Skin Appendage Disorders最新文献

{"title":"Novel Clinicopathologic Subungual Angiokeratoma Series Demonstrating Clinical Features Mimicking Nail Unit Melanoma.","authors":"Elen Deng, Meaghan C Dougher, Julia O Baltz, Nathaniel J Jellinek, Adam I Rubin, Kimberly M Ken","doi":"10.1159/000547969","DOIUrl":"10.1159/000547969","url":null,"abstract":"<p><strong>Introduction: </strong>Angiokeratomas are benign vascular tumors that typically present as a hyperkeratotic, red-brown to black papule on the lower extremities. Angiokeratomas in the subungual location are rare, with few reported cases in the literature.</p><p><strong>Case presentation: </strong>We present three biopsy-proven cases of subungual angiokeratomas with novel clinical features: involvement of the nail bed, clinically mimicking nodular melanoma, and involving a broad age range, with the youngest patient reported at 25 years old. Symptoms included tenderness and bleeding, while the clinical presentations ranged from evenly to irregularly pigmented nodule(s). Histopathology revealed morphologic findings; characteristics of angiokeratoma include multiple dilated vascular spaces within the superficial dermis and overlying epidermal hyperplasia.</p><p><strong>Conclusion: </strong>This case series expands the known clinical presentations of nail unit angiokeratomas and emphasizes the importance of including subungual angiokeratoma in the differential diagnosis of pigmented, nodular lesions of the nail unit.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"75-80"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of a Nail Cadaver Lab as a Teaching Tool for Dermatology Residents.","authors":"Christian Bailey-Burke, Jennifer Panara, Guanlin Guo, Lorrie Schmid, Jane Bellet, Erin Lesesky","doi":"10.1159/000548023","DOIUrl":"10.1159/000548023","url":null,"abstract":"<p><strong>Introduction: </strong>Instruction in nail procedures is limited in dermatology residency programs. Cadaveric-based educational sessions can help bridge the gap in nail procedure knowledge and confidence in residency education. This study evaluates a combined didactic and hands-on cadaveric workshop for two cohorts of second- and third-year dermatology residents at a single institution (2023 and 2025).</p><p><strong>Methods: </strong>Second- and third-year dermatology residents completed a pre-survey prior to the session to assess their comfort and confidence with nail procedures prior to completing a didactic nail surgery lecture and subsequent nail procedure cadaveric training. Participants completed a post-survey within a week after the nail cadaver lab training to re-assess their experience and confidence.</p><p><strong>Results: </strong>Participants demonstrated significant post-intervention improvements in comfort with nail procedures, including instruments needed to perform nail procedures, postoperative care, nail matrix biopsies, and nail avulsions, with confidence in complete and partial nail avulsions doubling. All residents endorsed the session's effectiveness and recommended repeating it for future dermatology residents.</p><p><strong>Conclusion: </strong>These findings highlight nail procedure cadaveric training as a reproducible, scalable intervention to address gaps in procedural dermatology education and enhance residents' skills in nail surgery.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"17-21"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topical Tacrolimus, Clobetasol, and Minoxidil for Primary Cicatricial Alopecias: A Retrospective Analysis of Clinical Outcomes and Safety.","authors":"Anna L Brinks, Caitlin A Kearney, Carli D Needle, Akshay Pulavarty, Archie Spindler, Derek Maas, Loren D Krueger, Kristen I Lo Sicco, Jerry Shapiro","doi":"10.1159/000548130","DOIUrl":"10.1159/000548130","url":null,"abstract":"<p><strong>Introduction: </strong>Primary cicatricial alopecias (PCAs) cause permanent hair loss and psychosocial distress. Management involves anti-inflammatory and hair growth-promoting therapies. A combination of tacrolimus, clobetasol, and minoxidil (TCM) may offer synergistic benefits by targeting distinct inflammatory pathways while increasing background hair density for improved camouflage. This study evaluates the safety and efficacy of TCM use in PCA patients.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of PCA patients aged 18+ years treated with TCM between January 1, 2009, and May 31, 2025. Outcomes included inflammatory activity on trichoscopy, scalp symptoms, provider- and patient-reported disease status, and objective hair measurements. Descriptive statistics were performed using SAS v9.4.</p><p><strong>Results: </strong>Eighty-two patients (80.5% female, mean age 61.5) were included, most commonly with frontal fibrosing alopecia or lichen planopilaris. TCM was typically prescribed as a compounded solution used 1-2 times/day for an average of 24.5 months. Adverse effects included worsened itch/burning (6.1%), hypertrichosis (4.9%), scalp irritation/dryness (4.8%), and atrophy (3.7%); most (62.2%) experienced no adverse effects. Provider-assessed inflammation and disease status improved or stabilized in 69.5% and 76.9%, respectively. Objective hair measurements also improved.</p><p><strong>Conclusions: </strong>TCM is well tolerated and, used alone or in conjunction with other therapies, appears to be effective. Improvements were seen in provider-reported outcomes and objective hair measurements.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"55-59"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trichonodosis: A Case Report and Literature Review.","authors":"Pattarada Chantanakul, Chinmanat Lekhavat","doi":"10.1159/000547816","DOIUrl":"10.1159/000547816","url":null,"abstract":"<p><strong>Introduction: </strong>Hair shaft disorders include congenital or acquired conditions characterized by structural abnormalities of the hair. Trichonodosis, or knotted hair, is a rare disorder characterized by the presence of knots along the hair shaft. It can occur spontaneously or be induced by mechanical forces.</p><p><strong>Case presentation: </strong>An 8-year-old girl presented with short, fine, curly hair since birth. Physical examination revealed diffusely curly scalp hair with visible breakage. Trichoscopy and light microscopy showed knotted hair segments, cortical fractures, and variation in hair shaft thickness. A diagnosis of spontaneous trichonodosis was made. Treatment with topical minoxidil and gentle hair care led to improved hair length and strength over 2 years.</p><p><strong>Conclusion: </strong>We propose that spontaneous trichonodosis with congenital onset and no mechanical triggers suggest a genetic predisposition. Although treatment options are limited, topical minoxidil may provide therapeutic benefit.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"71-74"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Unusual Compulsive Behavior Related to Scalp Psoriasis and Hair Follicle Anxiety in Young Men.","authors":"Ramon Grimalt","doi":"10.1159/000547907","DOIUrl":"10.1159/000547907","url":null,"abstract":"<p><strong>Introduction: </strong>Patients suffering from androgenetic alopecia may experience obsessive behaviors on observing their own scalp.</p><p><strong>Case presentation: </strong>This article describes a series of three cases of young men presenting with an unusual, seemingly compulsive behavior related to mild scalp psoriasis and a family history of androgenetic alopecia. Contrary to the typical goal of psoriasis treatment, these patients exhibit an intense fixation on scalp scales containing embedded hairs. They actively avoid dislodging these scales during routine hygiene or therapeutic efforts, fearing that their removal might accelerate hair loss. The cases involve young men (aged 24, 19, and 22) with significant anxiety about hair loss, which manifests as a meticulous and repetitive manipulation of their scalps to preserve these specific scales.</p><p><strong>Conclusion: </strong>This behavior may fall within the spectrum of body-focused repetitive behaviors. This observation underscores the importance for dermatologists to thoroughly question patients about underlying anxieties and specific scalp manipulation behaviors, especially in young men with a familial history of alopecia, to facilitate more effective clinical management.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"8-11"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric Pityriasis Amiantacea: A Multicenter Retrospective Study of 76 Patients.","authors":"Felipe Tavares Rodrigues, Rita Fernanda Cortez de Almeida, Luciana Rodino Lemes, Carla Jorge Machado, Bianca Maria Piraccini, Michela Starace, Luca Rapparini, Nino Lortkipanidze, Asmahanane Souissi, Sineida Berbert Ferreira, Luna Azulay-Abulafia, Taynara Barreto, Regina Lúcia Barbosa Santos, Antonella Tosti, Colombina Vincenzi, Daniel Asz Sigall, Sebastian Agusto Mercau, Andrei Doroshkevich, Tatiana Silyuk, Luis Enrique Sánchez-Dueñas, Gabriel Lazzeri Cortez, Isabella Doche, Claudia Montoya, Daniela Gutiérrez-Mendoza, Sergio Vaño-Galván, Hudson Dutra Rezende, Verena Florenço, Daniela Guzman-Sanchez, Alejandro Bonifaz, Daniel Fernandes Melo","doi":"10.1159/000547530","DOIUrl":"10.1159/000547530","url":null,"abstract":"<p><strong>Introduction: </strong>Pityriasis amiantacea (PA), also known as pseudotinea amiantacea, is a scalp disorder characterized by adherent scales surrounding hair tufts, with an unclear etiopathogenesis potentially linked to inflammatory scalp diseases such as psoriasis, seborrheic dermatitis, and atopic dermatitis.</p><p><strong>Methods: </strong>This retrospective multicenter study analyzed the epidemiology, clinical presentation, trichoscopic features, and management of 76 pediatric patients diagnosed with PA across 22 centers.</p><p><strong>Results: </strong>Pruritus was the hallmark symptom, and scarring alopecia was rare in pediatric patients. Regarding trichoscopy, recognizing the vascular patterns is demonstrated to be valuable for severe or unresponsive cases. In our study, monotherapy using topical steroid treatment generally led to favorable outcomes, suggesting that PA may be less aggressive in children due to earlier diagnosis and less severe inflammation.</p><p><strong>Conclusion: </strong>This study highlights the importance of recognizing PA in pruritic scalp conditions in pediatric patients, suggesting effective management strategies that can improve quality of life despite the psychosocial impact of the disease.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"1-7"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Onychotillomania Dentata: A Newly Defined Oral-Induced Pattern of Repetitive Nail Trauma.","authors":"Eduardo Corona-Rodarte, Juan Jimenez-Cauhe, Michela Starace, Matilde Iorizzo, Germán Juanicotena-Madrigal, Bianca Maria Piraccini, Brian Morrison, Daniel Asz-Sigall","doi":"10.1159/000547308","DOIUrl":"10.1159/000547308","url":null,"abstract":"<p><strong>Introduction: </strong>Onychotillomania is a body-focused repetitive behavior disorder characterized by compulsive trauma to the nail unit. While manual manipulation is well recognized, oral-induced mechanisms remain undocumented. We describe a novel subset involving frictional trauma from the teeth, which we term onychotillomania dentata.</p><p><strong>Case presentation: </strong>An 11-year-old female presented with a 1-year history of progressive thumbnail dystrophy. Clinical history revealed a habitual behavior occurring predominantly at night: inserting the thumbs into the mouth and rubbing the nail plates against the lower incisors in a repetitive anteroposterior motion. The patient described the behavior as soothing and unconscious. Signs of concomitant onychophagia were also present. Examination demonstrated central nail plate concavity, lamellar splitting, periungual erythema, and localized subungual hyperkeratosis. Dermoscopy revealed lamellar onychoschizia, linear furrows, and compact subungual debris. Behavioral counseling was initiated, including thumb guards during sleep and positive reinforcement strategies. Oral n-acetylcysteine (600 mg every 12 h) was prescribed as adjunctive therapy. Referral to pediatric psychodermatology was recommended for behavioral assessment and initiation of habit-reversal training.</p><p><strong>Conclusion: </strong>Onychotillomania dentata represents a previously undescribed pattern of nail trauma within the broader spectrum of onychotillomania. While classical onychotillomania typically results from manual manipulation, onychotillomania dentata is distinguished by repetitive oro-digital friction. Clinical features include central concavity, lamellar splitting, and linear furrows along the axis of mechanical trauma. Diagnosis often relies heavily on clinical morphology and dermoscopy, especially as many patients may deny their behavioral habit. Early recognition is crucial to avoid misdiagnosis and unnecessary treatment. Additionally, chronic mechanical friction may pose a risk of dental damage, including enamel erosion. Management involves behavioral modification strategies, pharmacologic support when appropriate, and interdisciplinary psychodermatologic care.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"65-70"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic Onychodystrophy Revealing Amelanotic Nail Unit Melanoma in a Moroccan Patient: A Case Report.","authors":"Bouchra Baghad, Fouzia Hali, Yousra Habibi, Fatima Anejjar, Bahija Lemrhari, Bouchra Mouaouya, Meriem Regragui, Mounia Diouri, Soumiya Chiheb","doi":"10.1159/000546886","DOIUrl":"10.1159/000546886","url":null,"abstract":"<p><strong>Introduction: </strong>Nail unit melanoma is a rare and potentially aggressive variant of acral lentiginous melanoma. Diagnosing amelanotic variants can be particularly challenging due to the absence of typical pigmentation. Here, we report a case of chronic onychodystrophy revealing amelanotic nail unit melanoma.</p><p><strong>Case presentation: </strong>A 48-year-old Moroccan patient presented with chronic persistent monodactylic nail dystrophy. Dermoscopy showed subungual hyperkeratosis with an atypical vascular pattern but no pigmented structures. A biopsy of the nail unit confirmed amelanotic melanoma. Staging (PET scan, lymph node ultrasound, and bone CT) excluded metastases. Surgical management led to metacarpophalangeal amputation of the thumb.</p><p><strong>Conclusion: </strong>This case underscores the need to consider amelanotic melanoma in patients with atypical or persistent nail lesions. Early recognition and prompt treatment can significantly affect prognosis. Monodactylous involvement with nail dystrophy, including nail plate destruction, should lead to a nail biopsy for an early and accurate diagnosis.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"22-28"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating Scarring Alopecia Therapies from the Patient Perspective: Knowledge, Barriers to Care, and Treatment Satisfaction.","authors":"Anna Brinks, Caitlin Kearney, Carli Needle, Akshay Pulavarty, Jerry Shapiro, Kristen I Lo Sicco","doi":"10.1159/000547557","DOIUrl":"10.1159/000547557","url":null,"abstract":"<p><strong>Introduction: </strong>Scarring alopecias (SAs) cause permanent hair loss and psychological distress. With no FDA-approved SA treatments, patients face significant barriers to care. Despite promising evidence supporting the use of Janus kinase inhibitors (JAKi) to treat SAs, access remains limited. This study aimed to assess the demographic profile, psychosocial burden, treatment experiences, and barriers to care among patients with SA.</p><p><strong>Methods: </strong>An IRB-approved online survey was distributed to adults (≥18 years) with a self-reported SA diagnosis via the Scarring Alopecia Foundation (SAF) listserv and at the April 2025 SAF Conference. Wilcoxon-Mann-Whitney U tests and χ² tests were performed using SAS v9.4.</p><p><strong>Results: </strong>Among 294 respondents (98.0% female, mean age 61, 81.3% White), common diagnoses included frontal fibrosing alopecia (66.3%), lichen planopilaris (41.5%), and central centrifugal cicatricial alopecia (12.6%). Only 37.5% reported well-controlled symptoms; 78.9% experienced SA-related depression or anxiety. JAKi awareness was high (71%), but use was low (30%), with significant differences based on gender, region, income, and education. Barriers to treatment access included provider reluctance (46%), insurance denial (18%), and high cost (16%).</p><p><strong>Conclusions: </strong>SA patients face significant psychosocial distress and barriers to accessing therapies. Improving equitable access to care requires enhanced provider education, broader insurance coverage, and stronger patient assistance programs.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"42-45"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dutasteride Infusion in Male Androgenetic Alopecia Using a Novel Drug Delivery Technique: MMP^®.","authors":"Luciana Gasques, Alice Lima, Mariana Lima, Antonella Tosti, Marcio Silva, Marina Barletta","doi":"10.1159/000546871","DOIUrl":"10.1159/000546871","url":null,"abstract":"<p><strong>Introduction: </strong>MMP® (the Portuguese acronym for microinfusão de medicamentos na pele [i.e., microinfusion of drugs into the skin]) is a novel drug delivery technique that uses microneedling to infuse drugs into the skin. Scalp microinfusion is a promising intervention for hair loss.</p><p><strong>Aim: </strong>The aim of the study was to evaluate the efficacy and safety of microinfusion of dutasteride with the MMP® technique compared with microinfusion of saline solution (placebo) in men with androgenetic alopecia (AGA). This is the first study that compared microinfusion with MMP® using dutasteride versus placebo for the treatment of AGA.</p><p><strong>Methods: </strong>A prospective, multicenter, controlled clinical trial was conducted in eight (8) adult male patients with AGA. Three applications of dutasteride or placebo (saline solution 0.9%) using the MMP® were made every 30 days. Photos pre- and posttreatment were analyzed by three blinded dermatologists and the patient. Efficacy and safety were evaluated.</p><p><strong>Results: </strong>No statistical difference in the clinical assessment was found between the groups. However, patient self-assessment reported marked improvement in the vertex area in the dutasteride group.</p><p><strong>Conclusion: </strong>Dutasteride microinfusion using the MMP® technique is effective in treating male AGA. Microneedling with MMP® without any medication is effective in treating male AGA.</p>","PeriodicalId":21844,"journal":{"name":"Skin Appendage Disorders","volume":" ","pages":"12-16"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145252708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}