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Wisco OJ, Diehl K, Clark MR, Gilson RT, Cohen LM. Pruritic Rash on the Shins. Am Fam Physician 2024; 109:Online. [PMID: 38227878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
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52
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Weisleder H, Valle A, Xie X, Mahmood S. Racial Disparities in Diagnosis and Treatment of Patients With Dermatomyositis of Different Skin Tones. J Clin Rheumatol 2024; 30:8-11. [PMID: 37747839 DOI: 10.1097/rhu.0000000000002031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
BACKGROUND Delays in the diagnosis and treatment of dermatological conditions in minorities are a well-documented health disparity. We aimed to determine if there was a delay in detection and treatment initiation for dermatomyositis (DM) and amyopathic dermatomyositis (ADM) in patients of different skin tones. METHODS Patients from Montefiore Medical Center who met the criteria for DM and ADM were included in this cohort study. Records were reviewed for date of first documented rash, creatine kinase levels, muscle weakness complaints, and date of first steroid or disease-modifying antirheumatic drug initiation. The median number of days between rash documentation and therapy initiation was compared for patients of different races, including non-Hispanic White, non-Hispanic Black, Hispanic, and other (Asian and unknown). Data were compared in White versus non-White skin. RESULTS Sixty-three DM and 9 ADM patients met the inclusion criteria. There was a shorter time to treatment initiation in White versus non-White patients, with a median number of 8 days compared with 21 days, respectively ( p = 0.05). Kaplan-Meier curves showed prolonged time to diagnosis and treatment in all other races when compared with White patients ( p = 0.03). DISCUSSION It took clinicians longer to diagnose and treat DM and ADM in patients of color. The trends observed emphasize the importance of increasing dermatology education of non-White skin to improve detection and treatment of DM and ADM and minimize health disparities.
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Lin RJ, Chung C, Wang CY, Wang PY, Sung WY, Tsai JJ. The cutaneous manifestation of dermatomyositis confounded with allergic rash might defer the diagnosis of malignancy. Int J Rheum Dis 2024; 27:e14945. [PMID: 37882482 DOI: 10.1111/1756-185x.14945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/04/2023] [Accepted: 10/10/2023] [Indexed: 10/27/2023]
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54
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Krech L, Welkoborsky HJ. [Unexplained buccal swelling in a woman with exanthema, fever, and worsening of general condition]. Laryngorhinootologie 2024; 103:53-55. [PMID: 37500069 DOI: 10.1055/a-2123-4377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/29/2023]
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55
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Shakhashiro M, McKay KM, Wilson CL. Linear rash in an 11-year-old girl. Int J Dermatol 2024; 63:41-42. [PMID: 37728149 DOI: 10.1111/ijd.16846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/14/2023] [Accepted: 09/06/2023] [Indexed: 09/21/2023]
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56
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Sakamoto T, Mizuta H, Amagai T. Persistent rash associated with multiple pulmonary nodules. Eur J Intern Med 2024; 119:127-128. [PMID: 37863701 DOI: 10.1016/j.ejim.2023.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 10/11/2023] [Indexed: 10/22/2023]
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57
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Curry A, Khalsa A, Yi D. Facial Lesions and Rash in a 2-month-old Boy. Pediatr Rev 2024; 45:52-56. [PMID: 38161160 DOI: 10.1542/pir.2021-005372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
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58
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Miao J, Zhang J, Huang X, Wu N, Wu D, Shen M. NLRP12-associated autoinflammatory disease in Chinese adult patients: a single-centre study. RMD Open 2023; 9:e003598. [PMID: 38123482 DOI: 10.1136/rmdopen-2023-003598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND NLRP12-associated autoinflammatory disease (NLRP12-AID) is an autosomal dominant autoinflammatory disorder caused by variants of NLRP12 gene. We aimed to report a cohort of Chinese adult patients with NLRP12-AID and summarised phenotypes and genotypes. METHODS Twenty patients were diagnosed with NLRP12-AID after performing whole-exome sequencing and were included in our cohort. Demographic information, clinical data and treatment response were collected and evaluated. A literature review of NLRP12-AID was performed, and the clinical features and mutated sites were summarised and compared with our cohort. RESULTS Among the 20 NLRP12-AID patients, the main clinical features of NLRP12-AID included fever, cutaneous rash, arthralgia/arthritis, pharyngitis/tonsillitis, lymphadenopathy, myalgia and abdominal pain/diarrhoea. Thirteen NLRP12 variants were detected as F402L, G39V, R1030X, R7G, E24A, Q90X, A218V, A259V, W581X, G729R, R859W, c.-150T>C and c.*126G>C. Glucocorticoids were used in 14 patients, immunosuppressive agents in 13, and tocilizumab in 2. Seventeen patients had good responses to therapy. When compared with 50 NLRP12-AID patients from other countries, Chinese patients had fewer variants in exon 3, higher incidences of cutaneous rash, pharyngitis/tonsillitis and lymphadenopathy. Among all these 70 NLRP12-AID patients, patients carrying non-exon-3 variants had higher frequencies of ocular involvement, pharyngitis/tonsillitis, headache and lymphadenopathy than those with exon-3 variants. CONCLUSION This is the largest cohort of NLRP12-AID in the world and seven novel variants of NLRP12 were identified. Chinese adult patients of NLRP12-AID had more non-specific symptoms such as pharyngitis/tonsillitis and lymphadenopathy when compared with patients from other countries, for which the less occurrence of exon-3 variants might be one possible reason.
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Phi DL, Dao TL, To MM, Nguyen TB, Nguyen DC, Gautret P, Hoang VT. Clinical and Laboratory Characteristics of Kawasaki Disease and COVID-19-Related Multisystem Inflammatory Syndrome in Children. J Korean Med Sci 2023; 38:e410. [PMID: 38111281 PMCID: PMC10727921 DOI: 10.3346/jkms.2023.38.e410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 09/14/2023] [Indexed: 12/20/2023] Open
Abstract
Geographical and racial factors constitute important distinctions between Kawasaki disease (KD) and multisystem inflammatory syndrome in children (MIS-C), but no study has been conducted in Vietnam. Forty-one children with KD from January 2018 to July 2020 and 42 with KD/MIS-C from August 2020 to December 2022 were included in this study. Of the patients, 52.3% were aged between 12 and 35 months. Only two were aged over 5 years, and both were belong to the KD/MIS-C group. A 59.5% of the patients were male. Apart from fever, all symptoms tended to be more frequent in patients with KD/MIS-C. The prevalence of diffuse skin rash, hand and foot edema or erythema and gastrointestinal signs was significantly higher in patients hospitalized with KD/MIS-C. There was no significant difference in laboratory findings between the two groups. Coronary artery dilation was more frequently observed in patients with KD/MIS-C compared to those with KD (40.5% vs. 14.6%, P = 0.009).
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60
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Infant with a florid rash. J Paediatr Child Health 2023; 59:1336-1337. [PMID: 38073248 DOI: 10.1111/jpc.1_16336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 01/10/2023] [Indexed: 12/18/2023]
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61
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Chawla S, Charan A, Tanwar GS. Widespread rash, leg pain and increased muscle bulk. Arch Dis Child Educ Pract Ed 2023; 108:467-468. [PMID: 37875325 DOI: 10.1136/archdischild-2023-326135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 09/23/2023] [Indexed: 10/26/2023]
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62
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Muralidharan M, Hill AE, Onwuegbuchu E, Laycock KM, Treat J, Congdon M. A Tale of 2 Febrile Rashes: A Case Study. Clin Pediatr (Phila) 2023; 62:1583-1586. [PMID: 36964692 DOI: 10.1177/00099228231163938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2023]
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63
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Yamaguchi H, Hagino N. Heliotrope rash and puffy fingers due to Kikuchi-Fujimoto disease. Joint Bone Spine 2023; 90:105606. [PMID: 37414136 DOI: 10.1016/j.jbspin.2023.105606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/08/2023]
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64
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Hanford J, Liu CC, Elkeeb A, Bylund R. Rash at Birth in a Preterm Neonate. Neoreviews 2023; 24:e809-e813. [PMID: 38036446 DOI: 10.1542/neo.24-12-e809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
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65
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Rajkumar J, B Warren J, Park J. Exfoliative Erythematous Rash in an 11-day-old Preterm Infant. Pediatr Rev 2023; 44:e33-e36. [PMID: 38036440 DOI: 10.1542/pir.2022-005739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
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66
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Flinn R. An unrelenting rash. JAAPA 2023; 36:46-48. [PMID: 37989171 DOI: 10.1097/01.jaa.0000991360.20046.c7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2023]
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Basu S, Sil A, Jindal AK, Tyagi R, Arafath MY, Vyas S, Rawat A. A young boy with rash, arthritis, and developmental delay: Monogenic lupus due to DNASE2 gene defect. Int J Rheum Dis 2023; 26:2599-2602. [PMID: 37431703 DOI: 10.1111/1756-185x.14826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 12/17/2022] [Accepted: 06/27/2023] [Indexed: 07/12/2023]
Abstract
Monogenic causes are increasingly being recognized in patients with lupus, especially in early-onset disease. We herein report a boy with a novel mutation in the DNase 2 (DNASE2) gene presenting with monogenic lupus. A 6-year-old boy with a global developmental delay with microcephaly presented with chronic febrile illness with anemia, rash, polyarthritis, renal involvement, and hepatosplenomegaly. Laboratory investigations revealed positive antinuclear antibody, high anti-dsDNA antibody titers, hypocomplementemia, hypergammaglobulinemia, nephrotic range proteinuria, and diffuse proliferative glomerulonephritis. Magnetic resonance imaging of brain showed altered signal intensity in subcortical white matter in bilateral fronto-parieto-temporal lobes. Targeted next-generation sequencing revealed a novel pathogenic variant in DNASE2. He was treated with oral prednisolone, mycophenolate mofetil, cyclosporine, and hydroxychloroquine and is doing well on follow up. DNASE2 deficiency has been reported as a rare genetic cause of monogenic lupus. DNASE2 deficiency should be suspected in patients with early-onset lupus with polyarthritis, erythematous rash, and neurological involvement.
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Truong K, Fong G, Ming A. Infant with a florid rash. J Paediatr Child Health 2023; 59:1333-1334. [PMID: 36688261 DOI: 10.1111/jpc.16336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 01/10/2023] [Indexed: 01/24/2023]
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69
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Gui M, Johansen M, Reeder M. An uncommon cause of swimmer's rash: Allergic contact dermatitis to persulfates in pools. Pediatr Dermatol 2023; 40:1091-1093. [PMID: 36935105 DOI: 10.1111/pde.15293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 02/25/2023] [Indexed: 03/21/2023]
Abstract
Allergic contact dermatitis (ACD) is an important diagnosis to consider in patients with dermatitis following specific exposures. Classically, ACD from persulfates is associated with hair-bleaching products and spa water/swimming pool exposure and is most commonly reported in adult men. We report a case of ACD to potassium peroxymonopersulfate (PPMS), a common pool "shocking" chemical, in a 7-year-old boy presenting with recurrent and diffuse dermatitis triggered by swimming pool exposure.
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Carballido-Vázquez AM, Volo V, Vega-López TL, Santamarina-Albertos AS, Garabito-Solovera EL, Martínez-García G, Manchado-López P. Recurrent reactive infectious mucocutaneous eruption (RIME) secondary to Chlamydophila pneumoniae infection in an adult. Australas J Dermatol 2023; 64:537-543. [PMID: 37823565 DOI: 10.1111/ajd.14173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/20/2023] [Accepted: 09/28/2023] [Indexed: 10/13/2023]
Abstract
The terminology surrounding the clinical syndrome characterized by acute mucositis with minimal skin involvement has been a subject of debate over time. In recent years, terms such as mycoplasma-induced rash and mucositis and reactive infectious mucocutaneous eruption (RIME) have been introduced to encompass milder mucocutaneous diseases associated with respiratory infections, with implications for management and prognosis. We report the first case of recurrent RIME associated with Chlamydophila pneumoniae infection in an adult patient. RIME is likely underreported due to misclassification and a lack of testing for potential pathogens. Early recognition of recurrent RIME is of particular interest from the patient's perspective to reduce the frequency and duration of hospital admissions.
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71
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Daurelle C, Gouveia A. [Febrile rash in adult patients. Which diagnoses should we evoke in ambulatory care?]. REVUE MEDICALE SUISSE 2023; 19:2122-2126. [PMID: 37938308 DOI: 10.53738/revmed.2023.19.849.2122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
The diagnostic approach to febrile skin eruptions in adults requires a systematic methodology, combining an accurate history with careful clinical evaluation. The most frequent etiologies of febrile exanthem in the immunocompetent patient can be categorized as infectious (viral or bacterial) or non-infectious (toxidermia, connectivitis or vasculitis). Mononucleosis, primary HIV infection, secondary syphilis, disseminated gonococcemia and exanthematous drug eruption, are mentioned in detail in this article due to the difficulty of establishing a diagnosis in ambulatory medicine. A clinical vignette is presented to illustrate the reasoning in primary care, with recourse to further investigations depending on the clinical course.
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Maurer BT. Top 10 pediatric rashes. JAAPA 2023; 36:1-4. [PMID: 37884043 DOI: 10.1097/01.jaa.0000979504.79684.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
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Novoa RH, Huaman K, Caballero P. Light-Emitting Diode (LED) Phototherapy versus Non-LED Phototherapy Devices for Hyperbilirubinemia in Neonates: A Systematic Review and Meta-analysis. Am J Perinatol 2023; 40:1618-1628. [PMID: 35436802 DOI: 10.1055/a-1827-7607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
This review was conducted to evaluate the efficacy of light-emitting diode (LED) phototherapy as compared with the conventional phototherapy in neonates with unconjugated hyperbilirubinemia and their adverse effects. We searched the following databases right from their inception till April, 2021: MEDLINE, EMBASE, Cochrane Library, and LILACS. Randomized clinical trials (RCTs) comparing the LED phototherapy with other light sources, which enrolled newborns (term and preterm) with unconjugated hyperbilirubinemia were included. We included 21 articles in this review. The treatment with the LED light therapy had a lower failure rate as compared with the non-LED one (RR = 0.60, 95% CI: 0.39-0.94). The mean duration of phototherapy was significantly shorter in the group with the LED light source as compared with the one with the non-LED light source (mean difference [hours]: -8.07, 95% CI: -8.45 to -7.68), regardless of the type of non-LED units. However, the rate of bilirubin showed a comparable decline (mean difference [mg/dL/h]: 0.01, 95% CI: -0.00, 0.03) in both the light sources, irrespective of irradiance or distance. No studies reported primary outcomes related to the neurotoxicity effects of hyperbilirubinemia in neonates. The LED light devices caused a significantly higher risk of hypothermia. Neonates were at a lower risk of developing hyperthermia and skin rash with the LED light therapy. Our findings provide support for the use of LED light source phototherapy due to its better clinical efficacy, which is evidenced by its shorter duration and lower rate of treatment failure, as compared with the non-LED light sources. KEY POINTS: · The efficacy of phototherapy is dependent on specific characteristics of light sources of phototherapy devices.. · LED phototherapy demonstrated better efficacy with shorter duration and lower rate of treatment failure.. · Adverse effects of phototherapy devices such as hypothermia, hyperthermia, and skin rash should be monitored..
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Roux C, Dupin N, Marey J, Sohier P, Charpentier MC. Interstitial lung disease with a rash and autoimmunity. Respir Med Res 2023; 84:101029. [PMID: 37619427 DOI: 10.1016/j.resmer.2023.101029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 05/04/2023] [Accepted: 05/16/2023] [Indexed: 08/26/2023]
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75
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Ferré EMN, Lee CCR, Kong HH, Cowen EW, Lionakis MS. APECED Rash as the First Manifestation of APECED Syndrome. J Clin Immunol 2023; 43:1774-1777. [PMID: 37665538 DOI: 10.1007/s10875-023-01578-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/28/2023] [Indexed: 09/05/2023]
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