Journal of Dermatology最新文献

{"title":"Cutaneous and Chest X-Ray Manifestation in a Patient With Chronic Systemic Mercury Poisoning With Embolism","authors":"Ranganath Ganga, Saurabh Mishra, Ajoy K. Behera, Mudalsha Ravina, Debankan Debnath","doi":"10.1111/1346-8138.70271","DOIUrl":"10.1111/1346-8138.70271","url":null,"abstract":"","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"53 6","pages":"e460-e461"},"PeriodicalIF":2.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tapinarof as a Therapeutic Aryl Hydrocarbon Receptor-Modulating Agent in the Treatment of Atopic Dermatitis","authors":"Gaku Tsuji,&nbsp;Yoko Fuyuno,&nbsp;Koji Kawamura,&nbsp;Ayako Yumine,&nbsp;Masaki Takemura,&nbsp;Yasutaka Mitamura,&nbsp;Kazuhiko Yamamura,&nbsp;Takeshi Nakahara","doi":"10.1111/1346-8138.70295","DOIUrl":"10.1111/1346-8138.70295","url":null,"abstract":"<p>Atopic dermatitis (AD) is a chronic inflammatory dermatitis underpinned by Type 2 inflammation driven by cytokines such as IL-4 and IL-13. It is characterized by skin barrier dysfunction, Th2 immune deviation, and pruritus. While biologics and oral Janus kinase (JAK) inhibitors demonstrate high therapeutic efficacy by targeting cytokines that exert their effects via the JAK, specifically IL-4, IL-13, and IL-31, comprehensive disease control requires additional approaches that modulate JAK-independent pathways. Factors such as TNF-α, IL-25, IL-33, microbial antigens, and physical stimuli activate mitogen-activated protein kinase and nuclear factor-κB signaling in a JAK-independent manner, sustaining the disease activity. Consequently, in some cases, a strategy incorporating topical treatment that inhibits JAK-independent pathways is indispensable alongside systemic treatment. One potential strategy of this kind involves the aryl hydrocarbon receptor (AhR), ligand-activated transcription factor. Under Th2-polarized conditions, the expression of indoleamine 2,3-dioxygenase 1 (IDO1) is downregulated, limiting the availability of tryptophan-derived metabolites. This scarcity of endogenous AhR ligands subsequently compromises physiological AhR signaling. Tapinarof, a therapeutic AhR-modulating agent (TAMA), activates AhR without generating excessive reactive oxygen species. This exerts multiple effects: enhancing antioxidant defenses via nuclear factor erythroid 2-related factor 2 (NRF2) activation, restoring barrier dysfunction, suppressing Th2 inflammation, and correcting abnormalities associated with pruritus-related molecules. Furthermore, clinical trials of tapinarof have demonstrated improvement of the disease activity and pruritus, with efficacy intensifying over long-term treatment. Although adverse events such as folliculitis, acne, contact dermatitis, and headache occur, they are generally manageable by adjusting the frequency of application based on their reversibility and time of onset. Moreover, considering potential antagonism by IL-24 induced by tapinarof, combining tapinarof with systemic agents, topical therapies, or phototherapy may serve to optimize the therapeutic effects. In conclusion, AhR functions as a molecular hub integrating AD pathology, and the TAMA tapinarof expands therapeutic strategies in the treatment of AD.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"53 6","pages":"867-879"},"PeriodicalIF":2.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1346-8138.70295","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Practice Guidelines for the Management of Porphyrias in Japan: Secondary Publication (English Translation)","authors":"Tadamichi Shimizu,&nbsp;Megumi Mizawa,&nbsp;Shinji Susa,&nbsp;Tomohide Adachi,&nbsp;Makoto Kunisada,&nbsp;Shigeru Kawara,&nbsp;Eijiro Akasaka,&nbsp;Shinichi Moriwaki,&nbsp;Chikako Nishigori,&nbsp;Akira Kawada,&nbsp;Committee for Guidelines for the Management of Porphyria","doi":"10.1111/1346-8138.70203","DOIUrl":"10.1111/1346-8138.70203","url":null,"abstract":"<p>Porphyrias are rare metabolic disorders caused by decreased or increased activity of one of the nine enzymes involved in the heme biosynthetic pathway, resulting in the accumulation of porphyrins or their precursors. Although nine subtypes are currently recognized, substantial overlap in clinical manifestations often makes diagnosis challenging. This article presents the English version of the first national clinical practice guidelines for porphyrias in Japan, originally published in 2025 by the Japanese Dermatological Association. The guidelines were developed by the Clinical Practice Guideline Committee, established as part of the Research Project on Intractable Diseases of the Ministry of Health, Labour and Welfare of Japan. Diagnostic and severity assessment criteria were based on those proposed by the Ministry research group. Clinical questions (CQs) were formulated, and recommendations were developed according to the principles of evidence-based medicine, incorporating both domestic and international evidence. The guidelines provide diagnostic criteria, severity classification, and evidence-based recommendations for the management of porphyrias. Although causative genes have been identified, the pathophysiology remains incompletely understood, and no curative therapy is currently available, and liver transplantation may be required in severe cases with liver failure. These guidelines aim to provide practical guidance for clinicians managing porphyrias in Japan. Future revisions will be necessary in response to advances in diagnostic technologies and therapeutic strategies.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"53 6","pages":"e420-e459"},"PeriodicalIF":2.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1346-8138.70203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147501284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tumor-Related Determinants of Reconstructive Method After Excision of Facial Basal Cell Carcinoma","authors":"Kazutoshi Nishimura,&nbsp;Anri Kimura,&nbsp;Anna Nakamura,&nbsp;Sumiko Takatsuka,&nbsp;Tatsuya Takenouchi","doi":"10.1111/1346-8138.70248","DOIUrl":"10.1111/1346-8138.70248","url":null,"abstract":"<div>\u0000 \u0000 <p>Basal cell carcinoma (BCC) is increasingly encountered in the context of population aging in Japan, and facial lesions frequently require reconstruction to preserve both function and appearance. This retrospective study analyzed 1149 facial BCCs treated with surgical excision at a single cancer center to describe reconstructive patterns and to identify factors influencing reconstructive method. Overall, local flap was the most frequently used reconstructive modality, followed by primary closure, skin graft, and secondary intention healing. In univariate analyses, tumors located at anatomical free-margin sites, larger tumor diameter, and aggressive histopathological subtypes were associated with increased use of flap or graft reconstruction. To identify factors independently associated with reconstructive method in clinically relevant settings, multivariate logistic regression analysis was performed among 649 cases in which primary closure was not feasible, comparing skin graft versus local flap reconstruction. Tumor diameter and histopathological subtype remained independently associated with reconstructive method. Specifically, larger tumor diameter and aggressive histopathological subtypes were independently associated with selection of skin graft reconstruction, whereas patient age, sex, and tumor location were not. These findings suggest that, when primary closure is not an option, tumor-centered factors—particularly tumor size and histopathological subtype—are associated with reconstructive strategy for facial BCC.</p>\u0000 </div>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"53 6","pages":"943-947"},"PeriodicalIF":2.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum TARC Levels Reflect the Severity and Prognosis of Atopic Dermatitis in Infants Under 6 Months of Age: A Retrospective Study in a Pediatric Primary Care Practice","authors":"Yumi Yamada,&nbsp;Shigemi Yoshihara","doi":"10.1111/1346-8138.70245","DOIUrl":"10.1111/1346-8138.70245","url":null,"abstract":"<div>\u0000 \u0000 <p>This study evaluated the clinical utility of serum TARC levels as an objective biomarker in infants with atopic dermatitis (AD) under 6 months of age in pediatric primary care practice, a population for which evidence remains limited. A retrospective search identified 61 infants (median age: 4 months) diagnosed with AD using The UK Working Party criteria and the Japanese guidelines for atopic dermatitis. These findings suggested a strong correlation between serum TARC levels and Objective SCORAD, and proposed the cutoff value for serum TARC demonstrating mild and moderate-to-severe AD was 2100 pg/mL derived using ROC analysis. Furthermore, in the group classified as the moderate-to-severe group based on the cutoff value, the period required to the duration until discontinuation of topical anti-inflammatory drugs was significantly longer than in the mild group. The recurrence rate of AD up to age 5 was significantly higher in this group than in the mild group. It is interesting to note that the incidence rate of Japanese cedar pollen allergy up to age 5 was significantly higher in the moderate-to-severe group. Based on these findings, it is hoped that measuring serum TARC in early infants with AD will be clinically useful for assessing the severity and prognosis.</p>\u0000 </div>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"53 6","pages":"939-942"},"PeriodicalIF":2.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erythropoietic Protoporphyria and Surgery: A Case of Successful Mastectomy With Perioperative Light Shielding Strategies Based on Light-Induced Hemolytic Threshold Assessment","authors":"Fumika Tateishi,&nbsp;Naoya Murayama,&nbsp;Ruri Nakamuta,&nbsp;Masahisa Watanabe,&nbsp;Aya Tanaka,&nbsp;Hiroyuki Murota","doi":"10.1111/1346-8138.70269","DOIUrl":"10.1111/1346-8138.70269","url":null,"abstract":"<p>A 50-year-old female patient was referred to our department for consultation regarding perioperative management of breast cancer surgery. She had a history of photosensitivity since childhood and was diagnosed with erythropoietic protoporphyria (EPP) during her first pregnancy. Because EPP is classified as a cutaneous porphyria that can cause hemolysis and liver impairment upon light exposure, we conducted a light-induced hemolysis test to determine intraoperative and postoperative exposure thresholds. Hemolysis was observed after 4 h of surgical light exposure. To minimize light-induced hemolysis during surgery, we applied optical films blocking light around the 400 nm wavelength range to the shadowless operating light, monitors, and overhead lamps. Under these conditions, a four-hour surgical procedure was successfully completed. No liver dysfunction or elevation of plasma protoporphyrin levels was observed intraoperatively or postoperatively. This case provided practical guidance for perioperative light management in EPP.</p>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"53 6","pages":"930-933"},"PeriodicalIF":2.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1346-8138.70269","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147825359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refractory Psoriatic Lesions in Japanese Patients With Biologics","authors":"Takayo Ando,&nbsp;Koji Kamiya,&nbsp;Megumi Kishimoto,&nbsp;Natsuko Sugihara,&nbsp;Junichi Sugai,&nbsp;Makiko Mieno,&nbsp;Mamitaro Ohtsuki,&nbsp;Mayumi Komine","doi":"10.1111/1346-8138.70289","DOIUrl":"10.1111/1346-8138.70289","url":null,"abstract":"<div>\u0000 \u0000 <p>Systemic therapies are required to control disease severity of patients with psoriasis vulgaris (PsO) and psoriatic arthritis (PsA) experiencing refractory skin lesions that persisted despite systemic therapies. Various oral medications and biologics are currently available in Japan. The aim of this study was to evaluate the treatment outcomes of refractory regions of PsO and PsA treated with systemic therapy. A total of 77 patients who received oral medications and biologics between 1 January 2010 and 31 March 2019 at the Jichi Medical University Hospital were enrolled. The PsO group included 39 men and 11 women, whereas the PsA group included 20 men and 7 women. Oral medications included etretinate (7 PsO patients and 3 PsA patients), cyclosporine (39 PsO patients and 20 PsA patients), apremilast (7 PsO patients), and methotrexate (5 PsA patients), including 4 patients treated with etretinate and cyclosporine combination (3 PsO patients and 1 PsA patient). The biologics included infliximab (5 PsO patients and 8 PsA patients), adalimumab (11 PsO patients and 11 PsA patients), ustekinumab (21 PsO patients and 6 PsA patients), guselkumab (5 PsO patients), secukinumab (2 PsO patients and 1 PsA patient), ixekizumab (5 PsO patients and 1 PsA patient), and brodalumab (1 PsO patient). The most common biologic-resistant regions were the lower extremities, followed by the upper extremities and back in patients with PsO, and the scalp, followed by the lower extremities and abdomen in patients with PsA. Despite the introduction of biologics, no significant differences were observed in the efficacy on the face, neck, palm, and buttocks in patients with PsO and the face, sole, and buttocks in patients with PsA compared to oral medications. These findings will provide useful information regarding biologic-resistant psoriatic regions in the Japanese patients.</p>\u0000 </div>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"53 6","pages":"914-924"},"PeriodicalIF":2.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of 0.5% Timolol Maleate Eye Drops for the Treatment of Facial Rosacea: A Randomized, Triple-Blind, Placebo-Controlled Clinical Trial","authors":"Ali Moradi,&nbsp;Safoura Shakoei,&nbsp;Shahin Hamzelou,&nbsp;Maryam Nasimi,&nbsp;Taha Shahbazi,&nbsp;Azin Ayatollahi","doi":"10.1111/1346-8138.70249","DOIUrl":"10.1111/1346-8138.70249","url":null,"abstract":"<div>\u0000 \u0000 <p>Rosacea is a chronic skin condition with limited effective and well-tolerated treatment options. This study investigated the efficacy of 0.5% timolol maleate eye drops in treating facial rosacea lesions. A randomized, triple-blind, placebo-controlled clinical trial was conducted at Razi Hospital in Tehran, involving 42 participants diagnosed with erythematotelangiectatic rosacea (ETR). Participants were randomized to receive either 0.5% timolol maleate eye drops or a placebo (distilled water) administered once daily for 4 weeks. The participants were evaluated in three visits (at baseline, after 4 weeks of treatment, and 4 weeks after stopping treatment) using a Mexameter MX18 device (for lightness and erythema), Clinician Erythema Assessment Scale (CEA), Global Flushing Severity Score (GFSS), Patient Self-Assessment (PSA), and Visioface device (for ΔL and ΔE criteria). The primary outcome was the change in erythema severity, assessed by the Mexameter MX18 device. The timolol group significantly reduced Erythema Index (<i>p</i>  &lt;  0.001) and other secondary outcomes, including CEA, PSA, and GFSS. No significant adverse effects were reported. In addition, MANOVA revealed a significant time × group interaction across outcomes, indicating that the pattern of changes over time was significantly different between the intervention and placebo groups. This study provides preliminary evidence that 0.5% timolol eye drops could be an effective and well-tolerated treatment for facial rosacea. However, the small sample size and short follow-up duration limited our results.</p>\u0000 </div>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"53 6","pages":"880-887"},"PeriodicalIF":2.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147793834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Features of Nasal and Paranasal Mucosal Melanomas in the Era of Immune Checkpoint Inhibitors: Insights From a Single-Institution Analysis","authors":"Yuma Waki,&nbsp;Teru Ebihara,&nbsp;Kazuhiro Omura,&nbsp;Akihiko Asahina,&nbsp;Yoshimasa Nobeyama","doi":"10.1111/1346-8138.70258","DOIUrl":"10.1111/1346-8138.70258","url":null,"abstract":"<div>\u0000 \u0000 <p>Immune checkpoint inhibitors (ICIs) have become the mainstay of systemic therapy for nasal cavity and paranasal sinus mucosal melanoma (NPMM), which can be classified into nasal cavity mucosal melanoma (NMM) and paranasal sinus mucosal melanoma (PMM). However, the clinical characteristics and prognostic factors of NPMM in the ICI era remain poorly defined, and real-world data are still limited. This study aimed to characterize the respective clinical features of NMM and PMM and to identify prognostic factors of NPMM in a real-world setting where ICIs are available. This retrospective study included 23 Japanese patients with NMM (<i>n</i> = 15) or PMM (<i>n</i> = 8) treated between 2015 and 2023. The diagnoses were confirmed clinically and histopathologically. Clinical data were evaluated using the Mann–Whitney <i>U</i> test, chi-square test, receiver operating characteristic curve analysis, and Kaplan<b>–</b>Meier survival analysis. Among 23 patients with NPMM, 22 patients (95.7%) received ICIs, with one patient declining ICI therapy. Compared with NMM, PMM patients showed significantly larger tumor size, more frequent bone invasion, shorter progression-free survival (PFS), as well as higher neutrophil counts and lower lymphocyte and platelet counts in the peripheral blood. Notably, neither neutrophil nor lymphocyte count alone correlated significantly with survival, but the neutrophil–lymphocyte ratio (NLR), which integrates both, was significantly higher in PMM and associated with worse prognosis at a cutoff of ≥ 4. Other poor prognostic factors included tumor size ≥ 45.5 mm, platelet count ≤ 247.5 × 10³/μL, and paranasal sinus origin. This study suggests that PMM shows significantly different outcomes compared with NMM, and that an elevated NLR may serve as a practical prognostic biomarker in the era of ICIs.</p>\u0000 </div>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"53 6","pages":"888-895"},"PeriodicalIF":2.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147635160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sunflower Seed–Induced Anaphylaxis With Immunoglobulin E Reactivity to 2S Albumins and Novel 60 kDa Antigen Identified by Immunoblot Analysis","authors":"Ayaka Aoki,&nbsp;Hiroko Fukamatsu,&nbsp;Takenobu Yamamoto,&nbsp;Yumi Aoyama","doi":"10.1111/1346-8138.70266","DOIUrl":"10.1111/1346-8138.70266","url":null,"abstract":"<div>\u0000 \u0000 <p>Sunflower seed allergy is uncommon, and reports of severe systemic reactions, such as anaphylaxis, are limited, particularly in Japan where sunflower seeds are not routinely consumed. A 38-year-old woman developed throat discomfort, dyspnea, and generalized urticaria within minutes of ingesting cookies containing sunflower seeds and was diagnosed with anaphylaxis. Her medical history included bronchial asthma and pollinosis caused by Japanese cedar and cypress. Skin prick testing (SPT) showed a strong positive (4+) reaction to sunflower seeds, while the results were negative for mugwort, cashew nut, and macadamia nut. Basophil activation testing (BAT) demonstrated marked upregulation of CD203c expression on basophils in response to sunflower seed extract, with an activation rate of 50.6% at 10 μg/mL, whereas the positive and negative controls showed activation of 34.5% and 1.8%, respectively. Serum analysis in immunoblotting revealed immunoglobulin E (IgE) binding to both the precursor and mature forms of 2S albumin, as well as to a novel 60 kDa antigen in sunflower seed and pollen extracts. Long-term exposure to sunflower seeds during childhood and adolescence while keeping birds may suggest sensitization via inhalation or skin contact rather than through oral ingestion or cross-reactivity with related pollens. 2S albumins are seed storage proteins found in high concentrations in several nuts and seeds and are major allergens capable of causing severe systemic reactions due to their resistance to heat processing and digestive enzymes. For the diagnosis and severity assessment of sunflower seed allergy, immunoblotting to detect IgE reactivity to 2S albumin is essential in addition to SPT and BAT. Detection of IgE antibodies against antigens of identical molecular weight in both sunflower seeds and pollen indicates the presence of shared antigens, suggesting that caution is necessary not only for sunflower seed ingestion but also for exposure to pollen.</p>\u0000 </div>","PeriodicalId":54848,"journal":{"name":"Journal of Dermatology","volume":"53 6","pages":"952-955"},"PeriodicalIF":2.7,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147655558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}