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Zhu C, Song Y, Xu Y, Zhu A, Baker JS, Liu W, Gu Y. Toe Box Shape of Running Shoes Affects In-Shoe Foot Displacement and Deformation: A Randomized Crossover Study. Bioengineering (Basel) 2024; 11:457. [PMID: 38790324 PMCID: PMC11118738 DOI: 10.3390/bioengineering11050457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 04/30/2024] [Accepted: 04/30/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Long-distance running is popular but associated with a high risk of injuries, particularly toe-related injuries. Limited research has focused on preventive measures, prompting exploration into the efficacy of raised toe box running shoes. PURPOSE This study aimed to investigate the effect of running shoes with raised toe boxes on preventing toe injuries caused by distance running. METHODS A randomized crossover design involved 25 male marathon runners (height: 1.70 ± 0.02 m, weight: 62.6 + 4.5 kg) wearing both raised toe box (extended by 8 mm along the vertical axis and 3 mm along the sagittal axis) and regular toe box running shoes. Ground reaction force (GRF), in-shoe displacement, and degree of toe deformation (based on the distance change between the toe and the metatarsal head) were collected. RESULTS Wearing raised toe box shoes resulted in a significant reduction in vertical (p = 0.001) and antero-posterior (p = 0.015) ground reaction forces during the loading phase, with a notable increase in vertical ground reaction force during the toe-off phase (p < 0.001). In-shoe displacement showed significant decreased movement in the forefoot medial (p < 0.001) and rearfoot (medial: p < 0.001, lateral: p < 0.001) and significant increased displacement in the midfoot (medial: p = 0.002, lateral: p < 0.001). Impact severity on the hallux significantly decreased (p < 0.001), while impact on the small toes showed no significant reduction (p = 0.067). CONCLUSIONS Raised toe box running shoes offer an effective means of reducing toe injuries caused by long-distance running.
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Affiliation(s)
- Chengyuan Zhu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
| | - Yang Song
- Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Faculty of Engineering, University of Szeged, 6700 Szeged, Hungary
| | - Yufan Xu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
| | - Aojie Zhu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
| | - Julien S. Baker
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
| | - Wei Liu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China
- Faculty of Engineering, University of Szeged, 6700 Szeged, Hungary
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Eijkenboom QL, Daxenberger F, Gust C, Hartmann D, Guertler A, Steckmeier S, Deussing M, French LE, Welzel J, Schuh S, Sattler EC. Line-field confocal optical coherence tomography, a novel non-invasive tool for the diagnosis of onychomycosis. J Dtsch Dermatol Ges 2024; 22:367-375. [PMID: 38279541 DOI: 10.1111/ddg.15310] [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: 06/27/2023] [Accepted: 10/24/2023] [Indexed: 01/28/2024]
Abstract
BACKGROUND AND OBJECTIVES Onychomycosis is common and important to distinguish from other nail diseases. Rapid and accurate diagnosis is necessary for optimal patient treatment and outcome. Non-invasive diagnostic tools have increasing potential for nail diseases including onychomycosis. This study evaluated line-field confocal optical coherence tomography (LC-OCT) as a rapid non-invasive tool for diagnosing onychomycosis as compared to confocal laser scanning microscopy (CLSM), optical coherence tomography (OCT), and conventional methods. PATIENTS AND METHODS In this prospective study 86 patients with clinically suspected onychomycosis and 14 controls were examined using LC-OCT, OCT, and CLSM. KOH-preparation, fungal culture, PCR, and histopathology were used as comparative conventional methods. RESULTS LC-OCT had the highest sensitivity and negative predictive value of all methods used, closely followed by PCR and OCT. Specificity and positive predictive value of LC-OCT were as high as with CLSM, while OCT scored much lower. The gold standard technique, fungal culture, showed the lowest sensitivity and negative predictive value. Only PCR and culture allowed species differentiation. CONCLUSIONS LC-OCT enables quick and non-invasive detection of onychomycosis, with advantages over CLSM and OCT, and similar diagnostic accuracy to PCR but lacking species differentiation. For accurate nail examination, LC-OCT requires well-trained and experienced operators.
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Affiliation(s)
| | - Fabia Daxenberger
- Department of Dermatology and Allergy, LMU University Hospital, LMU, Munich, Germany
| | - Charlotte Gust
- Department of Dermatology and Allergy, LMU University Hospital, LMU, Munich, Germany
| | - Daniela Hartmann
- Department of Dermatology and Allergy, LMU University Hospital, LMU, Munich, Germany
| | - Anne Guertler
- Department of Dermatology and Allergy, LMU University Hospital, LMU, Munich, Germany
| | - Stephanie Steckmeier
- Department of Dermatology and Allergy, LMU University Hospital, LMU, Munich, Germany
| | - Maximilian Deussing
- Department of Dermatology and Allergy, LMU University Hospital, LMU, Munich, Germany
| | - Lars Einar French
- Department of Dermatology and Allergy, LMU University Hospital, LMU, Munich, Germany
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, USA
| | - Julia Welzel
- Department of Dermatology, University Hospital Augsburg, Augsburg, Germany
| | - Sandra Schuh
- Department of Dermatology, University Hospital Augsburg, Augsburg, Germany
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3
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Eijkenboom QL, Daxenberger F, Gust C, Hartmann D, Guertler A, Steckmeier S, Deussing M, French LE, Welzel J, Schuh S, Sattler EC. Konfokale Line-Field optische Kohärenztomographie, ein innovatives nichtinvasives Instrument zur Diagnose der Onychomykose: Line-field confocal optical coherence tomography, a novel non-invasive tool for the diagnosis of onychomycosis. J Dtsch Dermatol Ges 2024; 22:367-376. [PMID: 38450988 DOI: 10.1111/ddg.15310_g] [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: 06/27/2023] [Accepted: 10/24/2023] [Indexed: 03/08/2024]
Abstract
ZusammenfassungHintergrund und ZieleOnychomykose ist weit verbreitet und sollte von anderen Nagelerkrankungen unterschieden werden. Eine rasche und genaue Diagnostik ist für die optimale Behandlung des Patienten und ein bestmögliches Ergebnis erforderlich. Nichtinvasive Techniken haben ein wachsendes Potenzial bei der Diagnose von Nagelerkrankungen, einschließlich Onychomykose. In dieser Studie wurde die konfokale Line‐Field optische Kohärenztomographie (LC‐OCT) als schnelle nichtinvasive Methode zur Diagnose von Onychomykose im Vergleich zur konfokalen Laserscanmikroskopie (KLM), optischen Kohärenztomographie (OCT) und konventionellen Methoden bewertet.Patienten und MethodikIn dieser prospektiven Studie wurden 86 Patienten mit klinischem Verdacht auf Onychomykose und 14 Kontrollen mittels LC‐OCT, OCT und KLM untersucht. KOH‐Präparation, Pilzkultur, PCR und Histopathologie wurden als vergleichende konventionelle Methoden eingesetzt.ErgebnisseLC‐OCT hatte die höchste Sensitivität und den höchsten negativen Vorhersagewert aller verwendeten Methoden, dicht gefolgt von PCR und OCT. Die Spezifität und der positive Vorhersagewert der LC‐OCT waren genauso hoch wie bei der KLM, während OCT deutlich schlechter abschnitt. Das Goldstandardverfahren Pilzkultur zeigte die geringste Sensitivität und den niedrigsten negativen Vorhersagewert. Nur PCR und Kultur ermöglichten eine Differenzierung der Pilzspezies.SchlussfolgerungenLC‐OCT ermöglicht eine schnelle und nichtinvasive Diagnostik von Onychomykose, mit Vorteilen gegenüber KLM und OCT und ähnlicher diagnostischer Genauigkeit wie die PCR, aber ohne Differenzierung der Pilzarten. Für eine genaue Nageluntersuchung erfordert die LC‐OCT gut geschulte und erfahrene Anwender.
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Affiliation(s)
| | - Fabia Daxenberger
- Klinik und Poliklinik für Dermatologie und Allergologie der LMU München, München, Deutschland
| | - Charlotte Gust
- Klinik und Poliklinik für Dermatologie und Allergologie der LMU München, München, Deutschland
| | - Daniela Hartmann
- Klinik und Poliklinik für Dermatologie und Allergologie der LMU München, München, Deutschland
| | - Anne Guertler
- Klinik und Poliklinik für Dermatologie und Allergologie der LMU München, München, Deutschland
| | - Stephanie Steckmeier
- Klinik und Poliklinik für Dermatologie und Allergologie der LMU München, München, Deutschland
| | - Maximilian Deussing
- Klinik und Poliklinik für Dermatologie und Allergologie der LMU München, München, Deutschland
| | - Lars Einar French
- Klinik und Poliklinik für Dermatologie und Allergologie der LMU München, München, Deutschland
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, USA
| | - Julia Welzel
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - Sandra Schuh
- Klinik für Dermatologie und Allergologie, Universitätsklinikum Augsburg, Augsburg, Deutschland
| | - Elke Christina Sattler
- Klinik und Poliklinik für Dermatologie und Allergologie der LMU München, München, Deutschland
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Corbella-Bagot L, Combalia A, Bosch-Amate X. Onychomadesis following pityriasis lichenoides et varioliformis acuta treated with methotrexate. J Dtsch Dermatol Ges 2023; 21:1567-1569. [PMID: 37847905 DOI: 10.1111/ddg.15253] [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: 05/22/2023] [Accepted: 08/14/2023] [Indexed: 10/19/2023]
Affiliation(s)
- Lluís Corbella-Bagot
- Department of Dermatology, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain
| | - Andrea Combalia
- Department of Dermatology, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain
| | - Xavier Bosch-Amate
- Department of Dermatology, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain
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5
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Corbella-Bagot L, Combalia A, Bosch-Amate X. Onychomadese nach Pityriasis lichenoides et varioliformis acuta, behandelt mit Methotrexat. J Dtsch Dermatol Ges 2023; 21:1567-1569. [PMID: 38082509 DOI: 10.1111/ddg.15253_g] [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: 05/22/2023] [Accepted: 08/14/2023] [Indexed: 12/18/2023]
Affiliation(s)
- Lluís Corbella-Bagot
- Department of Dermatology, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain
| | - Andrea Combalia
- Department of Dermatology, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain
| | - Xavier Bosch-Amate
- Department of Dermatology, Hospital Clínic Barcelona, University of Barcelona, Barcelona, Spain
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Gebhardt C, Eyerich K, Garzorz-Stark N. Status quo and future perspectives of molecular diagnostics in dermatology. J Dtsch Dermatol Ges 2023; 21:415-418. [PMID: 36892267 DOI: 10.1111/ddg.15010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 03/10/2023]
Abstract
Molecular diagnostics (MDx) has become an indispensable pillar of diagnostics in dermatology. Modern sequencing technologies allow for identification of rare genodermatoses, analysis of somatic mutations in melanoma are prerequisite for targeted therapies, and cutaneous infectious pathogens are quickly detected by PCR and other amplification methods. However, to push innovation in molecular diagnostics and tackle so far unmet clinical needs, research activities need to be bundled and the pipeline from idea to MDx product clearly rolled out. Only then, the requirements for technical validity and clinical utility of novel biomarkers can be fulfilled and the long-term vision of personalized medicine will be realized.
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Affiliation(s)
- Christoffer Gebhardt
- Department of Dermatology and Venereology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Kilian Eyerich
- Department of Dermatology and Venerology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Division of Dermatology and Venereology, Department of Medicine Solna, and Center for molecular medicine, Karolinska Institutet, Stockholm, Sweden
| | - Natalie Garzorz-Stark
- Division of Dermatology and Venereology, Department of Medicine Solna, and Center for molecular medicine, Karolinska Institutet, Stockholm, Sweden.,Technical University of Munich, School of Medicine, Department of Dermatology and Allergy, Munich, Germany
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Starace M, Rubin AI, Di Chiacchio NG, Pampaloni F, Alessandrini A, Piraccini BM, Iorizzo M. Diagnosis and surgical treatment of benign nail unit tumors. J Dtsch Dermatol Ges 2023; 21:116-129. [PMID: 36808456 DOI: 10.1111/ddg.14942] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 09/25/2022] [Indexed: 02/22/2023]
Abstract
Little is known about benign non-melanocytic nail tumors, probably due to their low pathogenicity. They are commonly misdiagnosed as inflammatory or infective diseases. They have various features, depending on the type of tumor and its location in the nail apparatus. The typical sign of a tumor is the presence of a mass and/or secondary nail changes from damaged nail structures. In particular, if a single digit is affected by a dystrophic sign or a symptom is reported without any explanation, the presence of a tumor should always be ruled out. Dermatoscopy helps to enhance visualization of the condition and in many cases supports the diagnosis. It may also assist in identifying the right place to biopsy, but it never replaces surgery. Most common non-melanocytic nail tumors are analyzed in this paper, including glomus tumor, exostosis, myxoid pseudocyst, acquired fibrokeratoma, onychopapilloma, onychomatricoma, superficial acral fibromyxoma and subungual keratoacanthoma. The aim of our study is to review the main clinical and dermatoscopic characteristics of the most common benign non-melanocytic nail tumors, to correlate them with the histopathology and to advise practitioners of the best surgical management.
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Affiliation(s)
- Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna.,Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Ital
| | - Adam I Rubin
- Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Hospital of the University of Pennsylvania, Philadelphia, PA and Section of Pediatric Dermatology, Children's Hospital of Philadelphia, Philadelphia, PA, United States of America
| | | | - Francesca Pampaloni
- Dermatology Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Aurora Alessandrini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna.,Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Ital
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna.,Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Ital
| | - Matilde Iorizzo
- Private Dermatology Practice, Bellinzona/Lugano, Switzerland
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Starace M, Rubin AI, Di Chiacchio NG, Pampaloni F, Alessandrini A, Piraccini BM, Iorizzo M. Diagnose und chirurgische Behandlung gutartiger Tumoren der Nägel. J Dtsch Dermatol Ges 2023; 21:116-130. [PMID: 36808451 DOI: 10.1111/ddg.14942_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 09/25/2022] [Indexed: 02/22/2023]
Affiliation(s)
- Michela Starace
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna.,Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Adam I Rubin
- Department of Dermatology, Department of Dermatology, Perelman School of Medicine at the University of Pennsylvania, Hospital of the University of Pennsylvania, Philadelphia, PA and Section of Pediatric Dermatology, Children's Hospital of Philadelphia, Philadelphia, PA, United States of America
| | | | - Francesca Pampaloni
- Dermatology Unit, Department of Medicine, University of Padova, Via Gallucci 4, 35121, Padova, Italy
| | - Aurora Alessandrini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna.,Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
| | - Bianca Maria Piraccini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna.,Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, Italy
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Bieber K, Harder M, Ständer S, Boch K, Kridin K, Köhler B, Anemüller W, Ernst AL, Zillikens D, Cavalar M, Ludwig RJ. DNA-Chip-basierte Diagnose der Onychomykose und Tinea pedis. J Dtsch Dermatol Ges 2022; 20:1112-1122. [PMID: 35971577 DOI: 10.1111/ddg.14819_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/22/2022] [Indexed: 11/28/2022]
Abstract
HINTERGRUND UND ZIELE Onychomykose (OM) und Tinea pedis (TP) sind häufige Pilzinfektionen der Haut. Aktuell basiert die Diagnose vornehmlich auf mikroskopischem Direktnachweis und/oder Kultur. Beide Methoden haben jedoch eine geringe bis mäßige Sensitivität und benötigen teilweise mehrere Wochen, bis endgültige Laborergebnisse vorliegen. Um die Diagnose kutaner Pilzinfektionen zu verbessern, wurden PCR-basierte Methoden entwickelt. Hier haben wir hier die Sensitivität und Spezifität einer Chip-basierten Multiplex-PCR mit mikroskopischen Direktnachweis und verglichen. PATIENTEN UND METHODIK In einer monozentrischen, prospektiven Studie wurden bei Patienten mit Verdacht auf OM (n = 67) oder TP (n = 73) Schuppenpräparate entnommen und mittels mikroskopischem Direktnachweis, Kultur und DNA-Chip-Technologie der Erregernachweis durchgeführt. In einem weiteren Ansatz wurde überprüft, ob Abstriche als Alternative zur Entnahme eines Schuppenpräparates verwendet werden können. Hierfür wurden 24 weitere OM/TP-Patienten rekrutiert und die Ergebnisse der DNA-Chip-Technologie aus Abstrichen mit denen aus den Schuppenpräparaten verglichen. ERGEBNISSE Im Vergleich aller Methoden hatte die DNA-Chip-Technologie die höchste Sensitivität, eine Kombination von DNA-Chip-Technologie mit mikroskopischem Direktnachweis erhöhte dies weiter. Ergebnisse dieser kombinierten Labordiagnostik sind innerhalb von 24 Stunden verfügbar. Der Vergleich der Probenentnahmetechniken (Abstrich beziehungsweise Schuppenpräparat) zeigte vergleichbare Ergebnisse. SCHLUSSFOLGERUNGEN Die molekulare Diagnostik (mittels DNA-Chip-Technologie) hat eine hohe Sensitivität für die OM- und TP-Diagnostik, insbesondere in Kombination mit dem mikroskopischen Direktnachweis.
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Affiliation(s)
- Katja Bieber
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | | | - Sascha Ständer
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - Katharina Boch
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - Khalaf Kridin
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Birgit Köhler
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | | | - Anna Lara Ernst
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - Detlef Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | | | - Ralf J Ludwig
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
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Bieber K, Harder M, Ständer S, Boch K, Kridin K, Köhler B, Anemüller W, Ernst AL, Zillikens D, Cavalar M, Ludwig RJ. DNA chip‐based diagnosis of onychomycosis and tinea pedis. J Dtsch Dermatol Ges 2022; 20:1112-1121. [DOI: 10.1111/ddg.14819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/22/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Katja Bieber
- Lübeck Institute of Experimental Dermatology University of Lübeck Lübeck Germany
| | | | - Sascha Ständer
- Department of Dermatology University of Lübeck Lübeck Germany
| | - Katharina Boch
- Department of Dermatology University of Lübeck Lübeck Germany
| | - Khalaf Kridin
- Lübeck Institute of Experimental Dermatology University of Lübeck Lübeck Germany
- Azrieli Faculty of Medicine Bar‐Ilan University Safed Israel
| | - Birgit Köhler
- Department of Dermatology University of Lübeck Lübeck Germany
| | | | - Anna Lara Ernst
- Lübeck Institute of Experimental Dermatology University of Lübeck Lübeck Germany
| | | | | | - Ralf J. Ludwig
- Lübeck Institute of Experimental Dermatology University of Lübeck Lübeck Germany
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