1932

Abstract

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by the formation of nodules, abscesses, and fistulae at intertriginous sites. Pain, pruritus, malodor, and suppuration have a significant impact on quality of life for HS patients. Prevalence figures vary greatly in the literature from 0.05% to 4.1%, and HS is more common in females. The current understanding of the etiology and pathogenesis of HS is incomplete; numerous hypotheses concern the interplay of lifestyle factors, skin microbiota, genetics, and a dysregulated immune system. Due to its phenotypic heterogeneity and multifactorial pathogenesis, HS is a complex disease that can prove challenging to manage. Two approved biologic therapies for the management of HS have led to clinical response in approximately 50% of treated patients. New therapies targeting the interleukin (IL)-1, IL-17, IL-36, and Janus kinase/signal transducer and activator of transcription (JAK/STAT) pathways are in ongoing clinical trials, and preliminary data offer hope for greater clinical efficacy in HS in the future.

Loading

Article metrics loading...

/content/journals/10.1146/annurev-med-051223-031234
2025-01-27
2025-02-07
Loading full text...

Full text loading...

/deliver/fulltext/med/76/1/annurev-med-051223-031234.html?itemId=/content/journals/10.1146/annurev-med-051223-031234&mimeType=html&fmt=ahah

Literature Cited

  1. 1.
    Revuz J. 2009.. Hidradenitis suppurativa. . J. Eur. Acad. Dermatol. Venereol. 23::98598
    [Google Scholar]
  2. 2.
    Canoui-Poitrine F, Revuz JE, Wolkenstein P, et al. 2009.. Clinical characteristics of a series of 302 French patients with hidradenitis suppurativa, with an analysis of factors associated with disease severity. . J. Am. Acad. Dermatol. 61:(1):5157
    [Google Scholar]
  3. 3.
    Poli F, Wolkenstein P, Revuz J. 2010.. Back and face involvement in hidradenitis suppurativa. . Dermatology 221:(2):13741
    [Google Scholar]
  4. 4.
    Revuz JE, Jemec GBE. 2016.. Diagnosing hidradenitis suppurativa. . Dermatol. Clin. 34::15
    [Google Scholar]
  5. 5.
    McCarthy S, Foley CC, Dvorakova V, et al. 2019.. PASH syndrome with bony destruction. . Clin. Exp. Dermatol. 44:(8):91820
    [Google Scholar]
  6. 6.
    Saunte DM, Boer J, Stratigos A, et al. 2015.. Diagnostic delay in hidradenitis suppurativa is a global problem. . Br. J. Dermatol. 173::154649
    [Google Scholar]
  7. 7.
    Ingram JR. 2020.. The epidemiology of hidradenitis suppurativa. . Br. J. Dermatol. 183:(6):99098
    [Google Scholar]
  8. 8.
    Cosmatos I, Matcho A, Weinstein R, et al. 2013.. Analysis of patient claims data to determine the prevalence of hidradenitis suppurativa in the United States. . J. Am. Acad. Dermatol. 68:(3):41219
    [Google Scholar]
  9. 9.
    Jemec GBE, Heidenheim M, Nielsen NH. 1996.. The prevalence of hidradenitis suppurativa and its potential precursor lesions. . J. Am. Acad. Dermatol. 35:(2):19194
    [Google Scholar]
  10. 10.
    Ingram JR, Jenkins-Jones S, Knipe DW, et al. 2018.. Population-based Clinical Practice Research Datalink study using algorithm modelling to identify the true burden of hidradenitis suppurativa. . Br. J. Dermatol. 178:(4):91724
    [Google Scholar]
  11. 11.
    Garg A, Lavian J, Lin G, et al. 2017.. Incidence of hidradenitis suppurativa in the United States: a sex- and age-adjusted population analysis. . J. Am. Acad. Dermatol. 77:(1):11822
    [Google Scholar]
  12. 12.
    Jemec GBE. 2012.. Hidradenitis suppurativa. . N. Engl. J. Med. 336:(2):15864
    [Google Scholar]
  13. 13.
    Lee JH, Kwon HS, Jung HM, et al. 2018.. Prevalence and comorbidities associated with hidradenitis suppurativa in Korea: a nationwide population-based study. . J. Eur. Acad. Dermatol. Venereol. 32:(10):178490
    [Google Scholar]
  14. 14.
    Garg A, Kirby JS, Lavian J, et al. 2017.. Sex- and age-adjusted population analysis of prevalence estimates for hidradenitis suppurativa in the United States. . JAMA Dermatol. 153:(8):76064
    [Google Scholar]
  15. 15.
    Deckers IE, Janse IC, van der Zee HH, et al. 2016.. Hidradenitis suppurativa (HS) is associated with low socioeconomic status (SES): a cross-sectional reference study. . J. Am. Acad. Dermatol. 75:(4):75559.e1
    [Google Scholar]
  16. 16.
    Wolk K, Join-Lambert O, Sabat R. 2020.. Aetiology and pathogenesis of hidradenitis suppurativa. . Br. J. Dermatol. 183::9991010
    [Google Scholar]
  17. 17.
    Miller IM, Ellervik C, Vinding GR, et al. 2014.. Association of metabolic syndrome and hidradenitis suppurativa. . JAMA Dermatol. 150:(12):127380
    [Google Scholar]
  18. 18.
    Tzellos T, Zouboulis CC, Gulliver W, et al. 2015.. Cardiovascular disease risk factors in patients with hidradenitis suppurativa: a systematic review and meta-analysis of observational studies. . Br. J. Dermatol. 173::114255
    [Google Scholar]
  19. 19.
    Karagiannidis I, Nikolakis G, Zouboulis CC. 2016.. Endocrinologic aspects of hidradenitis suppurativa. . Dermatol. Clin. 34::4549
    [Google Scholar]
  20. 20.
    von der Werth JM, Williams HC, Raeburn JA. 2000.. The clinical genetics of hidradenitis suppurativa revisited. . Br. J. Dermatol. 142:(5):94753
    [Google Scholar]
  21. 21.
    Canoui-Poitrine F, Le Thuaut A, Revuz JE, et al. 2013.. Identification of three hidradenitis suppurativa phenotypes: latent class analysis of a cross-sectional study. . J. Investig. Dermatol. 133:(6):150611
    [Google Scholar]
  22. 22.
    van Straalen KR, Prens EP, Willemsen G, et al. 2020.. Contribution of genetics to the susceptibility to hidradenitis suppurativa in a large, cross-sectional Dutch twin cohort. . JAMA Dermatol. 156:(12):135962
    [Google Scholar]
  23. 23.
    Radtke F, Fasnacht N, MacDonald HR. 2010.. Notch signaling in the immune system. . Immunity 32::1427
    [Google Scholar]
  24. 24.
    Wang B, Yang W, Wen W, et al. 2010.. γ-Secretase gene mutations in familial acne inversa. . Science 330:: 1065.
    [Google Scholar]
  25. 25.
    Gentle ME, Rose A, Bugeon L, Dallman MJ. 2012.. Noncanonical Notch signaling modulates cytokine responses of dendritic cells to inflammatory stimuli. . J. Immunol. 189:(3):127484
    [Google Scholar]
  26. 26.
    Ingram JR, Wood M, John B, et al. 2013.. Absence of pathogenic γ-secretase mutations in a South Wales cohort of familial and sporadic hidradenitis suppurativa (acne inversa). . Br. J. Dermatol. 168::87476
    [Google Scholar]
  27. 27.
    Pink AE, Simpson MA, Desai N, et al. 2012.. Mutations in the γ-secretase genes NCSTN, PSENEN, and PSEN1 underlie rare forms of hidradenitis suppurativa (acne inversa). . J. Investig. Dermatol. 132::245961
    [Google Scholar]
  28. 28.
    Nomura Y, Nomura T, Suzuki S, et al. 2014.. A novel NCSTN mutation alone may be insufficient for the development of familial hidradenitis suppurativa. . J. Dermatol. Sci. 74::18082
    [Google Scholar]
  29. 29.
    Calderón-Castrat X, Bancalari-Díaz D, Román-Curto C, et al. 2016.. PSTPIP1 gene mutation in a pyoderma gangrenosum, acne and suppurative hidradenitis (PASH) syndrome. . Br. J. Dermatol. 175::19498
    [Google Scholar]
  30. 30.
    Attanoos RL, Appleton MAC, Douglas-Jones AG. 1995.. The pathogenesis of hidradenitis suppurativa: a closer look at apocrine and apoeccrine glands. . Br. J. Dermatol. 133:(2):13438
    [Google Scholar]
  31. 31.
    Goldburg SR, Strober BE, Payette MJ. 2020.. Hidradenitis suppurativa: epidemiology, clinical presentation, and pathogenesis. . J. Am. Acad. Dermatol. 82::104558
    [Google Scholar]
  32. 32.
    Dvorak VC, Root RK, Macgregor R. 1977.. Host-defense mechanisms in hidradenitis suppurativa. . Arch. Dermatol. 113:(4):45053
    [Google Scholar]
  33. 33.
    Woods R, Kirke PN, Shanahan F, et al. 1988.. Hidradenitis suppurativa: glucose tolerance, clinical, microbiologic, and immunologic features and HLA frequencies in 27 patients. . Arch. Dermatol. 124:(7):104346
    [Google Scholar]
  34. 34.
    Vossen ARJV, van der Zee HH, Prens EP. 2018.. Hidradenitis suppurativa: a systematic review integrating inflammatory pathways into a cohesive pathogenic model. . Front. Immunol. 9::2965
    [Google Scholar]
  35. 35.
    Giamarellos-Bourboulis EJ, Antonopoulou A, Petropoulou C, et al. 2007.. Altered innate and adaptive immune responses in patients with hidradenitis suppurativa. . Br. J. Dermatol. 156:(1):5156
    [Google Scholar]
  36. 36.
    van der Zee HH, de Ruiter L, van den Broecke DG, et al. 2011.. Elevated levels of tumour necrosis factor (TNF)-α, interleukin (IL)-1β and IL-10 in hidradenitis suppurativa skin: a rationale for targeting TNF-α and IL-1β. . Br. J. Dermatol. 164:(6):129298
    [Google Scholar]
  37. 37.
    von Laffert M, Helmbold P, Wohlrab J, et al. 2010.. Hidradenitis suppurativa (acne inversa): early inflammatory events at terminal follicles and at interfollicular epidermis. . Exp. Dermatol. 19:(6):53337
    [Google Scholar]
  38. 38.
    Kelly G, Hughes R, McGarry T, et al. 2015.. Dysregulated cytokine expression in lesional and nonlesional skin in hidradenitis suppurativa. . Br. J. Dermatol. 173:(6):143139
    [Google Scholar]
  39. 39.
    di Caprio R, Balato A, Caiazzo G, et al. 2017.. IL-36 cytokines are increased in acne and hidradenitis suppurativa. . Arch. Dermatol. Res. 309:(8):67378
    [Google Scholar]
  40. 40.
    Kimball AB, Okun MM, Williams DA, et al. 2016.. Two phase 3 trials of adalimumab for hidradenitis suppurativa. . N. Engl. J. Med. 375:(5):42234
    [Google Scholar]
  41. 41.
    Kimball AB, Kerdel F, Adams D, et al. 2012.. Adalimumab for the treatment of moderate to severe hidradenitis suppurativa: a parallel randomized trial. . Ann. Intern. Med. 157:(12):84655
    [Google Scholar]
  42. 42.
    Miller I, Lynggaard CD, Lophaven S, et al. 2011.. A double-blind placebo-controlled randomized trial of adalimumab in the treatment of hidradenitis suppurativa. . Br. J. Dermatol. 165:(2):39198
    [Google Scholar]
  43. 43.
    Grant A, Gonzalez T, Montgomery MO, et al. 2010.. Infliximab therapy for patients with moderate to severe hidradenitis suppurativa: a randomized, double-blind, placebo-controlled crossover trial. . J. Am. Acad. Dermatol. 62:(2):20517
    [Google Scholar]
  44. 44.
    Banerjee A, McNish S, Shanmugam VK. 2017.. Interferon-gamma (IFN-γ) is elevated in wound exudate from hidradenitis suppurativa. . Immunol. Investig. 46:(2):14958
    [Google Scholar]
  45. 45.
    Gudjonsson JE, Tsoi LC, Ma F, et al. 2020.. Contribution of plasma cells and B cells to hidradenitis suppurativa pathogenesis. . JCI Insight 5:(19):e139930
    [Google Scholar]
  46. 46.
    Schlapbach C, Hänni T, Yawalkar N, Hunger RE. 2011.. Expression of the IL-23/Th17 pathway in lesions of hidradenitis suppurativa. . J. Am. Acad. Dermatol. 65:(4):79098
    [Google Scholar]
  47. 47.
    Moran B, Sweeney CM, Hughes R, et al. 2017.. Hidradenitis suppurativa is characterized by dysregulation of the Th17:Treg cell axis, which is corrected by anti-TNF therapy. . J. Investig. Dermatol. 137:(11):238995
    [Google Scholar]
  48. 48.
    Ring HC, Riis Mikkelsen P, Miller IM, et al. 2015.. The bacteriology of hidradenitis suppurativa: a systematic review. . Exp. Dermatol. 24::72731
    [Google Scholar]
  49. 49.
    Ring HC, Thorsen J, Saunte DM, et al. 2017.. The follicular skin microbiome in patients with hidradenitis suppurativa and healthy controls. . JAMA Dermatol. 153:(9):897905
    [Google Scholar]
  50. 50.
    Wortsman X, Revuz J, Jemec GBE. 2009.. Lymph nodes in hidradenitis suppurativa. . Dermatology 219:(1):2224
    [Google Scholar]
  51. 51.
    Amat-Samaranch V, Agut-Busquet E, Vilarrasa E, Puig L. 2009.. New perspectives on the treatment of hidradenitis suppurativa. . Ther. Adv. Chronic Dis. 12:. https://doi.org/10.1177/20406223211055920
    [Google Scholar]
  52. 52.
    Bettoli V, Join-Lambert O, Nassif A. 2016.. Antibiotic treatment of hidradenitis suppurativa. . Dermatol. Clin. 34::8189
    [Google Scholar]
  53. 53.
    Pink A, Anzengruber F, Navarini AA. 2018.. Acne and hidradenitis suppurativa. . Br. J. Dermatol. 178::61931
    [Google Scholar]
  54. 54.
    Kastner DL, Aksentijevich I, Goldbach-Mansky R. 2010.. Autoinflammatory disease reloaded: a clinical perspective. . Cell 140::78490
    [Google Scholar]
  55. 55.
    Benhadou F, van der Zee HH, Pascual JC, et al. 2019.. Pilonidal sinus disease: an intergluteal localization of hidradenitis suppurativa/acne inversa: a cross-sectional study among 2465 patients. . Br. J. Dermatol. 181:(6):1198206
    [Google Scholar]
  56. 56.
    Federico A, Rossi A, Caro G, et al. 2021.. Are dissecting cellulitis and hidradenitis suppurativa different diseases?. Clin. Dermatol. 39:(3):49699
    [Google Scholar]
  57. 57.
    Chen WT, Chi CC. 2019.. Association of hidradenitis suppurativa with inflammatory bowel disease: a systematic review and meta-analysis. . JAMA Dermatol. 155::102217
    [Google Scholar]
  58. 58.
    van der Zee HH, Horvath B, Jemec GBE, Prens EP. 2016.. The association between hidradenitis suppurativa and Crohn's disease: in search of the missing pathogenic link. . J. Investig. Dermatol. 136::174748
    [Google Scholar]
  59. 59.
    Garg A, Hundal J, Strunk A. 2018.. Overall and subgroup prevalence of Crohn disease among patients with hidradenitis suppurativa: a population-based analysis in the United States. . JAMA Dermatol. 154:(7):81418
    [Google Scholar]
  60. 60.
    Deckers IE, Benhadou F, Koldijk MJ, et al. 2017.. Inflammatory bowel disease is associated with hidradenitis suppurativa: results from a multicenter cross-sectional study. . J. Am. Acad. Dermatol. 76:(1):4953
    [Google Scholar]
  61. 61.
    Phan K, Charlton O, Smith SD. 2019.. Hidradenitis suppurativa and diabetes mellitus: updated systematic review and adjusted meta-analysis. . Clin. Exp. Dermatol. 44:(4):e12632
    [Google Scholar]
  62. 62.
    Egeberg A, Gislason GH, Hansen PR. 2016.. Risk of major adverse cardiovascular events and all-cause mortality in patients with hidradenitis suppurativa. . JAMA Dermatol. 152:(4):42934
    [Google Scholar]
  63. 63.
    Teede HJ, Misso ML, Costello MF, et al. 2018.. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. . Hum. Reprod. 33:(9):160218
    [Google Scholar]
  64. 64.
    Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. 2004.. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. . Fertil. Steril. 81:(1):2125
    [Google Scholar]
  65. 65.
    Jourabchi N, Fischer AH, Cimino-Mathews A, et al. 2017.. Squamous cell carcinoma complicating a chronic lesion of hidradenitis suppurativa: a case report and review of the literature. . Int. Wound J. 14:(2):43538
    [Google Scholar]
  66. 66.
    Micieli R, Alavi A. 2018.. Lymphedema in patients with hidradenitis suppurativa: a systematic review of published literature. . Int. J. Dermatol. 57:(12):147180
    [Google Scholar]
  67. 67.
    Jalenques I, Ciortianu L, Pereira B, et al. 2020.. The prevalence and odds of anxiety and depression in children and adults with hidradenitis suppurativa: systematic review and meta-analysis. . J. Am. Acad. Dermatol. 83::54253
    [Google Scholar]
  68. 68.
    Thorlacius L, Cohen AD, Gislason GH, et al. 2018.. Increased suicide risk in patients with hidradenitis suppurativa. . J. Investig. Dermatol. 138:(1):5257
    [Google Scholar]
  69. 69.
    Schneider-Burrus S, Jost A, Peters EMJ, et al. 2018.. Association of hidradenitis suppurativa with body image. . JAMA Dermatol. 154:(4):44751
    [Google Scholar]
  70. 70.
    Cuenca-Barrales C, Montero-Vílchez T, Szepietowski JC, et al. 2021.. Sexual impairment in patients with hidradenitis suppurativa: a systematic review. . J. Eur. Acad. Dermatol. Venereol. 35::34552
    [Google Scholar]
  71. 71.
    Ingram JR, Collier F, Brown D, et al. 2019.. British Association of Dermatologists guidelines for the management of hidradenitis suppurativa (acne inversa) 2018. . Br. J. Dermatol. 180:(5):100917
    [Google Scholar]
  72. 72.
    Zouboulis CC, Desai N, Emtestam L, et al. 2015.. European S1 guideline for the treatment of hidradenitis suppurativa/acne inversa. . J. Eur. Acad. Dermatol. Venereol. 29::61944
    [Google Scholar]
  73. 73.
    Shanmugam VK, Mulani S, McNish S, et al. 2018.. Longitudinal observational study of hidradenitis suppurativa: impact of surgical intervention with adjunctive biologic therapy. . Int. J. Dermatol. 57:(1):6269
    [Google Scholar]
  74. 74.
    Alikhan A, Sayed C, Alavi A, et al. 2019.. North American clinical management guidelines for hidradenitis suppurativa: a publication from the United States and Canadian Hidradenitis Suppurativa Foundations. Part II: Topical, intralesional, and systemic medical management. . J. Am. Acad. Dermatol. 81:(1):91101
    [Google Scholar]
  75. 75.
    Zouboulis CC, Bechara FG, Dickinson-Blok JL, et al. 2019.. Hidradenitis suppurativa/acne inversa: a practical framework for treatment optimization—systematic review and recommendations from the HS ALLIANCE working group. . J. Eur. Acad. Dermatol. Venereol. 33::1931
    [Google Scholar]
  76. 76.
    Join-Lambert O, Coignard-Biehler H, Jais JP, et al. 2016.. Efficacy of ertapenem in severe hidradenitis suppurativa: a pilot study in a cohort of 30 consecutive patients. . J. Antimicrob. Chemother. 71:(2):51320
    [Google Scholar]
  77. 77.
    Kimball AB, Jemec GBE, Alavi A, et al. 2023.. Secukinumab in moderate-to-severe hidradenitis suppurativa (SUNSHINE and SUNRISE): week 16 and week 52 results of two identical, multicentre, randomised, placebo-controlled, double-blind phase 3 trials. . Lancet 401:(10378):74761
    [Google Scholar]
  78. 78.
    Join-Lambert O, Coignard H, Jais JP, et al. 2011.. Efficacy of rifampin-moxifloxacin-metronidazole combination therapy in hidradenitis suppurativa. . Dermatology 222:(1):4958
    [Google Scholar]
  79. 79.
    Zouboulis CC, Okun MM, Prens EP, et al. 2019.. Long-term adalimumab efficacy in patients with moderate-to-severe hidradenitis suppurativa/acne inversa: 3-year results of a phase 3 open-label extension study. . J. Am. Acad. Dermatol. 80:(1):6069.e2
    [Google Scholar]
  80. 80.
    Zouboulis CC, Hansen H, Caposiena Caro RD, et al. 2020.. Adalimumab dose intensification in recalcitrant hidradenitis suppurativa/acne inversa. . Dermatology 236:(1):2530
    [Google Scholar]
  81. 81.
    Fries W, Belvedere A, Cappello M, et al. 2019.. Inflammatory bowel disease onset during secukinumab treatment: real concern or just an expression of dysregulated immune response?. Clin. Drug Investig. 39:(8):799803
    [Google Scholar]
  82. 82.
    Glatt S, Jemec GBE, Forman S, et al. 2021.. Efficacy and safety of bimekizumab in moderate to severe hidradenitis suppurativa: a phase 2, double-blind, placebo-controlled randomized clinical trial. . JAMA Dermatol. 157:(11):127988
    [Google Scholar]
  83. 83.
    Kimball AB, Jemec GB, Sayed CJ. 2024.. Efficacy and safety of bimekizumab in patients with moderate-to-severe hidradenitis suppurativa (BE HEARD I and BE HEARD II): two 48-week, randomised, double-blind, placebo-controlled, multicentre phase 3 trials. . Lancet 403:(10443):250419
    [Google Scholar]
  84. 84.
    Witte-Händel E, Wolk K, Tsaousi A, et al. 2019.. The IL-1 pathway is hyperactive in hidradenitis suppurativa and contributes to skin infiltration and destruction. . J. Investig. Dermatol. 139:(6):1294305
    [Google Scholar]
  85. 85.
    Hessam S, Sand M, Gambichler T, et al. 2018.. Interleukin-36 in hidradenitis suppurativa: evidence for a distinctive proinflammatory role and a key factor in the development of an inflammatory loop. . Br. J. Dermatol. 178:(3):76167
    [Google Scholar]
  86. 86.
    Bachelez H, Choon SE, Marrakchi S, et al. 2021.. Trial of spesolimab for generalized pustular psoriasis. . N. Engl. J. Med. 385:(26):243140
    [Google Scholar]
  87. 87.
    Alavi A, Prens E, Kimball AB, et al. 2023.. 43019 Spesolimab for hidradenitis suppurativa: a proof-of-concept study. . J. Am. Acad. Dermatol. 89:(3):AB89
    [Google Scholar]
  88. 88.
    Savage KT, Santillan MR, Flood KS, et al. 2020.. Tofacitinib shows benefit in conjunction with other therapies in recalcitrant hidradenitis suppurativa patients. . J. Am. Acad. Dermatol. Case Rep. 6:(2):99102
    [Google Scholar]
  89. 89.
    Kirby JS, Okun MM, Alavi A, et al. 2024.. Efficacy and safety of the oral Janus kinase 1 inhibitor povorcitinib (INCB054707) in patients with hidradenitis suppurativa in a phase 2, randomized, double-blind, dose-ranging, placebo-controlled study. . J. Am. Acad. Dermatol. 90:(3):52129
    [Google Scholar]
  90. 90.
    Kimball AB, Ackerman L, Schlosser BJ, et al. 2023.. Efficacy and safety of upadacitinib in moderate-to-severe hidradenitis suppurativa: a phase 2, randomized, placebo-controlled study. . J. Am. Acad. Dermatol. 89:(3):AB42
    [Google Scholar]
  91. 91.
    Kimball AB, Peeva E, Forman S, et al. 2024.. Brepocitinib, zimlovisertib, and ropsacitinib in hidradenitis suppurativa. . N. Engl. J. Med. Evid. 3:(3):EVIDoa2300155
    [Google Scholar]
  92. 92.
    Ingram JR, Hadjieconomou S, Piguet V. 2016.. Development of core outcome sets in hidradenitis suppurativa: systematic review of outcome measure instruments to inform the process. . Br. J. Dermatol. 175:(2):26372
    [Google Scholar]
/content/journals/10.1146/annurev-med-051223-031234
Loading
/content/journals/10.1146/annurev-med-051223-031234
Loading

Data & Media loading...

  • Article Type: Review Article
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error