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Kearney A, Williamson PR, Dodd S. A review of core outcome sets (COS) developed for different settings finds there is a subset of outcomes relevant for both research and routine care. J Clin Epidemiol 2024; 173:111440. [PMID: 38936556 DOI: 10.1016/j.jclinepi.2024.111440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Revised: 06/06/2024] [Accepted: 06/19/2024] [Indexed: 06/29/2024]
Abstract
OBJECTIVES To compare the outcomes selected for the same condition in core outcome sets (COSs) for research with those in COS for the routine care setting. METHODS A sample of COS was created from the most frequent five health areas within previous systematic reviews of COS for research and COS for routine care. Outcomes were extracted and categorized using an outcome taxonomy. Frequency of outcome domains included within COS were analyzed in subgroups according to research or care setting, patient involvement in COS development and health area. Matched sets of COS were created, where at least one research COS and one routine care COS exist for the same health condition, to identify the outcomes that were recommended for both settings. A similar process was used for a subset of paired COS matched in scope for both intervention and population as well as health condition. RESULTS The sample of COS comprised: 246 COS for research only, 76 COS for routine care only and 55 COS for both research and routine care. Across the 18 sets matched by health condition the median number (range) of outcomes included in both research COS and routine care COS was 6 (3-15), with differences noted across health areas. For the 11 paired COS matched by scope and health condition, the corresponding figures were 2 (2-8). Across all settings, COS that did not include patients as participants were less likely to include life impact outcomes. CONCLUSION Within a given health condition, a small number of core outcomes were found to be relevant for both research and care, offering a meaningful starting point for linking research and real-world evaluation.
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Affiliation(s)
- Anna Kearney
- Health Data Science, University of Liverpool, Liverpool, UK.
| | | | - Susanna Dodd
- Health Data Science, University of Liverpool, Liverpool, UK
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2
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Nadir U, Ahmed A, Yi MD, Hisham FI, Dave L, Kottner J, Ezzedine K, Garg A, Ingram JR, Jemec GBE, Spuls PI, Kirkham JJ, Cahn B, Alam M. Protocol of a scoping review of outcome domains in dermatology. BMJ Open 2024; 14:e079632. [PMID: 38320843 PMCID: PMC10860027 DOI: 10.1136/bmjopen-2023-079632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/26/2024] [Indexed: 02/15/2024] Open
Abstract
INTRODUCTION Core outcome sets (COSs) are agreed outcomes (domains (subdomains) and instruments) that should be measured as a minimum in clinical trials or practice in certain diseases or clinical fields. Worldwide, the number of COSs is increasing and there might be conceptual overlaps of domains (subdomains) and instruments within disciplines. The aim of this scoping review is to map and to classify all outcomes identified with COS projects relating to skin diseases. METHODS AND ANALYSIS We will conduct a scoping review of outcomes of skin disease-related COS initiatives to identify all concepts and their definitions. We will search PubMed, Embase and Cochrane library. The search dates will be 1 January 2010 (the point at which Core Outcome Measures in Effectiveness Trials (COMET) was established) to 1 January 2024. We will also review the COMET database and C3 website to identify parts of COSs (domains and/or instruments) that are being developed and published. This review will be supplemented by querying relevant stakeholders from COS organisations, dermatology organisations and patient organisations for additional COSs that were developed. The resulting long lists of outcomes will then be mapped into conceptually similar concepts. ETHICS AND DISSEMINATION This study was supported by departmental research funds from the Department of Dermatology at Northwestern University. An ethics committee review was waived since this protocol was done by staff researchers with no involvement of patient care. Conflicts of interests, if any, will be addressed by replacing participants with relevant conflicts or reassigning them. The results will be disseminated through publication in peer-reviewed journals, social media posts and promotion by COS organisations.
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Affiliation(s)
- Umer Nadir
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Areeba Ahmed
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Michael D Yi
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Loma Dave
- Department of Dermatology, Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jan Kottner
- Charité Universitätsmedizin Berlin, Berlin, Germany
| | - K Ezzedine
- Service de Dermatologie, AP-HP, Henri Mondor Hospital, Paris, France
| | - Amit Garg
- Department of Dermatology, Hofstra Northwell School of Medicine, Long Island, New York, USA
| | | | | | - Phyllis I Spuls
- Department of Dermatology, Amsterdam UMC, location Academic Medical Center, University of Amsterdam, Amsterdam Public Health, Infection and Immunity, Amsterdam, Netherlands
| | | | - Brian Cahn
- Department of Dermatology, University of Illinois, Chicago, Illinois, USA
| | - Murad Alam
- Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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3
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Gout HA, Fledderus AC, Lokhorst MM, Pasmans SGMA, Breugem CC, Lapid O, van der Horst CMAM. Safety and effectiveness of surgical excision of medium, large, and giant congenital melanocytic nevi: A systematic review and meta-analysis. J Plast Reconstr Aesthet Surg 2023; 77:430-455. [PMID: 36652871 DOI: 10.1016/j.bjps.2022.10.048] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 06/28/2022] [Accepted: 10/04/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND Treatment indications of congenital melanocytic naevi (CMN) have shifted from the prevention of malignant transformation more towards the improvement of appearance and psychosocial health. Surgical excision is often preferred, but its safety and effectiveness remain unclear. OBJECTIVE To assess the outcomes of surgical excision of medium-to-giant CMN. PRIMARY OUTCOME safety (complications). SECONDARY OUTCOME effectiveness (satisfaction and CMN core outcomes). METHODS PubMed, EMBASE, and CENTRAL were searched for studies on the excision of medium-to-giant CMN and/or CMN requiring reconstruction or serial excision. Meta-analyses of safety per patient were conducted, and pooled outcomes of safety and effectiveness were presented in summary-of-findings tables. RESULTS A total of 1444 studies were found, of which 22 were included, evaluating 643 eligible patients. Study quality varied, and reporting of baseline characteristics and outcomes was heterogeneous. Pooled proportions were overall 9.8% for major wound-related complications, 1.2% for minor wound-related complications, 1.2% for scar-related complications, and 4.3% for anatomical deformities. For large/giant CMN, complication rates were, respectively, 23.1%, 2.9%, 12.9%, and 2.4%; and for CMN with eyelid involvement, 0.5%, 3.3%, 0.4%, and 54.2%. Patients rated their satisfaction with the cosmetic outcome as 24.4% excellent, 71.0% good, and 4.6% poor/moderate. Physicians rated this as 18.3% excellent, 70.1% good, and 11.7% poor/moderate. Thirty-five other outcomes of effectiveness were summarized. However, many were rarely reported. CONCLUSIONS Surgical excision of CMN appears to be safe and effective in many cases, depending on CMN size and location. Major wound-related complications and scar-related complications occurred more frequently with large/giant CMN, whereas anatomical deformities occurred with the majority of CMN with eyelid involvement.
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Affiliation(s)
- H Antoine Gout
- Department of Plastic, Reconstructive, and Hand Surgery, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands.
| | - Anne C Fledderus
- Department of Plastic, Reconstructive, and Hand Surgery, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands; Department of Dermatology, Erasmus University Medical Center - Sophia Children's Hospital, Erasmus University Rotterdam, Dr. Molewaterplein 40, 3015GD Rotterdam, the Netherlands
| | - Max M Lokhorst
- Department of Plastic, Reconstructive, and Hand Surgery, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands
| | - Suzanne G M A Pasmans
- Department of Dermatology, Erasmus University Medical Center - Sophia Children's Hospital, Erasmus University Rotterdam, Dr. Molewaterplein 40, 3015GD Rotterdam, the Netherlands
| | - Corstiaan C Breugem
- Department of Plastic, Reconstructive, and Hand Surgery, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands
| | - Oren Lapid
- Department of Plastic, Reconstructive, and Hand Surgery, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands
| | - Chantal M A M van der Horst
- Department of Plastic, Reconstructive, and Hand Surgery, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105AZ Amsterdam, the Netherlands
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4
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Lechner A, Coleman S, Balzer K, Kirkham JJ, Muir D, Nixon J, Kottner J. Core outcomes for pressure ulcer prevention trials: results of an international consensus study. Br J Dermatol 2022; 187:743-752. [PMID: 35789479 DOI: 10.1111/bjd.21741] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 06/28/2022] [Accepted: 07/02/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is substantial heterogeneity between trial outcomes in pressure ulcer prevention research. The development of core outcome sets (COS) is one strategy to improve comparability between trial results and thus increase the quality of evidence. OBJECTIVES The aim of this study was to identify core outcomes for pressure ulcer prevention trials. METHODS A workshop was held with service users to discuss their views and understanding of the outcomes identified by a scoping review and to identify any missing outcomes. In a next step a Delphi survey comprising three rounds was conducted to evaluate a compiled list of outcomes by their importance. Afterwards the preselection from the Delphi survey was discussed in a virtual consensus meeting with the aim of agreeing on a final set of core outcomes. Individuals who had completed all three rounds of the Delphi survey were eligible to participate in this meeting. Participants included practitioners, service users, researchers and industry representatives. RESULTS The workshop did not reveal any missing outcomes, but the need for further efforts to make lay people understand what an outcome is in a study setting. The Delphi survey took place between December 2020 and June 2021. After the three rounds, 18 out of 37 presented outcomes were rated to be critically important. In the following consensus meeting six outcomes were prioritized to be included in the COS for pressure ulcer prevention trials: (1) pressure ulcer occurrence, (2) pressure ulcer precursor signs and symptoms, (3) mobility, (4) acceptability and comfort of intervention, (5) adherence/compliance and (6) adverse events/safety. CONCLUSION Based on a comprehensive list of outcomes in pressure ulcer prevention research, there was clear agreement on the six identified core outcomes in three international Delphi rounds and in the consensus meeting. Although outcome measurement instruments need to be identified next, the six identified core outcomes should already be considered in future trials, as service users, practitioners, researchers and industry representatives have agreed that they are critically important.
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Affiliation(s)
- Anna Lechner
- Department of Dermatology and Allergy, Clinical Research Center for Hair and Skin Science, Berlin, Germany
| | - Susanne Coleman
- Institute of Clinical Trials Research, Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - Katrin Balzer
- Institute of Clinical Trials Research, Clinical Trials Research Unit, University of Leeds, Leeds, UK.,Institute for Social Medicine and Epidemiology, Nursing Research Unit, University of Lübeck, Lübeck, Germany
| | - Jamie J Kirkham
- Centre for Biostatistics, The University of Manchester, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Delia Muir
- Institute of Clinical Trials Research, Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - Jane Nixon
- Institute of Clinical Trials Research, Clinical Trials Research Unit, University of Leeds, Leeds, UK
| | - Jan Kottner
- Institute of Clinical Nursing Science, Berlin, Germany
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5
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Fledderus AC, Widdershoven AL, Lapid O, Breugem CC, Pasmans SGMA, van der Horst CMAM, Engelen MM, Spuls PI. Neurological signs, symptoms and MRI abnormalities in patients with congenital melanocytic naevi and evaluation of routine MRI-screening: systematic review and meta-analysis. Orphanet J Rare Dis 2022; 17:95. [PMID: 35236387 PMCID: PMC8889704 DOI: 10.1186/s13023-022-02234-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 02/06/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A congenital melanocytic naevus (CMN) is a rare skin condition that can be associated with abnormalities of the central nervous system (CNS). These anomalies can sometimes cause severe complications, and rarely death. Adequate information about aetiology and management is therefore crucial. To identify how to monitor patients with CMN, we aimed to estimate the prevalence of neurological involvement in patients with CMN and to summarize what specific neurological signs and symptoms and MRI abnormalities are reported in the medical literature. In addition, we summarized and evaluated the recommendations regarding MRI-screening reported in the medical literature. METHODS This review was registered in PROSPERO and reported according to the MOOSE checklist. A search was conducted in EMBASE (Ovid), PubMed, and the Cochrane Library. We included studies with 10 or more patients with CMN, reporting on neurological signs and symptoms or CNS MRI. Study selection, data extraction and methodological quality assessment were performed by two independent reviewers. A meta-analysis was used to assess the prevalence of neurological signs and symptoms. RESULTS Out of 1287 studies, fourteen studies were eligible for inclusion of which eight were included in the meta-analysis. Neurological signs and symptoms prevalence was 7.04% (CI 95% 4.47-10.93%) in the meta-analysis group and 6.26% (95% CI 3.85-10%) in a subgroup of patients with a CMN > 6 cm, evaluated in seven studies. Neurodevelopmental delay and seizures were the most frequently reported signs and symptoms. CNS melanocytosis and hydrocephalus were the most frequently reported MRI abnormalities. It was not possible to estimate the increased risk of neurological involvement in patients with CMN due to low quality of evidence and clinical heterogeneity. CONCLUSION Standardization in CMN studies and a multi-centre prospective study are needed to evaluate neurological involvement. Based on current literature, it is not possible to make strong recommendations on routine MRI-screening. For now, every clinical centre should decide on its own policy and weigh the advantages and disadvantages of routine MRI.
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Affiliation(s)
- Anne C Fledderus
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
- Department of Dermatology, Amsterdam Public Health, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Location AMC, University of Amsterdam, 1100 DD, Amsterdam, The Netherlands.
| | - Anna Linn Widdershoven
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Department of Pediatric Neurology, Amsterdam Public Health, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Oren Lapid
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Corstiaan C Breugem
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Suzanne G M A Pasmans
- Department of Dermatology, Erasmus MC University Medical Center Rotterdam-Sophia Children's Hospital, Doctor Molewaterplein 40, 3015GD, Rotterdam, The Netherlands
| | - Chantal M A M van der Horst
- Department of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Marc M Engelen
- Department of Pediatric Neurology, Amsterdam Public Health, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Phyllis I Spuls
- Department of Dermatology, Amsterdam Public Health, Amsterdam University Medical Center, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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Heppt MV, Steeb T, Berking C. Another step on the road towards standardized outcome reporting for congenital melanocytic naevi: one more to go! Br J Dermatol 2021; 185:881-882. [PMID: 34468984 DOI: 10.1111/bjd.20691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 07/06/2021] [Indexed: 11/30/2022]
Affiliation(s)
- M V Heppt
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054, Erlangen, Germany.,Comprehensive Cancer Center Erlangen - European Metropolitan Region of Nuremberg, Erlangen, Germany
| | - T Steeb
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054, Erlangen, Germany.,Comprehensive Cancer Center Erlangen - European Metropolitan Region of Nuremberg, Erlangen, Germany
| | - C Berking
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054, Erlangen, Germany.,Comprehensive Cancer Center Erlangen - European Metropolitan Region of Nuremberg, Erlangen, Germany
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7
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Liu P, Su J, Zheng X, Chen M, Chen X, Li J, Peng C, Kuang Y, Zhu W. A Clinicopathological Analysis of Melanocytic Nevi: A Retrospective Series. Front Med (Lausanne) 2021; 8:681668. [PMID: 34447761 PMCID: PMC8383488 DOI: 10.3389/fmed.2021.681668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 06/17/2021] [Indexed: 12/22/2022] Open
Abstract
Purpose: Melanocytic nevi are common cutaneous lesions. This study aimed to demonstrate the concordance and discordance between clinical and histopathological diagnoses of melanocytic nevi and the importance of histological evaluation in differentiating malignant lesions from diseases with similar clinical manifestations. Patients and Methods: We studied 4,561 consecutive patients with a clinical diagnosis of melanocytic nevi from 2014 to 2019. We compared the clinical diagnosis with the histopathological diagnosis to establish a histopathological concordance rate and then investigated the effects of clinical characteristics and the reasons for removal on misclassification. Results: Among 4,561 patients who were clinically diagnosed with melanocytic nevi, the overall histopathological concordance rate was 82.11% (3,745 of 4,561 patients), while the histopathological discordance rate was 17.89% (816 of 4,561 patients). The histopathological concordance included 90.25% common acquired melanocytic nevi (3,380 of 3,745 patients) and 9.75% other benign melanocytic neoplasms (365 of 3,745 patients). The most common diagnostic change was to seborrheic keratosis (n = 470, 10.30%), followed by basal cell carcinoma (n = 64, 1.40%), vascular tumor (n = 53, 1.16%), fibroma (n = 43, 0.94%), epidermoid cyst (n = 34, 0.75%), wart (n = 30, 0.66%), melanoma (n = 24, 0.53%), Bowen's disease (n = 16, 0.35%), squamous cell carcinoma (n = 4, 0.09%), keratoacanthoma (n = 2, 0.04%), and other neoplasms (n = 76, 1.67%). Male sex, old age, location of the lesion, and the reasons for removal have a potential effect on misclassification. The percentages of misclassified lesions on the trunk and limbs and the perineum and buttocks were higher than those in lesions without a change in diagnosis. Importantly, locations of lesions on the head and neck were significantly related to a change in diagnosis to non-melanoma skin cancer, while locations on the hands and feet were significantly related to a change in diagnosis to melanoma. In addition to a typical clinical features, removal due to lesion changes or repeated stimulation was significantly associated with a change in diagnosis to melanoma. Conclusions: Our study emphasizes the clinical differential diagnosis of melanocytic nevi, especially the possibility of malignant tumors. The occurrence of clinical features associated with clinicopathological discordance should raise the clinical suspect and be carefully differentiated from malignant tumors.
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Affiliation(s)
- Panpan Liu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China.,Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
| | - Juan Su
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China.,Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
| | - Xuanwei Zheng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China.,Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
| | - Mingliang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China.,Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
| | - Xiang Chen
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China.,Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
| | - Jie Li
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China.,Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
| | - Cong Peng
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China.,Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
| | - Yehong Kuang
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China.,Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
| | - Wu Zhu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China.,Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
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8
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Heppt MV, Steeb T, Berking C. One set to collect them all? The development of a core domain set for medium-to-giant congenital melanocytic naevi. Br J Dermatol 2021; 185:247-248. [PMID: 33755194 DOI: 10.1111/bjd.19878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/07/2021] [Accepted: 01/07/2021] [Indexed: 11/29/2022]
Affiliation(s)
- M V Heppt
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Ulmenweg 18, Erlangen, 91054, Germany.,Comprehensive Cancer Center Erlangen - European Metropolitan Region of Nuremberg, Erlangen, Germany
| | - T Steeb
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Ulmenweg 18, Erlangen, 91054, Germany.,Comprehensive Cancer Center Erlangen - European Metropolitan Region of Nuremberg, Erlangen, Germany
| | - C Berking
- Department of Dermatology, Universitätsklinikum Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Ulmenweg 18, Erlangen, 91054, Germany.,Comprehensive Cancer Center Erlangen - European Metropolitan Region of Nuremberg, Erlangen, Germany
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