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A case of severe psoriasis successfully treated with bimekizumab in a hemodialysis patient with end-stage renal disease. 一例患有终末期肾病的血液透析患者使用双美珠单抗成功治疗严重银屑病的病例。
IF 1.8 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-02 DOI: 10.23736/S2784-8671.24.07920-9
Dario Buononato, Vittorio Tancredi, Eugenia V DI Brizzi, Giuseppe Argenziano, Anna Balato
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引用次数: 0
Devices for treatment of nail psoriasis. 治疗指甲银屑病的设备。
IF 1.8 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-10-01 DOI: 10.23736/S2784-8671.24.07919-2
Apostolos Katsiaunis, Shari R Lipner

Introduction: Nail psoriasis (NP) affects a significant proportion of cutaneous psoriasis patients, often leading to functional impairment and psychosocial distress. Despite available treatment options, challenges persist in achieving efficacy and with drug delivery, prompting investigation into novel therapeutic devices.

Evidence acquisition: A literature search was performed using the PubMed database for devices and lasers for NP on 17 October 2023 using the following search terms: device OR laser AND "nail psoriasis." Twenty-two articles were included describing treatment with pulsed dye laser, fractional carbon dioxide (CO2) laser, long-pulsed Nd:YAG laser, excimer laser, photodynamic therapy, intense pulsed light, and microneedling device.

Evidence synthesis: While some recent studies on use of therapeutic devices have shown promising results for NP treatment, current evidence supports an algorithmic approach including topical therapies, intralesional kenalog injections, and systemic therapies, depending on number of nails affected, presence of psoriatic arthritis, cutaneous psoriasis, comorbidities, and effect on quality of life. Laser therapy, although promising, requires further validation through extensive randomized trials before its inclusion in treatment regimens.

Conclusions: These exploratory findings highlight emerging therapies that may expand the spectrum of options available. Use of lasers for NP treatment could provide dermatologists with a broader arsenal for customizing treatment plans that address individual patient needs, taking into account comfort, cost, and compliance to enhance overall patient outcomes.

导言:指甲银屑病(NP)影响着相当一部分皮肤银屑病患者,常常导致功能障碍和社会心理困扰。尽管有多种治疗方法可供选择,但在实现疗效和药物输送方面仍存在挑战,这促使人们对新型治疗设备进行研究:2023年10月17日,我们使用PubMed数据库对用于NP的设备和激光进行了文献检索,检索词如下:设备或激光和 "指甲银屑病"。共收录了22篇文章,介绍了脉冲染料激光、点阵式二氧化碳(CO2)激光、长脉冲Nd:YAG激光、准分子激光、光动力疗法、强脉冲光和微针仪的治疗方法:虽然最近一些关于使用治疗设备治疗 NP 的研究显示出了良好的效果,但目前的证据支持一种算法方法,包括局部疗法、关节内注射凯纳洛和全身疗法,具体取决于受影响指甲的数量、是否存在银屑病关节炎、皮肤银屑病、合并症以及对生活质量的影响。激光疗法虽然前景广阔,但在纳入治疗方案之前,还需要通过广泛的随机试验进一步验证:这些探索性研究结果凸显了新出现的疗法,这些疗法可能会扩大可供选择的范围。使用激光治疗非小细胞肺结核可为皮肤科医生提供更广泛的治疗手段,在考虑舒适度、成本和依从性的基础上,定制满足患者个人需求的治疗方案,从而提高患者的整体治疗效果。
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引用次数: 0
Drug-induced photosensitivity associated with anticancer therapies. 与抗癌疗法相关的药物诱发光敏现象。
IF 1.8 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-06-17 DOI: 10.23736/S2784-8671.24.07782-X
Davide Fattore, Luca Potestio, Ariadna Ortiz Brugués, Vincent Sibaud

Introduction: Despite the promising results in terms of effectiveness of anticancer treatments, a wide range of dermatologic adverse reactions have been reported. Among them, skin photosensitivity, defined as a range of dermatologic conditions caused or exacerbated by sunlight exposure, is an emerging adverse event.

Evidence acquisition: A review of the current literature was performed to report the most characteristic phototoxic and photoallergic reactions associated with anticancer therapies, as well as other characteristic manifestations potentially related to photo-exposure, including UV recall, vitiligo-like reactions, drug-induced cutaneous lupus erythematosus, and UV-induced hyperpigmentation.

Evidence synthesis: A total of 30 manuscripts were collected in the present review, reporting several phototoxic and photoallergic reactions associated with anticancer therapies.

Conclusions: Photosensitivity reactions are an increasing challenge in cancer management. The raising awareness about this adverse event has increased the identification of potential photosensitizing drugs as well as its prevention and the management. However, more studies are required to improve the knowledge of this cutaneous toxicity and to define a personalized treatment strategy.

导言:尽管抗癌治疗的疗效令人欣喜,但各种皮肤病不良反应也时有报道。其中,皮肤光敏感性是指由日光照射引起或加剧的一系列皮肤病,是一种新出现的不良反应:证据收集:对目前的文献进行了综述,以报告与抗癌疗法相关的最具特征性的光毒性和光过敏反应,以及可能与光暴露相关的其他特征性表现,包括紫外线回忆、白癜风样反应、药物诱发的皮肤红斑狼疮和紫外线诱发的色素沉着:本综述共收集了30篇手稿,报告了与抗癌疗法相关的几种光毒性和光过敏反应:光敏反应是癌症治疗中一个日益严峻的挑战。随着人们对这种不良反应的认识不断提高,对潜在光敏性药物的识别、预防和管理也在不断加强。然而,还需要更多的研究来提高对这种皮肤毒性的认识,并确定个性化的治疗策略。
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引用次数: 0
Preserving esthetics and function: the double wedge solution for nipple-areola complex melanoma. 保持美观和功能:乳头乳晕复合黑色素瘤的双楔形解决方案。
IF 1.8 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-07-09 DOI: 10.23736/S2784-8671.24.07876-9
Camilla Salvini, Lavinia Quintarelli, Elisabetta Magnaterra, Roberto Maglie, Giulio Tosti, Nicola Pimpinelli
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引用次数: 0
Hand eczema: a review of clinical, dermoscopic and histological features. 手部湿疹:临床、皮肤镜和组织学特征综述。
IF 1.8 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-07-23 DOI: 10.23736/S2784-8671.24.07879-4
Elena Zappia, Nicole Macagno, Pietro Quaglino, Gabriele Roccuzzo, Simone Ribero

Introduction: Hand eczema (HE) is a prevalent inflammatory skin condition, impacting 15-20% of individuals, with a notable incidence rate of approximately 7.3 cases per 1000 person/years. This condition exhibits significant gender-based variability, with a higher prevalence in females. The clinical presentation of HE is characterized by pruritic erythematous, edematous, weeping plaques, vesicles, and/or bullae, showcasing considerable heterogeneity.

Evidence acquisition: A literature search was conducted across multiple databases, including Medline, Pubmed, Scopus, and the Cochrane Library. The search was conducted using the following key words and medical subject heading (MeSH) terms: "hand," "eczema," "dermatitis," "dermoscopy," and "histology," employing the Boolean term "AND" to combine the research terms for optimal search precision. PRISMA algorithm has been used for article screening. The search scope included manuscripts published up to October 1, 2023.

Evidence synthesis: Up to 50% of HE cases are associated with atopic dermatitis, emphasizing the complex interplay between various dermatological conditions. Common subtypes of HE include irritant contact dermatitis (ICD), allergic contact dermatitis (ACD), atopic hand eczema (AHE), and protein contact dermatitis/contact urticaria (PCD). The chronic nature of HE presents a substantial management challenge, often underestimated, leading to delayed treatment and potential progression to chronic hand eczema (CHE). Beyond individual health implications, HE exerts a profound impact on occupational, domestic, social, and psychological aspects, establishing itself as the most prevalent occupation-related skin disease. This paper seeks to establish a comprehensive classification system for HE, integrating clinical, dermoscopic, and histological elements. Dermoscopy, specifically, proves instrumental in distinguishing HE from palmar psoriasis, revealing characteristic features such as yellow scales and irregular vessels. Histopathological findings underscore the dynamic changes observed from acute to chronic stages, while challenges in differentiating hyperkeratotic HE from psoriasis underscore the necessity for a holistic diagnostic approach.

Conclusions: Accurate diagnosis and effective management of HE necessitate a holistic perspective that recognizes the inherent complexities of this inflammatory skin disease. By providing a multidimensional classification system, incorporating clinical, dermoscopic, and histological parameters, this paper aimed to contribute to a more nuanced understanding of HE and facilitate improved approaches to its diagnosis and treatment.

简介:手部湿疹(HE)是一种常见的炎症性皮肤病,影响 15-20% 的人,发病率约为 7.3 例/1000 人/年。这种疾病具有明显的性别差异,女性发病率更高。HE 的临床表现以瘙痒性红斑、水肿、哭泣性斑块、水泡和/或水疱为特征,具有相当大的异质性:在 Medline、Pubmed、Scopus 和 Cochrane 图书馆等多个数据库中进行了文献检索。检索时使用了以下关键词和医学主题词(MeSH):"手"、"湿疹"、"皮炎"、"皮肤镜 "和 "组织学",并使用布尔术语 "AND "来组合研究术语,以获得最佳搜索精度。文章筛选采用了 PRISMA 算法。检索范围包括截至 2023 年 10 月 1 日发表的手稿:多达 50% 的 HE 病例与特应性皮炎有关,强调了各种皮肤病之间复杂的相互作用。特应性湿疹的常见亚型包括刺激性接触性皮炎(ICD)、过敏性接触性皮炎(ACD)、特应性手部湿疹(AHE)和蛋白接触性皮炎/接触性荨麻疹(PCD)。手部湿疹的慢性特性给治疗带来了巨大挑战,而且往往被低估,导致治疗延误,并有可能发展为慢性手部湿疹(CHE)。除了对个人健康的影响外,手部湿疹还对职业、家庭、社会和心理产生深远影响,是最普遍的职业相关皮肤病。本文试图为手部湿疹建立一个全面的分类系统,将临床、皮肤镜和组织学要素整合在一起。皮肤镜检查尤其有助于区分 HE 和掌跖银屑病,可发现黄色鳞屑和不规则血管等特征。组织病理学发现强调了从急性到慢性阶段观察到的动态变化,而将角化过度性 HE 与银屑病区分开来的挑战则强调了采用整体诊断方法的必要性:结论:要对 HE 进行准确诊断和有效管理,就必须从整体角度认识这种炎症性皮肤病的内在复杂性。本文提供了一个结合临床、皮肤镜和组织学参数的多维分类系统,旨在帮助人们更深入地了解 HE,并改进其诊断和治疗方法。
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引用次数: 0
Epstein-Barr virus-related polymorphic eruption in a pediatric patient. 一名儿科患者出现与爱泼斯坦-巴氏病毒相关的多形性皮疹。
IF 1.8 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-08-02 DOI: 10.23736/S2784-8671.24.07972-6
Alessia Paganelli, Elena Ficarelli, Alberico Motolese
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引用次数: 0
Management of small wounds: result of an Italian survey. 小伤口的处理:意大利调查的结果。
IF 1.8 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-07-09 DOI: 10.23736/S2784-8671.24.07875-7
Maria R Nasca, Alessandra Scilletta, Salvo Lantieri, Stefano Veraldi, Giuseppe Micali

Background: Infection at the surgical site is a frequent complication of office skin procedures, such as electrodesiccation, laser therapy, superficial peelings, curettage, cryotherapy, and incisional or shave biopsies. The use of antibiotic therapy in their prevention is highly controversial due to the raising phenomenon of antibiotic resistance. Italy ranks fifth among high-income countries for resistance to antibiotics, with a rate seven times higher than Scandinavia. In order to raise awareness on this alarming issue, a survey was planned to disclose the misuse of topical antibiotics in the dermatologic practice.

Methods: A specifically designed questionnaire aimed at analyzing the topical management of skin lesions following common office skin procedures was distributed nationwide to physicians engaged in the management of small surgical wounds and then collected for statistical data processing and evaluation.

Results: A total of 1500 forms were distributed nationwide, 1340 (89.3%) of which were completed by dermatologists. Analysis of the collected data showed that more than 70% of the respondents always use topical antibiotics in the attempt of preventing possible post-procedure superinfections.

Conclusions: This survey confirms not only an antibiotic misuse by a large part of the respondents, but above all the widespread erroneous belief that such therapeutic approach can be useful in averting the risk of infections postoperatively. These findings may obviously explain the spread of antibiotic resistance in Italy and confirm that there is an absolute need to raise awareness among dermatologists about the damage caused by the misuse of antibiotics in the management of small wounds.

背景:手术部位感染是诊室皮肤手术(如电灼、激光治疗、表皮剥脱、刮除术、冷冻治疗和切口或剃须活检)的常见并发症。由于抗生素耐药性现象日益严重,使用抗生素治疗来预防这些并发症备受争议。意大利的抗生素耐药性在高收入国家中排名第五,比斯堪的纳维亚高出七倍。为了提高人们对这一令人担忧的问题的认识,我们计划开展一项调查,以揭露皮肤科临床中局部抗生素的滥用情况:方法:在全国范围内向从事小手术伤口处理的医生发放一份专门设计的调查问卷,旨在分析常见诊室皮肤手术后皮损的局部处理情况,然后收集数据进行统计处理和评估:全国共发放了 1500 份调查表,其中 1340 份(89.3%)由皮肤科医生填写。对收集到的数据进行的分析表明,70% 以上的受访者总是使用局部抗生素来预防术后可能出现的超级感染:这项调查不仅证实了大部分受访者滥用抗生素,更重要的是,他们普遍错误地认为这种治疗方法有助于避免术后感染的风险。这些发现显然可以解释抗生素耐药性在意大利的蔓延,并证实绝对有必要提高皮肤科医生对在治疗小伤口时滥用抗生素所造成的损害的认识。
{"title":"Management of small wounds: result of an Italian survey.","authors":"Maria R Nasca, Alessandra Scilletta, Salvo Lantieri, Stefano Veraldi, Giuseppe Micali","doi":"10.23736/S2784-8671.24.07875-7","DOIUrl":"10.23736/S2784-8671.24.07875-7","url":null,"abstract":"<p><strong>Background: </strong>Infection at the surgical site is a frequent complication of office skin procedures, such as electrodesiccation, laser therapy, superficial peelings, curettage, cryotherapy, and incisional or shave biopsies. The use of antibiotic therapy in their prevention is highly controversial due to the raising phenomenon of antibiotic resistance. Italy ranks fifth among high-income countries for resistance to antibiotics, with a rate seven times higher than Scandinavia. In order to raise awareness on this alarming issue, a survey was planned to disclose the misuse of topical antibiotics in the dermatologic practice.</p><p><strong>Methods: </strong>A specifically designed questionnaire aimed at analyzing the topical management of skin lesions following common office skin procedures was distributed nationwide to physicians engaged in the management of small surgical wounds and then collected for statistical data processing and evaluation.</p><p><strong>Results: </strong>A total of 1500 forms were distributed nationwide, 1340 (89.3%) of which were completed by dermatologists. Analysis of the collected data showed that more than 70% of the respondents always use topical antibiotics in the attempt of preventing possible post-procedure superinfections.</p><p><strong>Conclusions: </strong>This survey confirms not only an antibiotic misuse by a large part of the respondents, but above all the widespread erroneous belief that such therapeutic approach can be useful in averting the risk of infections postoperatively. These findings may obviously explain the spread of antibiotic resistance in Italy and confirm that there is an absolute need to raise awareness among dermatologists about the damage caused by the misuse of antibiotics in the management of small wounds.</p>","PeriodicalId":14526,"journal":{"name":"Italian Journal of Dermatology and Venereology","volume":" ","pages":"509-512"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141558698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Dermoscopy and confocal microscopy of giant unresectable melanoma of the scalp. 头皮巨大不可切除黑色素瘤的皮肤镜和共聚焦显微镜检查。
IF 1.8 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-07-16 DOI: 10.23736/S2784-8671.24.07947-7
Martina Cavicchi, Alessandra Acciardi, Antonio Alma, Silvana Ciardo, Roberta Depenni, Caterina Longo, Sara Bassoli
{"title":"Dermoscopy and confocal microscopy of giant unresectable melanoma of the scalp.","authors":"Martina Cavicchi, Alessandra Acciardi, Antonio Alma, Silvana Ciardo, Roberta Depenni, Caterina Longo, Sara Bassoli","doi":"10.23736/S2784-8671.24.07947-7","DOIUrl":"10.23736/S2784-8671.24.07947-7","url":null,"abstract":"","PeriodicalId":14526,"journal":{"name":"Italian Journal of Dermatology and Venereology","volume":" ","pages":"573-575"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141619979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Healthcare resource utilization and related cost among hospitalized patients with prurigo nodularis: a retrospective cohort study using Italian health claims data. 结节性瘙痒症住院患者的医疗资源利用率和相关费用:一项利用意大利医疗报销数据进行的回顾性队列研究。
IF 1.8 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-09-09 DOI: 10.23736/S2784-8671.24.07970-2
Donia Bahloul, Gianluca Ronci, Danielle L Isaman, Maria P Pedone, Luca Degli Esposti, Elisa Giacomini, Chiara Veronesi, Cataldo Patruno, Andrea Chiricozzi, Paolo Amerio

Background: Prurigo nodularis (PN) is a chronic, inflammatory skin disease characterized by intense itch. Little evidence exists on the burden of PN in Italy. This real-world analysis aimed to investigate the healthcare resource consumption and related direct costs of patients hospitalized for PN.

Methods: The analysis utilized the administrative databases of healthcare units that cover approximately 12 million inhabitants across Italy. Adult patients were included by ICD-9-CM=698.3 (lichen simplex chronicus; neurodermatitis circumscripta; PN) as proxy of PN diagnosis, from 01/2010 to 09/2021, and had 1 year of data availability before (baseline) and after (follow-up) hospitalization (index date). These patients were 1:2 matched by age, sex, and index date (year) to adults without such hospitalization in the baseline period (matched non-PN controls).

Results: The analysis comprised 295 PN-hospitalized patients, matched with 590 non-PN individuals (mean age 63.2 years, 43.7% female). At baseline, patients had a greater comorbidity burden than non-PN controls, including higher prevalence of hypertension (56.6% vs. 36.6%, respectively), dyslipidemia (26.4% vs. 18.0%), diabetes (24.4% vs. 12.5%) and mental health conditions (14.9% vs. 7.8%). During 1-year follow-up, PN-hospitalized patients had significantly higher resource consumption than matched controls, in terms of mean number of prescriptions most commonly prescribed in PN patients (5.1 vs. 1.9, P<0.001), other drugs (11.7 vs. 6.5, P<0.001), all-cause hospitalization (1.4 vs. 0.1, P<0.001) and outpatient services (5.4 vs. 2.5, P<0.001). Mean annual all-cause healthcare costs for patients over 1-year follow-up were € 3847 total (€ 875 drugs, € 2652 hospitalization, € 320 outpatient services), higher than those for the matched controls, of € 711 total (P<0.001) (€ 353 drugs, € 228 hospitalization, € 130 outpatient services).

Conclusions: Patients hospitalized for PN had a higher comorbidity burden at baseline and greater healthcare resource consumption during 1-year follow-up compared to matched controls, with a 5.4-fold increase in all-cause healthcare costs, indicating substantial clinical burden and remaining unmet need in these patients.

背景:结节性瘙痒症(PN)是一种以剧烈瘙痒为特征的慢性炎症性皮肤病。在意大利,有关结节性白斑病负担的证据很少。这项真实世界分析旨在调查因结节性瘙痒症住院的患者的医疗资源消耗和相关直接成本:分析利用了覆盖意大利全国约 1200 万居民的医疗单位的行政数据库。成年患者以 ICD-9-CM=698.3(慢性单纯性苔藓;周身神经性皮炎;PN)作为 PN 诊断的代表,纳入时间为 2010 年 1 月 1 日至 2021 年 9 月 9 日,住院前(基线)和住院后(随访)(索引日期)均有 1 年的可用数据。这些患者与基线期未住院的成人(匹配的非 PN 对照组)按年龄、性别和指标日期(年份)进行了 1:2 匹配:分析包括 295 名 PN 住院患者和 590 名非 PN 患者(平均年龄 63.2 岁,女性占 43.7%)。与非 PN 对照组相比,基线患者的合并症负担更重,包括高血压(56.6% 对 36.6%)、血脂异常(26.4% 对 18.0%)、糖尿病(24.4% 对 12.5%)和精神疾病(14.9% 对 7.8%)的患病率更高。在为期 1 年的随访中,就 PN 患者最常用处方的平均数量而言,PN 住院患者的资源消耗明显高于匹配对照组(5.1 对 1.9,PC 结论:与匹配对照组相比,PN 住院患者的基线合并症负担更高,随访 1 年期间的医疗资源消耗也更大,全因医疗费用增加了 5.4 倍,这表明这些患者的临床负担很重,仍有大量需求未得到满足。
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引用次数: 0
3D line-field confocal optical coherence tomography (LC-OCT) volume rendering of eccrine poroma. 无孔孔瘤的三维线场共焦光学相干断层成像(LC-OCT)体绘。
IF 1.8 4区 医学 Q3 DERMATOLOGY Pub Date : 2024-10-01 Epub Date: 2024-06-17 DOI: 10.23736/S2784-8671.24.07883-6
Gerardo Palmisano, Simone Cappilli, Cristina Guerriero, Alessandro DI Stefani, Ketty Peris
{"title":"3D line-field confocal optical coherence tomography (LC-OCT) volume rendering of eccrine poroma.","authors":"Gerardo Palmisano, Simone Cappilli, Cristina Guerriero, Alessandro DI Stefani, Ketty Peris","doi":"10.23736/S2784-8671.24.07883-6","DOIUrl":"10.23736/S2784-8671.24.07883-6","url":null,"abstract":"","PeriodicalId":14526,"journal":{"name":"Italian Journal of Dermatology and Venereology","volume":" ","pages":"572-573"},"PeriodicalIF":1.8,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141330954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Italian Journal of Dermatology and Venereology
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