>t<span class="blank _3"></span> <span class="blank"> </span>t<span class="blank _3"></span>he<span class="blank _3"></span>ra<span class="blank _3"></span>py<span class="blank _3"></span> <span class="blank"> </span>t<span class="blank _3"></span>o <span class="blank _6"> </span>mi<span class="blank _3"></span>no<span class="blank _3"></span>xi<span class="blank _3"></span>di<span class="blank _3"></span>l <span class="blank _6"> </span>5%<span class="blank _3"></span> <span class="blank"> </span>s<span class="blank _3"></span>ol<span class="blank _3"></span>ut<span class="blank _3"></span>io<span class="blank _3"></span>n <span class="blank _6"> </span>in<span class="blank _3"></span> <span class="blank"> </span>t<span class="blank _3"></span>he<span class="blank _3"></span> <span class="blank"> </span>t<span class="blank _3"></span>re<span class="blank _3"></span>at<span class="blank _3"></span>me<span class="blank _3"></span>nt<span class="blank _3"></span> <span class="blank"> </span>o<span class="blank _3"></span>f <span class="blank _6"> </span>pa<span class="blank _3"></span>ti<span class="blank _3"></span>en<span class="blank _3"></span>ts<span class="blank _3"></span> <span class="blank"> </span>w<span class="blank _3"></span>it<span class="blank _3"></span>h</div><div class="t m0 x47 h29 y2c1 ff6 fs7 fc0 sc0 ls6 ws7">a<span class="blank _3"></span>nd<span class="blank _3"></span>r<span class="blank _0"></span>o<span class="blank _3"></span>ge<span class="blank _3"></span>n<span class="blank _0"></span>e<span class="blank _3"></span>ti<span class="blank _3"></span>c<span class="blank _0"></span> <span class="blank _3"></span>al<span class="blank _3"></span>o<span class="blank _0"></span>p<span class="blank _3"></span>ec<span class="blank _3"></span>ia<span class="blank _3"></span>.<span class="blank _3"></span> I<span class="blank _3"></span>n<span class="blank _0"></span>d<span class="blank _3"></span>ia<span class="blank _3"></span>n<span class="blank _0"></span> <span class="blank _3"></span>J <span class="blank _3"></span>D<span class="blank _0"></span>e<span class="blank _3"></span>rm<span class="blank _3"></span>a<span class="blank _0"></span>t<span class="blank _3"></span>ol<span class="blank _3"></span> <span class="blank _0"></span>V<span class="blank _3"></span>en<span class="blank _3"></span>e<span class="blank _0"></span>r<span class="blank _3"></span>eo<span class="blank _3"></span>l<span class="blank _0"></span> <span class="blank _3"></span>Le<span class="blank _3"></span>p<span class="blank _0"></span>r<span class="blank _3"></span>ol<span class="blank _3"></span>. <span class="blank _3"></span>2<span class="blank _3"></span>01<span class="blank _3"></span>8<span class="blank _0"></span>;<span class="blank _3"></span> 8<span class="blank _3"></span>4<span class="blank _0"></span>:<span class="blank _3"></span>54<span class="blank _3"></span>7<span class="blank _0"></span>-<span class="blank _3"></span>55<span class="blank _3"></span>3<span class="blank _0"></span>.</div><div class="t m0 x47 h29 y2c2 ff6 fs7 fc0 sc0 ls6">R</div><div class="t m0 x2b h29 y2c3 ff6 fs7 fc0 sc0 ls6 ws7">o<span class="blank _3"></span>ss<span class="blank _3"></span>i<span class="blank _0"></span> A<span class="blank _3"></span>,<span class="blank _3"></span> C<span class="blank _3"></span>am<span class="blank _3"></span>po<span class="blank _3"></span> D<span class="blank _3"></span>,<span class="blank _3"></span> F<span class="blank _3"></span>or<span class="blank _3"></span>t<span class="blank _0"></span>u<span class="blank _3"></span>na<span class="blank _3"></span> M<span class="blank _3"></span>C<span class="blank _0"></span>,<span class="blank _3"></span> e<span class="blank _3"></span>t <span class="blank _3"></span>al<span class="blank _3"></span>.<span class="blank _0"></span> A<span class="blank _3"></span> p<span class="blank _3"></span>r<span class="blank _3"></span>el<span class="blank _3"></span>i<span class="blank _0"></span>m<span class="blank _3"></span>in<span class="blank _3"></span>a<span class="blank _0"></span>r<span class="blank _3"></span>y <span class="blank _3"></span>st<span class="blank _3"></span>u<span class="blank _0"></span>d<span class="blank _3"></span>y <span class="blank _3"></span>on<span class="blank _3"></span> t<span class="blank _3"></span>o<span class="blank _0"></span>p<span class="blank _3"></span>ic<span class="blank _3"></span>a<span class="blank _0"></span>l<span class="blank _3"></span> c<span class="blank _3"></span>et<span class="blank _3"></span>ir<span class="blank _3"></span>i<span class="blank _3"></span>zi<span class="blank _3"></span>n<span class="blank _0"></span>e<span class="blank _3"></span> i<span class="blank _3"></span>n<span class="blank _1b"></span>25</div><div class="t m0 x47 h29 y2c4 ff6 fs7 fc0 sc0 ls6">t</div><div class="t m0 x33 h29 y2c5 ff6 fs7 fc0 sc0 ls6 ws7">h<span class="blank _3"></span>e <span class="blank _1c"></span>t<span class="blank _3"></span>he<span class="blank _1c"></span>ra<span class="blank _3"></span>p<span class="blank _3"></span>eu<span class="blank _1c"></span>ti<span class="blank _3"></span>c<span class="blank _3"></span> <span class="blank _3"></span>m<span class="blank _0"></span>a<span class="blank _3"></span>na<span class="blank _1c"></span>ge<span class="blank _3"></span>m<span class="blank _3"></span>en<span class="blank _1c"></span>t <span class="blank _1c"></span>o<span class="blank _3"></span>f <span class="blank _1c"></span>a<span class="blank _3"></span>nd<span class="blank _3"></span>r<span class="blank _3"></span>og<span class="blank _1c"></span>en<span class="blank _3"></span>e<span class="blank _3"></span>ti<span class="blank _1c"></span>c <span class="blank _1c"></span>a<span class="blank _3"></span>lo<span class="blank _3"></span>p<span class="blank _3"></span>ec<span class="blank _1c"></span>ia<span class="blank _3"></span>.<span class="blank _3"></span> <span class="blank _3"></span>J<span class="blank _0"></span> <span class="blank _1c"></span>De<span class="blank _3"></span>r<span class="blank _3"></span>m<span class="blank _0"></span>a<span class="blank _3"></span>to<span class="blank _1c"></span>lo<span class="blank _3"></span>g<span class="blank _3"></span> <span class="blank _3"></span>T<span class="blank _0"></span>r<span class="blank _3"></span>ea<span class="blank _1c"></span>t.<span class="blank _3"></span> <span class="blank _1c"></span>20<span class="blank _3"></span>1<span class="blank _3"></span>8;</div><div class="t m0 x47 h29 y2c6 ff6 fs7 fc0 sc0 ls6">2</div><div class="t m0 x2b h29 y2c7 ff6 fs7 fc0 sc0 ls6 ws12">9<span class="blank _3"></span>:1<span class="blank _3"></span>4<span class="blank _0"></span>9<span class="blank _3"></span>-1<span class="blank _3"></span>5<span class="blank _0"></span>1<span class="blank _3"></span>.</div><div class="t m0 x47 h29 y2c8 ff6 fs7 fc0 sc0 ls6 ws7">C<span class="blank _3"></span>ha<span class="blank _3"></span>n<span class="blank _0"></span> <span class="blank _3"></span>L,<span class="blank _3"></span> <span class="blank _0"></span>C<span class="blank _3"></span>oo<span class="blank _3"></span>k<span class="blank _0"></span> <span class="blank _3"></span>DK<span class="blank _3"></span>. <span class="blank _3"></span>F<span class="blank _3"></span>em<span class="blank _3"></span>a<span class="blank _0"></span>l<span class="blank _3"></span>e <span class="blank _3"></span>p<span class="blank _0"></span>a<span class="blank _3"></span>tt<span class="blank _3"></span>e<span class="blank _0"></span>r<span class="blank _3"></span>n <span class="blank _3"></span>h<span class="blank _0"></span>a<span class="blank _3"></span>ir<span class="blank _3"></span> <span class="blank _0"></span>l<span class="blank _3"></span>os<span class="blank _3"></span>s<span class="blank _0"></span>.<span class="blank _3"></span> A<span class="blank _3"></span>u<span class="blank _0"></span>s<span class="blank _3"></span>t <span class="blank _3"></span>J <span class="blank _3"></span>G<span class="blank _3"></span>en<span class="blank _3"></span> <span class="blank _0"></span>P<span class="blank _3"></span>ra<span class="blank _3"></span>c<span class="blank _0"></span>t<span class="blank _3"></span>. <span class="blank _3"></span>2<span class="blank _0"></span>0<span class="blank _3"></span>18<span class="blank _3"></span>;<span class="blank _0"></span> <span class="blank _3"></span>47<span class="blank _3"></span>:<span class="blank _0"></span>4<span class="blank _3"></span>59<span class="blank _3"></span>-<span class="blank _0"></span>4<span class="blank _3"></span>64<span class="blank _3"></span>.<span class="blank _0"></span> <span class="blank _1d"></span>2<span class="blank _3"></span>6</div><div class="t m0 x47 h29 y2c9 ff6 fs7 fc0 sc0 ls6 ws7">S<span class="blank _0"></span>i<span class="blank _0"></span>n<span class="blank _0"></span>c<span class="blank _0"></span>l<span class="blank _0"></span>a<span class="blank _3"></span>ir<span class="blank _3"></span> <span class="blank _1"> </span>RD<span class="blank _3"></span>. Fe<span class="blank _3"></span>ma<span class="blank _3"></span>le<span class="blank _3"></span> <span class="blank _1"> </span>pa<span class="blank _3"></span>tt<span class="blank _3"></span>er<span class="blank _3"></span>n h<span class="blank _0"></span>a<span class="blank _0"></span>i<span class="blank _0"></span>r<span class="blank _3"></span> <span class="blank _1"> </span>lo<span class="blank _3"></span>ss<span class="blank _3"></span>: A p<span class="blank _0"></span>i<span class="blank _0"></span>l<span class="blank _0"></span>o<span class="blank _0"></span>t<span class="blank _0"></span> st<span class="blank _3"></span>ud<span class="blank _3"></span>y in<span class="blank _3"></span>ve<span class="blank _3"></span>st<span class="blank _3"></span>ig<span class="blank _3"></span>at<span class="blank _3"></span>in<span class="blank _3"></span>g co<span class="blank _3"></span>mb<span class="blank _3"></span>in<span class="blank _3"></span>at<span class="blank _3"></span>io<span class="blank _3"></span>n<span class="blank _1b"></span>2<span class="blank _0"></span>7</div><div class="t m0 x47 h29 y2ca ff6 fs7 fc0 sc0 ls6 ws7">t<span class="blank _3"></span>he<span class="blank _3"></span>ra<span class="blank _3"></span>p<span class="blank _3"></span>y w<span class="blank _3"></span>it<span class="blank _3"></span>h<span class="blank _0"></span> lo<span class="blank _3"></span>w<span class="blank _3"></span>-d<span class="blank _3"></span>os<span class="blank _3"></span>e<span class="blank _3"></span> <span class="blank _1"> </span>or<span class="blank _3"></span>a<span class="blank _3"></span>l m<span class="blank _3"></span>in<span class="blank _3"></span>o<span class="blank _0"></span>x<span class="blank _3"></span>id<span class="blank _3"></span>il<span class="blank _3"></span> an<span class="blank _3"></span>d<span class="blank _3"></span> <span class="blank _1"> </span>sp<span class="blank _3"></span>i<span class="blank _3"></span>ro<span class="blank _3"></span>n<span class="blank _0"></span>o<span class="blank _3"></span>la<span class="blank _3"></span>ct<span class="blank _3"></span>o<span class="blank _3"></span>ne<span class="blank _3"></span>. I<span class="blank _3"></span>nt<span class="blank _3"></span> J D<span class="blank _3"></span>er<span class="blank _3"></span>m<span class="blank _3"></span>at<span class="blank _3"></span>ol<span class="blank _3"></span> 20<span class="blank _3"></span>1<span class="blank _3"></span>8;</div><div class="t m0 x47 h29 y2cb ff6 fs7 fc0 sc0 ls6 ws12">5<span class="blank _3"></span>7:<span class="blank _3"></span>1<span class="blank _0"></span>0<span class="blank _3"></span>4\u2013<span class="blank _3"></span>0<span class="blank _0"></span>9<span class="blank _3"></span>.</div><div class="t m0 x47 h29 y2cc ff6 fs7 fc0 sc0 ls6">J</div><div class="t m0 x33 h29 y2cd ff6 fs7 fc0 sc0 ls6 ws7">i<span class="blank _3"></span>me<span class="blank _3"></span>n<span class="blank _3"></span>ez<span class="blank _3"></span>-<span class="blank _0"></span>C<span class="blank _3"></span>au<span class="blank _3"></span>h<span class="blank _3"></span>e <span class="blank _1c"></span>J<span class="blank _0"></span>,<span class="blank _3"></span> <span class="blank _3"></span>Sa<span class="blank _3"></span>c<span class="blank _3"></span>ed<span class="blank _3"></span>a<span class="blank _3"></span>-C<span class="blank _3"></span>o<span class="blank _3"></span>rr<span class="blank _3"></span>a<span class="blank _0"></span>l<span class="blank _3"></span>o <span class="blank _1c"></span>D<span class="blank _3"></span>, <span class="blank _1c"></span>R<span class="blank _0"></span>o<span class="blank _3"></span>dr<span class="blank _3"></span>i<span class="blank _3"></span>gu<span class="blank _3"></span>e<span class="blank _0"></span>s<span class="blank _3"></span>-B<span class="blank _3"></span>a<span class="blank _3"></span>ra<span class="blank _3"></span>t<span class="blank _0"></span>a<span class="blank _3"></span> <span class="blank _3"></span>R<span class="blank _0"></span>,<span class="blank _3"></span> </div><div class="t m2 x4a h2a y2ce ffa fsb fc0 sc0 ls6">e</div><div class="t m2 x4b h2a y2cf ffa fsb fc0 sc0 ls6 ws7">t<span class="blank _3"></span> <span class="blank _3"></span>a<span class="blank _0"></span>l<span class="blank _3"></span>.</div><div class="t m0 x4c h29 y2ce ff6 fs7 fc0 sc0 ls6">S</div><div class="t m0 x4d h29 y2cf ff6 fs7 fc0 sc0 ls6 ws7">a<span class="blank _3"></span>fe<span class="blank _3"></span>t<span class="blank _3"></span>y <span class="blank _1c"></span>o<span class="blank _0"></span>f<span class="blank _3"></span> <span class="blank _3"></span>lo<span class="blank _3"></span>w<span class="blank _3"></span>-d<span class="blank _3"></span>o<span class="blank _3"></span>se<span class="blank _1b"></span>2<span class="blank _3"></span>8</div><div class="t m0 x47 h29 y2d0 ff6 fs7 fc0 sc0 ls6">o</div><div class="t m0 x2b h29 y2d1 ff6 fs7 fc0 sc0 ls6 ws7">r<span class="blank _3"></span>al<span class="blank _3"></span> <span class="blank _3"></span>mi<span class="blank _3"></span>n<span class="blank _3"></span>ox<span class="blank _3"></span>id<span class="blank _3"></span>i<span class="blank _3"></span>l <span class="blank _1c"></span>tr<span class="blank _3"></span>e<span class="blank _0"></span>a<span class="blank _3"></span>tm<span class="blank _3"></span>e<span class="blank _0"></span>n<span class="blank _3"></span>t <span class="blank _1c"></span>fo<span class="blank _3"></span>r<span class="blank _0"></span> <span class="blank _3"></span>h<span class="blank _0"></span>a<span class="blank _3"></span>ir<span class="blank _3"></span> <span class="blank _3"></span>lo<span class="blank _3"></span>s<span class="blank _3"></span>s.<span class="blank _3"></span> <span class="blank _3"></span>A <span class="blank _1c"></span>sy<span class="blank _3"></span>s<span class="blank _3"></span>te<span class="blank _3"></span>ma<span class="blank _3"></span>t<span class="blank _3"></span>ic<span class="blank _3"></span> <span class="blank _3"></span>re<span class="blank _3"></span>v<span class="blank _3"></span>ie<span class="blank _3"></span>w<span class="blank _0"></span> <span class="blank _3"></span>a<span class="blank _0"></span>n<span class="blank _3"></span>d <span class="blank _1c"></span>po<span class="blank _3"></span>o<span class="blank _0"></span>l<span class="blank _3"></span>ed<span class="blank _3"></span>-<span class="blank _0"></span>a<span class="blank _3"></span>na<span class="blank _3"></span>l<span class="blank _0"></span>y<span class="blank _3"></span>si<span class="blank _3"></span>s<span class="blank _0"></span> <span class="blank _3"></span>o<span class="blank _0"></span>f</div><div class="t m0 x47 h29 y2d2 ff6 fs7 fc0 sc0 ls6">i</div><div class="t m0 x33 h29 y2d3 ff6 fs7 fc0 sc0 ls6 ws7">n<span class="blank _3"></span>di<span class="blank _3"></span>v<span class="blank _0"></span>i<span class="blank _3"></span>du<span class="blank _3"></span>a<span class="blank _0"></span>l<span class="blank _3"></span> p<span class="blank _3"></span>a<span class="blank _0"></span>t<span class="blank _3"></span>ie<span class="blank _3"></span>nt<span class="blank _3"></span> <span class="blank _3"></span>da<span class="blank _3"></span>t<span class="blank _0"></span>a<span class="blank _3"></span>. <span class="blank _3"></span>D<span class="blank _0"></span>e<span class="blank _3"></span>rm<span class="blank _3"></span>a<span class="blank _0"></span>t<span class="blank _3"></span>ol<span class="blank _3"></span> <span class="blank _0"></span>T<span class="blank _3"></span>he<span class="blank _3"></span>r<span class="blank _0"></span>.<span class="blank _3"></span> 2<span class="blank _3"></span>0<span class="blank _0"></span>2<span class="blank _3"></span>0;<span class="blank _3"></span> <span class="blank _0"></span>3<span class="blank _3"></span>3:<span class="blank _3"></span>1<span class="blank _0"></span>4<span class="blank _3"></span>10<span class="blank _3"></span>6-<span class="blank _3"></span>1<span class="blank _3"></span>41<span class="blank _3"></span>1<span class="blank _0"></span>4<span class="blank _3"></span>.</div><div class="t m0 x47 h29 y2d4 ff6 fs7 fc0 sc0 ls6">L</div><div class="t m0 x2b h29 y2d5 ff6 fs7 fc0 sc0 ls6 ws7">e<span class="blank _3"></span>e <span class="blank _3"></span>S<span class="blank _0"></span>W<span class="blank _3"></span>, <span class="blank _3"></span>J<span class="blank _0"></span>u<span class="blank _3"></span>ha<span class="blank _3"></span>s<span class="blank _0"></span>z<span class="blank _3"></span> M<span class="blank _3"></span>,<span class="blank _0"></span> <span class="blank _3"></span>Mo<span class="blank _3"></span>b<span class="blank _3"></span>as<span class="blank _3"></span>he<span class="blank _3"></span>r<span class="blank _3"></span> P<span class="blank _3"></span>,</div><div class="t m2 x23 h2a y2d6 ffa fsb fc0 sc0 ls6">e</div><div class="t m2 x4e h2a y2d7 ffa fsb fc0 sc0 ls6 ws7">t<span class="blank _3"></span> a<span class="blank _3"></span>l<span class="blank _0"></span>.</div><div class="t m0 x4f h29 y2d6 ff6 fs7 fc0 sc0 ls6">A</div><div class="t m0 xa h29 y2d7 ff6 fs7 fc0 sc0 ls6 ws7"> <span class="blank _3"></span>Sy<span class="blank _3"></span>s<span class="blank _0"></span>t<span class="blank _3"></span>em<span class="blank _3"></span>a<span class="blank _0"></span>t<span class="blank _3"></span>ic<span class="blank _3"></span> <span class="blank _0"></span>R<span class="blank _3"></span>ev<span class="blank _3"></span>i<span class="blank _0"></span>e<span class="blank _3"></span>w <span class="blank _3"></span>o<span class="blank _0"></span>f<span class="blank _3"></span> T<span class="blank _3"></span>o<span class="blank _0"></span>p<span class="blank _3"></span>ic<span class="blank _3"></span>a<span class="blank _0"></span>l<span class="blank _3"></span> F<span class="blank _3"></span>i<span class="blank _0"></span>n<span class="blank _3"></span>as<span class="blank _3"></span>t<span class="blank _0"></span>e<span class="blank _3"></span>ri<span class="blank _3"></span>d<span class="blank _0"></span>e<span class="blank _1b"></span>2<span class="blank _3"></span>9</div><div class="t m0 x47 h29 y2d8 ff6 fs7 fc0 sc0 ls6">i</div><div class="t m0 x33 h29 y2d9 ff6 fs7 fc0 sc0 ls6 ws7">n<span class="blank _0"></span> <span class="blank _7"> </span>th<span class="blank _3"></span>e <span class="blank _7"> </span>Tr<span class="blank _3"></span>ea<span class="blank _3"></span>tm<span class="blank _3"></span>en<span class="blank _3"></span>t <span class="blank _2"> </span>of<span class="blank _0"></span> <span class="blank _7"> </span>An<span class="blank _3"></span>dr<span class="blank _3"></span>og<span class="blank _3"></span>en<span class="blank _3"></span>et<span class="blank _3"></span>ic<span class="blank _3"></span> <span class="blank _6"> </span>A<span class="blank _0"></span>l<span class="blank _0"></span>o<span class="blank _0"></span>p<span class="blank _0"></span>e<span class="blank _0"></span>c<span class="blank _0"></span>i<span class="blank _0"></span>a<span class="blank _3"></span> <span class="blank _6"> </span>in<span class="blank _3"></span> <span class="blank _6"> </span>M<span class="blank _0"></span>e<span class="blank _0"></span>n<span class="blank _0"></span> <span class="blank _7"> </span>an<span class="blank _3"></span>d <span class="blank _7"> </span>W<span class="blank _0"></span>o<span class="blank _0"></span>m<span class="blank _0"></span>e<span class="blank _0"></span>n<span class="blank _0"></span>.<span class="blank _3"></span> <span class="blank _6"> </span>J <span class="blank _7"> </span>D<span class="blank _0"></span>r<span class="blank _0"></span>u<span class="blank _0"></span>g<span class="blank _3"></span>s</div><div class="t m0 x47 h29 y2da ff6 fs7 fc0 sc0 ls6">D</div><div class="t m0 x1a h29 y2db ff6 fs7 fc0 sc0 ls6 ws7">e<span class="blank _3"></span>rm<span class="blank _3"></span>a<span class="blank _0"></span>t<span class="blank _3"></span>ol<span class="blank _3"></span>.<span class="blank _0"></span> <span class="blank _3"></span>20<span class="blank _3"></span>1<span class="blank _0"></span>8<span class="blank _3"></span>;1<span class="blank _3"></span>7:<span class="blank _3"></span> <span class="blank _3"></span>45<span class="blank _3"></span>7<span class="blank _0"></span>-<span class="blank _3"></span>46<span class="blank _3"></span>3<span class="blank _0"></span>.</div><div class="t m0 x47 h29 y2dc ff6 fs7 fc0 sc0 ls6">F</div><div class="t m0 x2b h29 y2dd ff6 fs7 fc0 sc0 ls6 ws12">e<span class="blank _3"></span>rn<span class="blank _3"></span>á<span class="blank _3"></span>nd<span class="blank _1c"></span>ez<span class="blank _3"></span><span class="ffe ws13">\u2010<span class="blank _3"></span><span class="ff6 ws7">Ni<span class="blank _3"></span>e<span class="blank _3"></span>to<span class="blank _1c"></span> <span class="blank _3"></span>D,<span class="blank _1c"></span> <span class="blank _3"></span>Sa<span class="blank _3"></span>c<span class="blank _3"></span>ed<span class="blank _1c"></span>a<span class="ffe ws13">\u2010<span class="blank _3"></span><span class="ff6 ws7">C<span class="blank _3"></span>or<span class="blank _3"></span>r<span class="blank _3"></span>al<span class="blank _1c"></span>o <span class="blank _1c"></span>D<span class="blank _3"></span>, <span class="blank _1c"></span>R<span class="blank _0"></span>o<span class="blank _3"></span>dr<span class="blank _1c"></span>íg<span class="blank _3"></span>u<span class="blank _3"></span>ez<span class="blank _3"></span><span class="ffe ws13">\u2010<span class="blank _3"></span><span class="ff6 ws7">B<span class="blank _0"></span>a<span class="blank _3"></span>ra<span class="blank _3"></span>t<span class="blank _3"></span>a <span class="blank _1c"></span>R<span class="blank _3"></span>, </span></span></span></span></span></span></div><div class="t m2 x4b h2a y2de ffa fsb fc0 sc0 ls6">e</div><div class="t m2 x50 h2a y2df ffa fsb fc0 sc0 ls6 ws7">t<span class="blank _3"></span> <span class="blank _3"></span>a<span class="blank _0"></span>l<span class="blank _3"></span>.<span class="blank _0"></span> </div><div class="t m0 x4d h29 y2de ff6 fs7 fc0 sc0 ls6">O</div><div class="t m0 x51 h29 y2df ff6 fs7 fc0 sc0 ls6 ws7">r<span class="blank _3"></span>al<span class="blank _3"></span> <span class="blank _1c"></span>bi<span class="blank _3"></span>c<span class="blank _3"></span>al<span class="blank _3"></span>u<span class="blank _3"></span>ta<span class="blank _1c"></span>mi<span class="blank _3"></span>d<span class="blank _3"></span>e<span class="blank _1b"></span>30</div><div class="t m0 x47 h29 y2e0 ff6 fs7 fc0 sc0 ls6 ws7">f<span class="blank _3"></span>or<span class="blank _3"></span> <span class="blank _0"></span>f<span class="blank _3"></span>em<span class="blank _3"></span>a<span class="blank _0"></span>l<span class="blank _3"></span>e <span class="blank _3"></span>p<span class="blank _0"></span>a<span class="blank _3"></span>tt<span class="blank _3"></span>er<span class="blank _3"></span>n<span class="blank _3"></span> h<span class="blank _3"></span>a<span class="blank _0"></span>i<span class="blank _3"></span>r <span class="blank _3"></span>l<span class="blank _0"></span>o<span class="blank _3"></span>ss<span class="blank _3"></span>:<span class="blank _0"></span> <span class="blank _3"></span>a <span class="blank _3"></span>p<span class="blank _0"></span>i<span class="blank _3"></span>lo<span class="blank _3"></span>t<span class="blank _0"></span> <span class="blank _3"></span>st<span class="blank _3"></span>u<span class="blank _0"></span>d<span class="blank _3"></span>y.<span class="blank _3"></span> <span class="blank _0"></span>D<span class="blank _3"></span>er<span class="blank _3"></span>m<span class="blank _0"></span>a<span class="blank _3"></span>to<span class="blank _3"></span>lo<span class="blank _3"></span>g<span class="blank _3"></span>ic<span class="blank _3"></span> <span class="blank _0"></span>T<span class="blank _3"></span>he<span class="blank _3"></span>r<span class="blank _0"></span>a<span class="blank _3"></span>py<span class="blank _3"></span>.<span class="blank _0"></span>2<span class="blank _3"></span>01<span class="blank _3"></span>9<span class="blank _0"></span>;<span class="blank _3"></span> 3<span class="blank _3"></span>2<span class="blank _0"></span>:<span class="blank _3"></span> 3<span class="blank _3"></span>9<span class="blank _0"></span>.</div><div class="t m0 x47 h29 y2e1 ff6 fs7 fc0 sc0 ls6 ws7">F<span class="blank _3"></span>er<span class="blank _3"></span>ia<span class="blank _3"></span>l<span class="blank _0"></span>-<span class="blank _3"></span>Is<span class="blank _3"></span>ma<span class="blank _3"></span>i<span class="blank _3"></span>l F<span class="blank _3"></span>, M<span class="blank _0"></span>e<span class="blank _3"></span>ah<span class="blank _3"></span> N,<span class="blank _3"></span> Ca<span class="blank _3"></span>rv<span class="blank _3"></span>a<span class="blank _0"></span>l<span class="blank _3"></span>ho<span class="blank _3"></span> L,<span class="blank _3"></span> </div><div class="t m2 x48 h2a y2e2 ffa fsb fc0 sc0 ls6 ws7">e<span class="blank _3"></span>t a<span class="blank _3"></span>l.<span class="blank _3"></span> </div><div class="t m0 x49 h29 y2e2 ff6 fs7 fc0 sc0 ls6 ws7">S<span class="blank _3"></span>af<span class="blank _3"></span>et<span class="blank _3"></span>y<span class="blank _0"></span> o<span class="blank _0"></span>f<span class="blank _3"></span> <span class="blank _1"> </span>or<span class="blank _3"></span>a<span class="blank _3"></span>l b<span class="blank _0"></span>i<span class="blank _3"></span>ca<span class="blank _3"></span>lu<span class="blank _3"></span>t<span class="blank _3"></span>am<span class="blank _3"></span>id<span class="blank _3"></span>e<span class="blank _3"></span> <span class="blank _1"> </span>in<span class="blank _3"></span> fe<span class="blank _3"></span>m<span class="blank _0"></span>a<span class="blank _3"></span>le<span class="blank _1b"></span>3<span class="blank _3"></span>1</div><div class="t m0 x47 h29 y2e3 ff6 fs7 fc0 sc0 ls6 ws7">p<span class="blank _0"></span>a<span class="blank _3"></span>tt<span class="blank _3"></span>er<span class="blank _3"></span>n h<span class="blank _3"></span>ai<span class="blank _3"></span>r l<span class="blank _0"></span>o<span class="blank _0"></span>s<span class="blank _3"></span>s:<span class="blank _3"></span> <span class="blank _1"> </span>A<span class="blank _0"></span> re<span class="blank _3"></span>tr<span class="blank _3"></span>os<span class="blank _3"></span>p<span class="blank _0"></span>e<span class="blank _0"></span>c<span class="blank _3"></span>ti<span class="blank _3"></span>ve<span class="blank _3"></span> <span class="blank _1"> </span>r<span class="blank _0"></span>e<span class="blank _3"></span>vi<span class="blank _3"></span>ew<span class="blank _3"></span> <span class="blank _1"> </span>o<span class="blank _0"></span>f<span class="blank _0"></span> 31<span class="blank _3"></span>6 p<span class="blank _3"></span>at<span class="blank _3"></span>ie<span class="blank _3"></span>nt<span class="blank _3"></span>s<span class="blank _0"></span>.<span class="blank _0"></span> J A<span class="blank _3"></span>m A<span class="blank _0"></span>c<span class="blank _3"></span>ad<span class="blank _3"></span> <span class="blank _1"> </span>De<span class="blank _3"></span>r<span class="blank _0"></span>m<span class="blank _0"></span>a<span class="blank _3"></span>to<span class="blank _3"></span>l</div><div class="t m0 x47 h29 y2e4 ff6 fs7 fc0 sc0 ls6 ws7">2<span class="blank _3"></span>02<span class="blank _3"></span>0<span class="blank _0"></span>;<span class="blank _3"></span> 8<span class="blank _3"></span>3<span class="blank _0"></span>:<span class="blank _3"></span> 1<span class="blank _3"></span>47<span class="blank _3"></span>8<span class="blank _3"></span>-1<span class="blank _3"></span>4<span class="blank _0"></span>7<span class="blank _3"></span>9.</div><div class="t m0 x47 h29 y2e5 ff6 fs7 fc0 sc0 ls6 ws7">A<span class="blank _3"></span>lv<span class="blank _3"></span>e<span class="blank _0"></span>s<span class="blank _3"></span> <span class="blank _0"></span>R<span class="blank _3"></span>, <span class="blank _3"></span>G<span class="blank _3"></span>ri<span class="blank _3"></span>m<span class="blank _0"></span>a<span class="blank _3"></span>lt<span class="blank _3"></span> <span class="blank _3"></span>R.<span class="blank _3"></span> <span class="blank _3"></span>A <span class="blank _1c"></span>re<span class="blank _3"></span>v<span class="blank _3"></span>ie<span class="blank _3"></span>w<span class="blank _0"></span> <span class="blank _3"></span>of<span class="blank _3"></span> <span class="blank _3"></span>P<span class="blank _0"></span>l<span class="blank _3"></span>at<span class="blank _3"></span>e<span class="blank _0"></span>l<span class="blank _3"></span>et<span class="blank _3"></span>-<span class="blank _0"></span>R<span class="blank _3"></span>ic<span class="blank _3"></span>h<span class="blank _0"></span> <span class="blank _3"></span>P<span class="blank _0"></span>l<span class="blank _3"></span>as<span class="blank _3"></span>ma<span class="blank _3"></span>:<span class="blank _3"></span> <span class="blank _0"></span>H<span class="blank _3"></span>is<span class="blank _3"></span>t<span class="blank _0"></span>o<span class="blank _3"></span>ry<span class="blank _3"></span>,<span class="blank _0"></span> <span class="blank _3"></span>B<span class="blank _0"></span>i<span class="blank _3"></span>ol<span class="blank _3"></span>o<span class="blank _0"></span>g<span class="blank _3"></span>y,<span class="blank _3"></span> <span class="blank _3"></span>Me<span class="blank _3"></span>c<span class="blank _0"></span>h<span class="blank _3"></span>an<span class="blank _3"></span>i<span class="blank _0"></span>s<span class="blank _3"></span>m<span class="blank _1b"></span>32</div><div class="t m0 x1b h29 y2e6 ff6 fs7 fc0 sc0 ls6 ws7">o<span class="blank _3"></span>f <span class="blank _3"></span>A<span class="blank _0"></span>c<span class="blank _3"></span>ti<span class="blank _3"></span>o<span class="blank _0"></span>n<span class="blank _3"></span>, <span class="blank _3"></span>a<span class="blank _0"></span>n<span class="blank _3"></span>d <span class="blank _3"></span>Cl<span class="blank _3"></span>a<span class="blank _3"></span>ss<span class="blank _3"></span>i<span class="blank _0"></span>f<span class="blank _3"></span>ic<span class="blank _3"></span>a<span class="blank _0"></span>t<span class="blank _3"></span>io<span class="blank _3"></span>n<span class="blank _0"></span>.<span class="blank _3"></span> S<span class="blank _3"></span>k<span class="blank _0"></span>i<span class="blank _3"></span>n <span class="blank _3"></span>A<span class="blank _0"></span>p<span class="blank _3"></span>pe<span class="blank _3"></span>n<span class="blank _0"></span>d<span class="blank _3"></span>ag<span class="blank _3"></span>e<span class="blank _0"></span> <span class="blank _3"></span>Di<span class="blank _3"></span>so<span class="blank _3"></span>r<span class="blank _3"></span>d.<span class="blank _3"></span> <span class="blank _0"></span>2<span class="blank _3"></span>01<span class="blank _3"></span>8<span class="blank _0"></span>;<span class="blank _3"></span> 4<span class="blank _3"></span>:<span class="blank _0"></span>1<span class="blank _3"></span>8-<span class="blank _3"></span>2<span class="blank _0"></span>4<span class="blank _3"></span>. </div><div class="t m0 x1b h29 y2e7 ff6 fs7 fc0 sc0 ls6 ws7">B<span class="blank _0"></span>u<span class="blank _0"></span>t<span class="blank _0"></span>t<span class="blank _0"></span> <span class="blank _2"> </span>G,<span class="blank _3"></span> <span class="blank _7"> </span>Hu<span class="blank _3"></span>ss<span class="blank _3"></span>ai<span class="blank _3"></span>n <span class="blank _2"> </span>I,<span class="blank _3"></span> <span class="blank _7"> </span>Ja<span class="blank _3"></span>wa<span class="blank _3"></span>d <span class="blank _2"> </span>Ah<span class="blank _3"></span>me<span class="blank _3"></span>d <span class="blank _2"> </span>F,<span class="blank _3"></span> </div><div class="t m2 x3e h2a y2e8 ffa fsb fc0 sc0 ls6 ws7">e<span class="blank _0"></span>t<span class="blank _0"></span> <span class="blank _2"> </span>al<span class="blank _3"></span>. </div><div class="t m0 x42 h29 y2e8 ff6 fs7 fc0 sc0 ls6 ws7">E<span class="blank _0"></span>f<span class="blank _0"></span>f<span class="blank _0"></span>i<span class="blank _0"></span>c<span class="blank _3"></span>ac<span class="blank _0"></span>y<span class="blank _3"></span> <span class="blank _7"> </span>of<span class="blank _3"></span> <span class="blank _7"> </span>pl<span class="blank _3"></span>at<span class="blank _3"></span>el<span class="blank _3"></span>et<span class="blank _3"></span><span class="ffe ws13">\u2010<span class="ff6 ws7">r<span class="blank _3"></span>ic<span class="blank _3"></span>h <span class="blank _2"> </span>pl<span class="blank _3"></span>as<span class="blank _3"></span>ma<span class="blank _3"></span> <span class="blank _7"> </span>in<span class="blank _1b"></span>3<span class="blank _3"></span>3</span></span></div><div class="t m0 x1b h29 y2e9 ff6 fs7 fc0 sc0 ls6">a</div><div class="t m0 x3c h29 y2ea ff6 fs7 fc0 sc0 ls6 ws7">n<span class="blank _3"></span>dr<span class="blank _3"></span>o<span class="blank _0"></span>g<span class="blank _3"></span>en<span class="blank _3"></span>e<span class="blank _0"></span>t<span class="blank _3"></span>ic<span class="blank _3"></span> <span class="blank _0"></span>a<span class="blank _3"></span>lo<span class="blank _3"></span>p<span class="blank _0"></span>e<span class="blank _3"></span>ci<span class="blank _3"></span>a <span class="blank _3"></span>p<span class="blank _3"></span>at<span class="blank _3"></span>i<span class="blank _0"></span>e<span class="blank _3"></span>nt<span class="blank _3"></span>s<span class="blank _0"></span> <span class="blank _3"></span>J <span class="blank _3"></span>C<span class="blank _0"></span>o<span class="blank _3"></span>sm<span class="blank _3"></span>e<span class="blank _0"></span>t<span class="blank _3"></span> D<span class="blank _3"></span>e<span class="blank _0"></span>r<span class="blank _3"></span>ma<span class="blank _3"></span>t<span class="blank _0"></span>o<span class="blank _3"></span>l.<span class="blank _3"></span> 2<span class="blank _3"></span>0<span class="blank _3"></span>19<span class="blank _3"></span>;<span class="blank _0"></span> <span class="blank _3"></span>18<span class="blank _3"></span>:<span class="blank _0"></span> <span class="blank _3"></span>99<span class="blank _3"></span>6<span class="blank _0"></span>-<span class="blank _3"></span>10<span class="blank _3"></span>0<span class="blank _0"></span>1<span class="blank _3"></span>.</div><div class="t m2 x1b h2a y2eb ffa fsb fc0 sc0 ls6">S</div><div class="t m2 x1e h2a y2ec ffa fsb fc0 sc0 ls6 ws7">t<span class="blank _0"></span>a<span class="blank _0"></span>r<span class="blank _3"></span>ac<span class="blank _3"></span>e <span class="blank _2"> </span>M<span class="blank _3"></span>, <span class="blank _1"> </span>Al<span class="blank _3"></span>es<span class="blank _3"></span>sa<span class="blank _3"></span>nd<span class="blank _3"></span>ri<span class="blank _3"></span>ni<span class="blank _3"></span> <span class="blank _2"> </span>A<span class="blank _0"></span>,<span class="blank _0"></span> <span class="blank _2"> </span>D<span class="blank _3"></span>'A<span class="blank _3"></span>cu<span class="blank _3"></span>nt<span class="blank _3"></span>o <span class="blank _1"> </span>C,<span class="blank _3"></span> <span class="blank _2"> </span>et<span class="blank _3"></span> <span class="blank _2"> </span>a<span class="blank _3"></span>l.</div><div class="t m0 x52 h29 y2eb ff6 fs7 fc0 sc0 ls6">P</div><div class="t m0 x26 h29 y2ec ff6 fs7 fc0 sc0 ls6 ws7">l<span class="blank _0"></span>a<span class="blank _0"></span>t<span class="blank _0"></span>e<span class="blank _0"></span>l<span class="blank _3"></span>et<span class="blank _0"></span>-<span class="blank _3"></span>ri<span class="blank _0"></span>c<span class="blank _3"></span>h <span class="blank _2"> </span>p<span class="blank _3"></span>la<span class="blank _3"></span>sm<span class="blank _3"></span>a <span class="blank _1"> </span>on<span class="blank _3"></span> <span class="blank _2"> </span>fe<span class="blank _3"></span>ma<span class="blank _3"></span>le</div><div class="t m2 x13 h2a y2eb ffa fsb fc0 sc0 ls6">3</div><div class="t m2 x53 h2a y2ec ffa fsb fc0 sc0 ls6">4</div><div class="t m0 x1b h29 y2bf ff6 fs7 fc0 sc0 ls6 ws7">a<span class="blank _3"></span>nd<span class="blank _3"></span>r<span class="blank _0"></span>o<span class="blank _3"></span>ge<span class="blank _3"></span>n<span class="blank _0"></span>e<span class="blank _3"></span>ti<span class="blank _3"></span>c<span class="blank _0"></span> a<span class="blank _3"></span>lo<span class="blank _3"></span>p<span class="blank _0"></span>e<span class="blank _3"></span>ci<span class="blank _3"></span>a<span class="blank _0"></span>:<span class="blank _3"></span> Te<span class="blank _3"></span>s<span class="blank _3"></span>te<span class="blank _3"></span>d<span class="blank _0"></span> o<span class="blank _3"></span>n <span class="blank _0"></span>1<span class="blank _3"></span>0 p<span class="blank _3"></span>a<span class="blank _3"></span>ti<span class="blank _3"></span>en<span class="blank _3"></span>t<span class="blank _3"></span>s.<span class="blank _3"></span> J<span class="blank _3"></span> Co<span class="blank _3"></span>s<span class="blank _0"></span>m<span class="blank _3"></span>et<span class="blank _3"></span> D<span class="blank _3"></span>er<span class="blank _3"></span>m<span class="blank _0"></span>a<span class="blank _3"></span>to<span class="blank _3"></span>l<span class="blank _0"></span>.<span class="blank _3"></span> 20<span class="blank _3"></span>1<span class="blank _3"></span>9;<span class="blank _3"></span> 1<span class="blank _0"></span>8<span class="blank _3"></span>:5<span class="blank _3"></span>9<span class="blank _0"></span>-</div><div class="t m0 x1b h29 y2c0 ff6 fs7 fc0 sc0 ls6 ws12">6<span class="blank _3"></span>4.</div><div class="t m0 x1b h29 y2c1 ff6 fs7 fc0 sc0 ls6 ws7">G<span class="blank _3"></span>en<span class="blank _3"></span>t<span class="blank _0"></span>i<span class="blank _3"></span>le<span class="blank _3"></span> P<span class="blank _3"></span>, <span class="blank _0"></span>G<span class="blank _3"></span>ar<span class="blank _3"></span>c<span class="blank _0"></span>o<span class="blank _3"></span>vi<span class="blank _3"></span>c<span class="blank _0"></span>h<span class="blank _3"></span> S.<span class="blank _3"></span> A<span class="blank _3"></span>u<span class="blank _0"></span>t<span class="blank _3"></span>ol<span class="blank _3"></span>o<span class="blank _0"></span>g<span class="blank _3"></span>ou<span class="blank _3"></span>s<span class="blank _0"></span> a<span class="blank _3"></span>ct<span class="blank _3"></span>i<span class="blank _3"></span>va<span class="blank _3"></span>t<span class="blank _0"></span>e<span class="blank _3"></span>d <span class="blank _0"></span>p<span class="blank _3"></span>la<span class="blank _3"></span>t<span class="blank _0"></span>e<span class="blank _3"></span>le<span class="blank _3"></span>t<span class="blank _0"></span>-<span class="blank _3"></span>ri<span class="blank _3"></span>c<span class="blank _0"></span>h<span class="blank _3"></span> pl<span class="blank _3"></span>a<span class="blank _3"></span>sm<span class="blank _3"></span>a<span class="blank _0"></span> (<span class="blank _3"></span>A<span class="blank _0"></span>A<span class="blank _3"></span>-P<span class="blank _3"></span>R<span class="blank _0"></span>P<span class="blank _3"></span>) a<span class="blank _3"></span>n<span class="blank _3"></span>d<span class="blank _1b"></span>35</div><div class="t m0 x1b h29 y2c2 ff6 fs7 fc0 sc0 ls6">n</div><div class="t m0 x1e h29 y2c3 ff6 fs7 fc0 sc0 ls6 ws7">o<span class="blank _0"></span>n<span class="blank _0"></span>-<span class="blank _0"></span>a<span class="blank _0"></span>c<span class="blank _3"></span>ti<span class="blank _0"></span>v<span class="blank _3"></span>at<span class="blank _0"></span>e<span class="blank _3"></span>d <span class="blank _2"> </span>(A<span class="blank _3"></span>-P<span class="blank _3"></span>RP<span class="blank _3"></span>) <span class="blank _2"> </span>in<span class="blank _3"></span> <span class="blank _7"> </span>h<span class="blank _0"></span>a<span class="blank _0"></span>i<span class="blank _3"></span>r <span class="blank _2"> </span>gr<span class="blank _3"></span>ow<span class="blank _3"></span>th<span class="blank _3"></span>: <span class="blank _2"> </span>a <span class="blank _2"> </span>r<span class="blank _0"></span>e<span class="blank _0"></span>t<span class="blank _3"></span>ro<span class="blank _3"></span>sp<span class="blank _0"></span>e<span class="blank _3"></span>ct<span class="blank _0"></span>i<span class="blank _3"></span>ve<span class="blank _0"></span>,<span class="blank _3"></span> <span class="blank _7"> </span>bl<span class="blank _3"></span>in<span class="blank _3"></span>de<span class="blank _3"></span>d,<span class="blank _3"></span> <span class="blank _7"> </span>ra<span class="blank _3"></span>nd<span class="blank _3"></span>om<span class="blank _3"></span>iz<span class="blank _3"></span>ed</div><div class="t m0 x1b h29 y2c4 ff6 fs7 fc0 sc0 ls6">e</div><div class="t m0 x1e h29 y2c5 ff6 fs7 fc0 sc0 ls6 ws7">v<span class="blank _3"></span>al<span class="blank _3"></span>u<span class="blank _0"></span>a<span class="blank _3"></span>ti<span class="blank _3"></span>o<span class="blank _0"></span>n<span class="blank _3"></span> i<span class="blank _3"></span>n<span class="blank _0"></span> <span class="blank _3"></span>an<span class="blank _3"></span>dr<span class="blank _3"></span>o<span class="blank _3"></span>ge<span class="blank _3"></span>n<span class="blank _0"></span>e<span class="blank _3"></span>ti<span class="blank _3"></span>c<span class="blank _0"></span> <span class="blank _3"></span>al<span class="blank _3"></span>o<span class="blank _0"></span>p<span class="blank _3"></span>ec<span class="blank _3"></span>i<span class="blank _0"></span>a<span class="blank _3"></span>. <span class="blank _3"></span>E<span class="blank _0"></span>x<span class="blank _3"></span>pe<span class="blank _3"></span>r<span class="blank _0"></span>t<span class="blank _3"></span> O<span class="blank _3"></span>p<span class="blank _0"></span>i<span class="blank _3"></span>n <span class="blank _3"></span>B<span class="blank _0"></span>i<span class="blank _3"></span>ol<span class="blank _3"></span> T<span class="blank _3"></span>h<span class="blank _3"></span>er<span class="blank _3"></span>.<span class="blank _0"></span> <span class="blank _3"></span>20<span class="blank _3"></span>2<span class="blank _0"></span>0<span class="blank _3"></span>; <span class="blank _3"></span>2<span class="blank _0"></span>0<span class="blank _3"></span>:3<span class="blank _3"></span>2<span class="blank _0"></span>7<span class="blank _3"></span>-3<span class="blank _3"></span>3<span class="blank _0"></span>7<span class="blank _3"></span>.</div><div class="t m0 x1b h29 y2c6 ff6 fs7 fc0 sc0 ls6">A</div><div class="t m0 x1e h29 y2c7 ff6 fs7 fc0 sc0 ls6 ws7">b<span class="blank _3"></span>da<span class="blank _3"></span>l<span class="blank _3"></span>la<span class="blank _3"></span>h<span class="blank _3"></span> <span class="blank _3"></span>MA<span class="blank _3"></span>,<span class="blank _3"></span> <span class="blank _3"></span>E<span class="blank _0"></span>l<span class="blank _3"></span>-Z<span class="blank _3"></span>a<span class="blank _3"></span>wa<span class="blank _3"></span>h<span class="blank _3"></span>ry<span class="blank _3"></span> <span class="blank _3"></span>K<span class="blank _3"></span>A,<span class="blank _3"></span> <span class="blank _1c"></span>Be<span class="blank _3"></span>s<span class="blank _3"></span>ar<span class="blank _3"></span> <span class="blank _3"></span>H<span class="blank _3"></span>. <span class="blank _1c"></span>M<span class="blank _3"></span>es<span class="blank _3"></span>o<span class="blank _3"></span>th<span class="blank _3"></span>e<span class="blank _3"></span>ra<span class="blank _3"></span>p<span class="blank _3"></span>y <span class="blank _1c"></span>u<span class="blank _0"></span>s<span class="blank _3"></span>in<span class="blank _3"></span>g<span class="blank _3"></span> <span class="blank _3"></span>du<span class="blank _1c"></span>ta<span class="blank _3"></span>s<span class="blank _0"></span>t<span class="blank _3"></span>er<span class="blank _3"></span>i<span class="blank _3"></span>de<span class="blank _3"></span> <span class="blank _1c"></span>co<span class="blank _3"></span>n<span class="blank _3"></span>ta<span class="blank _3"></span>i<span class="blank _3"></span>ni<span class="blank _3"></span>n<span class="blank _0"></span>g<span class="blank _1b"></span>3<span class="blank _3"></span>6</div><div class="t m0 x1b h29 y2c8 ff6 fs7 fc0 sc0 ls6 ws7">s<span class="blank _0"></span>o<span class="blank _0"></span>l<span class="blank _0"></span>u<span class="blank _0"></span>t<span class="blank _0"></span>i<span class="blank _3"></span>on<span class="blank _3"></span> <span class="blank _7"> </span>i<span class="blank _0"></span>n<span class="blank _0"></span> <span class="blank _2"> </span>m<span class="blank _0"></span>a<span class="blank _0"></span>l<span class="blank _0"></span>e<span class="blank _0"></span> <span class="blank _2"> </span>p<span class="blank _0"></span>a<span class="blank _0"></span>t<span class="blank _0"></span>t<span class="blank _0"></span>e<span class="blank _3"></span>rn<span class="blank _0"></span> <span class="blank _2"> </span>h<span class="blank _0"></span>a<span class="blank _0"></span>i<span class="blank _0"></span>r<span class="blank _3"></span> <span class="blank _7"> </span>l<span class="blank _0"></span>o<span class="blank _0"></span>s<span class="blank _0"></span>s<span class="blank _3"></span>: <span class="blank _2"> </span>A<span class="blank _0"></span>c<span class="blank _0"></span>o<span class="blank _0"></span>n<span class="blank _0"></span> <span class="blank _2"> </span>t<span class="blank _0"></span>r<span class="blank _0"></span>o<span class="blank _0"></span>l<span class="blank _0"></span>l<span class="blank _3"></span>ed<span class="blank _3"></span> <span class="blank _7"> </span>p<span class="blank _0"></span>i<span class="blank _0"></span>l<span class="blank _0"></span>o<span class="blank _3"></span>t <span class="blank _2"> </span>s<span class="blank _0"></span>t<span class="blank _0"></span>u<span class="blank _0"></span>d<span class="blank _0"></span>y<span class="blank _0"></span>.<span class="blank _3"></span>J <span class="blank _2"> </span>P<span class="blank _0"></span>a<span class="blank _0"></span>n<span class="blank _0"></span> <span class="blank _2"> </span>A<span class="blank _0"></span>r<span class="blank _0"></span>a<span class="blank _0"></span>b<span class="blank _0"></span> <span class="blank _2"> </span>L<span class="blank _0"></span>e<span class="blank _0"></span>a<span class="blank _0"></span>g</div><div class="t m0 x1b h29 y2c9 ff6 fs7 fc0 sc0 ls6 ws12">D<span class="blank _3"></span>er<span class="blank _3"></span>m<span class="blank _0"></span>a<span class="blank _3"></span>to<span class="blank _3"></span>l<span class="blank _0"></span>.<span class="blank _3"></span>20<span class="blank _3"></span>09<span class="blank _3"></span>;<span class="blank _3"></span>20<span class="blank _3"></span>:<span class="blank _0"></span>1<span class="blank _3"></span>37<span class="blank _3"></span>.</div><div class="t m0 x1b h29 y2ca ff6 fs7 fc0 sc0 ls6 ws7">M<span class="blank _0"></span>o<span class="blank _0"></span>f<span class="blank _0"></span>t<span class="blank _0"></span>a<span class="blank _3"></span>h <span class="blank _6"> </span>N,<span class="blank _3"></span> <span class="blank _6"> </span>Mo<span class="blank _3"></span>ft<span class="blank _3"></span>ah<span class="blank _3"></span> <span class="blank _6"> </span>N,<span class="blank _3"></span> <span class="blank _d"> </span>A<span class="blank _0"></span>b<span class="blank _0"></span>d<span class="blank _0"></span>-<span class="blank _0"></span>E<span class="blank _0"></span>l<span class="blank _3"></span>az<span class="blank _0"></span>i<span class="blank _3"></span>z <span class="blank _6"> </span>G,<span class="blank _3"></span> </div><div class="t m2 x18 h2a y2ed ffa fsb fc0 sc0 ls6 ws7">e<span class="blank _0"></span>t<span class="blank _0"></span> <span class="blank _6"> </span>al<span class="blank _3"></span>. </div><div class="t m0 x54 h29 y2ed ff6 fs7 fc0 sc0 ls6 ws7">M<span class="blank _0"></span>e<span class="blank _0"></span>s<span class="blank _0"></span>o<span class="blank _0"></span>t<span class="blank _3"></span>he<span class="blank _0"></span>r<span class="blank _3"></span>ap<span class="blank _0"></span>y<span class="blank _3"></span> <span class="blank _d"> </span>us<span class="blank _3"></span>in<span class="blank _3"></span>g <span class="blank _7"> </span>du<span class="blank _3"></span>ta<span class="blank _3"></span>st<span class="blank _3"></span>er<span class="blank _3"></span>id<span class="blank _3"></span>e<span class="blank _1b"></span>37</div><div class="t m0 x1b h29 y2ee ff6 fs7 fc0 sc0 ls6 ws7">c<span class="blank _0"></span>o<span class="blank _0"></span>n<span class="blank _0"></span>t<span class="blank _0"></span>a<span class="blank _3"></span>in<span class="blank _0"></span>i<span class="blank _3"></span>ng<span class="blank _0"></span> <span class="blank _f"> </span>pr<span class="blank _3"></span>ep<span class="blank _3"></span>ar<span class="blank _3"></span>at<span class="blank _3"></span>io<span class="blank _3"></span>n <span class="blank _f"> </span>i<span class="blank _0"></span>n<span class="blank _0"></span> <span class="blank _f"> </span>tr<span class="blank _3"></span>ea<span class="blank _3"></span>tm<span class="blank _3"></span>en<span class="blank _3"></span>to<span class="blank _3"></span> <span class="blank _19"> </span>fe<span class="blank _3"></span>ma<span class="blank _3"></span>le<span class="blank _3"></span> <span class="blank _f"> </span>pa<span class="blank _3"></span>tt<span class="blank _0"></span>e<span class="blank _3"></span>rn<span class="blank _3"></span> <span class="blank _19"> </span>ha<span class="blank _3"></span>ir<span class="blank _3"></span> <span class="blank _19"> </span>lo<span class="blank _3"></span>ss<span class="blank _3"></span>:</div><div class="t m0 x1b h29 y2ef ff6 fs7 fc0 sc0 ls6">P</div><div class="t m0 x1e h29 y2f0 ff6 fs7 fc0 sc0 ls6 ws7">h<span class="blank _3"></span>ot<span class="blank _3"></span>o<span class="blank _0"></span>g<span class="blank _3"></span>ra<span class="blank _3"></span>p<span class="blank _0"></span>h<span class="blank _3"></span>ic<span class="blank _3"></span>,<span class="blank _0"></span>m<span class="blank _3"></span>or<span class="blank _3"></span>p<span class="blank _0"></span>h<span class="blank _3"></span>om<span class="blank _3"></span>et<span class="blank _3"></span>r<span class="blank _3"></span>ic<span class="blank _3"></span> <span class="blank _3"></span>an<span class="blank _3"></span>d<span class="blank _0"></span> <span class="blank _3"></span>u<span class="blank _0"></span>l<span class="blank _3"></span>tr<span class="blank _3"></span>a<span class="blank _0"></span>s<span class="blank _3"></span>tr<span class="blank _3"></span>u<span class="blank _0"></span>c<span class="blank _3"></span>tu<span class="blank _3"></span>r<span class="blank _0"></span>a<span class="blank _3"></span>l <span class="blank _3"></span>e<span class="blank _3"></span>va<span class="blank _3"></span>l<span class="blank _0"></span>u<span class="blank _3"></span>at<span class="blank _3"></span>i<span class="blank _0"></span>o<span class="blank _3"></span>n.<span class="blank _3"></span> <span class="blank _3"></span>J <span class="blank _1c"></span>Eu<span class="blank _3"></span>r<span class="blank _0"></span> <span class="blank _3"></span>Ac<span class="blank _3"></span>a<span class="blank _3"></span>d <span class="blank _1c"></span>De<span class="blank _3"></span>rm<span class="blank _3"></span>a<span class="blank _3"></span>to<span class="blank _3"></span>l</div><div class="t m0 x1b h29 y2f1 ff6 fs7 fc0 sc0 ls6">V</div><div class="t m0 x1e h29 y2f2 ff6 fs7 fc0 sc0 ls6 ws12">e<span class="blank _3"></span>ne<span class="blank _3"></span>r<span class="blank _0"></span>e<span class="blank _3"></span>ol<span class="blank _3"></span>.<span class="blank _0"></span>2<span class="blank _3"></span>01<span class="blank _3"></span>3<span class="blank _0"></span>;<span class="blank _3"></span>27<span class="blank _3"></span>:6<span class="blank _3"></span>8<span class="blank _3"></span>6.</div><div class="t m0 x1b h29 y2f3 ff6 fs7 fc0 sc0 ls6">R</div><div class="t m0 x1e h29 y2f4 ff6 fs7 fc0 sc0 ls6 ws7">e<span class="blank _3"></span>gu<span class="blank _3"></span>e<span class="blank _0"></span>r<span class="blank _3"></span>o-<span class="blank _3"></span>D<span class="blank _0"></span>e<span class="blank _3"></span>l <span class="blank _1c"></span>Cu<span class="blank _3"></span>r<span class="blank _0"></span>a<span class="blank _3"></span> <span class="blank _0"></span>L<span class="blank _3"></span>, <span class="blank _1c"></span>Du<span class="blank _3"></span>r<span class="blank _0"></span>á<span class="blank _3"></span>n-<span class="blank _3"></span>V<span class="blank _0"></span>i<span class="blank _3"></span>an<span class="blank _3"></span> <span class="blank _3"></span>C,<span class="blank _3"></span> <span class="blank _3"></span>D<span class="blank _0"></span>e<span class="blank _3"></span> <span class="blank _0"></span>Q<span class="blank _3"></span>ui<span class="blank _3"></span>n<span class="blank _0"></span>t<span class="blank _3"></span>an<span class="blank _3"></span>a<span class="blank _0"></span>-<span class="blank _3"></span>Sa<span class="blank _3"></span>n<span class="blank _0"></span>c<span class="blank _3"></span>ho<span class="blank _3"></span> <span class="blank _3"></span>A.<span class="blank _3"></span> <span class="blank _3"></span>F<span class="blank _0"></span>R<span class="blank _3"></span>-M<span class="blank _3"></span>e<span class="blank _0"></span>s<span class="blank _3"></span>ot<span class="blank _3"></span>e<span class="blank _0"></span>r<span class="blank _3"></span>ap<span class="blank _3"></span>i<span class="blank _0"></span>a<span class="blank _3"></span> <span class="blank _0"></span>c<span class="blank _3"></span>on<span class="blank _1b"></span>3<span class="blank _3"></span>8</div><div class="t m0 x1b h29 y2f5 ff6 fs7 fc0 sc0 ls6">d</div><div class="t m0 x1e h29 y2f6 ff6 fs7 fc0 sc0 ls6 ws7">u<span class="blank _3"></span>ta<span class="blank _3"></span>s<span class="blank _0"></span>t<span class="blank _3"></span>er<span class="blank _3"></span>i<span class="blank _3"></span>da<span class="blank _3"></span>,<span class="blank _0"></span> <span class="blank _1c"></span>un<span class="blank _3"></span>a<span class="blank _0"></span> <span class="blank _1c"></span>fu<span class="blank _3"></span>t<span class="blank _3"></span>ur<span class="blank _3"></span>a<span class="blank _0"></span> <span class="blank _1c"></span>al<span class="blank _3"></span>t<span class="blank _0"></span>e<span class="blank _3"></span>rn<span class="blank _3"></span>a<span class="blank _3"></span>ti<span class="blank _3"></span>v<span class="blank _0"></span>a<span class="blank _3"></span> <span class="blank _3"></span>pa<span class="blank _3"></span>r<span class="blank _3"></span>a <span class="blank _1c"></span>e<span class="blank _0"></span>l<span class="blank _3"></span> <span class="blank _3"></span>tr<span class="blank _3"></span>a<span class="blank _3"></span>ta<span class="blank _3"></span>m<span class="blank _3"></span>ie<span class="blank _3"></span>n<span class="blank _0"></span>t<span class="blank _3"></span>o <span class="blank _1c"></span>d<span class="blank _0"></span>e<span class="blank _3"></span> <span class="blank _3"></span>l<span class="blank _0"></span>a<span class="blank _3"></span> <span class="blank _3"></span>al<span class="blank _3"></span>o<span class="blank _3"></span>pe<span class="blank _3"></span>c<span class="blank _0"></span>i<span class="blank _3"></span>a <span class="blank _1c"></span>a<span class="blank _0"></span>n<span class="blank _3"></span>dr<span class="blank _3"></span>o<span class="blank _3"></span>gé<span class="blank _3"></span>n<span class="blank _0"></span>i<span class="blank _3"></span>ca</div><div class="t m0 x1b h29 y2f7 ff6 fs7 fc0 sc0 ls6">A</div><div class="t m0 x1e h29 y2f8 ff6 fs7 fc0 sc0 ls6 ws7">c<span class="blank _3"></span>ta<span class="blank _3"></span>s<span class="blank _0"></span> <span class="blank _3"></span>De<span class="blank _3"></span>r<span class="blank _0"></span>m<span class="blank _3"></span>os<span class="blank _3"></span>if<span class="blank _3"></span>i<span class="blank _3"></span>li<span class="blank _3"></span>o<span class="blank _0"></span>g<span class="blank _3"></span>r.<span class="blank _3"></span> <span class="blank _0"></span>2<span class="blank _3"></span>02<span class="blank _3"></span>0<span class="blank _0"></span>;<span class="blank _3"></span> 1<span class="blank _3"></span>1<span class="blank _0"></span>1<span class="blank _3"></span>: <span class="blank _3"></span>4<span class="blank _0"></span>1<span class="blank _3"></span>9-<span class="blank _3"></span>4<span class="blank _0"></span>2<span class="blank _3"></span>0.</div><div class="t m0 x1b h29 y2f9 ff6 fs7 fc0 sc0 ls6">S</div><div class="t m0 x1e h29 y2fa ff6 fs7 fc0 sc0 ls6 ws7">a<span class="blank _3"></span>ce<span class="blank _3"></span>d<span class="blank _0"></span>a<span class="blank _3"></span>-C<span class="blank _3"></span>o<span class="blank _0"></span>r<span class="blank _3"></span>ra<span class="blank _3"></span>l<span class="blank _0"></span>o<span class="blank _3"></span> <span class="blank _0"></span>D<span class="blank _3"></span>, <span class="blank _1c"></span>Ro<span class="blank _3"></span>d<span class="blank _0"></span>r<span class="blank _3"></span>ig<span class="blank _3"></span>u<span class="blank _0"></span>e<span class="blank _3"></span>s-<span class="blank _3"></span>B<span class="blank _0"></span>a<span class="blank _3"></span>ra<span class="blank _3"></span>t<span class="blank _0"></span>a<span class="blank _3"></span> <span class="blank _0"></span>A<span class="blank _3"></span>R,<span class="blank _3"></span> <span class="blank _3"></span>Va<span class="blank _3"></span>ñ<span class="blank _3"></span>ó-<span class="blank _3"></span>G<span class="blank _0"></span>a<span class="blank _3"></span>lv<span class="blank _3"></span>á<span class="blank _0"></span>n<span class="blank _3"></span> <span class="blank _0"></span>S<span class="blank _3"></span>, </div><div class="t m2 x55 h2a y2fb ffa fsb fc0 sc0 ls6">e</div><div class="t m2 x56 h2a y2fc ffa fsb fc0 sc0 ls6 ws7">t<span class="blank _3"></span> <span class="blank _0"></span>a<span class="blank _3"></span>l.<span class="blank _3"></span> </div><div class="t m0 x57 h29 y2fb ff6 fs7 fc0 sc0 ls6">M</div><div class="t m0 x58 h29 y2fc ff6 fs7 fc0 sc0 ls6 ws7">e<span class="blank _3"></span>so<span class="blank _3"></span>t<span class="blank _0"></span>h<span class="blank _3"></span>er<span class="blank _3"></span>a<span class="blank _0"></span>p<span class="blank _3"></span>y <span class="blank _1c"></span>wi<span class="blank _3"></span>t<span class="blank _0"></span>h<span class="blank _1b"></span>3<span class="blank _3"></span>9</div><div class="t m0 x1b h29 y2fd ff6 fs7 fc0 sc0 ls6">D</div><div class="t m0 x3d h29 y2fe ff6 fs7 fc0 sc0 ls6 ws7">u<span class="blank _3"></span>ta<span class="blank _3"></span>st<span class="blank _3"></span>e<span class="blank _3"></span>ri<span class="blank _3"></span>de<span class="blank _3"></span> in<span class="blank _3"></span> th<span class="blank _3"></span>e<span class="blank _3"></span> <span class="blank _1"> </span>Tr<span class="blank _3"></span>e<span class="blank _3"></span>at<span class="blank _3"></span>m<span class="blank _0"></span>e<span class="blank _3"></span>nt<span class="blank _3"></span> of<span class="blank _3"></span> <span class="blank _1"> </span>A<span class="blank _3"></span>nd<span class="blank _3"></span>ro<span class="blank _3"></span>g<span class="blank _3"></span>en<span class="blank _3"></span>e<span class="blank _0"></span>t<span class="blank _3"></span>ic<span class="blank _3"></span> <span class="blank _1"> </span>A<span class="blank _3"></span>lo<span class="blank _3"></span>pe<span class="blank _3"></span>c<span class="blank _3"></span>ia<span class="blank _3"></span>.<span class="blank _0"></span> In<span class="blank _3"></span>t<span class="blank _0"></span> J<span class="blank _0"></span> Tr<span class="blank _3"></span>i<span class="blank _3"></span>ch<span class="blank _3"></span>ol<span class="blank _3"></span>o<span class="blank _3"></span>gy<span class="blank _3"></span>. 2<span class="blank _3"></span>01<span class="blank _3"></span>7<span class="blank _3"></span>;</div><div class="t m0 x1b h29 y2ff ff6 fs7 fc0 sc0 ls6 ws12">9<span class="blank _3"></span>:1<span class="blank _3"></span>4<span class="blank _0"></span>3<span class="blank _3"></span>-1<span class="blank _3"></span>4<span class="blank _0"></span>5<span class="blank _3"></span>.</div><div class="t m0 x1b h29 y300 ff6 fs7 fc0 sc0 ls6 ws7">S<span class="blank _3"></span>ta<span class="blank _3"></span>r<span class="blank _0"></span>a<span class="blank _3"></span>ce<span class="blank _3"></span> M<span class="blank _3"></span>, A<span class="blank _3"></span>l<span class="blank _3"></span>es<span class="blank _3"></span>s<span class="blank _0"></span>a<span class="blank _3"></span>nd<span class="blank _3"></span>r<span class="blank _0"></span>i<span class="blank _3"></span>ni<span class="blank _3"></span> A<span class="blank _3"></span>, B<span class="blank _3"></span>r<span class="blank _3"></span>an<span class="blank _3"></span>d<span class="blank _0"></span>i<span class="blank _3"></span> N,<span class="blank _3"></span> </div><div class="t m2 x39 h2a y2e2 ffa fsb fc0 sc0 ls6 ws7">e<span class="blank _3"></span>t a<span class="blank _3"></span>l<span class="blank _3"></span>. </div><div class="t m0 x59 h29 y2e2 ff6 fs7 fc0 sc0 ls6 ws7">P<span class="blank _3"></span>re<span class="blank _3"></span>l<span class="blank _0"></span>i<span class="blank _3"></span>mi<span class="blank _3"></span>n<span class="blank _0"></span>a<span class="blank _3"></span>ry<span class="blank _3"></span> r<span class="blank _3"></span>es<span class="blank _3"></span>u<span class="blank _0"></span>l<span class="blank _3"></span>ts<span class="blank _3"></span> o<span class="blank _3"></span>f t<span class="blank _3"></span>h<span class="blank _3"></span>e u<span class="blank _3"></span>s<span class="blank _3"></span>e o<span class="blank _3"></span>f<span class="blank _3"></span> sc<span class="blank _3"></span>a<span class="blank _3"></span>lp<span class="blank _1b"></span>4<span class="blank _3"></span>0</div><div class="t m0 x1b h29 y2e3 ff6 fs7 fc0 sc0 ls6 ws7">m<span class="blank _3"></span>ic<span class="blank _3"></span>r<span class="blank _0"></span>o<span class="blank _3"></span>ne<span class="blank _3"></span>e<span class="blank _0"></span>d<span class="blank _3"></span>li<span class="blank _3"></span>ng<span class="blank _3"></span> i<span class="blank _3"></span>n d<span class="blank _3"></span>i<span class="blank _0"></span>f<span class="blank _3"></span>fe<span class="blank _3"></span>r<span class="blank _0"></span>e<span class="blank _3"></span>nt<span class="blank _3"></span> t<span class="blank _0"></span>y<span class="blank _3"></span>pe<span class="blank _3"></span>s<span class="blank _0"></span> o<span class="blank _3"></span>f a<span class="blank _3"></span>l<span class="blank _0"></span>o<span class="blank _3"></span>pe<span class="blank _3"></span>c<span class="blank _0"></span>i<span class="blank _3"></span>a.<span class="blank _3"></span> J<span class="blank _0"></span> C<span class="blank _3"></span>os<span class="blank _3"></span>me<span class="blank _3"></span>t<span class="blank _3"></span> De<span class="blank _3"></span>r<span class="blank _0"></span>m<span class="blank _3"></span>at<span class="blank _3"></span>o<span class="blank _0"></span>l<span class="blank _3"></span>. 2<span class="blank _3"></span>0<span class="blank _0"></span>2<span class="blank _3"></span>0;<span class="blank _3"></span> 1<span class="blank _0"></span>9<span class="blank _3"></span>:6<span class="blank _3"></span>4<span class="blank _0"></span>6<span class="blank _3"></span>-</div><div class="t m0 x1b h29 y2e4 ff6 fs7 fc0 sc0 ls6 ws12">6<span class="blank _3"></span>50<span class="blank _3"></span>.</div></div><div class="pi" data-data="{"ctm":[1.000000,0.000000,0.000000,1.000000,0.000000,0.000000]}"></div></div>
