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Najidh S, Zoutman WH, Schrader AMR, Willemze R, Tensen CP, Vermeer MH. PD-1 Overexpression in Sézary Syndrome Is Epigenetically Regulated. J Invest Dermatol 2023; 143:2538-2541.e7. [PMID: 37270066 DOI: 10.1016/j.jid.2023.03.1687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 02/13/2023] [Accepted: 03/21/2023] [Indexed: 06/05/2023]
Affiliation(s)
- Safa Najidh
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands.
| | - Willem H Zoutman
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Anne M R Schrader
- Department of Pathology, Leiden University Medical Center, Leiden, the Netherlands
| | - Rein Willemze
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Cornelis P Tensen
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
| | - Maarten H Vermeer
- Department of Dermatology, Leiden University Medical Center, Leiden, the Netherlands
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Sonego B, Ibatici A, Rivoli G, Angelucci E, Sola S, Massone C. Histopathological Markers for Target Therapies in Primary Cutaneous Lymphomas. Cells 2023; 12:2656. [PMID: 37998391 PMCID: PMC10670482 DOI: 10.3390/cells12222656] [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: 10/04/2023] [Revised: 11/09/2023] [Accepted: 11/17/2023] [Indexed: 11/25/2023] Open
Abstract
In recent years, targeted (biological) therapies have become available also for primary cutaneous T-cell lymphomas (PCTCLs) including anti-CD30 (brentuximab vedotin) in mycosis fungoides, primary cutaneous anaplastic large T-cell lymphoma, lymphomatoid papulosis; anti-CCR4 (mogamulizumab) in Sezary syndrome; anti-CD123 (tagraxofusp) in blastic plasmocytoid cell neoplasm. Moreover, anti-PD1 (nivolumab), anti-PDL1 (pembrolizumab, atezolizumab), anti-CD52 (alemtuzumab), anti-KIR3DL2-CD158k (lacutamab), and anti-CD70 (cusatuzumab) have been tested or are under investigations in phase II trials. The expression of these epitopes on neoplastic cells in skin biopsies or blood samples plays a central role in the management of PCTCL patients. This narrative review aims to provide readers with an update on the latest advances in the newest therapeutic options for PCTCLs.
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Affiliation(s)
- Benedetta Sonego
- Dermatology Clinic, University of Trieste, 35125 Trieste, Italy;
| | - Adalberto Ibatici
- UO Ematologia e Terapie Cellulari, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (A.I.); (G.R.); (E.A.)
| | - Giulia Rivoli
- UO Ematologia e Terapie Cellulari, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (A.I.); (G.R.); (E.A.)
| | - Emanuele Angelucci
- UO Ematologia e Terapie Cellulari, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy; (A.I.); (G.R.); (E.A.)
| | - Simona Sola
- Surgical Pathology, Galliera Hospital, 16128 Genoa, Italy;
| | - Cesare Massone
- Dermatology Unit & Scientific Directorate, Galliera Hospital, 16128 Genoa, Italy
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Hu ZH, Lu L, Feng JD, Song HB, Zhang SY, Yang L, Wang T, Liu YH. Real-World Clinical Characteristics, Management, and Outcomes of 44 Paediatric Patients with Hypopigmented Mycosis Fungoides. Acta Derm Venereol 2023; 103:adv6226. [PMID: 37606155 PMCID: PMC10461309 DOI: 10.2340/actadv.v103.6226] [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: 12/14/2022] [Accepted: 06/19/2023] [Indexed: 08/23/2023] Open
Abstract
Hypopigmented mycosis fungoides is a rare form of mycosis fungoides that is characterized by achromic lesions, early onset of disease, a predilection for darker skinned populations, and a predominance of CD8+ T cells. Due to the rarity and heterogeneous presentation of hypopigmented mycosis fungoides, there are no criteria that clearly define the clinical characteristics and treatment regimens for this condition. This retrospective study of 44 paediatric patients with hypopigmented mycosis fungoides aimed to summarize their epidemiological and clinical characteristics and assess the effectiveness and safety of different treatment regimens. Clinical manifestations were further classified into 3 morphological groups: hypopigmented lesions, papules overlying hypopigmented lesions, and erythematous plaques overlying hypopigmented lesions. In addition, the results of this study suggest that interferon alpha might be an effective and well-tolerated therapy that could shorten the treatment time to complete response compared with other treatments. Maintenance therapy and long-term follow-up reduced the recurrence rate.
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Affiliation(s)
- Zhong-Hui Hu
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Lu Lu
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Jin-Di Feng
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Hong-Bin Song
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Shi-Yu Zhang
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Lu Yang
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China
| | - Tao Wang
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China.
| | - Yue-Hua Liu
- Department of Dermatology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Dermatologic and Immunologic Diseases, Beijing, China.
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Di Raimondo C, Lombardo P, Tesei C, Esposito F, Meconi F, Secchi R, Lozzi F, Monopoli A, Narducci MG, Scala E, Angeloni C, De Stefano A, Rahimi S, Bianchi L, Cantonetti M. Role of Neutrophil-to-Lymphocyte Ratio (NLR) in Patients with Mycosis Fungoides. Diagnostics (Basel) 2023; 13:diagnostics13111979. [PMID: 37296831 DOI: 10.3390/diagnostics13111979] [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: 05/05/2023] [Revised: 05/28/2023] [Accepted: 06/02/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND The neutrophil/lymphocyte ratio (NLR) at baseline has been demonstrated to correlate with higher stages of disease and to be a prognostic factor in numerous cancers. However, its function as a prognostic factor for mycosis fungoides (MF) has not been yet clarified. OBJECTIVE Our work aimed to assess the association of the NLR with different stages of MF and to outline whether higher values of this marker are related to a more aggressive MF. METHODS We retrospectively calculated the NLRs in 302 MF patients at the moment of diagnosis. The NLR was obtained using the complete blood count values. RESULTS The median NLR among patients with early stage disease (low-grade IA-IB-IIA) was 1.88, while the median NLR for patients with high-grade MF (IIB-IIIA-IIIB) was 2.64. Statistical analysis showed positive associations of advanced MF stages with NLRs higher than 2.3. CONCLUSIONS Our analysis demonstrates that the NLR represents a cheap and easily available parameter functioning as a marker for advanced MF. This might guide physicians in recognizing patients with advanced stages of disease requiring a strict follow-up or an early treatment.
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Affiliation(s)
- Cosimo Di Raimondo
- Department of Dermatology, University of Roma Tor Vergata, 00133 Rome, Italy
| | - Paolo Lombardo
- Istituto Dermopatico dell'Immacolata, IDI-IRCCS, 00167 Rome, Italy
| | - Cristiano Tesei
- Department of Hematology, University of Roma Tor Vergata, 00133 Rome, Italy
| | - Fabiana Esposito
- Department of Hematology, University of Roma Tor Vergata, 00133 Rome, Italy
| | - Federico Meconi
- Department of Hematology, University of Roma Tor Vergata, 00133 Rome, Italy
| | - Roberto Secchi
- Department of Hematology, University of Roma Tor Vergata, 00133 Rome, Italy
| | - Flavia Lozzi
- Department of Dermatology, University of Roma Tor Vergata, 00133 Rome, Italy
| | | | | | - Enrico Scala
- Istituto Dermopatico dell'Immacolata, IDI-IRCCS, 00167 Rome, Italy
| | - Cecilia Angeloni
- Department of Diagnostic Imaging and Interventional Radiology, University of Roma Tor Vergata, 00133 Rome, Italy
| | - Alberto De Stefano
- Volunteers Association of Fondazione Policlinico "Tor Vergata", 00133 Rome, Italy
| | - Siavash Rahimi
- Istituto Dermopatico dell'Immacolata, IDI-IRCCS, 00167 Rome, Italy
| | - Luca Bianchi
- Department of Dermatology, University of Roma Tor Vergata, 00133 Rome, Italy
| | - Maria Cantonetti
- Istituto Dermopatico dell'Immacolata, IDI-IRCCS, 00167 Rome, Italy
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Zeng L, Xu H, Li SH, Xu SY, Chen K, Qin LJ, Miao L, Wang F, Deng L, Wang FH, Li L, Fu S, Liu N, Wang R, Li YQ, Wang HY. Cross-cohort analysis identified an immune checkpoint-based signature to predict the clinical outcomes of neuroblastoma. J Immunother Cancer 2023; 11:jitc-2022-005980. [PMID: 37130627 PMCID: PMC10163522 DOI: 10.1136/jitc-2022-005980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/16/2023] [Indexed: 05/04/2023] Open
Abstract
BACKGROUND Neuroblastoma (NB) places a substantial health burden on families worldwide. This study aimed to develop an immune checkpoint-based signature (ICS) based on the expression of immune checkpoints to better assess patient survival risk and potentially guide patient selection for immunotherapy of NB. METHODS Immunohistochemistry integrated with digital pathology was used to determine the expression levels of 9 immune checkpoints in 212 tumor tissues used as the discovery set. The GSE85047 dataset (n=272) was used as a validation set in this study. In the discovery set, the ICS was constructed using a random forest algorithm and confirmed in the validation set to predict overall survival (OS) and event-free survival (EFS). Kaplan-Meier curves with a log-rank test were drawn to compare the survival differences. A receiver operating characteristic (ROC) curve was applied to calculate the area under the curve (AUC). RESULTS Seven immune checkpoints, including PD-L1, B7-H3, IDO1, VISTA, T-cell immunoglobulin and mucin domain containing-3 (TIM-3), inducible costimulatory molecule (ICOS) and costimulatory molecule 40 (OX40), were identified as abnormally expressed in NB in the discovery set. OX40, B7-H3, ICOS and TIM-3 were eventually selected for the ICS model in the discovery set, and 89 patients with high risk had an inferior OS (HR 15.91, 95% CI 8.87 to 28.55, p<0.001) and EFS (HR 4.30, 95% CI 2.80 to 6.62, p<0.001). Furthermore, the prognostic value of the ICS was confirmed in the validation set (p<0.001). Multivariate Cox regression analysis demonstrated that age and the ICS were independent risk factors for OS in the discovery set (HR 6.17, 95% CI 1.78 to 21.29 and HR 1.18, 95% CI 1.12 to 1.25, respectively). Furthermore, nomogram A combining the ICS and age demonstrated significantly better prognostic value than age alone in predicting the patients' 1-year, 3-year and 5-year OS in the discovery set (1 year: AUC, 0.891 (95% CI 0.797 to 0.985) vs 0.675 (95% CI 0.592 to 0.758); 3 years: 0.875 (95% CI 0.817 to 0.933) vs 0.701 (95% CI 0.645 to 0.758); 5 years: 0.898 (95% CI 0.851 to 0.940) vs 0.724 (95% CI 0.673 to 0.775), respectively), which was confirmed in the validation set. CONCLUSIONS We propose an ICS that significantly differentiates between low-risk and high-risk patients, which might add prognostic value to age and provide clues for immunotherapy in NB.
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Affiliation(s)
- Liang Zeng
- Department of Pathology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, National Children's Medical Center for South Central Region, Guangzhou, China
| | - Hui Xu
- Department of Pathology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, National Children's Medical Center for South Central Region, Guangzhou, China
| | - Shu-Hua Li
- Molecular Diagnosis and Gene Testing Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shuo-Yu Xu
- Department of General Surgery, Southern Medical University Nanfang Hospital, Guangzhou, China
- Bio-totem Pte. Ltd, Foshan, China
| | - Kai Chen
- Department of Pathology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, National Children's Medical Center for South Central Region, Guangzhou, China
| | - Liang-Jun Qin
- Department of Pathology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, National Children's Medical Center for South Central Region, Guangzhou, China
| | - Lei Miao
- Guangzhou Institute of Paediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health,Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, National Children's Medical Center for South Central Region, Guangzhou, China
| | - Fang Wang
- Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Ling Deng
- Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China; Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
| | - Feng-Hua Wang
- Department of Thoracic Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Le Li
- Department of Thoracic Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Sha Fu
- Guangdong Provincial Key Laboratory of Malignant Tumour Epigenetics and Gene Regulation, Cellular & Molecular Diagnostics Center, Sun Yat-Sen Memorial Hospital, Guangzhou, China
| | - Na Liu
- Department of Experimental Research, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Ran Wang
- Department of Pathology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ying-Qing Li
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center; Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
| | - Hai-Yun Wang
- Department of Pathology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health, National Children's Medical Center for South Central Region, Guangzhou, China
- Guangzhou Institute of Paediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangdong Provincial Clinical Research Center for Child Health,Guangdong Provincial Key Laboratory of Research in Structural Birth Defect Disease, National Children's Medical Center for South Central Region, Guangzhou, China
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Han Z, Wu X, Qin H, Yuan YC, Zain J, Smith DL, Akilov OE, Rosen ST, Feng M, Querfeld C. Blockade of the Immune Checkpoint CD47 by TTI-621 Potentiates the Response to Anti-PD-L1 in Cutaneous T Cell Lymphoma. J Invest Dermatol 2023:S0022-202X(23)00158-6. [PMID: 36863449 PMCID: PMC10363206 DOI: 10.1016/j.jid.2023.02.017] [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: 11/22/2022] [Revised: 01/27/2023] [Accepted: 02/06/2023] [Indexed: 03/04/2023]
Abstract
Cutaneous T cell lymphoma (CTCL) is an incurable and cosmetically disfiguring disease associated with microenvironmental signals. We investigated the effects of CD47 and PD-L1 immune checkpoint blockades, as a strategy for targeting both innate and adaptive immunity. CIBERSORT analysis identified the immune cell composition in the CTCL tumor microenvironment and the immune checkpoint expression profile for each immune cell gene cluster from CTCL lesions. We investigated the relationship between MYC and CD47 and PD-L1 expression and found that MYC shRNA knockdown and MYC functional suppression by TTI-621 (SIRPαFc) and anti-PD-L1 (durvalumab) in CTCL cell lines reduced the expression of CD47 and PD-L1 mRNA and protein as measured by qPCR and flow cytometry, respectively. In vitro, blockade of the CD47-SIRPα interaction with TTI-621 increased the phagocytic activity of macrophages against CTCL cells and enhanced CD8+ T-cell-mediated killing in a mixed leucocyte reaction. Moreover, TTI-621 synergized with anti-PD-L1 in macrophages reprogram to M1-like phenotypes and inhibited CTCL cell growth. These effects were mediated by cell‒death-related pathways, including apoptosis, autophagy, and necroptosis. Collectively, our findings demonstrate that CD47 and PD-L1 are critical regulators of immune surveillance in CTCL and dual targeting of CD47 and PD-L1 will provide insight into tumor immunotherapy for CTCL.
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Affiliation(s)
- Zhen Han
- Division of Dermatology, City of Hope, Duarte, CA; Beckman Research Institute, City of Hope, Duarte, CA
| | - Xiwei Wu
- Integrative Genomics Core, City of Hope, Duarte, CA; Computational and Quantitative Medicine, City of Hope, Duarte, CA
| | - Hanjun Qin
- Integrative Genomics Core, City of Hope, Duarte, CA
| | - Yate-Ching Yuan
- Computational and Quantitative Medicine, City of Hope, Duarte, CA; Translational Bioinformatics, Center for informatics, City of Hope, Duarte, CA
| | - Jasmine Zain
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - D Lynne Smith
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Oleg E Akilov
- Cutaneous Lymphoma Program, Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Steven T Rosen
- Beckman Research Institute, City of Hope, Duarte, CA; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA
| | - Mingye Feng
- Beckman Research Institute, City of Hope, Duarte, CA; Department of Immuno-Oncology, City of Hope, Duarte, CA
| | - Christiane Querfeld
- Division of Dermatology, City of Hope, Duarte, CA; Beckman Research Institute, City of Hope, Duarte, CA; Department of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA; Department of Pathology, City of Hope, Duarte, CA.
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Mycosis Fungoides and Sézary Syndrome: Microenvironment and Cancer Progression. Cancers (Basel) 2023; 15:cancers15030746. [PMID: 36765704 PMCID: PMC9913729 DOI: 10.3390/cancers15030746] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 01/27/2023] Open
Abstract
Mycosis fungoides and Sézary syndrome are epidermotropic cutaneous lymphomas, and both of them are rare diseases. Mycosis fungoides is the most frequent primary cutaneous lymphoma. In about 25% of patients with mycosis fungoides, the disease may progress to higher stages. The pathogenesis and risk factors of progression in mycosis fungoides and Sézary syndrome are not yet fully understood. Previous works have investigated inter- and intrapatient tumor cell heterogeneity. Here, we overview the role of the tumor microenvironment of mycosis fungoides and Sézary syndrome by describing its key components and functions. Emphasis is put on the role of the microenvironment in promoting tumor growth or antitumor immune response, as well as possible therapeutic targets. We focus on recent advances in the field and point out treatment-related alterations of the microenvironment. Deciphering the tumor microenvironment may help to develop strategies that lead to long-term disease control and cure.
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Mitteldorf C. Multistaining for a better understanding of lymphoma biology. Br J Dermatol 2022; 187:139-140. [PMID: 35508376 DOI: 10.1111/bjd.21590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Christina Mitteldorf
- Department for Dermatology, Venereology and Allergology, University Medical Centre Göttingen, Göttingen, Niedersachsen, Germany
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