J. Vilaplana, M. Alsina, J. Coll, J. Reig, G. Campos, C. Trullás, C. Pelejero, M. Recasens, D. Costa, C. Romaguera
Propylene glycol (PG) has been described as responsible for contact allergy and irritant reactions, but there are a lot of non-conclusive studies reporting a different percentage of patients irritated, with diverse concentrations and doses applied. As this substance is contained in a large amount of products, we reviewed its irritant capacity and the appropriate concentration to be tested. PG from two different origins was tested in 230 healthy volunteers. We applied 25 µl of PG at two different concentrations (70 and 100%). PG from origin B (PGB) was tested furthermore with two different qualities. Biophysical measurements were performed in those subjects patch-tested with PGB and its acute dermal irritation was tested in human skin culture. After 48 h results did not show any difference between PG from both origins and qualities. After 96 h PGB was slightly more irritant than PGA. Biophysical measurements only increased significantly in the subjects with a positive allergic reaction and there were no differences in the in vitro test. PG is not valid as pattern of irritation even at 100% concentration because it irritates a small percentage of patients. The recommended concentration should be between 30 and 70% in water, and the 100% concentration could be used in non-reactive patients.
{"title":"Propylene Glycol Today","authors":"J. Vilaplana, M. Alsina, J. Coll, J. Reig, G. Campos, C. Trullás, C. Pelejero, M. Recasens, D. Costa, C. Romaguera","doi":"10.1159/000092606","DOIUrl":"https://doi.org/10.1159/000092606","url":null,"abstract":"Propylene glycol (PG) has been described as responsible for contact allergy and irritant reactions, but there are a lot of non-conclusive studies reporting a different percentage of patients irritated, with diverse concentrations and doses applied. As this substance is contained in a large amount of products, we reviewed its irritant capacity and the appropriate concentration to be tested. PG from two different origins was tested in 230 healthy volunteers. We applied 25 µl of PG at two different concentrations (70 and 100%). PG from origin B (PGB) was tested furthermore with two different qualities. Biophysical measurements were performed in those subjects patch-tested with PGB and its acute dermal irritation was tested in human skin culture. After 48 h results did not show any difference between PG from both origins and qualities. After 96 h PGB was slightly more irritant than PGA. Biophysical measurements only increased significantly in the subjects with a positive allergic reaction and there were no differences in the in vitro test. PG is not valid as pattern of irritation even at 100% concentration because it irritates a small percentage of patients. The recommended concentration should be between 30 and 70% in water, and the 100% concentration could be used in non-reactive patients.","PeriodicalId":12086,"journal":{"name":"Exogenous Dermatology","volume":"242 1","pages":"313 - 317"},"PeriodicalIF":0.0,"publicationDate":"2004-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80509920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Long-standing tradition (and standard textbooks) suggest that separating irritation and allergic contact dermatitis (and their biologies) is straightforward. This overview examines this dogma, stressing that the similarities (at least in the efferent limbs) may be as great as the mechanistic differences.
{"title":"Immunologic Patterns in Allergic and Irritant Contact Dermatitis: Similarities","authors":"E. Dika, Nara Branco, H. Maibach","doi":"10.1159/000087149","DOIUrl":"https://doi.org/10.1159/000087149","url":null,"abstract":"Long-standing tradition (and standard textbooks) suggest that separating irritation and allergic contact dermatitis (and their biologies) is straightforward. This overview examines this dogma, stressing that the similarities (at least in the efferent limbs) may be as great as the mechanistic differences.","PeriodicalId":12086,"journal":{"name":"Exogenous Dermatology","volume":"31 1","pages":"113 - 120"},"PeriodicalIF":0.0,"publicationDate":"2004-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84851494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Pirot, F. Falson, C. Pailler-Mattéi, H. Maibach
Water and osmolyte homeostasis is an essential biological function. Remarkably devoid of aquaporin (i.e., water channel protein) expression, the stratumcorneumavoids a substantial transepidermal water loss, compulsory for the adaptation to terrestrial life. In spite of its heterogeneity, the stratum corneumexhibits a homogeneous water transport, whereas highly osmotic endogenous materials control its water-holding capacity and skin’s physical properties (e.g., stiffness, firmness, flexibility) under various conditions. However, the contingent interplay between water homeostasis of the stratum corneumand an exogenous osmotic stress has been not reported, although constituting a cornerstone of skin physiology. Here, we show that an osmotic shock reinforces the endogenous stratum corneumosmolality proportionally to the osmotic pressure exerted against it and, therefore, reduces the magnitude of outward water transfer and net evaporation. The strengthening of endogenous osmolality enhanced the water-holding capacity of the stratum corneum with respect to chemical potentials. This property was found for organic osmolytes, but questioned for mineral electrolytes characterized by minimal stratum corneumpermeability. Besides, straightforward experiments performed using a built-in house osmometer, a so-called ‘corneosmometer’, have confirmed water transfer through the stratum corneumsubmitted to a gradient of osmotic pressure. Thus, the ambivalent function of the stratum corneum, which firstly behaves as an ideal osmometer and secondly adapts its own osmolality to an exogenous gradient of osmotic pressure, has been clearly demonstrated. This duality influences the water-holding capacity of the stratum corneum, by regulating the water transfer proportionally to an initial osmotic stress, and, finally, conditions the further capacity of the stratum corneumto facilitate or impede skin hydration.
{"title":"Stratum Corneum: An Ideal Osmometer?","authors":"F. Pirot, F. Falson, C. Pailler-Mattéi, H. Maibach","doi":"10.1159/000093798","DOIUrl":"https://doi.org/10.1159/000093798","url":null,"abstract":"Water and osmolyte homeostasis is an essential biological function. Remarkably devoid of aquaporin (i.e., water channel protein) expression, the stratumcorneumavoids a substantial transepidermal water loss, compulsory for the adaptation to terrestrial life. In spite of its heterogeneity, the stratum corneumexhibits a homogeneous water transport, whereas highly osmotic endogenous materials control its water-holding capacity and skin’s physical properties (e.g., stiffness, firmness, flexibility) under various conditions. However, the contingent interplay between water homeostasis of the stratum corneumand an exogenous osmotic stress has been not reported, although constituting a cornerstone of skin physiology. Here, we show that an osmotic shock reinforces the endogenous stratum corneumosmolality proportionally to the osmotic pressure exerted against it and, therefore, reduces the magnitude of outward water transfer and net evaporation. The strengthening of endogenous osmolality enhanced the water-holding capacity of the stratum corneum with respect to chemical potentials. This property was found for organic osmolytes, but questioned for mineral electrolytes characterized by minimal stratum corneumpermeability. Besides, straightforward experiments performed using a built-in house osmometer, a so-called ‘corneosmometer’, have confirmed water transfer through the stratum corneumsubmitted to a gradient of osmotic pressure. Thus, the ambivalent function of the stratum corneum, which firstly behaves as an ideal osmometer and secondly adapts its own osmolality to an exogenous gradient of osmotic pressure, has been clearly demonstrated. This duality influences the water-holding capacity of the stratum corneum, by regulating the water transfer proportionally to an initial osmotic stress, and, finally, conditions the further capacity of the stratum corneumto facilitate or impede skin hydration.","PeriodicalId":12086,"journal":{"name":"Exogenous Dermatology","volume":"111 1","pages":"339 - 349"},"PeriodicalIF":0.0,"publicationDate":"2004-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78055475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Pirot, Bénédicte Morel, G. Peyrot, Tiphaine Vuillet, V. Faivre, Christine Bodeau, F. Falson
The stratum corneum (SC) is characterized by highly hydrophilic compounds exhibiting osmotic properties. The role of osmosis in iontophoretic transdermal drug delivery has been a subject in numerous studies. However, the effects of osmosis on the water-holding capacity (WHC) of SC and skin hydration need to be clarified. In the present study, the WHC and skin hydration were found to be correlated with osmotic pressure and the SC permeability of osmolytes. The WHC and skin hydration enhancement were related to the increase in SC osmolality. A mathematical model was proposed to predict the WHC and skin hydration from physicochemical parameters of compounds.
{"title":"Effects of Osmosis on Water-Holding Capacity of Stratum corneum and Skin Hydration","authors":"F. Pirot, Bénédicte Morel, G. Peyrot, Tiphaine Vuillet, V. Faivre, Christine Bodeau, F. Falson","doi":"10.1159/000078693","DOIUrl":"https://doi.org/10.1159/000078693","url":null,"abstract":"The stratum corneum (SC) is characterized by highly hydrophilic compounds exhibiting osmotic properties. The role of osmosis in iontophoretic transdermal drug delivery has been a subject in numerous studies. However, the effects of osmosis on the water-holding capacity (WHC) of SC and skin hydration need to be clarified. In the present study, the WHC and skin hydration were found to be correlated with osmotic pressure and the SC permeability of osmolytes. The WHC and skin hydration enhancement were related to the increase in SC osmolality. A mathematical model was proposed to predict the WHC and skin hydration from physicochemical parameters of compounds.","PeriodicalId":12086,"journal":{"name":"Exogenous Dermatology","volume":"21 1","pages":"252 - 257"},"PeriodicalIF":0.0,"publicationDate":"2004-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74084723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Routine patch testing is usually performed with 2-day occlusion. Yet, shortening the application period, without diminishing diagnostic accuracy, would benefit patients. Previous studies document that differences in application time may produce variable results. Objective: Our objective was to determine whether 1-day application elicits similar results to 2-day application in diagnostic patch testing. Methods: Simultaneous duplicate patch test series were applied to the opposite sides of the upper back on 250 consecutive patients, using the TRUE test system. One set of allergens was removed after 24 and the other after 48 h. Results: A total of 221 positive reactions were observed either after 24 or 48 h of occlusion in 113 (46%) patients. Of these, 190 were concordant, i.e. positive, after 24 and 48 h of occlusion, and 31 were discordant. Twenty-nine of the discordant reactions were observed only after 48 h of occlusion and 2 only after 24 h of occlusion. Of the 27 (19%) patients with discordant patch test reactions, the allergen was deemed to be of definite present or past relevance in 16 (6% of the total and 14% of all patients with positive reactions). Conclusion: These data confirm that the overall concordance of results after 24 and 48 h of application is high. However, clinically relevant allergens would have been missed in 16 patients if only the 24-hour occlusion test was performed. In the light of these results, we consider that the standard 48-hour application remains appropriate for diagnostic patch testing.
{"title":"24-Hour versus 48-Hour Occlusion in Patch Testing","authors":"S. Ale, H. Maibach","doi":"10.1159/000078696","DOIUrl":"https://doi.org/10.1159/000078696","url":null,"abstract":"Background: Routine patch testing is usually performed with 2-day occlusion. Yet, shortening the application period, without diminishing diagnostic accuracy, would benefit patients. Previous studies document that differences in application time may produce variable results. Objective: Our objective was to determine whether 1-day application elicits similar results to 2-day application in diagnostic patch testing. Methods: Simultaneous duplicate patch test series were applied to the opposite sides of the upper back on 250 consecutive patients, using the TRUE test system. One set of allergens was removed after 24 and the other after 48 h. Results: A total of 221 positive reactions were observed either after 24 or 48 h of occlusion in 113 (46%) patients. Of these, 190 were concordant, i.e. positive, after 24 and 48 h of occlusion, and 31 were discordant. Twenty-nine of the discordant reactions were observed only after 48 h of occlusion and 2 only after 24 h of occlusion. Of the 27 (19%) patients with discordant patch test reactions, the allergen was deemed to be of definite present or past relevance in 16 (6% of the total and 14% of all patients with positive reactions). Conclusion: These data confirm that the overall concordance of results after 24 and 48 h of application is high. However, clinically relevant allergens would have been missed in 16 patients if only the 24-hour occlusion test was performed. In the light of these results, we consider that the standard 48-hour application remains appropriate for diagnostic patch testing.","PeriodicalId":12086,"journal":{"name":"Exogenous Dermatology","volume":"47 1","pages":"270 - 276"},"PeriodicalIF":0.0,"publicationDate":"2004-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84739176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Copper and its alloys are subject to chemical reactions on exposure to environmental or physiological factors, whereby products are potentially generated which become diffusible through mammalian skin. The chemistry of oxidation is reviewed as well as the factors contributing to corrosion. Skin exudates (sweat and sebum) can react with metal surfaces they come in contact with, but even in the healthy organism their composition is variable, as a function of physical, pharmacological and environmental conditions, gender, age, sweat rate or body site. This overview addresses sweat and sebum composition, and discusses components which determine the skin’s corrosive action: chloride ion, low-molecular-weight acids and amino acids in sweat, and fatty acids in sebum, which hold the potential to solubilize copper-containing metal objects. These components can form copper salts and soaps whose molecular characteristics (size and polarity) will determine the rate and route of cutaneous penetration.
{"title":"Corrosion Chemistry of Copper: Formation of Potentially Skin-Diffusible Compounds","authors":"J. Hostynek,","doi":"10.1159/000091906","DOIUrl":"https://doi.org/10.1159/000091906","url":null,"abstract":"Copper and its alloys are subject to chemical reactions on exposure to environmental or physiological factors, whereby products are potentially generated which become diffusible through mammalian skin. The chemistry of oxidation is reviewed as well as the factors contributing to corrosion. Skin exudates (sweat and sebum) can react with metal surfaces they come in contact with, but even in the healthy organism their composition is variable, as a function of physical, pharmacological and environmental conditions, gender, age, sweat rate or body site. This overview addresses sweat and sebum composition, and discusses components which determine the skin’s corrosive action: chloride ion, low-molecular-weight acids and amino acids in sweat, and fatty acids in sebum, which hold the potential to solubilize copper-containing metal objects. These components can form copper salts and soaps whose molecular characteristics (size and polarity) will determine the rate and route of cutaneous penetration.","PeriodicalId":12086,"journal":{"name":"Exogenous Dermatology","volume":"100 1","pages":"263 - 269"},"PeriodicalIF":0.0,"publicationDate":"2004-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74706826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aspergillus species are important fungi of the environment, some of them being responsible for severe infections. Many distinct diseases form the human aspergillosis spectrum. The pathomechanisms differ according to the affected organ and the immune status of the patient. The fungus can be responsible for allergic reactions. It may also act as a saprophytic colonizer of air spaces. Infection may remain limited to the skin and nails. It may also be invasive, particularly in immunocompromised patients, in the lungs, paranasal sinus and gastrointestinal tract. Hematogeneous disseminated aspergillosis represents another dramatic form of the disease.
{"title":"Comparative Clinicopathological Manifestations of Human Aspergillosis","authors":"G. Piérard, J. Arrese, P. Quatresooz","doi":"10.1159/000089608","DOIUrl":"https://doi.org/10.1159/000089608","url":null,"abstract":"Aspergillus species are important fungi of the environment, some of them being responsible for severe infections. Many distinct diseases form the human aspergillosis spectrum. The pathomechanisms differ according to the affected organ and the immune status of the patient. The fungus can be responsible for allergic reactions. It may also act as a saprophytic colonizer of air spaces. Infection may remain limited to the skin and nails. It may also be invasive, particularly in immunocompromised patients, in the lungs, paranasal sinus and gastrointestinal tract. Hematogeneous disseminated aspergillosis represents another dramatic form of the disease.","PeriodicalId":12086,"journal":{"name":"Exogenous Dermatology","volume":"141 1","pages":"144 - 153"},"PeriodicalIF":0.0,"publicationDate":"2004-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76601900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The fragrance material linalool has been cited as a moderately frequent cause of allergic contact dermatitis. The literature shows that when the underlying clinical and experimental data are analyzed, a clear cause-effect relationship has infrequently or rarely been established. On the basis of the generally weak sensitizing potential of this substance coupled with its generally low exposure conditions, the prevalence of clinical cases would not be expected to be particularly high. This is not to say that linalool is a frequent inducer of type IV allergy in members of the public. However, it remains to be seen how often such an allergy, once established, is responsible for any of the cases of allergic contact dermatitis commonly ascribed in the literature. Indeed, in some cases, patch test conditions may not be optimal for differentiating between clinically relevant and irrelevant allergy to linalool.
{"title":"Is There Evidence that Linalool Causes Allergic Contact Dermatitis?","authors":"J. Hostynek,, H. Maibach","doi":"10.1159/000078688","DOIUrl":"https://doi.org/10.1159/000078688","url":null,"abstract":"The fragrance material linalool has been cited as a moderately frequent cause of allergic contact dermatitis. The literature shows that when the underlying clinical and experimental data are analyzed, a clear cause-effect relationship has infrequently or rarely been established. On the basis of the generally weak sensitizing potential of this substance coupled with its generally low exposure conditions, the prevalence of clinical cases would not be expected to be particularly high. This is not to say that linalool is a frequent inducer of type IV allergy in members of the public. However, it remains to be seen how often such an allergy, once established, is responsible for any of the cases of allergic contact dermatitis commonly ascribed in the literature. Indeed, in some cases, patch test conditions may not be optimal for differentiating between clinically relevant and irrelevant allergy to linalool.","PeriodicalId":12086,"journal":{"name":"Exogenous Dermatology","volume":"558 1","pages":"223 - 229"},"PeriodicalIF":0.0,"publicationDate":"2004-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87010057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L. Rodrigues, P. Pinto, J. Magro, Nuno Furtado, Maria Angélica Roberto
Background: Cutaneous ‘barrier’ recovery is a main objective in wound healing. Despite its potential interest, transepidermal water loss (TEWL) measurement has not yet entered the healing follow-up routine, in part due to instrumental limitations. Objective: To develop an experimental model using TEWL data, to quantify the in vivo ‘barrier’ function. Methods: Thermal burn trauma patients referred for autografting surgery, were submitted to a 24-hour ‘plastic occlusion stress test’ (POST) in the grafted and donor areas during the healing process, and TEWL data were parameterised as the evaporation half-life and the dynamic water mass. Results: Chosen parameters clearly differentiate the 2 processes at the grafted and donor sites, with the latter involving a slower recovery. Conclusion: The interest of TEWL as an indicator of the ‘barrier’ recovery in such a complex condition is well demonstrated, especially if rigorously obtained allowing a quantitative follow-up and results comparison.
{"title":"Quantitative Follow-Up of the Cutaneous Barrier Function in Wound Healing","authors":"L. Rodrigues, P. Pinto, J. Magro, Nuno Furtado, Maria Angélica Roberto","doi":"10.1159/000092010","DOIUrl":"https://doi.org/10.1159/000092010","url":null,"abstract":"Background: Cutaneous ‘barrier’ recovery is a main objective in wound healing. Despite its potential interest, transepidermal water loss (TEWL) measurement has not yet entered the healing follow-up routine, in part due to instrumental limitations. Objective: To develop an experimental model using TEWL data, to quantify the in vivo ‘barrier’ function. Methods: Thermal burn trauma patients referred for autografting surgery, were submitted to a 24-hour ‘plastic occlusion stress test’ (POST) in the grafted and donor areas during the healing process, and TEWL data were parameterised as the evaporation half-life and the dynamic water mass. Results: Chosen parameters clearly differentiate the 2 processes at the grafted and donor sites, with the latter involving a slower recovery. Conclusion: The interest of TEWL as an indicator of the ‘barrier’ recovery in such a complex condition is well demonstrated, especially if rigorously obtained allowing a quantitative follow-up and results comparison.","PeriodicalId":12086,"journal":{"name":"Exogenous Dermatology","volume":"316 1","pages":"303 - 306"},"PeriodicalIF":0.0,"publicationDate":"2004-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75450087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Exogenous factors implicated in or suspected of precipitating cutaneous lupus erythematosus are reviewed. Environmental risk factors (including infectious disease, dietary data, ultraviolet light, medications, pesticides and heavy metals) that are potentially related to the development of lupus erythematosus are discussed.
{"title":"Exogenous Factors in Cutaneous Lupus Erythematosus","authors":"A. Trattner","doi":"10.1159/000091905","DOIUrl":"https://doi.org/10.1159/000091905","url":null,"abstract":"Exogenous factors implicated in or suspected of precipitating cutaneous lupus erythematosus are reviewed. Environmental risk factors (including infectious disease, dietary data, ultraviolet light, medications, pesticides and heavy metals) that are potentially related to the development of lupus erythematosus are discussed.","PeriodicalId":12086,"journal":{"name":"Exogenous Dermatology","volume":"93 1","pages":"257 - 261"},"PeriodicalIF":0.0,"publicationDate":"2004-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85410322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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