Atopic eczema: burden of disease and individual suffering - results from a large EU study in adults.
Identifieur interne : 000653 ( Main/Exploration ); précédent : 000652; suivant : 000654Atopic eczema: burden of disease and individual suffering - results from a large EU study in adults.
Auteurs : J. Ring [Allemagne, Suisse] ; A. Zink [Allemagne] ; B W M. Arents [Belgique] ; I A Seitz [Allemagne] ; U. Mensing [Allemagne] ; M C Schielein [Allemagne] ; N. Wettemann [Allemagne] ; G. De Carlo [Belgique] ; A. Fink-Wagner [Belgique]Source :
- Journal of the European Academy of Dermatology and Venereology : JEADV [ 1468-3083 ] ; 2019.
Descripteurs français
- KwdFr :
- Absentéisme (MeSH), Acuité des besoins du patient (MeSH), Adolescent (MeSH), Adulte (MeSH), Adulte d'âge moyen (MeSH), Coûts indirects de la maladie (MeSH), Dépression (étiologie), Eczéma atopique (complications), Eczéma atopique (psychologie), Eczéma atopique (thérapie), Enquêtes et questionnaires (MeSH), Femelle (MeSH), Humains (MeSH), Jeune adulte (MeSH), Mâle (MeSH), Qualité de vie (MeSH), Sujet âgé (MeSH), Sujet âgé de 80 ans ou plus (MeSH), Union européenne (MeSH), Échelles d'évaluation en psychiatrie (MeSH), Émotions (MeSH), Études transversales (MeSH).
- MESH :
- psychologie : Eczéma atopique.
- thérapie : Eczéma atopique.
- étiologie : Dépression.
- complications : Absentéisme, Acuité des besoins du patient, Adolescent, Adulte, Adulte d'âge moyen, Coûts indirects de la maladie, Eczéma atopique, Enquêtes et questionnaires, Femelle, Humains, Jeune adulte, Mâle, Qualité de vie, Sujet âgé, Sujet âgé de 80 ans ou plus, Union européenne, Échelles d'évaluation en psychiatrie, Émotions, Études transversales.
English descriptors
- KwdEn :
- Absenteeism (MeSH), Adolescent (MeSH), Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Cost of Illness (MeSH), Cross-Sectional Studies (MeSH), Depression (etiology), Dermatitis, Atopic (complications), Dermatitis, Atopic (psychology), Dermatitis, Atopic (therapy), Emotions (MeSH), European Union (MeSH), Female (MeSH), Humans (MeSH), Male (MeSH), Middle Aged (MeSH), Patient Acuity (MeSH), Psychiatric Status Rating Scales (MeSH), Quality of Life (MeSH), Surveys and Questionnaires (MeSH), Young Adult (MeSH).
- MESH :
- complications : Dermatitis, Atopic.
- etiology : Depression.
- psychology : Dermatitis, Atopic.
- therapy : Dermatitis, Atopic.
- Absenteeism, Adolescent, Adult, Aged, Aged, 80 and over, Cost of Illness, Cross-Sectional Studies, Emotions, European Union, Female, Humans, Male, Middle Aged, Patient Acuity, Psychiatric Status Rating Scales, Quality of Life, Surveys and Questionnaires, Young Adult.
Abstract
BACKGROUND
Atopic eczema (AE, atopic dermatitis) is one of the most common non-communicable inflammatory skin diseases affecting 1-5% of the adult population in Europe with marked impairment in quality of life. In spite of great progress in understanding the pathophysiology of disturbed skin barrier and immune deviation, AE still represents a problem in daily clinical practice. Furthermore, the true impact of AE on individual suffering is often not recognized.
OBJECTIVES
With a large European study, we wanted to provide insights into the actual suffering and individual burden of disease in adult patients with AE.
METHODS
A total of 1189 adult patients (18-87 years, 56% female) with moderate to severe AE were recruited in nine European countries by dermatologists or allergists together with the help of patient organizations. A computer-assisted telephone interview was performed by experienced interviewers between October 2017 and March 2018. The following instruments were used to assess severity or measure quality of life: Patient-Oriented Eczema Measure (POEM), Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS-D) and a newly developed Atopic Eczema Score of Emotional Consequences (AESEC). Patients were also asked to self-assess the severity of their disease.
RESULTS
Despite current treatment, 45% of participants still had actual moderate to very severe AE in POEM. Due to their skin disease, 57% missed at least 1 day of work in the preceding year. DLQI showed moderate to extremely large impairment in 55%. According to HADS-D, 10% scored on or above the threshold of eight points with signs of depressive symptoms. Assessed with AESEC, 57% were emotionally burdened with feelings such as 'trying to hide the eczema', 'feeling guilty about eczema', having 'problems with intimacy' and more. Of persons actually suffering from severe AE, 88% stated that their AE at least partly compromised their ability to face life.
CONCLUSIONS
This real-life study shows that adults with a moderate to severe form of AE are suffering more than what would be deemed acceptable. There is a need for increased awareness of this problem among healthcare professionals, policymakers and the general public to support research in the development of new and more effective treatments and provide access to better and affordable health care for affected patients.
DOI: 10.1111/jdv.15634
PubMed: 31002197
Affiliations:
- Allemagne, Belgique, Suisse
- Bavière, District de Haute-Bavière, Région de Bruxelles-Capitale
- Bruxelles, Munich
- Université Louis-et-Maximilien de Munich
Links toward previous steps (curation, corpus...)
Le document en format XML
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Mensing</name><affiliation wicri:level="3"><nlm:affiliation>IMAS International, Munich, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>IMAS International, Munich</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Haute-Bavière</region><settlement type="city">Munich</settlement></placeName></affiliation></author><author><name sortKey="Schielein, M C" sort="Schielein, M C" uniqKey="Schielein M" first="M C" last="Schielein">M C Schielein</name><affiliation wicri:level="4"><nlm:affiliation>Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Dermatology and Allergy, Technical University of Munich, Munich</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Haute-Bavière</region><settlement type="city">Munich</settlement></placeName><orgName type="university">Université Louis-et-Maximilien de Munich</orgName></affiliation></author><author><name sortKey="Wettemann, N" sort="Wettemann, N" uniqKey="Wettemann N" first="N" last="Wettemann">N. Wettemann</name><affiliation wicri:level="3"><nlm:affiliation>IMAS International, Munich, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>IMAS International, Munich</wicri:regionArea><placeName><region type="land" nuts="1">Bavière</region><region type="district" nuts="2">District de Haute-Bavière</region><settlement type="city">Munich</settlement></placeName></affiliation></author><author><name sortKey="De Carlo, G" sort="De Carlo, G" uniqKey="De Carlo G" first="G" last="De Carlo">G. De Carlo</name><affiliation wicri:level="3"><nlm:affiliation>European Federation of Allergy and Airway Diseases Patient's Associations, Brussels, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>European Federation of Allergy and Airway Diseases Patient's Associations, Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName></affiliation></author><author><name sortKey="Fink Wagner, A" sort="Fink Wagner, A" uniqKey="Fink Wagner A" first="A" last="Fink-Wagner">A. Fink-Wagner</name><affiliation wicri:level="3"><nlm:affiliation>European Federation of Allergy and Airway Diseases Patient's Associations, Brussels, Belgium.</nlm:affiliation><country xml:lang="fr">Belgique</country><wicri:regionArea>European Federation of Allergy and Airway Diseases Patient's Associations, Brussels</wicri:regionArea><placeName><settlement type="city">Bruxelles</settlement><region nuts="2">Région de Bruxelles-Capitale</region></placeName></affiliation></author></analytic><series><title level="j">Journal of the European Academy of Dermatology and Venereology : JEADV</title><idno type="eISSN">1468-3083</idno><imprint><date when="2019" type="published">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Absenteeism (MeSH)</term><term>Adolescent (MeSH)</term><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Cost of Illness (MeSH)</term><term>Cross-Sectional Studies (MeSH)</term><term>Depression (etiology)</term><term>Dermatitis, Atopic (complications)</term><term>Dermatitis, Atopic (psychology)</term><term>Dermatitis, Atopic (therapy)</term><term>Emotions (MeSH)</term><term>European Union (MeSH)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Patient Acuity (MeSH)</term><term>Psychiatric Status Rating Scales (MeSH)</term><term>Quality of Life (MeSH)</term><term>Surveys and Questionnaires (MeSH)</term><term>Young Adult (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Absentéisme (MeSH)</term><term>Acuité des besoins du patient (MeSH)</term><term>Adolescent (MeSH)</term><term>Adulte (MeSH)</term><term>Adulte d'âge moyen (MeSH)</term><term>Coûts indirects de la maladie (MeSH)</term><term>Dépression (étiologie)</term><term>Eczéma atopique (complications)</term><term>Eczéma atopique (psychologie)</term><term>Eczéma atopique (thérapie)</term><term>Enquêtes et questionnaires (MeSH)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Jeune adulte (MeSH)</term><term>Mâle (MeSH)</term><term>Qualité de vie (MeSH)</term><term>Sujet âgé (MeSH)</term><term>Sujet âgé de 80 ans ou plus (MeSH)</term><term>Union européenne (MeSH)</term><term>Échelles d'évaluation en psychiatrie (MeSH)</term><term>Émotions (MeSH)</term><term>Études transversales (MeSH)</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Dermatitis, Atopic</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Depression</term></keywords><keywords scheme="MESH" qualifier="psychologie" xml:lang="fr"><term>Eczéma atopique</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Dermatitis, Atopic</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Dermatitis, Atopic</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Eczéma atopique</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Dépression</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Absenteeism</term><term>Adolescent</term><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Cost of Illness</term><term>Cross-Sectional Studies</term><term>Emotions</term><term>European Union</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Patient Acuity</term><term>Psychiatric Status Rating Scales</term><term>Quality of Life</term><term>Surveys and Questionnaires</term><term>Young Adult</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="fr"><term>Absentéisme</term><term>Acuité des besoins du patient</term><term>Adolescent</term><term>Adulte</term><term>Adulte d'âge moyen</term><term>Coûts indirects de la maladie</term><term>Eczéma atopique</term><term>Enquêtes et questionnaires</term><term>Femelle</term><term>Humains</term><term>Jeune adulte</term><term>Mâle</term><term>Qualité de vie</term><term>Sujet âgé</term><term>Sujet âgé de 80 ans ou plus</term><term>Union européenne</term><term>Échelles d'évaluation en psychiatrie</term><term>Émotions</term><term>Études transversales</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Atopic eczema (AE, atopic dermatitis) is one of the most common non-communicable inflammatory skin diseases affecting 1-5% of the adult population in Europe with marked impairment in quality of life. In spite of great progress in understanding the pathophysiology of disturbed skin barrier and immune deviation, AE still represents a problem in daily clinical practice. Furthermore, the true impact of AE on individual suffering is often not recognized.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVES</b></p><p>With a large European study, we wanted to provide insights into the actual suffering and individual burden of disease in adult patients with AE.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>A total of 1189 adult patients (18-87 years, 56% female) with moderate to severe AE were recruited in nine European countries by dermatologists or allergists together with the help of patient organizations. A computer-assisted telephone interview was performed by experienced interviewers between October 2017 and March 2018. The following instruments were used to assess severity or measure quality of life: Patient-Oriented Eczema Measure (POEM), Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS-D) and a newly developed Atopic Eczema Score of Emotional Consequences (AESEC). Patients were also asked to self-assess the severity of their disease.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Despite current treatment, 45% of participants still had actual moderate to very severe AE in POEM. Due to their skin disease, 57% missed at least 1 day of work in the preceding year. DLQI showed moderate to extremely large impairment in 55%. According to HADS-D, 10% scored on or above the threshold of eight points with signs of depressive symptoms. Assessed with AESEC, 57% were emotionally burdened with feelings such as 'trying to hide the eczema', 'feeling guilty about eczema', having 'problems with intimacy' and more. Of persons actually suffering from severe AE, 88% stated that their AE at least partly compromised their ability to face life.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS</b></p><p>This real-life study shows that adults with a moderate to severe form of AE are suffering more than what would be deemed acceptable. There is a need for increased awareness of this problem among healthcare professionals, policymakers and the general public to support research in the development of new and more effective treatments and provide access to better and affordable health care for affected patients.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">31002197</PMID><DateCompleted><Year>2020</Year><Month>01</Month><Day>15</Day></DateCompleted><DateRevised><Year>2020</Year><Month>01</Month><Day>15</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1468-3083</ISSN><JournalIssue CitedMedium="Internet"><Volume>33</Volume><Issue>7</Issue><PubDate><Year>2019</Year><Month>Jul</Month></PubDate></JournalIssue><Title>Journal of the European Academy of Dermatology and Venereology : JEADV</Title><ISOAbbreviation>J Eur Acad Dermatol Venereol</ISOAbbreviation></Journal><ArticleTitle>Atopic eczema: burden of disease and individual suffering - results from a large EU study in adults.</ArticleTitle><Pagination><MedlinePgn>1331-1340</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1111/jdv.15634</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Atopic eczema (AE, atopic dermatitis) is one of the most common non-communicable inflammatory skin diseases affecting 1-5% of the adult population in Europe with marked impairment in quality of life. In spite of great progress in understanding the pathophysiology of disturbed skin barrier and immune deviation, AE still represents a problem in daily clinical practice. Furthermore, the true impact of AE on individual suffering is often not recognized.</AbstractText><AbstractText Label="OBJECTIVES" NlmCategory="OBJECTIVE">With a large European study, we wanted to provide insights into the actual suffering and individual burden of disease in adult patients with AE.</AbstractText><AbstractText Label="METHODS" NlmCategory="METHODS">A total of 1189 adult patients (18-87 years, 56% female) with moderate to severe AE were recruited in nine European countries by dermatologists or allergists together with the help of patient organizations. A computer-assisted telephone interview was performed by experienced interviewers between October 2017 and March 2018. The following instruments were used to assess severity or measure quality of life: Patient-Oriented Eczema Measure (POEM), Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS-D) and a newly developed Atopic Eczema Score of Emotional Consequences (AESEC). Patients were also asked to self-assess the severity of their disease.</AbstractText><AbstractText Label="RESULTS" NlmCategory="RESULTS">Despite current treatment, 45% of participants still had actual moderate to very severe AE in POEM. Due to their skin disease, 57% missed at least 1 day of work in the preceding year. DLQI showed moderate to extremely large impairment in 55%. According to HADS-D, 10% scored on or above the threshold of eight points with signs of depressive symptoms. Assessed with AESEC, 57% were emotionally burdened with feelings such as 'trying to hide the eczema', 'feeling guilty about eczema', having 'problems with intimacy' and more. Of persons actually suffering from severe AE, 88% stated that their AE at least partly compromised their ability to face life.</AbstractText><AbstractText Label="CONCLUSIONS" NlmCategory="CONCLUSIONS">This real-life study shows that adults with a moderate to severe form of AE are suffering more than what would be deemed acceptable. There is a need for increased awareness of this problem among healthcare professionals, policymakers and the general public to support research in the development of new and more effective treatments and provide access to better and affordable health care for affected patients.</AbstractText><CopyrightInformation>© 2019 European Academy of Dermatology and Venereology.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ring</LastName><ForeName>J</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Christine Kühne Center for Allergy Research and Education (CK-Care), Davos, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Zink</LastName><ForeName>A</ForeName><Initials>A</Initials><Identifier Source="ORCID">https://orcid.org/0000-0001-9313-6588</Identifier><AffiliationInfo><Affiliation>Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Arents</LastName><ForeName>B W M</ForeName><Initials>BWM</Initials><AffiliationInfo><Affiliation>European Federation of Allergy and Airway Diseases Patient's Associations, Brussels, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Seitz</LastName><ForeName>I A</ForeName><Initials>IA</Initials><AffiliationInfo><Affiliation>IMAS International, Munich, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mensing</LastName><ForeName>U</ForeName><Initials>U</Initials><AffiliationInfo><Affiliation>IMAS International, Munich, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schielein</LastName><ForeName>M C</ForeName><Initials>MC</Initials><AffiliationInfo><Affiliation>Department of Dermatology and Allergy, Technical University of Munich, Munich, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wettemann</LastName><ForeName>N</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>IMAS International, Munich, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>de Carlo</LastName><ForeName>G</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>European Federation of Allergy and Airway Diseases Patient's Associations, Brussels, Belgium.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fink-Wagner</LastName><ForeName>A</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>European Federation of Allergy and Airway Diseases Patient's Associations, Brussels, Belgium.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><Agency>Sanofi Genzyme</Agency><Country></Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2019</Year><Month>06</Month><Day>06</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>J Eur Acad Dermatol Venereol</MedlineTA><NlmUniqueID>9216037</NlmUniqueID><ISSNLinking>0926-9959</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000041" MajorTopicYN="N">Absenteeism</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000369" MajorTopicYN="N">Aged, 80 and over</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D017281" MajorTopicYN="Y">Cost of Illness</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003430" MajorTopicYN="N">Cross-Sectional Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003863" MajorTopicYN="N">Depression</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003876" MajorTopicYN="N">Dermatitis, Atopic</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000523" MajorTopicYN="Y">psychology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004644" MajorTopicYN="N">Emotions</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005062" MajorTopicYN="N">European Union</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D062072" MajorTopicYN="N">Patient Acuity</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011569" MajorTopicYN="N">Psychiatric Status Rating Scales</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011788" MajorTopicYN="Y">Quality of Life</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011795" MajorTopicYN="N">Surveys and Questionnaires</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D055815" MajorTopicYN="N">Young Adult</DescriptorName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2018</Year><Month>12</Month><Day>07</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2019</Year><Month>04</Month><Day>01</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2019</Year><Month>4</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>1</Month><Day>16</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2019</Year><Month>4</Month><Day>20</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">31002197</ArticleId><ArticleId IdType="doi">10.1111/jdv.15634</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Allemagne</li><li>Belgique</li><li>Suisse</li></country><region><li>Bavière</li><li>District de Haute-Bavière</li><li>Région de Bruxelles-Capitale</li></region><settlement><li>Bruxelles</li><li>Munich</li></settlement><orgName><li>Université Louis-et-Maximilien de Munich</li></orgName></list><tree><country name="Allemagne"><region name="Bavière"><name sortKey="Ring, J" sort="Ring, J" uniqKey="Ring J" first="J" last="Ring">J. Ring</name></region><name sortKey="Mensing, U" sort="Mensing, U" uniqKey="Mensing U" first="U" last="Mensing">U. Mensing</name><name sortKey="Schielein, M C" sort="Schielein, M C" uniqKey="Schielein M" first="M C" last="Schielein">M C Schielein</name><name sortKey="Seitz, I A" sort="Seitz, I A" uniqKey="Seitz I" first="I A" last="Seitz">I A Seitz</name><name sortKey="Wettemann, N" sort="Wettemann, N" uniqKey="Wettemann N" first="N" last="Wettemann">N. Wettemann</name><name sortKey="Zink, A" sort="Zink, A" uniqKey="Zink A" first="A" last="Zink">A. Zink</name></country><country name="Suisse"><noRegion><name sortKey="Ring, J" sort="Ring, J" uniqKey="Ring J" first="J" last="Ring">J. Ring</name></noRegion></country><country name="Belgique"><region name="Région de Bruxelles-Capitale"><name sortKey="Arents, B W M" sort="Arents, B W M" uniqKey="Arents B" first="B W M" last="Arents">B W M. Arents</name></region><name sortKey="De Carlo, G" sort="De Carlo, G" uniqKey="De Carlo G" first="G" last="De Carlo">G. De Carlo</name><name sortKey="Fink Wagner, A" sort="Fink Wagner, A" uniqKey="Fink Wagner A" first="A" last="Fink-Wagner">A. Fink-Wagner</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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