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Mechanism, Diagnostic and Therapeutic Novelties in Dermatology: 2nd Edition
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Mechanism, Diagnostic and Therapeutic Novelties in Dermatology: 2nd Edition

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: closed (31 October 2024) | Viewed by 16634

Special Issue Editors

Dr. Jose Carlos Armario Hita

E-Mail Website1 Website2
Guest Editor
Department of Dermatology, Hospital Universitario de Puerto Real, 11510 Puerto Real, Spain
Interests: atopic dermatitis; psoriasis; biological treatment; contact dermatitis; urticaria
Dr. Jose Juan Pereyra Rodriguez

E-Mail Website
Guest Editor
Department of Dermatology, Hospital Universitario Virgen del Rocio, 41013 Seville, Spain
Interests: atopic dermatitis; psoriasis; biological treatment; contact dermatitis
Special Issues, Collections and Topics in MDPI journals
Dr. Ricardo Ruiz-Villaverde

E-Mail Website
Guest Editor
Dermatology Department, Hospital Universitario San Cecilio, Instituto Biosanitario Ibs Granada, 18016 Granada, Spain
Interests: psoriasis; atopic dermatitis; biological treatments
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Following the success of the first volume of our Special Issue “Mechanism, Diagnostic and Therapeutic Novelties in Dermatology”, we now invite high-quality submissions for volume II in the Medical Research Section. The first volume is available at https://www.mdpi.com/journal/life/special_issues/610FW69Y66.

Dermatology is one of the oldest specialties and yet one of the most innovative and constantly evolving ones, too. It is a fairly self-sufficient specialty, as the accessibility of the skin, mucous membranes, appendages, etc., allows for a diagnosis without resorting to complementary means on many occasions. However, there is currently a real revolution in the understanding of the pathophysiological mechanisms of different inflammatory and tumoral skin diseases, in the complementary techniques that we use to develop diagnoses (ultrasonography, dermoscopy, confocal microscopy, etc.), and in the availability of alternative approaches to treatment which use biological drugs and synthetic molecules of high economic impact.

For all of these reasons, we believe that this Special Issue of Life is incredibly topical, and we are looking forward to gathering all of those novel aspects that incur in the pathophysiology, diagnosis and treatment of skin diseases.

Dr. Jose Carlos Armario Hita
Dr. Jose Juan Pereyra Rodriguez
Dr. Ricardo Ruiz-Villaverde
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Life is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • physiopathology
  • skin sonography
  • dermoscopy
  • innovation
  • confocal microscopy
  • biological treatment
  • psoriasis
  • atopic dermatitis
  • immune-mediated diseases
  • urticaria
  • laser CO2

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Published Papers (9 papers)

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11 pages, 700 KiB  
Article
Predicting Factors and Clinical Characteristics of Pruritus in Psoriasis: A Cross-Sectional Survey
by Silviu-Horia Morariu, Ovidiu Simion Cotoi, Oana Mirela Tiucă, Mircea Ambros, Roxana-Ioana Ilcuș, Liuba Garaga, Ailincăi Raluca, Diana Horea, Andreea-Beatrix Bălan, Mădălina Husariu, Anca Gînj, Alexandra Țiplic, Andrea Hidi, Biborka Szabo, Radu Alexandru Stan and Alin Codruț Nicolescu
Life 2024, 14(7), 827; https://doi.org/10.3390/life14070827 - 28 Jun 2024
Viewed by 691
Abstract
Pruritus is an important symptom among patients affected by psoriasis. To date, no general agreement has been established regarding pruritus as a measure of psoriasis severity. This study aims to assess psoriatic pruritis prevalence and characteristics using a comprehensive itch questionnaire. A semi-structured [...] Read more.
Pruritus is an important symptom among patients affected by psoriasis. To date, no general agreement has been established regarding pruritus as a measure of psoriasis severity. This study aims to assess psoriatic pruritis prevalence and characteristics using a comprehensive itch questionnaire. A semi-structured questionnaire consisting of 48 questions was applied to patients diagnosed with psoriasis and admitted to the Dermatology Department of Mures Clinical County Hospital, Romania. A total of 163 patients were enrolled, out of which 115 (70.55%) reported itch. Patients with itch had higher PASI (p = 0.003) and DLQI scores (p < 0.001). The itch was most frequently described as a crawling sensation, mainly located in the lesional skin and aggravated by stress and temperature variation. It had a moderate intensity (6.18 ± 2.46). Emollients were the treatment preferred by most patients in alleviating itch, while biologics exerted a protective effect on itch development (OR = −0.24; p < 0.0001) and negatively correlated with itch intensity (r = −0.23; p < 0.0001). Advanced age, high BMI, and PASI scores were indicators of itch presence, while female gender, high PASI score, and frequent itch episodes indicate highly intense pruritus (≥7 on the VAS). A better understanding of itch and its clinical features will guide physicians toward the best treatment option and would, ultimately, benefit the patient. Full article
(This article belongs to the Special Issue Mechanism, Diagnostic and Therapeutic Novelties in Dermatology: 2nd Edition)
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13 pages, 690 KiB  
Article
New-Onset Hidradenitis Suppurativa in Psoriasis Patients: A Multi-Center, Retrospective Cohort Study
by Chen-Pi Li, Shao-Wei Lo, Ru-Yin Tsai, Hui-Chin Chang and Shuo-Yan Gau
Life 2024, 14(6), 730; https://doi.org/10.3390/life14060730 - 6 Jun 2024
Cited by 4 | Viewed by 1476
Abstract
Background: Previous research has indicated a potential correlation between hidradenitis suppurativa (HS) and psoriasis (PSO), two chronic inflammatory dermatological diseases. However, there is a lack of comprehensive evaluations that consider a variety of clinical and demographic factors, and the risk of developing HS [...] Read more.
Background: Previous research has indicated a potential correlation between hidradenitis suppurativa (HS) and psoriasis (PSO), two chronic inflammatory dermatological diseases. However, there is a lack of comprehensive evaluations that consider a variety of clinical and demographic factors, and the risk of developing HS in PSO patients remains unclear. Our study aims to examine HS risk over time among PSO patients versus matched controls while considering the influence of confounders to provide insights into the potential link between these two diseases. Method: In this multi-institutional cohort study using the TriNetX database, we matched 202,318 patients with PSO with an equivalent number of individuals without PSO, using propensity score matching. The study period extended from 1 January 2005 to 31 December 2018. We computed hazard ratios and their respective 95% confidence intervals (CIs) to evaluate the probability of HS manifestation over a period of 5 years in patients with PSO in comparison to those without PSO. Results: PSO patients demonstrated a consistently higher risk of developing HS than matched controls across all analytic models with the hazard ratios (HR) ranging from 1.43 (95% CI 1.30–1.56) to 5.91 (95% CI 2.49–14.04). Stratified analyses showed the increased HS risk was observed in both genders but only significant in those aged 18–64 years. Kaplan–Meier analysis indicated PSO patients had a higher cumulative probability of developing HS over time (HR 1.77, 95% CI 1.49–1.89). Conclusions: PSO was associated with increased HS risk, highlighting the importance of considering HS as a potential comorbidity in PSO patients and may have implications for early detection, prevention, and management strategies for both conditions. Shared inflammatory pathways, genetic components, and skin dysbiosis may contribute. Further research should elucidate underlying mechanisms. Full article
(This article belongs to the Special Issue Mechanism, Diagnostic and Therapeutic Novelties in Dermatology: 2nd Edition)
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12 pages, 243 KiB  
Article
HOMA-IR Index and Pediatric Psoriasis Severity—A Retrospective Observational Study
by Adelina Maria Sendrea, Denis Iorga, Mihai Dascalu, Alina Suru and Carmen Maria Salavastru
Life 2024, 14(6), 700; https://doi.org/10.3390/life14060700 - 29 May 2024
Viewed by 793
Abstract
Psoriasis is a chronic inflammatory disease with specific cutaneous and nail lesions. Recent data has emphasized its systemic nature, highlighting metabolic conditions found in patients. Insulin resistance was identified in adult psoriasis, sometimes related to psoriasis severity. Data regarding this relationship in children [...] Read more.
Psoriasis is a chronic inflammatory disease with specific cutaneous and nail lesions. Recent data has emphasized its systemic nature, highlighting metabolic conditions found in patients. Insulin resistance was identified in adult psoriasis, sometimes related to psoriasis severity. Data regarding this relationship in children are limited. Consequently, we tested the association between the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) and Psoriasis Area and Severity Index (PASI) using a retrospective dataset of 43 children with various types of psoriasis. First, we attempted to replicate the relationship between the HOMA-IR and PASI. Second, we explored potential associations between these variables and others in the dataset. The results illustrated no association between HOMA-IR and PASI (p-value = 0.512). The exploratory findings hinted at a connection between nail pitting and insulin resistance (p-value = 0.038), yet Bonferroni adjustments suggested the risk of a false-positive finding. Noteworthy associations were found between the HOMA-IR and body mass index (BMI) (p-value = 0.001), the PASI and quality of life impairment (p-value = 0.005), and psoriasis severity and type (p-value = 0.001). The null hypothesis that insulin resistance in children is not positively associated with psoriasis severity cannot be rejected. Pilot estimates of variables and covariates of interest are provided for further confirmatory studies assessing this hypothesis. Full article
(This article belongs to the Special Issue Mechanism, Diagnostic and Therapeutic Novelties in Dermatology: 2nd Edition)
14 pages, 1587 KiB  
Article
Characteristics of Gut Microbiota in Rosacea Patients—A Cross-Sectional, Controlled Pilot Study
by Anne Guertler, Pascal Hering, Cátia Pacífico, Nikolaus Gasche, Barbara Sladek, Miriam Irimi, Lars E. French, Benjamin M. Clanner-Engelshofen and Markus Reinholz
Life 2024, 14(5), 585; https://doi.org/10.3390/life14050585 - 1 May 2024
Cited by 1 | Viewed by 2127
Abstract
Background: Recent studies have suggested a possible connection between rosacea and patients’ gut microbiota. Objective: To investigate the differences in fecal microbial profiles between patients with rosacea and healthy controls. Methods: Gut microbiota of 54 rosacea patients (RP) were analyzed using MiSeq 16S [...] Read more.
Background: Recent studies have suggested a possible connection between rosacea and patients’ gut microbiota. Objective: To investigate the differences in fecal microbial profiles between patients with rosacea and healthy controls. Methods: Gut microbiota of 54 rosacea patients (RP) were analyzed using MiSeq 16S rRNA sequencing. Enterotypes, the Firmicutes/Bacteroides (F/B) ratio, the significance of alpha and beta diversity, and differential abundance analysis (DAA) were calculated and compared with age- and gender-matched controls (CP, n = 50). Results: Significant changes in the enterotypes and F/B ratio were observed between the RP and CP (p = 0.017 and p = 0.002, respectively). The RP showed a decreased microbial richness and diversity compared to the CP (Shannon p = 0.012, inverse Simpson p = 0.034). Beta diversity also differed between both groups (PERMANOVA, p = 0.006). Fourteen significantly different taxa were detected according to DAA. Faecalibacterium prausnitzii (coef. −0.0800, p = 0.008), Lachnoospiraceae ND 3007 group sp. (coef. −0.073, p < 0.001), and Ruminococcaceae (coef. −0.072, p = 0.015) were significantly decreased; Oscillobacter sp. (coef. 0.023, p = 0.031), Flavonifractor plautii (coef. 0.011, p = 0.037), and Ruminococccaceae UBA 1819 (coef. 0.010, p = 0.031) were significantly increased in the RP compared to the CP. Conclusion: Significant alterations in gut microbiota were present in the RP. Taxonomic shifts and reduced richness and diversity were observed when compared to the CP. Larger prospective studies are needed to investigate correlations with clinical features and to translate these findings into future therapeutic approaches. Full article
(This article belongs to the Special Issue Mechanism, Diagnostic and Therapeutic Novelties in Dermatology: 2nd Edition)
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12 pages, 1011 KiB  
Article
Deficit of Omega-3 Fatty Acids in Acne Patients—A Cross-Sectional Pilot Study in a German Cohort
by Anne Guertler, Tobias Fiedler, Diana Lill, Anne-Charlotte Kuna, Arina Volsky, Jens Wallmichrath, Till Kämmerer, Lars E. French and Markus Reinholz
Life 2024, 14(4), 519; https://doi.org/10.3390/life14040519 - 17 Apr 2024
Viewed by 3130
Abstract
Omega-3 fatty acids (ω-3 FAs) exert anti-inflammatory effects, including the downregulation of pro-inflammatory cytokines, eicosanoids, and insulin-like growth factor-1. Therefore, they may improve acne severity as an adjunct treatment. However, there is a paucity of data regarding patients’ existing deficits. The aim of [...] Read more.
Omega-3 fatty acids (ω-3 FAs) exert anti-inflammatory effects, including the downregulation of pro-inflammatory cytokines, eicosanoids, and insulin-like growth factor-1. Therefore, they may improve acne severity as an adjunct treatment. However, there is a paucity of data regarding patients’ existing deficits. The aim of this study was to determine ω-3 FA levels in acne patients in correlation with self-reported dietary preferences and clinical severity. A single-center, cross-sectional study of 100 acne patients was conducted. Patients’ blood parameters, including ω-3 FAs levels, were assessed using the HS-omega-3 Index® in erythrocytes (Omegametrix® GmbH, Martinsried, Germany). Dietary preferences were assessed using a standardized food frequency questionnaire. Clinical dermatologic evaluation was performed using the Investigator Global Assessment (IGA) of acne. The values of the HS-omega-3 Index® were outside the recommended range of 8–11% in 96 patients (mean 5.15%), independent of the clinical severity or affected anatomic sites. A severe deficit (HS-omega-3 Index® < 4%) was seen more commonly in men than in women (p = 0.021). The regular consumption of legumes was significantly associated with higher ω-3 FA levels (p = 0.003), as was oral ω-3 FA supplementation (p = 0.006) and the lack of sunflower oil intake (p = 0.008). This pilot study demonstrated a deficit of ω-3 FAs in a German acne cohort. Higher ω-3 FAs levels were observed in patients with regular legume intake and oral ω-3 FAs supplementation. Further prospective studies are needed to investigate whether the clinical severity of acne improves in patients with normal HS-omega-3 Index®. Full article
(This article belongs to the Special Issue Mechanism, Diagnostic and Therapeutic Novelties in Dermatology: 2nd Edition)
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10 pages, 1487 KiB  
Communication
Primary Cutaneous CD4 Small/Medium T-Cell Lymphoproliferative Disorder Following COVID-19 Vaccination—What Do We Know about Lymphoproliferative Disorders and Cutaneous Lymphomas after COVID-19 Vaccination? A Report of an Atypical Case and a Review of the Literature
by Francisco Javier De la Torre-Gomar, Jose María Llamas-Molina, Maria Dolores Pegalajar-García, Carmen Pérez-Valencia, Alejandro Carrero-Castaño and Ricardo Ruiz-Villaverde
Life 2024, 14(3), 386; https://doi.org/10.3390/life14030386 - 14 Mar 2024
Viewed by 1739
Abstract
The association between Primary cutaneous CD4 small/medium T-cell lymphoproliferative disorder (PCSM-TCLPD) and COVID-19 immunization has been sparsely documented in the medical literature. Reviewing the literature, albeit infrequently, we can find cases of the recurrence and new onset of lymphoproliferative processes and cutaneous lymphomas [...] Read more.
The association between Primary cutaneous CD4 small/medium T-cell lymphoproliferative disorder (PCSM-TCLPD) and COVID-19 immunization has been sparsely documented in the medical literature. Reviewing the literature, albeit infrequently, we can find cases of the recurrence and new onset of lymphoproliferative processes and cutaneous lymphomas following the COVID-19 vaccine. Many of the entities we encounter are classified as cutaneous lymphoproliferative disorders. The prevailing hypothesis suggests that the predominant cutaneous reactions to SARS-CoV-2 vaccines may stem from T-cell-mediated immune activation responses to vaccine components, notably messenger RNA (mRNA). Specifically, it is posited that the presence of cutaneous lymphoid infiltrates may be linked to immune system stimulation, supported by the absence, to date, of instances of primary cutaneous B-cell lymphoma following mRNA vaccination. Within this context, it is imperative to underscore that the etiological association between PCSM-TCLPD and COVID-19 vaccination should not discourage vaccination efforts. Instead, it underscores the necessity for continuous surveillance, in-depth investigation, and comprehensive follow-up studies to delineate the specific attributes and underlying mechanisms of such cutaneous manifestations post vaccination. Full article
(This article belongs to the Special Issue Mechanism, Diagnostic and Therapeutic Novelties in Dermatology: 2nd Edition)
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15 pages, 3292 KiB  
Article
Exploring the Potential of IL-4 and IL-13 Plasma Levels as Biomarkers in Atopic Dermatitis
by George G. Mitroi, Elena Leocadia Pleșea, George F. Mitroi, Mihaela Roxana Mitroi, Carmen Daniela Neagoe and Simona Laura Ianoși
Life 2024, 14(3), 352; https://doi.org/10.3390/life14030352 - 7 Mar 2024
Viewed by 2803
Abstract
Atopic dermatitis (AD) is a persistent inflammatory skin condition that impacts individuals of various age groups, including both children and adults. Its pathophysiology involves allergens penetrating a disrupted epidermal barrier, triggering the dermal cells to produce pro-inflammatory cytokines and eliciting a T-cell-mediated immune [...] Read more.
Atopic dermatitis (AD) is a persistent inflammatory skin condition that impacts individuals of various age groups, including both children and adults. Its pathophysiology involves allergens penetrating a disrupted epidermal barrier, triggering the dermal cells to produce pro-inflammatory cytokines and eliciting a T-cell-mediated immune response. Notably, interleukins (ILs), particularly interleukin 4 (IL-4) and interleukin 13 (IL-13), play a key role in AD pathogenesis. Therapies directed at inflammatory mechanisms, including Dupilumab, have demonstrated notable effectiveness in enhancing skin lesions, alleviating subjective symptoms, and improving the overall quality of life for individuals with AD. Despite therapeutic advances, assessing AD severity remains challenging. The commonly used tools, such as the SCORAD and DLQI scores, rely on subjective patient responses. Paraclinically, the search for universal biomarkers continues, with efforts to identify reliable indicators reflecting disease severity and treatment response. Various biomarkers, including Th2-related chemokines and cytokines, have been explored, but none have gained universal recognition for routine clinical use. This study aims to investigate the dynamics of the plasma levels of IL-4 and IL-13 during Dupilumab treatment and establish correlations between these ILs and disease severity, as measured using the SCORAD and DLQI scores. The ultimate endpoint is to determine whether IL-4 and IL-13 can serve as reliable biomarkers, assessing their correlation with patient-reported feelings and disease activity and potentially influencing their inclusion or exclusion as diagnostic elements in routine clinical practice. Full article
(This article belongs to the Special Issue Mechanism, Diagnostic and Therapeutic Novelties in Dermatology: 2nd Edition)
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12 pages, 1523 KiB  
Article
Bimekizumab: Short-Term Effectiveness and Safety in Real Clinical Practice in Andalucia, Spain
by Ricardo Ruiz-Villaverde, Lourdes Rodriguez-Fernandez-Freire, Marta Cebolla-Verdugo, Alvaro Prados-Carmona, Carlos Hernández-Montoya, José Carlos Armario-Hita and Manuel Galán-Gutiérrez
Life 2024, 14(3), 281; https://doi.org/10.3390/life14030281 - 20 Feb 2024
Cited by 1 | Viewed by 2122
Abstract
Introduction: Psoriasis, a chronic inflammatory skin disease, affects 2–10% of the population globally. Bimekizumab (BMK), a monoclonal antibody targeting IL-17, is a dual inhibitor of IL17 A and F that has shown efficacy in treating moderate to severe plaque psoriasis. This real-world [...] Read more.
Introduction: Psoriasis, a chronic inflammatory skin disease, affects 2–10% of the population globally. Bimekizumab (BMK), a monoclonal antibody targeting IL-17, is a dual inhibitor of IL17 A and F that has shown efficacy in treating moderate to severe plaque psoriasis. This real-world evidence (RWE) study aims to assess BMK’s efficiency and safety in naïve and refractory patients. Material and methods: A retrospective analysis of a multicenter observational study included 22 patients treated with BMK from April 2023 to February 2023 in five Andalusian hospitals. Ethical approval was obtained, and patients provided informed consent. Assessment criteria encompassed Psoriasis Area and Severity Index (PASI), body surface area (BSA), VAS pruritus, Dermatology Life Quality Index (DLQI), and minimum disease activity (MDA) at 0, 4, 12, and 24 weeks. Results: Patients, predominantly with plaque psoriasis, exhibited significant improvements in PASI (baseline 15.7 to 0.4 at week 16), BSA (baseline 20.7 to 0.43 at week 16), DLQI (baseline 17.93 to 0.43 at week 16), and pruritus (baseline 7.12 to 0.4 at week 16). At week 16, 95.4% achieved MDA. No safety concerns or treatment discontinuations were reported. Discussion: This RWE study aligns with pivotal clinical trials, confirming BMK’s efficacy and safety. Notably, BMK demonstrated rapid and sustained psoriasis clearance, even in challenging areas. The study’s limitations include a small sample size, suggesting the need for further exploration of patient-reported outcomes. Conclusion: Bimekizumab exhibited optimal efficacy and safety profiles in treating moderate to severe plaque psoriasis in a real-world setting. Rapid response, sustained clearance, and favorable safety outcomes contribute to improved patient experiences. Future research could delve into patient-reported outcomes and expand sample sizes to enhance the understanding of BMK’s real-world effectiveness. Full article
(This article belongs to the Special Issue Mechanism, Diagnostic and Therapeutic Novelties in Dermatology: 2nd Edition)
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Case Report
The Importance of In Vivo Reflectance Confocal Microscopy in a Case of Desmoplastic Melanoma
by Miruna Ioana Cristescu, Liliana Gabriela Popa, Elena Codruta Cozma, Ana Maria Celarel, Valentin Tudor Popa, Mihai Lupu and Vlad Mihai Voiculescu
Life 2024, 14(5), 574; https://doi.org/10.3390/life14050574 - 30 Apr 2024
Viewed by 1135
Abstract
Desmoplastic melanoma accounts for 5% of all cases of melanoma, but its diagnosis can be difficult due to its frequent clinical presentation with amelanotic lesions. Histologically, spindled melanocytes surrounded by a collagenous stroma are observed. Compared with other types of melanoma, the desmoplastic [...] Read more.
Desmoplastic melanoma accounts for 5% of all cases of melanoma, but its diagnosis can be difficult due to its frequent clinical presentation with amelanotic lesions. Histologically, spindled melanocytes surrounded by a collagenous stroma are observed. Compared with other types of melanoma, the desmoplastic types presents greater local aggression, and is more prone to local recurrence, but has a lower risk of lymph node metastasis. Early detection, accurate staging, and proper surgical management are the main factors associated with higher survival rates in melanoma patients. Reflectance confocal microscopy (RCM) has proven to be a valuable imaging tool in the diagnosis of skin neoplasms, being useful for orientating practitioners towards the diagnosis of melanoma and indicating the necessity of performing a diagnostic biopsy. We present the case of 52-year-old woman, who presented to the dermatology department with an irregular, dark-colored plaque in the right deltoid region. Dermoscopy showed asymmetry with an atypical network and some areas of regression. RCM revealed pagetoid cells in the upper epidermis, cell atypia, non-edged papillae, dermal inflammation, and nucleated cells in the dermis, which are highly suggestive of melanoma. A biopsy was also performed. A histopathology exam confirmed the diagnosis of superficially spreading melanoma with a desmoplastic component, and revealed a Breslow index of 0.9 mm, Clark level IV, an absence of mitoses, angiolymphatic invasion and regression, and complete excision. The CT and PET-CT scans were negative. A biopsy of the axillary sentinel lymph node was conducted, with a negative result obtained, establishing the IB stage of the disease. The patient will remain under follow-up to look for a recurrence or a new primary melanoma. Full article
(This article belongs to the Special Issue Mechanism, Diagnostic and Therapeutic Novelties in Dermatology: 2nd Edition)
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