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Kametani T, Otani Y, Ohigashi T, Kubo T, Sakuda T, Furuta D, Ito Y, Shigenobu Y, Kakimoto M, Kawahara A, Kikuchi Y, Kobayashi T, Miyamori D, Kishikawa N, Kanno K, Ito M. Granulocyte Colony-stimulating Factor-induced Aortitis with Lung Injury, Splenomegaly, and a Rash During Treatment for Recurrent Extraosseous Mucinous Chondrosarcoma. Intern Med 2021; 60:1311-1315. [PMID: 33191326 PMCID: PMC8112981 DOI: 10.2169/internalmedicine.5913-20] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein report a case of aortitis induced by granulocyte colony-stimulating factor (G-CSF) that coincided with lung injury, splenomegaly, and cutaneous manifestations during treatment for recurrent extraosseous mucinous chondrosarcoma. Computed tomography revealed large-vessel vasculitis, splenomegaly, and pulmonary interstitial changes. Treatment with prednisolone was successful. Because sarcoma is a rare disease, this case is valuable for showing clinicians that G-CSF preparations could cause aortitis regardless of the patient's underlying diseases or therapeutic pharmacological backgrounds.
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Affiliation(s)
- Takahiro Kametani
- Department of General Internal Medicine, Hiroshima University Hospital, Japan
| | - Yuichiro Otani
- Department of General Internal Medicine, Hiroshima University Hospital, Japan
| | - Toshikazu Ohigashi
- Department of Pharmaceutical Services, Hiroshima University Hospital, Japan
| | - Tadahiko Kubo
- Department of Orthopaedic Surgery, Hiroshima University, Graduate School of Biomedical & Health Sciences, Japan
| | - Tomohiko Sakuda
- Department of Orthopaedic Surgery, Hiroshima University, Graduate School of Biomedical & Health Sciences, Japan
| | - Daisuke Furuta
- Department of Orthopaedic Surgery, Hiroshima University, Graduate School of Biomedical & Health Sciences, Japan
| | - Yayoiko Ito
- Department of General Internal Medicine, Hiroshima University Hospital, Japan
| | - Yuya Shigenobu
- Department of General Internal Medicine, Hiroshima University Hospital, Japan
| | - Masaki Kakimoto
- Department of General Internal Medicine, Hiroshima University Hospital, Japan
| | - Akihiro Kawahara
- Department of General Internal Medicine, Hiroshima University Hospital, Japan
| | - Yuka Kikuchi
- Department of General Internal Medicine, Hiroshima University Hospital, Japan
| | - Tomoki Kobayashi
- Department of General Internal Medicine, Hiroshima University Hospital, Japan
| | - Daisuke Miyamori
- Department of General Internal Medicine, Hiroshima University Hospital, Japan
| | - Nobusuke Kishikawa
- Department of General Internal Medicine, Hiroshima University Hospital, Japan
| | - Keishi Kanno
- Department of General Internal Medicine, Hiroshima University Hospital, Japan
| | - Masanori Ito
- Department of General Internal Medicine, Hiroshima University Hospital, Japan
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Abstract
Neutrophilic drug reactions are unique eruptions that can affect hospitalized patients and share a common pathophysiology with neutrophils as the key mediators of inflammation. They range in clinical presentation from papules and plaques to bullae and erosions to pustules. Although there is some overlap in presentation, each has distinguishing features that aid the clinician in differentiation from one another and from other drug hypersensitivity reactions. Much of the data on these reactions are from case reports and series or retrospective review studies. There are limited prospective observational studies dedicated to these adverse drug reactions. We review the more common and life-threatening neutrophilic drug reactions, their proposed mechanism of action, and their management.
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Affiliation(s)
- Alexandra J Coromilas
- Department of Dermatology, Columbia University Medical Center, New York, New York, USA
| | - Stephanie M Gallitano
- Department of Dermatology, Columbia University Medical Center, New York, New York, USA.
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Puar N, Scheele A, Perez Marques F, Panicker J. Neutrophilic eccrine hidradenitis secondary to pegfilgrastim in a patient with synovial sarcoma. Clin Case Rep 2019; 7:533-536. [PMID: 30899488 PMCID: PMC6406152 DOI: 10.1002/ccr3.1932] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 08/30/2018] [Accepted: 09/12/2018] [Indexed: 11/16/2022] Open
Abstract
Here, we report a case of neutrophilic eccrine hidradenitis (NEH) in a teenage male with synovial sarcoma associated with extracutaneous manifestations including myositis and splenomegaly secondary to pegfilgrastim. To the best of our knowledge, NEH has not been previously reported to occur in association with extracutaneous manifestations.
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Affiliation(s)
- Neha Puar
- University of Kansas HospitalKansas CityKansas
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Hawryluk EB, Linskey KR, Duncan LM, Nazarian RM. Broad range of adverse cutaneous eruptions in patients on TNF-alpha antagonists. J Cutan Pathol 2012; 39:481-92. [PMID: 22515220 DOI: 10.1111/j.1600-0560.2012.01894.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Biologic therapies targeting tumor necrosis factor (TNF)-alpha have become a mainstay in the management of a number of autoimmune diseases. We report a series of adverse skin eruptions in six patients (four females, two males, age: 21-58 years, mean: 39) receiving 4 months to 10 years (mean 3.1 years) of anti-TNF-alpha therapies (infliximab, n = 4; adalimumab, n = 1 or etanercept, n = 1). The following drug-associated diagnoses were made in eight skin biopsies performed at Massachusetts General Hospital between 3/2007 and 10/2010: pustular folliculitis, psoriasis, interface dermatitis, neutrophilic eccrine hidradenitis, Sweet's syndrome, lupus, vasculitis and palmoplantar pustulosis. The descriptions of neutrophilic eccrine hidradenitis-like and Sweet's-like hypersensitivity eruptions induced by anti-TNF-alpha therapies are the first such cases described in the literature. Each cutaneous eruption improved or resolved with switching to a different TNF-alpha inhibitor, discontinuation of the anti-TNF-alpha agent, and/or topical or systemic steroids. There was a clear chronologic relationship with, and clinical remission upon withdrawal or steroid suppression of the anti-TNF-alpha agents. The mechanism for such diverse cutaneous eruptions among this class of medications remains poorly understood. The cutaneous adverse reaction profile of TNF-alpha inhibitors is broad and should be considered in the histopathologic differential in this clinical setting.
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Affiliation(s)
- Elena B Hawryluk
- Department of Dermatology, Harvard Medical School, Boston, MA, USA
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Lee WJ, Kim CH, Chang SE, Lee MW, Choi JH, Moon KC, Koh JK. Generalized idiopathic neutrophilic eccrine hidradenitis in childhood. Int J Dermatol 2010; 49:75-8. [DOI: 10.1111/j.1365-4632.2009.04169.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Uhara H, Saida T, Nakazawa H, Ito T. Neutrophilic dermatoses with acute myeloid leukemia associated with an increase of serum colony-stimulating factor. J Am Acad Dermatol 2008; 59:S10-2. [DOI: 10.1016/j.jaad.2007.08.026] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2007] [Revised: 08/13/2007] [Accepted: 08/28/2007] [Indexed: 11/25/2022]
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Heidary N, Naik H, Burgin S. Chemotherapeutic agents and the skin: An update. J Am Acad Dermatol 2008; 58:545-70. [PMID: 18342708 DOI: 10.1016/j.jaad.2008.01.001] [Citation(s) in RCA: 140] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2007] [Revised: 01/07/2008] [Accepted: 01/10/2008] [Indexed: 12/17/2022]
Abstract
UNLABELLED Chemotherapeutic agents give rise to numerous well described adverse effects that may affect the skin, hair, mucous membranes, or nails. The mucocutaneous effects of longstanding agents have been extensively studied and reviewed. Over the last 2 decades, a number of new molecular entities for the treatment of cancer have been approved by the United States Food and Drug Administration (FDA). This article reviews the cutaneous toxicity patterns of these agents. It also reviews one drug that has not received FDA approval but is in use outside the United States and is important dermatologically. Particular emphasis is placed on the novel signal transduction inhibitors as well as on newer literature pertaining to previously described reactions. LEARNING OBJECTIVES At the completion of this learning activity, participants should able to list the newer chemotherapeutic agents that possess significant mucocutaneous side effects and describe the range of reactions that are seen with each drug. In addition, they should be able to formulate appropriate management strategies for these reactions.
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Affiliation(s)
- Noushin Heidary
- Ronald O. Perelman Department of Dermatology, New York University, New York, USA
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Srivastava M, Scharf S, Meehan SA, Polsky D. Neutrophilic eccrine hidradenitis masquerading as facial cellulitis. J Am Acad Dermatol 2007; 56:693-6. [PMID: 17109994 DOI: 10.1016/j.jaad.2006.07.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2006] [Revised: 06/19/2006] [Accepted: 07/18/2006] [Indexed: 10/23/2022]
Abstract
Neutrophilic eccrine hidradenitis typically manifests as erythematous plaques on the face, trunk, or extremities. This eruption has been associated with numerous factors, but most commonly is seen with chemotherapy, particularly cytarabine. We report a 73-year-old woman with acute myelogenous leukemia who developed rapidly expansive neutrophilic eccrine hidradenitis mimicking facial cellulitis only after a course of cytarabine was followed by granulocyte-colony stimulating factor. Prompt diagnosis is imperative to prevent prolonged antimicrobial therapy.
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Affiliation(s)
- Monika Srivastava
- Ronald O. Perelman Department of Dermatology, New York University School of Medicine, NY 10016, USA
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Abstract
A 75-year-old man was treated for non-small cell lung cancer (NSCLC) (stage IIIb) with three-cycle chemotherapy (cisplatin and paclitaxel) for 3 weeks. No skin lesions were observed during the first and second chemotherapy cycles. After the third chemotherapy cycle, he developed slightly pruritic skin eruptions on the anterior chest. He was treated for 1 month with topical steroid without improvement, and was referred to our dermatologic department. Skin examination revealed slightly elevated, dusky, erythematous, edematous patches on the anterior chest in a bilateral distribution (Fig. 1). Histologic examination of a biopsy specimen taken from the cutaneous lesions showed a neutrophilic infiltrate surrounding the secretory eccrine glands. The epithelial cells of the eccrine ducts and coils were not affected. There was a mild superficial perivascular infiltrate of mainly lymphocytes. These changes were consistent with a diagnosis of neutrophilic eccrine hidradenitis (Fig. 2). He was treated with dapsone, 50 mg/day, and methylprednisolone, 8 mg/day, for 2 weeks, and his skin lesions improved. Two months later the erythematous eruptions recurred on the chest, back, and extremities without the use of any chemotherapeutic agent, and were treated effectively with the same drugs.
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Affiliation(s)
- Seung Gyu Lee
- Department of Dermatology, Inha University, College of Medicine, Incheon, South Korea
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Ferran M, Gallardo F, Salar A, Iglesias M, Barranco C, Pujol RM. Granulomatous Dermatitis with Enlarged Histiocytes: A Characteristic Pattern of Granulocyte Colony-Stimulating Factor. Dermatology 2006; 212:188-93. [PMID: 16484826 DOI: 10.1159/000090660] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2005] [Accepted: 09/09/2005] [Indexed: 11/19/2022] Open
Abstract
Two patients developed a pruritic maculopapular rash following treatment with granulocyte colony-stimulating factor (G-CSF). Histopathological examination disclosed a superficial dermal inflammatory infiltrate composed of interstitially arranged large histiocytic CD68+ cells and perivascularly disposed lymphocytes. Large histiocytes were interspersed among the collagen bundles with associated slight deposits of mucin. Elastophagocytosis was occasionally observed, and a slight reduction of dermal elastic fibers was also noted. There was no evidence of frank granuloma formation, fibrosis or significant changes of collagen bundles. This histopathological variant of granulomatous dermatitis with "enlarged histiocytes" seems to be characteristic of an unusual cutaneous reaction secondary to CSF treatment.
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Affiliation(s)
- Marta Ferran
- Department of Dermatology, Hospital del Mar, IMAS, Passeig Maritim 25-29, ES-08003 Barcelona, Spain.
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Shih IH, Huang YH, Yang CH, Yang LC, Hong HS. Childhood neutrophilic eccrine hidradenitis: A clinicopathologic and immunohistochemical study of 10 patients. J Am Acad Dermatol 2005; 52:963-6. [PMID: 15928612 DOI: 10.1016/j.jaad.2005.01.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Neutrophilic eccrine hidradenitis (NEH) is occasionally reported in patients who have not received chemotherapy. OBJECTIVE The purpose of this study was to describe the clinicopathologic features of NEH occurring in healthy children and to investigate the interleukin (IL)-8 expression in the cutaneous lesions. METHODS Ten children with characteristic histologic features of NEH were collected from the Chang Gung Memorial Hospital. Their formalin-fixed, paraffin-embedded specimens were examined by immunohistochemical staining for IL-8. RESULTS The age of first presentation at our clinic ranged from 6 months to 14 months with a median age of 9.1 months. The onset of the disease clustered in the summertime. The most common clinical appearance was multiple erythematous papules and nodules on the limbs. Two of 7 biopsy specimens grew coagulase-negative Staphylococcus . None of patients had underlying systemic disease and all had complete resolution of the lesions within 3 weeks. Immunohistochemical staining for IL-8 was negative in the 10 cases studied. CONCLUSION Childhood NEH appears as urticaria-like erythematous nodules and plaques on the limbs, trunk, or scalp. This benign and limited disease occurs with a predilection for summer months. In our study, onset was in children less than 15 months of age. IL-8 was not detected in the cutaneous lesions.
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Affiliation(s)
- I-Hsin Shih
- Department of Dermatology, Chang Gung MemorialHospital, Taipei 105, Taiwan
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Abecassis S, Ingen-Housz-Oro S, Cavelier-Balloy B, Arnulf B, Bachelez H, Dubertret L. [Particular histological features of a case of Sweet's syndrome induced by G-CSF]. Ann Dermatol Venereol 2005; 131:369-72. [PMID: 15258512 DOI: 10.1016/s0151-9638(04)93617-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Sweet's syndrome may occur during medullar aplasia, especially after treatment with exogenous growth factors such as G-CSF. In this context, Sweet's syndrome presents particular histological features that we detail in this observation. CASE REPORT A 50 year-old man was treated for multiple myeloma with a mobilizating chemotherapy prior to autologous stem cell transplantation. Four days after the onset of G-CSF, he presented with a febrile generalized eruption of erythematous infiltrated lesions. Histological examination of a skin biopsy showed a neutrophilic infiltrate associated with atypical xanthomized histiocytes and vascular hyperplasia with marked endothelial turgescence. Treatment with a short cause of oral corticosteroids was efficient. DISCUSSION The classical histological features of Sweet's syndrome consist in a dermal neutrophilic infiltrate with edema. In our patient, we noticed the presence of atypical histiocytes among the dermal neutrophilic infiltrate. These histiocytes are described in maculo-papular eruptions induced by G-CSF, and should not be confused with a malignant infiltrate associated with a hemopathy. Vascular hyperplasia may be related to the angiogenic properties of G-CSF. Knowledge of these histological features would enable clinicians and histologists to recognize the appropriate diagnosis.
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Affiliation(s)
- S Abecassis
- Service de Dermatologie I, Hôpital Saint-Louis, 1, avenue Claude Vellefaux, 75010 Paris
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Antonovich DD, Berke A, Grant-Kels JM, Fung M. Infectious eccrine hidradenitis caused by nocardia. J Am Acad Dermatol 2004; 50:315-8. [PMID: 14726895 DOI: 10.1016/s0190-9622(03)02163-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Neutrophilic eccrine hidradenitis is a nonspecific clinical reaction pattern classified as a neutrophilic dermatosis that typically occurs in the setting of chemotherapy for hematologic malignant disease. Neutrophilic eccrine hidradenitis more rarely has been reported in association with infectious agents, including Serratia, Enterobacter, Staphylococcus, and HIV. We describe the first case of infectious eccrine hidradenitis occurring in a patient with cutaneous Nocardia infection.
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Affiliation(s)
- Diana D Antonovich
- Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut 06030, USA
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Nijsten TEC, Meuleman L, Lambert J. Chronic pruritic neutrophilic eccrine hidradenitis in a patient with Behçet's disease. Br J Dermatol 2002; 147:797-800. [PMID: 12366434 DOI: 10.1046/j.1365-2133.2002.04926.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Neutrophilic eccrine hidradenitis (NEH) is a rare distinct entity that usually presents as asymptomatic erythematous papules that disappear spontaneously in 1-3 weeks. However, its appearance may be polymorphic, pruritic, recurrent or even chronic as is described in this case. The histological combination of neutrophilic infiltration in and necrosis of the eccrine secretory gland epithelium is highly characteristic for NEH. It typically occurs in patients receiving chemotherapeutic drugs for malignancies, but other associations have also been reported. To our knowledge, we report the first case of NEH in a patient with Behçet's disease (BD). Cutaneous manifestations of BD, an inflammatory systemic disorder of unknown origin, include neutrophilic dermatoses such as Sweet's syndrome and pyoderma gangrenosum, although these are unusual in BD. NEH could be another neutrophilic dermatosis related to BD. This observation suggests that NEH is not strictly related to chemotherapeutic drugs and malignancies. It appears to be a reactive dermatosis associated with other factors as well, including BD. Treatment was successful with dapsone 100 mg daily.
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Affiliation(s)
- T E C Nijsten
- Department of Dermatology, University Hospital Antwerp, Wilrijkstraat 10, B-2650 Edegem, Belgium
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Marini M, Wright D, Ropolo M, Abbruzzese M, Casas G. Neutrophilic eccrine hidradenitis secondary to topotecan. J DERMATOL TREAT 2002; 13:35-7. [PMID: 12006137 DOI: 10.1080/09546630252775234] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Neutrophilic eccrine hidradenitis (NEH) is a self-restricted inflammatory condition, usually secondary to chemotherapeutic agents and less frequently to other drugs such as zidovudine or various infections. NEH clinical features include erythematous, occasionally painful nodules and plaques. Histological examinations reveal neutrophilic infiltrates and degeneration of eccrine glands. METHODS A 45-year-old female was treated with topotecan and colony-stimulating factor for ovarian cancer. RESULTS The erythematous and slightly pruritic plaques on the upper and lower limbs and ear lobes appeared approximately 1 week after chemotherapy and spontaneously subsided in about 10 days, only to recur after the next drug dose. A skin biopsy revealed NEH; all skin cultures were negative. CONCLUSION It is believed that this patient developed topotecan-induced NEH; this relationship with therapy rather than the underlying disease rules out a paraneoplastic reaction, and negative cultures excluded infectious causes. In addition, since skin lesions recurred after CSF was discontinued, this agent was not involved. Studies relating NEH to topotecan, a topoisomerasa I inhibitor, have not reported such an event in the literature.
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Affiliation(s)
- M Marini
- Department of Dermatology, Hospital de Clínicas, University of Buenos Aires School of Medicine, Buenos Aires, Argentina.
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Keane FM, Munn SE, Buckley DA, Hopster D, Mufti GJ, du Vivier AW. Neutrophilic eccrine hidradenitis in two neutropaenic patients. Clin Exp Dermatol 2001; 26:162-5. [PMID: 11298106 DOI: 10.1046/j.1365-2230.2001.00785.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We describe two patients, who presented with erythematous facial plaques, in keeping with neutrophilic eccrine hidradenitis, during chemotherapy for acute myeloid leukaemia. Both patients were neutropaenic and febrile. Histology showed a dermal neutrophilic infiltrate around the eccrine glands with gland destruction. The importance of recognizing this disorder is to prevent the inappropriate use of antibiotics as it is self limiting.
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Affiliation(s)
- F M Keane
- Department of Dermatology, King's College Hospital, London, UK
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Roustan G, Salas C, Cabrera R, Simón A. Neutrophilic eccrine hidradenitis unassociated with chemotherapy in a patient with acute myelogenous leukemia. Int J Dermatol 2001. [DOI: 10.1046/j.1365-4362.2001.11775.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Bachmeyer C, Reygagne P, Aractingi S. Recurrent neutrophilic eccrine hidradenitis in an HIV-1-infected patient. Dermatology 2000; 200:328-30. [PMID: 10894966 DOI: 10.1159/000018398] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Most cases of neutrophilic eccrine hidradenitis (NEH) have been reported in patients receiving chemotherapy for acute myelogenous leukemia or other malignant diseases. We report the case of an HIV-1-infected patient who presented several and strikingly similar episodes of NEH without any medication as well as another one after the first course of chemotherapy for a B-cell non-Hodgkin's lymphoma. This case strengthens the hypothesis that NEH may occur in different situations, as reported for other neutrophilic dermatoses.
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Affiliation(s)
- C Bachmeyer
- Unité de Dermatologie, Hôpital Tenon, Paris, France
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Kallarackal G, Jones SM. Psoriatic arthritis, nail disease and pustules following Hodgkin's lymphoma. Rheumatology (Oxford) 2000; 39:930-1. [PMID: 10952760 DOI: 10.1093/rheumatology/39.8.930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Affiliation(s)
- C Bachmeyer
- Unité de Dermatologie, Hôpital Tenon, Paris, France
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