New articles from Acta Dermato-Venereologica Acta Dermato-Venereologica is an international peer-review journal for clinical and experimental research in the field of dermatology and venereology. 95:4 2015 - A Solitary Red Nodule on the Back: A Quiz
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2014-10-20 Quiz
95:4 2015 - Vegetating Inguinal and Perianal Lesions: A Quiz
Abstract is missing (Quiz)]]>
2014-11-20 Quiz
95:4 2015 - Tonic Water-induced Generalized Bullous Fixed Eruption
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2014-11-04 Shortcom
95:4 2015 - Drug-induced Hypersensitivity Syndrome in Association with Varicella
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2014-11-12 Shortcom
95:4 2015 - Cellulitis-like Skin Eruption of Purulent Tenosynovitis Caused by Streptococcus dysgalactiae
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2014-11-11 Shortcom
95:4 2015 - Cutaneous Marginal Zone B-cell Lymphoma Evolving into Anetoderma: A Role of Matrix Metalloproteinases?
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2014-11-11 Shortcom
95:4 2015 - Anti-SRP Antibody-positive Myopathy with Universal Alopecia and Multiple Vitiligo
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2014-11-10 Shortcom
95:4 2015 - Fatal Thrombotic Thrombocytopenic Purpura in a Psoriasis Patient Treated with Ustekinumab and Methotrexate
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2014-11-06 Clinical
95:4 2015 - Mucous Membrane Pemphigoid with IgG Autoantibodies to the 120-kDa Ectodomain of Type XVII Collagen (BP180/Linear IgA Dermatosis Antigen) in a Patient with Idiopathic Thrombocytopenic Purpura
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2014-10-21 Shortcom
95:4 2015 - A Case of Extranodal Natural Killer/T-cell Lymphoma Mimicking Refractory Behçet’s Disease
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2014-10-02 Shortcom
95:4 2015 - Mycobacterium ulcerans Disease (Buruli Ulcer) in Mali: A New Potential African Endemic Country
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2014-10-16 Shortcom
95:4 2015 - Consequences of Acne on Stress, Fatigue, Sleep Disorders and Sexual Activity: A Population-based Study
Acne is a common disease among young people, which could have a serious impact on quality of life. Based on a survey using the quotas method on a large sample of the French population, we studied the impact of acne on feelings of stress, fatigue upon waking, sleep disorders and sexual activity. We did not establish any relationship to sleep disorders, but clearly ascertained that people with acne (n = 1,375) feel more stressed and have less sexual intercourse. Hence, 18% of people from acne group declared to be stressed every day (13.9% in control group) and 37.5% had no sexual intercourse (20.4% in control group; n = 891). To our knowledge, this is the first study to show that fatigue upon waking is strongly associated with the presence of acne (65.4% versus 58.4%). This study emphasises the fact that acne could have a deep resounding impact on the lives of people suffering from the disease.]]>
2014-11-14 Clinical
95:4 2015 - Incidence, Serum IgE and TARC/CCL17 Levels in Atopic Dermatitis Associated with Other Allergic Diseases: An Update from the Ishigaki Cohort
Population cohort studies are important for understanding the current status of the target disease and its relation to comorbidity, gender, age, or environmental factors. To better understand atopic dermatitis (AD) and its related diseases, we initiated in 2001 a population cohort study of nursery school children from Ishigaki Island, Okinawa, Japan. The cohort study comprised a dermatologist-based physical examination, questionnaire administration, and blood sample analysis. The mean prevalence of AD was 6.3%. Questionnaire-based bronchial asthma and egg allergy in the children and paternal and sibling AD were statistically significant risk factors for AD. Boys with AD had a high incidence of asthma that was coexistent with a high serum total immunoglobulin E level. Also a high incidence of egg allergy was associated with greater AD severity as assessed by TARC/CCL17. ]]>
2014-12-02 Clinical
95:4 2015 - Atopic Diathesis in Hypohidrotic/anhidrotic Ectodermal Dysplasia
Recently, patients with hypohidrotic/anhidrotic ectodermal dysplasia (H/AED) have been reported to have a higher prevalence of symptoms suggestive of atopic disorders than the general population. To better understand atopic diathesis in H/AED, 6 cases of clinically or genetically diagnosed H/AED were examined. The following criteria were evaluated with patient consent: sweating, blood test results, histopathology and filaggrin staining. Five of 6 H/AED cases displayed atopic dermatitis-like manifestations, and 3 of these 5 cases experienced periorbital lesions. H/AED patients tended to present with atopic dermatitis-like eruptions with characteristics potentially indicative of periorbital lesions. Atopic diathesis in H/AED appeared not to be associated with filaggrin. We could speculate that hypohidrosis or anhidrosis itself might impair skin barrier function and contribute to atopic diathesis.]]>
2014-10-21 Clinical
95:4 2015 - Delay in the Histopathologic Diagnosis of Mycosis Fungoides
The diagnosis of mycosis fungoides (MF) is difficult in early stages and is based on a combination of clinical findings and histopathologic criteria. The aim of this study was to assess the diagnostic delay in MF and to investigate the rationale for multiple biopsies in a single-centre, retrospective study of 157 patients with MF. The first biopsy was diagnostic for MF in 25% of cases. The median diagnostic delay was 2.3 years and depended on whether the diagnosis was established after one or multiple biopsies. The chance of a biopsy resulting in a diagnosis of MF was 25% irrespective of the number of the biopsy in the sequence. There was a significant diagnostic delay, especially in patients in whom the initial biopsy was not specific. Sampling error and unnecessary postponement of subsequent biopsies are likely factors and therefore multiple biopsies should be considered in patients with skin lesions suggesting MF.]]>
2014-11-03 Clinical
95:4 2015 - Linear IgA Bullous Dermatosis: A Retrospective Study of 23 Patients in Denmark
Linear IgA bullous dermatosis (LAD) is an autoimmune, chronic bullous disease affecting primarily young children and adults. Studies on LAD are relatively sparse and from Scandinavia we could only find a few case reports. Therefore we decided to conduct a retrospective investigation of patients seen at our department since 1972. A total of 23 patients were identified; 7 children (F:M ratio 0.75) and 16 adults (F:M ratio 0.78). Mean age at disease onset in the two age groups were 2.7 and 56.8 years. Estimated incidence rate in our region: 0.67 per million per year. The most commonly used treatment modalities were corticosteroids, dapsone and sulphapyridine. ]]>
2014-11-13 Clinical
95:4 2015 - Correlation of Conventional and Conformational Anti-desmoglein Antibodies with Phenotypes and Disease Activities in Patients with Pemphigus Vulgaris
Pemphigus is an autoimmune disease characterised by anti-desmoglein (Dsg) antibodies in the serum of patients. The disease can be divided into pemphigus foliaceus and pemphigus vulgaris. Anti-Dsg1 antibody is generally related to pemphigus with cutaneous lesion, and the anti-Dsg3 antibody is related to pemphigus with mucosa lesion. Twenty-nine patients with pemphigus vulgaris were selected in the clinical study. The severity of the cutaneous and mucosa lesions of these patients was evaluated using Pemphigus disease area index (PDAI). Conventional and conformational anti-Dsg index values were determined using enzyme-linked immunosorbent assay (ELISA) and ethylenediaminetetraacetic acid-treated ELISA. The relationship between clinical phenotypes and immunological profiles was analysed. In the correlation analysis, both the conventional and conformational anti-Dsg1 ELISA index values were correlated with the total and cutaneous PDAIs. In addition, conformational anti-Dsg3 ELISA index values exhibited a positive correlation with cutaneous PDAI in both types of pemphigus vulgaris, whereas no correlation was observed for the conventional anti-Dsg3 ELISA index values.]]>
2014-11-06 Clinical
95:4 2015 - Clinical Characterisation at Onset of Childhood Psoriasis – A Cross Sectional Study in Sweden
Epidemiological data in childhood psoriasis are accumulating. However, reliable information captured at onset is lacking. In a cross sectional study we recruited 109 children < 16 years within 12 months of psoriasis onset and explored the clinical characteristics. Pre-pubertal children, especially boys, more often had inverse involvement (OR = 2.8, 95% CI = 1.1, 7.1, p ≤ 0.05). HLA-C*06 was positively associated with facial lesions (OR = 3.8, 95% CI = 1.5, 9.7, p < 0.01) and guttate phenotype and was more common in pubertal children. A high PASI score was not associated with overweight or early age at onset, and gender did not influence disease onset. Psoriasis can be difficult to diagnose in children, especially in pre-pubertals. Thorough examination of facial and genital areas can help in establishing the diagnosis. Our published genetic data in combination with the clinical findings presented herein indicate that puberty may separate different populations of childhood psoriasis.]]>
2014-11-04 Clinical
95:4 2015 - Itch in Burn Areas After Skin Transplantation: Patient Characteristics, Influencing Factors and Therapy
Pruritus is a frequently encountered symptom following burns. Higher intensity of itching has been associated with depth of the wounds and specific body locations but these differences are not well understood. Our aim was to investigate the intensity of post burn pruritus in grafted and non-grafted burns across anatomic areas and to report on itch-inducing factors and applied treatments. The study included 226 patients prospectively followed for 18 months. Results showed that grafted patients and non-grafted patients reported similar overall itch intensity in-hospital. At 3 months post burn, grafted patients had higher overall itch scores, a difference that was found robust across the study period. Grafted wounds were found to produce higher mean itch intensity at 3 months post burn but this difference disappeared at 12 months post burn. Differences in itch prevalence rates were found across anatomic areas, but only in non-grafted burns. The differences in itch intensity on patient level versus wound level suggest that on the longer run, peripheral mechanism do not explain the higher itch scores in grafted patients.]]>
2014-09-30 Clinical
95:4 2015 - Body Attention, Ignorance and Awareness Scale: Assessing Relevant Concepts for Physical and Psychological Functioning in Psoriasis
A certain level of attention to bodily signals may be adaptive in the management of chronic skin conditions, as a lack of attention may lead to inadequate self-care behaviour and, consequently, may affect functioning and treatment outcomes. The purpose of this study was to develop a body awareness questionnaire and to investigate its psychometric properties and physical and psychological correlates in a cross-sectional study in patients with psoriasis (n?=?475). The 16-item Body Attention, Ignorance and Awareness Scale demonstrated a 3-factor structure that could be interpreted as body ignorance, body attention, and body awareness (Cronbach’s ? of 0.73, 0.74, and 0.68, respectively). Higher body ignorance was significantly related to more physical symptoms and worse psychological functioning. Body attention and body awareness showed small significant correlations with coping and personality. Given the negative influence of impaired psychological functioning on treatment outcomes, it may be clinically important to screen for theses constructs of body awareness in chronic skin conditions.]]>
2014-11-05 Investigative
95:4 2015 - Pruritus in Psoriasis: A Study of Personality Traits, Depression and Anxiety
Pruritus intensity is often not proportional to disease severity in patients with psoriasis or other pruritic dermatoses. Increasing evidence indicates that psychological factors may play an important role in the overall aetiology of pruritus. The aim of this study was to examine whether patients with psoriasis and severe pruritus differ psychologically from those with mild pruritus. In this study of 101 patients with plaque psoriasis, those with severe pruritus reported significantly higher scores for both depression and anxiety. Using the Swedish universities Scales of Personality, 4 personality traits were significantly associated with severe pruritus: Somatic trait anxiety, Embitterment, Mistrust, and Physical trait aggression. These results indicate that patients with psoriasis and severe pruritus might have a more vulnerable psychological constitution. This suggests important opportunities for clinicians to identify patients who could benefit from psychological interventions.]]>
2014-09-25 Investigative
95:4 2015 - Psoriasis and Skin Pain: Instrumental and Biological Evaluations
The prevalence of skin pain and the molecular mechanisms responsible for pain in psoriasis remain unclear. This study assessed skin pain in 163 patients (98 males, 65 females, range 18–81 years) with plaque psoriasis, evaluating: the subjective/objective features of this symptom compared with clinical severity of the disease; and the role of interleukin (IL)-33, (involved in both psoriasis and pain pathogenesis), in psoriasis-related pain. Clinical measures used were a questionnaire, plaque Physician Global Assessment (PGA) index, pressure algometry to measure pain threshold and tactile/thermal sensitivity test. IL-33 gene expression was examined in vivo (n = 12) in patients skin and through an ex vivo model of nociception using sodium dodecyl sulphate. Of the psoriatic patients 43.6% reported skin pain during the previous week; itchy, unpleasant, aching, sensitive, hot/burning, tender and cramping were the most reported qualities. Patients’ pain threshold decreased with increasing PGA index and pain intensity. Sensitivity to touch/heat was reduced in lesional skin, compared with unaffected psoriatic skin. IL-33 expression was increased in lesional skin of patients reporting pain and in the ex vivo system. In conclusion, symptoms of skin pain should be taken into account in the management of psoriasis.]]>
2014-09-17 Investigative
95:4 2015 - Patch Testing with a Textile Dye Mix in Two Concentrations – A Multicentre Study by the Swedish Contact Dermatitis Research Group
Disperse dyes, which are used for colouring synthetic textile fibres, are well-known contact sensitisers. To investigate the outcome of patch-testing with a textile dye mix (TDM) at 7 dermatology clinics in Sweden, a TDM tested at 2 concentrations was included into the baseline series during one year. The mix consisted of Disperse (D) Blue 35, D Yellow 3, D Orange 1 and 3, D Red 1 and 17, all 1.0%, and D Blue 106 and D Blue 124, each 0.3% in the mix 6.6% and 1.0% each in the mix 8.0%. In 2,122 tested patients, contact allergy to the TDM at the concentration 8.0% was found in 2.8% and to the TDM at 6.6% in 2.5% of the patients. The contact allergy to the TDM could explain or contribute to the dermatitis in about 35% of the patients. Conclusion: contact allergy to the TDM is common and inclusion into the Swedish baseline series should be considered.]]>
2014-11-03 Investigative
95:4 2015 - Melanoma Incidence Increases in the Elderly of Catalonia But Not in the Younger Population: Effect of Prevention or Consequence of Immigration?
All cases of MM diagnosed in 23 hospitals in Catalonia, from 2000 to 2007 were recorded and melanoma incidence calculated and adjusted for the European standard population via the direct method. The age standardised rate/100,000 inhabitants varied from 6.74 in 2000 to 8.64 in 2007 for all melanomas and from 4.79 to 5.80 for invasive MMs; the Breslow thickness was stable during the period. The increase in invasive melanoma incidence in the elderly was remarkable, the crude rate/100,000 inhabitants increasing from 11.04 (2000) to 15.49 (2007) in the 60–64 year population, while remaining more stable in the 30–34 year range, from 3.97 in 2000 to 4.55 in 2007, and with a tendency to decrease from 5.1 in 2000 to 2.5 in 2007 for the age range of 25–29 years. These lower age ranges are much more affected by immigration. Despite the large immigrant population (nearly one million immigrants arrived in Catalonia during the study period from countries with a low melanoma incidence), melanoma incidence in our region has risen considerably and this trend is likely to persist in the near future.]]>
2014-11-12 Investigative
95:4 2015 - Itch Prevalence and Characteristics in a Hispanic Geriatric Population: A Comprehensive Study Using a Standardized Itch Questionnaire
A cross-sectional study of geriatric patients was performed to provide a comprehensive description of the prevalence and clinical characteristics of chronic itch affecting Hispanic geriatric subjects in Mexico. Participants were recruited from both nursing homes and geriatric ambulatory care centers. Patients without dementia were evaluated using an itch intensity and characteristic questionnaire and were assessed for itch-related dermatoses (n = 302). Data on medications and underlying systemic diseases were obtained from medical records. The prevalence of chronic itch was 25% in this population. Of those with chronic itch, 69% had xerosis, 28% had itch-related dermatoses, and 96% had documented comorbidities. The most common comorbidities were diabetes mellitus (OR = 2.3, 95% CI 1.3–3.9, p = 0.003) and chronic venous insufficiency (OR = 4.4, 95% CI 1.6–12.2, p = 0.002). The most common areas where patients experienced itch were legs (54%), back (45%), scalp (28%) and arms (27%). Patients experienced the greatest amount of itch in the winter (77%) and during the night (65%). Chronic itch is a common problem in the studied Hispanic geriatric population, and its presence significantly correlates with xerosis, diabetes, and venous insufficiency.]]>
2014-11-06 Investigative
95:4 2015 - Decrease in Chymase Activity is Associated with Increase in IL-6 Expression in Mast Cells in Atopic Dermatitis
Mast cell chymase and interleukin (IL)-6 can be involved in atopic dermatitis and chymase can degrade IL-6. Our aim was therefore to study the expression of mast cell chymase and IL-6 in atopic skin using enzyme- and immunohistochemistry and to analyse their interaction in vitro. Chymase activity was significantly reduced in mast cells in skin lesions whereas the percentage of IL-6+ mast cells was increased. Low recombinant human (rh)-chymase concentration (10–100 ng/ml) stimulated and higher concentration (1,000 ng/ml) inhibited the proliferation of T cells and peripheral blood mononuclear cells. Rh-IL-6 inhibited T-cell proliferation, and even inhibited the proliferation induced by rh-chymase. Pretreatment of rh-IL-6 with a high rh-chymase concentration prevented the IL-6-induced inhibition in T-cell proliferation. The results suggest that reduction in chymase activity can give rise to increased cellular effects of mast cell IL-6 and that chymase and IL-6 can modify each other’s effects.]]>
2014-11-03 Investigative
95:4 2015 - Increased Expression of the Wnt Signalling Inhibitor Dkk-1 in Non-lesional Skin and Peripheral Blood Mononuclear Cells of Patients with Plaque Psoriasis
Psoriasis is a common inflammatory skin disease characterised by abnormal keratinocyte proliferation, increased dermal angiogenesis and systemic inflammation. The cell signalling cascades provoked by Wnt proteins and their inhibitors, such as Dickkopf-1, play crucial roles to maintain homeostasis of a variety of tissues, including skin, and are also involved in angiogenesis and innate immunity. This study was designed to investigate the distribution of Dickkopf-1, in lesional and non-lesional skin, in serum and in peripheral blood mononuclear cell (PBMCs) of patients with psoriasis compared with healthy controls. Our results showed significantly increased mRNA and protein expression of Dickkopf-1 in non-lesional compared with lesional skin and healthy control skin. No significant differences of Dickkopf-1 serum levels were observed, but Dickkopf-1 protein expression was significantly increased in patients’ PBMC. Increased levels of Dickkopf-1 in PBMC, suggest a possible role of Dickkopf-1 in the chronic systemic inflammation of psoriasis. Increased levels of Dickkopf-1 in non-lesional psoriasis skin offers new insights in the local inflammatory processes in psoriasis skin since Wnt signalling regulates angiogenesis. In conclusion, Dickkopf-1 may be a possible target for future treatment options.]]>
2014-11-05 Investigative
95:4 2015 - Serum Infliximab Concentrations in Psoriatic Patients Treated with Infliximab: A Systematic Review
The efficacy of infliximab is influenced by individual variability in its pharmacokinetics and pharmacodynamics. Serum infliximab concentrations could therefore be related to the efficacy and tolerance of infliximab, and assist adjustment of treatment. The aim of this systematic review was to assess the value of measuring serum infliximab concentrations in psoriatic patients. A bibliographic search was performed on MEDLINE, CENTRAL, EMBASE, LILACS for original studies on serum infliximab concentrations in psoriatic patients treated with infliximab. Ten articles were included, representing evaluation of serum infliximab concentrations in 733 patients. Predictive value of higher serum infliximab concentrations on long-term response maintenance was suggested in 3 studies. There was no information regarding the value of such measurements for adjustment of infliximab dosage. Trough serum infliximab concentrations that are at least detectable (>0.1 mg/L) at steady state (week 22) seem to be associated with maintaining a clinical response in the long term.]]>
2014-11-03 Special
95:4 2015 - Health-related Quality of Life in Patients with Cutaneous Rosacea: A Systematic Review
Health-related quality of life (HRQoL) of rosacea patients is a relevant outcome measure in research and clinical practice. A review of the literature was systematically carried out regarding levels of HRQoL of patients with rosacea, including associations between HRQoL scores, demographic and clinical characteristics. Searches were performed in Cochrane, PubMed, EMBASE, PsycINFO, CINAHL and LILACS. HRQoL studies in patients with cutaneous rosacea, using validated HRQoL instruments, published between 1991 and 2014, were included. Data extraction was performed independently by 2 authors. Study design, demographics, clinical characteristics and HRQoL scores were summarized per HRQoL questionnaire. Associations between HRQoL, demographic and clinical characteristics were explored. Out of 984 references, 12 studies were included. Three HRQoL instruments were used: Short Form-36 (SF-36), Dermatology Life Questionnaire Index (DLQI) and Rosacea Quality of Life Index (RosaQoL). Because of the heterogeneity of the included studies, data synthesis was hardly feasible. All studies reported a negative impact on HRQoL, which appeared to be associated with disease severity and age. Results regarding the association with sex and subtype were mixed. With regard to the clinical relevance of HRQoL scores of rosacea patients, it seems that rosacea has a small to moderate effect on HRQoL.]]>
2014-10-14 Special
95:4 2015 - Factors That Predict Remission of Infant Atopic Dermatitis: A Systematic Review
The individual prognosis of infants with atopic dermatitis (AD) is important for parents, healthcare professionals, and society. The aim of this study was to investigate predictors for remission of infant AD until school age. A systematic review was carried out of clinical and epidemiological studies investigating the effect of filaggrin gene (FLG) loss-of-function mutations, sex, exposure to pets, topical anti-inflammatory treatment, disease severity, and atopic sensitization during infancy on complete remission of infant-onset AD until 6–7 years of age. Systematic electronic searches until September 2013, data abstraction, and study quality assessment (Newcastle-Ottawa Scale) were performed. From 3,316 abstracts identified, 2 studies of good study quality were included. Parental allergies and sex did not significantly affect remission. For non-remission of AD, the included articles reported an association with any atopic sensitization at 2 years old (adjusted odds ratio [aOR] 2.76; 95% confidence interval (CI) 1.29–5.91), frequent scratching with early AD (aOR 5.86; 95% CI 3.04–11.29), objective severity score at 2 years old (aOR 1.10; 95% CI 1.07–1.14), and exposure to pets (cat OR 2.33; 95% CI 0.85–6.38). It is largely unknown which factors predict remission of infant AD. This is a highly relevant research gap that hinders patient information on the prognosis of infant-onset AD]]>
2014-10-14 Special
95:4 2015 - Buruli Ulcer – A Rapidly Changing Scene
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2014-08-25 Commentary
95:3 2015 - Vegetating Nodules Following Erosions on the Oral Cavity: A Quiz
Abstract is missing (Quiz)]]>
2014-08-27 Quiz
95:3 2015 - Erythematous-to-Brownish Plaques on the Upper Back: A Quiz
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2014-09-17 Quiz
95:3 2015 - Solitary Red-purple Plaque on the Chest of a 7-year-old Boy: A Quiz
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2014-09-09 Quiz
95:3 2015 - Apocrine Hidrocystoma of the Urethral Meatus: A Case Report
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2014-08-18 Shortcom
95:3 2015 - Eumycetoma on the Foot Caused by Madurella mycetomatis: Amputation After Significant Worsening During Pregnancy
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2014-09-17 Shortcom
95:3 2015 - Oral Lichen Planus with Severe Nail Involvement in a 10-year-old Boy
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2014-09-10 Shortcom
95:3 2015 - Development of Necrotising Fasciitis in a Patient Treated for Rheumatoid Arthritis with Tocilizumab
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2014-09-10 Shortcom
95:3 2015 - Successful Treatment of Morbihan Disease with Long-term Minocycline and its Association with Mast Cell Infiltration
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2014-09-09 Shortcom
95:3 2015 - Cutaneous Manifestations of Methotrexate-associated Lymphoproliferative Disorders: Report of Two Cases and a Review of the Literature
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2014-09-09 Shortcom