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Jimenez-Cauhe J, Pirmez R, Müller-Ramos P, Melo DF, Ortega-Quijano D, Moreno-Arrones OM, Saceda-Corralo D, Gil-Redondo R, Hermosa-Gelbard A, Dias-Sanabria B, Restom D, Porriño-Bustamante ML, Pindado-Ortega C, Berna-Rico E, Fernandez-Nieto D, Ramos M, Jaen-Olasolo P, Vaño-Galvan S. Safety of Low-Dose Oral Minoxidil in Patients With Hypertension and Arrhythmia: A Multicenter Study of 264 Patients. Actas Dermosifiliogr 2024; 115:T28-T35. [PMID: 37923070 DOI: 10.1016/j.ad.2023.10.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 07/20/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Systemic adverse effects (AE) are a major concern of low-dose oral minoxidil (LDOM) treatment, especially in patients with arterial hypertension or arrhythmia. The objective of this study was to evaluate the safety of LDOM in patients with hypertension or arrhythmia. PATIENTS AND METHODS Retrospective multicenter study of patients with hypertension or arrhythmia treated with LDOM for any type of alopecia. RESULTS A total of 254 patients with hypertension [176 women (69.3%) and 78 men (30.7%)] with a mean age of 56.9 years (range 19-82) were included. From them, the dose of LDOM was titrated in 128 patients, allowing the analysis of 382 doses. Patients were receiving a mean of 1.45 (range 0-5) antihypertensive drugs. Systemic AE were detected in 26 cases (6.8%) and included lightheadedness (3.1%), fluid retention (2.6%), general malaise (0.8%), tachycardia (0.8%) and headache (0.5%), leading to LDOM discontinuation in 6 cases (1.5%). Prior treatment with doxazosin (P<0.001), or with three or more antihypertensive drugs (P=0.012) was associated with a higher risk of discontinuation of LDOM. CONCLUSIONS LDOM treatment showed a favorable safety profile in patients with hypertension or arrhythmia, similar to general population.
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Affiliation(s)
- J Jimenez-Cauhe
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - R Pirmez
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - P Müller-Ramos
- Universidade Estadual Paulista - UNESP, Botucatu, São Paulo, Brazil
| | - D F Melo
- Dermatology Department, University of State of Rio de Janeiro (UERJ), Spain
| | - D Ortega-Quijano
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - O M Moreno-Arrones
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - D Saceda-Corralo
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain.
| | - R Gil-Redondo
- Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain; Dermatology Department, Hospital Universitario La Paz, Madrid, Spain
| | - A Hermosa-Gelbard
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - B Dias-Sanabria
- Universidade Federal do Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - D Restom
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - C Pindado-Ortega
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - E Berna-Rico
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain
| | - D Fernandez-Nieto
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - M Ramos
- Cardiology Department, Hospital Universitario de la Cruz Roja San Jose y Santa Adela, Universidad Alfonso X El Sabio, Madrid, Spain
| | - P Jaen-Olasolo
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - S Vaño-Galvan
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
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Jimenez-Cauhe J, Pirmez R, Müller-Ramos P, Melo DF, Ortega-Quijano D, Moreno-Arrones OM, Saceda-Corralo D, Gil-Redondo R, Hermosa-Gelbard A, Dias-Sanabria B, Restom D, Porriño-Bustamante ML, Pindado-Ortega C, Berna-Rico E, Fernandez-Nieto D, Ramos M, Jaen-Olasolo P, Vaño-Galvan S. Safety of Low-Dose Oral Minoxidil in Patients With Hypertension and Arrhythmia: A Multicenter Study of 264 Patients. Actas Dermosifiliogr 2024; 115:28-35. [PMID: 37652097 DOI: 10.1016/j.ad.2023.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 07/16/2023] [Accepted: 07/20/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND AND OBJECTIVE Systemic adverse effects (AE) are a major concern of low-dose oral minoxidil (LDOM) treatment, especially in patients with arterial hypertension or arrhythmia. The objective of this study was to evaluate the safety of LDOM in patients with hypertension or arrhythmia. PATIENTS AND METHODS Retrospective multicenter study of patients with hypertension or arrhythmia treated with LDOM for any type of alopecia. RESULTS A total of 254 patients with hypertension [176 women (69.3%) and 78 men (30.7%)] with a mean age of 56.9 years (range 19-82) were included. From them, the dose of LDOM was titrated in 128 patients, allowing the analysis of 382 doses. Patients were receiving a mean of 1.45 (range 0-5) antihypertensive drugs. Systemic AE were detected in 26 cases (6.8%) and included lightheadedness (3.1%), fluid retention (2.6%), general malaise (0.8%), tachycardia (0.8%) and headache (0.5%), leading to LDOM discontinuation in 6 cases (1.5%). Prior treatment with doxazosin (P<0.001), or with three or more antihypertensive drugs (P=0.012) was associated with a higher risk of discontinuation of LDOM. CONCLUSIONS LDOM treatment showed a favorable safety profile in patients with hypertension or arrhythmia, similar to general population.
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Affiliation(s)
- J Jimenez-Cauhe
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - R Pirmez
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - P Müller-Ramos
- Universidade Estadual Paulista - UNESP, Botucatu, São Paulo, Brazil
| | - D F Melo
- Dermatology Department, University of State of Rio de Janeiro (UERJ), Spain
| | - D Ortega-Quijano
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - O M Moreno-Arrones
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - D Saceda-Corralo
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain.
| | - R Gil-Redondo
- Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain; Dermatology Department, Hospital Universitario La Paz, Madrid, Spain
| | - A Hermosa-Gelbard
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - B Dias-Sanabria
- Universidade Federal do Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - D Restom
- Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - C Pindado-Ortega
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - E Berna-Rico
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain
| | - D Fernandez-Nieto
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - M Ramos
- Cardiology Department, Hospital Universitario de la Cruz Roja San Jose y Santa Adela, Universidad Alfonso X El Sabio, Madrid, Spain
| | - P Jaen-Olasolo
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
| | - S Vaño-Galvan
- Dermatology Department, Hospital Universitario Ramon y Cajal, IRYCIS, Universidad de Alcala, Spain; Trichology Unit, Grupo de Dermatologia Pedro Jaen, Madrid, Spain
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Olsen EA, Harries M, Tosti A, Bergfeld W, Blume-Peytavi U, Callender V, Chasapi V, Correia O, Cotsarelis G, Dhurat R, Dlova N, Doche I, Enechukwu N, Grimalt R, Itami S, Hordinsky M, Khobzei K, Lee WS, Malakar S, Messenger A, McMichael A, Mirmirani P, Ovcharenko Y, Papanikou S, Pinto GM, Piraccini BM, Pirmez R, Reygagne P, Roberts J, Rudnicka L, Saceda-Corralo D, Shapiro J, Silyuk T, Sinclair R, Soares RO, Souissi A, Vogt A, Washenik K, Zlotogorski A, Canfield D, Vano-Galvan S. Guidelines for clinical trials of frontal fibrosing alopecia: consensus recommendations from the International FFA Cooperative Group (IFFACG). Br J Dermatol 2021; 185:1221-1231. [PMID: 34105768 DOI: 10.1111/bjd.20567] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Frontal fibrosing alopecia (FFA) has become one of the most common causes of cicatricial alopecia worldwide. However, there is a lack of clear aetiology and robust clinical trial evidence for the efficacy and safety of agents currently used for treatment. OBJECTIVES To enable data to be collected worldwide on FFA using common criteria and assessment methods. METHODS A multicentre, international group of experts in hair loss was convened by email to create consensus recommendations for clinical trials. Consensus was defined at > 90% agreement on each recommended part of these guidelines. RESULTS Standardized diagnostic criteria, severity rating, staging, and investigator and patient assessment of scalp hair loss and other clinical features of FFA were created. CONCLUSIONS These guidelines should allow the collection of reliable aggregate data on FFA and advance efforts in both clinical and basic research to close knowledge gaps in this condition.
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Affiliation(s)
- E A Olsen
- Duke University Medical Center, Durham, NC, USA
| | - M Harries
- University of Manchester, MAHSC and NIHR Manchester Biomedical Research Centre, Salford Royal NHS Foundation Trust, Salford, UK
| | - A Tosti
- University of Miami Miller School of Medicine, Miami, FL, USA
| | | | | | - V Callender
- Callender Dermatology & Cosmetic Center and Howard University College of Medicine, Washington, DC, USA
| | - V Chasapi
- Andreas Sygros Hospital, Athens, Greece
| | - O Correia
- Centro Dermatologia Epidermis, Porto, Portugal
| | - G Cotsarelis
- University of Pennsylvania, Philadelphia, PA, USA
| | - R Dhurat
- LTM Medical College & Hospital Sion, Mumbai, India
| | - N Dlova
- University of KwaZulu Natal, Durban, South Africa
| | - I Doche
- University of Sao Paulo Medical School, Sao Paulo, SP, Brazil
| | - N Enechukwu
- Nnamdi Azikiwe University Awka, Anambra State, Nigeria
| | - R Grimalt
- Universitat Internacional de Catalunya, Barcelona, Spain
| | - S Itami
- Oita University, Oita, Japan
| | - M Hordinsky
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - K Khobzei
- Kyiv Medical University, Kyiv, Ukraine
| | - W-S Lee
- Yonsei University, Wonju College of Medicine, Wonju, Gangwon-do, Republic of Korea
| | - S Malakar
- Rita Skin Foundation, Kolkata, West Bengal, India
| | | | - A McMichael
- Wake Forest School of Medicine, Winston Salem, NC, USA
| | - P Mirmirani
- Kaiser Permanente Northern California, Vallejo, CA, USA
| | - Y Ovcharenko
- V.N. Karazin Kharkiv National University, Kharkiv, Ukraine
| | | | - G M Pinto
- University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - R Pirmez
- Instituto de Dermatologia Professor Rubem David Azulay - Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - P Reygagne
- Centre Sabouraud, Hôpital Saint Louis, Paris, France
| | - J Roberts
- Northwest Dermatology Institute, Portland, OR, USA
| | - L Rudnicka
- Medical University of Warsaw, Warsaw, Poland
| | - D Saceda-Corralo
- Ramón y Cajal Hospital, IRYCIS, University of Alcala, Madrid, Spain
| | - J Shapiro
- New York University Grossman School of Medicine, New York, NY, USA
| | - T Silyuk
- Hair Treatment and Transplantation Center Private Practice, Saint Petersburg, Russia
| | - R Sinclair
- University of Melbourne and Sinclair Dermatology, Melbourne, VIC, Australia
| | - R O Soares
- Cuf Descobertas Hospital, Lisbon, Portugal
| | - A Souissi
- Department of Dermatology, University of Tunis El Manar, Tunis, Tunisia
| | - A Vogt
- Charité-Universitaetsmedizin, Berlin, Germany
| | - K Washenik
- Bosley Medical Group, Beverly Hills, CA and New York University Grossman School of Medicine, New York, NY, USA
| | - A Zlotogorski
- Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - D Canfield
- Canfield Scientific, Inc, Parsippany, NJ, USA
| | - S Vano-Galvan
- Ramón y Cajal Hospital, IRYCIS, University of Alcala, Madrid, Spain
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Pirmez R, Duque-Estrada B, Donati A, Campos-do-Carmo G, Valente N, Romiti R, Sodré C, Tosti A. Clinical and dermoscopic features of lichen planus pigmentosus in 37 patients with frontal fibrosing alopecia. Br J Dermatol 2016; 175:1387-1390. [DOI: 10.1111/bjd.14722] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- R. Pirmez
- Department of Dermatology; Instituto de Dermatologia Professor Rubem David Azulay; Santa Casa de Misericórdia do Rio de Janeiro; Rio de Janeiro Brazil
| | - B. Duque-Estrada
- Department of Dermatology; Instituto de Dermatologia Professor Rubem David Azulay; Santa Casa de Misericórdia do Rio de Janeiro; Rio de Janeiro Brazil
| | - A. Donati
- Department of Dermatology; Universidade de São Paulo; São Paulo Brazil
| | - G. Campos-do-Carmo
- Department of Dermatology; Instituto Nacional de Câncer (INCA); Rio de Janeiro Brazil
| | - N.S. Valente
- Department of Dermatology; Universidade de São Paulo; São Paulo Brazil
| | - R. Romiti
- Department of Dermatology; Universidade de São Paulo; São Paulo Brazil
| | - C.T. Sodré
- Department of Dermatology; Instituto de Dermatologia Professor Rubem David Azulay; Santa Casa de Misericórdia do Rio de Janeiro; Rio de Janeiro Brazil
| | - A. Tosti
- Department of Dermatology and Cutaneous Surgery; University of Miami Miller School of Medicine; Miami FL U.S.A
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Affiliation(s)
- R. Pirmez
- Department of Dermatology; Instituto de Dermatologia Professor Rubem David Azulay - Santa Casa da Misericórdia do Rio de Janeiro; Rio de Janeiro Brazil
| | - M. del Rei
- Sector of Dermatology; Universidade Federal do Rio de Janeiro; Rio de Janeiro Brazil
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Affiliation(s)
- R Pirmez
- Department of Dermatology, Instituto de Dermatologia Professor Rubem David Azulay - Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
| | - C T Sodré
- Department of Dermatology, Instituto de Dermatologia Professor Rubem David Azulay - Santa Casa da Misericórdia do Rio de Janeiro, Rio de Janeiro, Brazil
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Pirmez R, Duque-Estrada B, Abraham LS, Pinto GM, de Farias DC, Kelly Y, Doche I. It's not all traction: the pseudo 'fringe sign' in frontal fibrosing alopecia. Br J Dermatol 2015; 173:1336-8. [PMID: 26138941 DOI: 10.1111/bjd.14005] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- R Pirmez
- Department of Dermatology, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rua Visconde de Pirajá 330, salas 1001-1003, Rio de Janeiro, 22410-000, RJ, Brazil.
| | - B Duque-Estrada
- Department of Dermatology, Instituto de Dermatologia Professor Rubem David Azulay, Santa Casa de Misericórdia do Rio de Janeiro, Rua Visconde de Pirajá 330, salas 1001-1003, Rio de Janeiro, 22410-000, RJ, Brazil
| | - L S Abraham
- Department of Dermatology, Hospital Universitário de Brasília, Brasilia, DF, Brazil
| | - G M Pinto
- Department of Dermatology, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
| | - D C de Farias
- Department of Dermatology, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - Y Kelly
- Department of Dermatology, Universidade de São Paulo, São Paulo, SP, Brazil
| | - I Doche
- Department of Dermatology, Universidade de São Paulo, São Paulo, SP, Brazil
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Pirmez R, Fernandes A, Melo M. Photoaggravated contact dermatitis to Kathon CG (methylchloroisothiazolinone/methylisothiazolinone): a novel pattern of involvement in a growing epidemic? Br J Dermatol 2015; 173:1343-4. [DOI: 10.1111/bjd.13986] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- R. Pirmez
- Department of Dermatology; Instituto de Dermatologia Professor Rubem David Azulay; Santa Casa de Misericórdia do Rio de Janeiro; Rio de Janeiro RJ Brazil
| | - A.L.C. Fernandes
- Occupational Dermatology Sector; Center for the Study of Worker Health and Human Ecology; National School of Public Health Sergio Arouca; FIOCRUZ; Rio de Janeiro RJ Brazil
| | - M.G.M. Melo
- Occupational Dermatology Sector; Center for the Study of Worker Health and Human Ecology; National School of Public Health Sergio Arouca; FIOCRUZ; Rio de Janeiro RJ Brazil
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Pirmez R, Donati A, Valente NS, Sodré CT, Tosti A. Glabellar red dots in frontal fibrosing alopecia: a further clinical sign of vellus follicle involvement. Br J Dermatol 2014; 170:745-6. [PMID: 24116835 DOI: 10.1111/bjd.12683] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- R Pirmez
- Sector of Dermatology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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del Rei M, Pirmez R, Sodré C, Tosti A. Coexistence of frontal fibrosing alopecia and discoid lupus erythematosus of the scalp in 7 patients: just a coincidence? J Eur Acad Dermatol Venereol 2014; 30:151-3. [DOI: 10.1111/jdv.12642] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- M. del Rei
- Sector of Dermatology; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - R. Pirmez
- Sector of Dermatology; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - C.T. Sodré
- Sector of Dermatology; Federal University of Rio de Janeiro; Rio de Janeiro Brazil
| | - A. Tosti
- Department of Dermatology and Cutaneous Surgery; University of Miami Miller School of Medicine; Miami FL USA
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