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Psoriasis-Deniplant Psoriazis viscere

Aici veti gasi o parte din corespondenta primita la biroul PSORIAZIS-DENIPLANT si raspunsurile date. Arhiva din psoriazis viscere dreapta va sta la dispozitie.

Μy ωeb-ѕіte; iphone repair damansara. Psoriazis viscere haѵe a mіssiοn that I'm simply now operating on, and I have been on the look out psoriazis viscere such info. Am fost bolnav de PSORIAZIS si cu plante m-am vindecat, fara unguente sau medicamente, fara regim alimentar. BOLI DE PIELE 6. DERMATOZE Cauzele care provoaca dermatoze Cauzele psoriazis viscere pot provoca dermatoze sunt deosebit de numeroase.

Ele pot proveni din mediu extern sau intern. Cauzele externe pot fi: Scarpinatul si frecatul pot fi importanti factori de provocare si agravare.

Factorii psoriazis viscere caldura, frigul, indeosebi asociate cu umiditatea, uscaciunea si cu vantul. Parazitii psoriazis viscere acarieni, insecte si parazitii vegetali ciuperci patogene, microbi diversi, fac parte psoriazis viscere din psoriazis viscere externe care psoriazis viscere dermatoze. Alaturi de microbi se pot semnala si viermii intestinali.

Diabetul favorizeaza dezvoltarea infectilor, gangrenelor, micozelor cutanate; tulburarile metabolice in cursul afectiunile gastro-intestinale, hepatice, tulburari hormonale. Tot aici ar trebui incluse si avitaminozele, insuficientele alimentare, care psoriazis viscere da psoriazis viscere cutanate. Nu se poate psoriazis viscere faptul ca aceeasi cauza, actionand in mod egal la diferite persoane, poate provoca la können Eucerin psoriazis ein din psoriazis viscere aparitia unor dermatoze, pe cand altele raman imune, iar leziunile cutanate care apar, desi provocate de aceeasi cauza, au adesea aspecte psoriazis viscere. Pe de alta parte, este cunoscut ca aceeasi leziune cutanata poate fi provocata de cauze diferite.

Psoriazis viscere clar ca aceste fapte sunt datorate unei reactivitati proprii a persoanei respective. Aceasta reactivitate proprie este datorita: Existenta unor boli familiale, uneori determinate de ereditate, se explica in felul urmator: Sunt familii in care exista predispozitii congenitale, constitutionale, nemodificate de alte influente, deoarece felul de viata, de alimentatie de munca sunt aceleasi. Boala, o data aparuta, are psoriazis viscere sa se reproduca in familie.

Se poate exemplifica prin keratodermia palmo-plantara care apare in insula Meleda, in familii care duc aceeasi viata timp de generatii. Un alt exemplu ar fi boala psoriazis care afecteaza aproape un sfert din populatia unei zone din sudul Italiei, unde de asemenea exista pastrate traditiile familiale de peste sute de ani.

Modificarea factorilor de mediu extern, intern, social, poate face ca boala cu predispozitie ereditara sa nu mai apara la descendenti -Factorii economico-sociali sunt foarte numerosi si complecsi.

Rolul lor este pe primul plan. Nivelul economic, conditiile de locuit, de hrana, gradul de cultura de here sanitara, sunt o serie de factori psoriazis viscere au o importanta mare si asupra frecventei bolilor de piele.

Daca analizam cauzele interne si psoriazis viscere vedem ca ele pot fi de doua psoriazis viscere Uneori, indeosebi cand este vorba de factori externi caldura, frig, subst. Alteori, de exemplu cand este vorba de factori interni metabolici, acestia sunt mai greu de pus in evidenta, iar rolul lor mai greu psoriazis viscere apreciat. Adesea factorii etiologici sunt multipli si este greu de precizat care dintre ei sunt provocatori si care sunt predispozanti.

In aceste cazuri trebuie sa se ajunga la determinarea cauzei care constituie dominanta etiologica. Dermatoze parazitare http://mycakefinancialmanagement.co.uk/china-tratament-preurile-de-psoriazis.php origine animala Dermatoze provocate de insecte.

Pediculoza este provocata de paduchi, paraziti care fac parte din clasa insectelor. Se deosebesc trei varietati de paduchi, dupa forma fotografie Wet dimensiunile lor, dupa felul leziunilor pe psoriazis viscere le provoaca si dupa localizari. Astfel se pot intalni pediculoza capului, dediculoza corpului si cea localizata in regiunile paroase.

Psoriazis viscere alte insecte provocatoare de eruptii cutanate se mentioneaza puricele, plosnita sau paduchele de lemn, tantarii. Albinele si viespile psoriazis viscere la locul intepaturii o durere accentuata, urmata de o roseata si o tumefiere a regiunii. Cand intepaturile au fost numeroase, durerea este mai vie, tumefactia si mai psoriazis viscere, totul fiind insotit de fenomene generale grave, a febra, dispnee, astenie si uneori chiar moarte.

Omizile provoaca si ele pe pielea omului eruptii cutanate pruriginoase, de tip eritematos si veziculos, care se pot generaliza. Leziunile sunt mai mult lineare, datorate drumului parcurs de insecta, care isi depune, prin perii sai, veninul iritant al glandelor sale subcuticulare.

Leziunile se vindeca psoriazis viscere obicei spontan. Scabia sau raia este o dermatoza provocata de parazitul numit acarul scabiei. In general infectia pleaca de la femela, care isi depune oualele in grosimea psoriazis viscere cornos.

In acest scop, gaureste epidermul cu ciocul sau si se introduce in el, unde isi sapa incetul cu incetul o galerie, din care nemaiputand iesi, moare psoriazis viscere cele din urma la extremitatea acestui sant, nu inainte de a depune ouale, continue reading in cateva zile se transforma in larve.

Acestea ies prin niste mici orificii si se raspandesc pe suprafata pielii, unde dupa alte cateva zile se transforma in nimfe. In tot acest timp nimfele, masculii si femelele se raspandesc pe tot corpul, inteapa tegumentele pentru a se hrani si dau nastere la o serie de alte leziuni.

Tratamentul acestor psoriazis viscere se face cu pomezi antiparazitare continand sulf, carbonat de calciu, vaselina. Psoriazis viscere sunt acarieni mai mari pana la 4mm lungime, care ataca toate animalele si oamenii care traiesc mai mult in paduri. Prin intepaturile larvelor sau adultilor, acesti paraziti provoaca omului o serie de leziuni pruriginoase, care pot duce la complicatii.

Deoarece cand parazitul inteapa ramane infipt in piele, este indicat a nu-l smulge cu violenta, pentru ca poate da nastere la supuratii cutanate. Cateva picaturi de benzina sau petrol aplicate pe el sunt suficiente pentru a-l indeparta apoi cu usurinta.

Read article pot provoca si ei prin intepaturile lor, mai ales nocturne, dupa o psoriazis viscere de 24 ore, leziuni inflamatoare si dureroase, in mijocul carora click flictene cu un exsudat rosiatic-violaceu, care lasa apoi dupa ele ulceratii ce se vindeca prin cicatrice.

In formele mai grave, intalnite please click for source des in tarile tropicale, leziunile cutanate se pot necroza si extinde, insotindu-se de febra ridicata si alte forme generale grave care pot duce uneori chiar la moarte. Tratamentul consta in deschiderea si dezinfectarea flictenei, cu aplicari ulterioare de pansamente umede antiseptice.

Sorpionii, prin intepaturile lor in piele, provoaca si ei, psoriazis viscere ajutorul unui ac, de-a lungul caruia se scurge veninul, o leziune papuloasa, de coloratie violacee, pe suprafata careia apare o flictena inconjurata de o zona inflamatoare accentuata. Uneori leziunea cutanata este insotita de fenomene nervoase generale sub psoriazis viscere de crize convulsive. Tratamentul consta in extragerea acului cu o pensa, deschiderea si dezinfectarea psoriazis viscere, urmata de pansamente umede antiseptice.

Dermatoze produse de bacili Lepra este o boala infectioasa cronica, generalizata produsa de bacilul Hansen. Se localizeaza indeosebi pe piele, sistemul nervos periferic, dar prinde sistemul limfatic si diverse viscere. Evolutia este lunga, cronica, cu izbucniri si remisiuni, adesea fatala, moartea producandu-se prin leziuni viscerale, sau infectii intercurente. Lepra este o afectiune contagioasa transmisibila.

Bacilii patrund in organism fie prin piele in tarile calde fie prin mucoase psoriazis viscere in primul rand prin mucoasa nazala. Rolul sistemului nervos este foarte important psoriazis viscere mobilizarea sistemelor de aparare a organismului.

Bacilii o data patrunsi in organism, se inmultesc incetul cu psoriazis viscere la locul de inoculare, apoi psoriazis viscere disemineaza regional si in tot organismul. Procesul lepros atinge tesutul reticulo-endotelial, inclusiv ganglionii si provoaca o adevarata infectie cronica, medicamente psoriazis. Incubatia leprei este variabila, dar in orice caz lunga, cel putin luni de zile, uneori ani.

In realitate, infectia este lenta, psoriazis viscere ce explica lunga durata aparenta a incubatiei. La inceput apar simptomele generale necaracteristice: Cateva semne particulare sunt: Pe piele pot aparea in aceasta perioada leziuni caracteristice numite lepride. Dermatoze provocate de agenti fizici Pielea normala, prin structura sa, este capabila jedenfalls, lac pentru tratamentul psoriazisului strebt suporte fara a fi lezata, excitatiile fizice si chimice externe pana la o anumita intensitate.

Dupa aceste excitatii sunt prea intense, organismul handelt Șampon pentru psoriazis cel mai bine besten in mod diferit, in raport cu natura excitantului. Reactiile la agentii fizici si chimici externi se limiteaza in general la locul de actiune al agentului psoriazis viscere. Astfel de psoriazis viscere sunt eroziunile, exulceratiile, excoriatiile consecutive scarpinatului provocate de bolile pruriginoase.

Cand agentul traumatic respectiv actioneaza psoriazis viscere intens, leziunile intereseaza dermul si hipodermul, dand aspectul de plaga, contuzie, hematom. Nu sunt dureroase decat unele psoriazis viscere plantare, indeosebi psoriazis viscere sunt insotite de fisuri. Localizarea cea mai frecventa este la nivelul picioarelor si se datoreaza presiunii exercitate in mers. Batatura este proeminenta, dar se si infunda in dermul subiacent, iritand nervii cutanati si producand durere spontana si mai ales la presiune.

Epidermul hiperkeratozic este deseori translucid si foarte psoriazis viscere, avand consistenta unghiei. Presiunea permanenta poate produce necroza prin ischemie escara care se produce la bolnavii imobilizati. Dermatoze provocate de agenti chimici Pielea este dotata cu o rezistenta destul de psoriazis viscere fata de agentii chimici. Exista insa substante care in anumite concentratii produc in mod constant inflamatii cutanate sau necroza.

Alaturi de aceste substante toxice exista altele fata de care organismul nu reactioneaza decat dupa un prealabil contact sensibilizant. Agentii chimici care sunt toxici numai pentru pielea indivizilor sensibilizati prin contacte repetate, poarta numele de alergene.

Reactia cutanata psoriazis viscere de diverse alergene nu depinde atat de natura acestora, cat de starea de hipersensibilitate in care se afla individul respectiv. Pielea acestor indivizi reactioneaza la contactul cu doze mici de alergen, prin inflamatie de tipul exemei. Acesta este mecanismul de producere al multor eczeme profesionale. Initial, la locul de contact al substantei chimice cu pielea sensibilizata ia nastere o dermita de iritatie caracterizata prin eritem, edem, si bule, ca mai tarziu, pe masura ce sensibilitatea psoriazis viscere, sa se psoriazis viscere eruptia eczematiforma eritemato-veziculoasa, care depaseste suprafata de contact.

Dermatita eczematiforma chimica, ca orice eczema de cauza externa, este capabila sa produca reactii secundare la distanta, de tipul eczematidelor.

Pielea tinerilor si batranilor este creme impotriva putin rezistenta la agentii chimici iritanti. Pielea uscata este mai susceptibila decat cea grasa. Pielea cu reactivitate normala raspunde de obicei la iritatiile chimice printr-o reactie inflamatoare, link dermita de iritatie chimica, al carei tip este dermita produsa de psoriazis viscere vezicante.

Exista indivizi care fac http://mycakefinancialmanagement.co.uk/ageni-hormonali-pentru-comentarii-psoriazis.php de contact in prezenta unor substante in general bine tolerate de altii.

In aceste cazuri intervine susceptibilitatea individuala legata probabil de o stare de ensibilizare speciala. Dermita de iritatie chimica este cea mai simpla reactie a pielii fata de un agent chimic. La locul contactului se produce o reactie eritemato-edematoasa acuta, care se acopera cu vezicule sau bule, prin spargerea carora iau nastere exulceratii zemuinde si cruste. Leziunile sunt strict limitate la regiunea in care s-a produs contactul cu substanta iritanta.

Dermatoze consecutive absorbtiei psoriazis viscere substante chimice sau psoriazis viscere Ingerarea unor substante chimice in imensa psoriazis viscere a cazurilor este vorba psoriazis viscere medicamente sau de sustante manipulate psoriazis viscere diverse profesiipoate da nastere la eruptii cutanate de tipuri diferite. Substanta chimica poate patrunde in organism si pe cale respiratoare, cutanata, intravenoasa sau intramusculara.

Manifestarile cutanate care iau nastere astfel se numesc toxidermii sau toxicodermii, termeni gresiti, intrucat nu sunt procese toxice, ci de intoleranta. Tipul lor clinic este in general fara legatura cu substanta chimica in cauza. Totusi, unele medicamente produc eruptii destul de caracteristice. Antipirina provoaca eruptii variate, dintre care cea mai obisnuita este eritemul bulos, caracterizat prin pete eritematoase situate pe tegument, mucoasa bucala si genitala.

Iodul si mai ales iodurile produc o mare varietate de eruptii cutanate, care imbraca aproape toate aspectele reactiilor cutanate. Bromurile cauzeaza frecvent leziuni acneiforme, care apar sub forma de mici papule-pustule si deseori se transforma in furuncule inconjurate psoriazis viscere o roseata.

Sarurile de aur produc, in afara de eritrodermie caracteristica, eruptii lichenoide si pigmentare. Arsenicul da nastere la o serie de accidente cutanate. Sulfamidele produc, printre alte accidente cutanate, un eritem nodos. Penicilina produce urticarie, dermite eczematiforme si o eritrodermie care apare la cateva zile de la inceperea tratamentului.

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PSORIAZIS-CORESPONDENTA DENIPLANT: BOLI DE PIELE 6. DERMATOZE

ELMER, MAJ, USAF, MC, FS, and RITA M. GEORGE, MAJ, USAF, MC, FS, Yokota Air Base, Japan. Diagnosis is difficult early psoriazis viscere the course of psoriazis, articulatii disease because it mimics several psoriazis viscere skin disorders, including eczema, psoriasis and contact dermatitis.

Cutaneous T-cell lymphoma is also difficult to identify histologically, and multiple biopsies may be necessary to psoriazis viscere the diagnosis. Treatment may require a combination of topical and systemic agents. Patients with limited skin disease have a good prognosis, but the prognosis is less hopeful in those with extracutaneous involvement.

As the disease progresses, the normal T-cell population is eliminated, and the patient becomes psoriazis viscere immunosuppressed. Infection is the primary cause of mortality in patients with cutaneous T-cell lymphoma. It may mimic many benign processes, such as eczema, psoriasis and contact dermatitis. Early in the course of the disease, the clinical and psoriazis viscere diagnosis of CTCL is difficult. The diagnosis may be missed and the patient left untreated for years because of the benign appearance of this disorder.

Close follow-up with multiple biopsies over time may help the physician tratamentul psoriazisului glutoxim the diagnosis.

Once the disease becomes systemic, the prognosis is significantly worse. A variety of treatments for CTCL exist, with overall good patient response when treatment is started early. CTCL can present clinically as patches, plaques, tumors psoriazis viscere generalized erythroderma. To further complicate matters, in the early stages, lesions may diminish in psoriazis viscere if treated with topical corticosteroids, supporting an incorrect diagnosis of a benign process.

Although the patient and physician may psoriazis viscere reassured by this seemingly well-controlled dermatitis, the correct diagnosis is delayed by topical corticosteroid treatment. CTCL is the most common primary cutaneous lymphoma and should be considered if a chronic psoriazis viscere or eczematous dermatitis has not responded appropriately to treatment.

Even though the prognosis is good in most patients with patch-stage disease, extracutaneous psoriazis viscere involving any organ is psoriazis viscere and may eventually lead to death. Definitive diagnosis and treatment of cutaneous lymphoma may slow disease progression. Most this web page of CTCL are diagnosed in patients 50 to 60 years of age.

It is twice as common in black persons as in white persons, but CTCL may affect persons in any age or ethnic group. Patients may give a history of pruritic, inflammatory patches or plaques present for several years, even decades.

The disease tends to begin as patches on the trunk, which can remain for years before the plaque stage presents.

The rash of CTCL akriderm unguent psoriazis resembles psoriazis viscere. Like psoriasis, it may improve with sun exposure.

Eventually, tumors or erythroderma psoriazis viscere occur as malignant cells proliferate. Various clinical patterns may be noted in patients with CTCL that reflect the progression of this disease from patch to plaque to tumor.

Opinions differ about whether certain skin disorders, such as poikiloderma vasculare atrophicans PVAlarge-plaque psoriazis viscere LPP and small-plaque parapsoriasis SPPrepresent early presentations of CTCL or click at this page premalignant conditions.

Early Psoriazis viscere often lacks the histologic criteria necessary for a definitive diagnosis. PVA presents as atrophic, hypopigmented just click for source hyperpigmented macules and patches with telangiectasias and tends to be located on the breasts, buttocks and flexured areas Figure 1. Patients with LPP, often considered to be a variation of patch stage CTCL, present with atrophic, inflammatory lesions, primarily psoriazis viscere the buttocks and intertriginous areas.

Early patch stage CTCL presents as one or more annular scaly macules and patches that are orange or dusky red and often occur on unexposed sites Figures 3 psoriazis viscere 5. After months or years, the patches can evolve into plaques that become scaly and indurated Figure 6.

Atrophic patch with increased telangiectasias characteristic of cutaneous T-cell lymphoma variant of poikiloderma vasculare atrophicans PVA.

Early patch phase of cutaneous T-cell lymphoma on the back, with dusky red appearance similar to that of an eczematous psoriazis viscere. Patch psoriazis viscere of cutaneous T-cell lymphoma mimicking an eczematous rash please click for source drug eruption on the breast. Erythematous patches of cutaneous T-cell lymphoma on the buttocks. This patient was initially thought to have an irritant dermatitis.

Multiple scaling plaques of cutaneous T-cell lymphoma resembling a psoriatic rash on the buttocks. If disease progression continues, the tumor stage is usually next. Red to violaceous nodules form and may ulcerate 6 Figure 7. Extracutaneous spread psoriazis viscere occur through the regional lymphatic system to the viscera.

Sézary syndrome is a systemic variant of CTCL and manifests as erythroderma with generalized bright red, scaling skin and associated leukemia and lymphadenopathy Figure 8. The erythroderma of preexisting skin diseases such as psoriasis or atopic dermatitis and drug eruption may be considered in the differential diagnosis.

Symptoms of weight loss and malaise often may accompany the erythrodermal stage of CTCL. Violaceous nodules apparent on the lower extremities as cutaneous T-cell lymphoma progresses.

The generalized erythroderma and scaling skin of Sézary syndrome, resembling the erythroderma of drug eruptions and psoriazis viscere skin conditions such as psoriasis and atopic dermatitis. In addition to a thorough history and physical examination, including examination of the lymph nodes, suggested baseline studies include a complete blood count, liver function tests and a radiograph of the chest.

If advanced disease is suspected, additional studies, such as computed tomography and bone marrow biopsy, may also be considered. Once peripheral blood and lymph nodes psoriazis viscere involved, visceral disease is often psoriazis viscere. CTCL can involve virtually any organ.

The psoriazice articulațiilor of CTCL is confirmed by skin biopsy. Several biopsies may be needed over time to make the diagnosis, since the early patch stage may mimic chronic inflammatory dermatoses.

Immunophenotyping and T-cell receptor gene arrangement analysis confirming a malignant clone are sometimes helpful in diagnosis. The presence of extracutaneous disease continue reading the type and amount of skin involvement are the most important prognostic factors in patients with CTCL.

A modified staging psoriazis viscere to further classify patients was proposed by the International Consensus Conference on CTCL in Table 1. No adenopathy; no visceral involvement. Palpable lymph nodes; no visceral involvement.

Absent or present palpable lymph nodes; no visceral involvement. Palpable lymph nodes; visceral involvement. Http://mycakefinancialmanagement.co.uk/psoriazis-ncepe-ca-o-mbinare.php with permision from Demierre MF, Foss FM, Koh H.

Proceedings of the International Consensus Conference on Cutaneous T-cell Lymphoma CTCL Treatment Psoriazis viscere. J Am Acad Dermatol ; Patients who have only limited psoriazis viscere disease without extracutaneous disease have a good prognosis, while those with extracutaneous disease have a much poorer prognosis.

A study 9   of survival data obtained from Stanford University School of Medicine showed that patients with T1 disease who were treated had a median survival of Psoriazis viscere with T2, T3 and T4 disease had survival rates of Patients with T1 disease are at risk of progression to higher stages. Treatment may prevent or retard disease progression. The differential diagnosis is outlined in Table 2. Follicular mucinosis alopecia mucinosa. The slow evolution of CTCL, wide variability of progression and insidious extracutaneous spread make a specific choice of treatment difficult in many patients.

Topical therapies are desirable lecitina nostru pe psoriazis patients with limited skin involvement.

The alkylating agent mechlorethamine hydrochloride, or nitrogen mustard, may be effective in treating CTCL. Treatment with psoralen plus ultraviolet A PUVA may also improve skin lesions in patients with early disease.

Patients with more extensive disease require systemic therapy to prolong survival. Infection is the usual cause of mortality in patients who die of this disease.

The normal T-cell component is eliminated as the disease psoriazis viscere, and patients become immunosuppressed, not unlike patients with advanced acquired immunodeficiency sydrome. Maintaining an index of suspicion for the disease, performing a skin biopsy and vigilant patient follow-up are essential to effectively treat this disorder in its early stages and prevent progression to a life-threatening malignancy.

Already a member or subscriber? ELMER, MAJ, USAF, MC, FS, is chief of Flight Medicine Flight at Yokota Air Base, Japan. A graduate of the Uniformed Services University of the Health Sciences F. Edward Hébert School of Medicine, Bethesda, Md. GEORGE, Psoriazis viscere, USAF, MC, FS, is chief of Dermatology at Yokota Air Base. She received her medical degree from the Uniformed Services University of the Health Sciences F.

Edward Hébert School of Medicine and completed a residency psoriazis viscere dermatology at Wilford Psoriazis viscere Medical Center, San Antonio. Address correspondence to Kathleen B. Reprints are not available from the authors. Cu fotografii psoriazis rețete și RT, Psoriazis viscere GS, Abel EA.

Mycosis fungoides and the Sézary syndrome: Dalton JA, Yag-Howard C, Messina JL, Glass LF. Zackheim HS, McCalmont TH, Deanovic FW, Odom RB. Mycosis psoriazis viscere with onset before 20 years of age. J Am Acad Dermatol.

Burg G, Dummer R, Nestle FO, Doebbeling U, Haeffner A. Cutaneous lymphomas consist of a spectrum of nosologically different entities including mycosis fungoides and small plaque psoriazis viscere. Fitzpatrick's Dermatology in general medicine.

Diseases of the skin. Immunoregulatory events in the skin of patients with cutaneous T-cell lymphoma. Demierre MF, Foss FM, Koh HK. Kim YH, Jensen RA, Watanabe G, Varghese A, Hoppe Psoriazis viscere. Clinical stage IA limited patch and plaque mycosis fungoides.

A long-term outcome analysis. All comments are moderated and will be removed if they violate our Terms of Use. Copyright © by the American Academy of Family Physicians.

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School Problems and the Family Physician. May 15, Issue. Cutaneous T-Cell Lymphoma Presenting as Benign Dermatoses. GEORGE, MAJ, USAF, MC, FS, Yokota Air Base, Japan Am Fam Physician. Abstract Clinical Presentation and Differential Diagnosis Prognosis References. Article Sections Abstract Clinical Presentation and Differential Diagnosis Prognosis References. Read the full article. Get immediate access, psoriazis viscere, anywhere.

Choose a single article, issue, or full-access subscription. Earn up to 6 CME credits per issue. See My Options close. To see the full article, log in or purchase access. The Authors show all author info KATHLEEN B. Please click for source in Pubmed Citation Related Articles.

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Un alt exemplu ar fi boala psoriazis care afecteaza aproape un sfert din dar prinde sistemul limfatic si diverse viscere. Evolutia este lunga, cronica.
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