Changes in the nail unit in patients with secondary lymphoedema identified using clinical, dermoscopic and ultrasound examination
Identifieur interne : 000189 ( PascalFrancis/Checkpoint ); précédent : 000188; suivant : 000190Changes in the nail unit in patients with secondary lymphoedema identified using clinical, dermoscopic and ultrasound examination
Auteurs : E. Le Fourn [France] ; E. Duhard [France] ; V. Tauveron [France] ; A. Maruani [France] ; M. Samimi [France] ; G. Lorette [France] ; L. Vaillant [France] ; L. Machet [France]Source :
- British journal of dermatology : (1951) [ 0007-0963 ] ; 2011.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
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Abstract
Background Secondary lymphoedema is characterized by lymphatic stasis that is often the result of a lymph node lesion. At advanced stages it may cause trophic changes in the skin. However, the presence of changes in the nail unit has not been reported to date. Objectives The aim of this study was to determine the presence of nail abnormalities in cases of secondary lymphoedema. Methods This was a prospective study, conducted on patients with unilateral secondary lymphoedema. A comparative clinical and dermoscopic examination and 20-MHz high-resolution ultrasound imaging of the affected limb and the contralateral limb were performed. Results Thirty-three patients were included. On physical examination, hyperkeratosis of the lateral nail folds, friability of the nail surface, 'ragged' proximal nail folds and cuticle and apparent leuconychia were observed more frequently on the lymphoedematous limb. The ultrasound study of the nails of the thumb and the big toe did not reveal any differences in thickness of the different structures of the nail between the lymphoedema side and the opposite side. The nail matrix was longer on the lymphoedema side. Conclusions Our study showed mild changes in the nail unit compatible with the xerosis often associated with severe lymphoedema. However, the study also showed frequent evidence of 'ragged' cuticles, which in these patients at high risk of erysipelas are entry points for bacteria. This should be taken into account when counselling patients with limb lymphoedema in order to prevent erysipelas.
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Samimi</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Dermatology, CHRU Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Lymphology Unit, CHRU Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation></author><author><name sortKey="Lorette, G" sort="Lorette, G" uniqKey="Lorette G" first="G." last="Lorette">G. Lorette</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Dermatology, CHRU Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>University François Rabelais de Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation></author><author><name sortKey="Vaillant, L" sort="Vaillant, L" uniqKey="Vaillant L" first="L." last="Vaillant">L. 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Le Fourn</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Dermatology, CHRU Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation></author><author><name sortKey="Duhard, E" sort="Duhard, E" uniqKey="Duhard E" first="E." last="Duhard">E. Duhard</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Dermatology, CHRU Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation></author><author><name sortKey="Tauveron, V" sort="Tauveron, V" uniqKey="Tauveron V" first="V." last="Tauveron">V. Tauveron</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Dermatology, CHRU Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Lymphology Unit, CHRU Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation></author><author><name sortKey="Maruani, A" sort="Maruani, A" uniqKey="Maruani A" first="A." last="Maruani">A. Maruani</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Dermatology, CHRU Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>University François Rabelais de Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>UMR INSERM U930, ERL 3106</s1><s2>Tours</s2><s3>FRA</s3><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation></author><author><name sortKey="Samimi, M" sort="Samimi, M" uniqKey="Samimi M" first="M." last="Samimi">M. Samimi</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Dermatology, CHRU Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Lymphology Unit, CHRU Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation></author><author><name sortKey="Lorette, G" sort="Lorette, G" uniqKey="Lorette G" first="G." last="Lorette">G. Lorette</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Dermatology, CHRU Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>University François Rabelais de Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation></author><author><name sortKey="Vaillant, L" sort="Vaillant, L" uniqKey="Vaillant L" first="L." last="Vaillant">L. Vaillant</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Lymphology Unit, CHRU Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>University François Rabelais de Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>UMR INSERM U930, ERL 3106</s1><s2>Tours</s2><s3>FRA</s3><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation></author><author><name sortKey="Machet, L" sort="Machet, L" uniqKey="Machet L" first="L." last="Machet">L. Machet</name><affiliation wicri:level="3"><inist:fA14 i1="01"><s1>Department of Dermatology, CHRU Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>University François Rabelais de Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation><affiliation wicri:level="3"><inist:fA14 i1="04"><s1>UMR INSERM U930, ERL 3106</s1><s2>Tours</s2><s3>FRA</s3><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Centre-Val de Loire</region><region type="old region">Région Centre</region><settlement type="city">Tours</settlement></placeName></affiliation></author></analytic><series><title level="j" type="main">British journal of dermatology : (1951)</title><title level="j" type="abbreviated">Br. j. dermatol. : (1951)</title><idno type="ISSN">0007-0963</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">British journal of dermatology : (1951)</title><title level="j" type="abbreviated">Br. j. dermatol. : (1951)</title><idno type="ISSN">0007-0963</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Dermatology</term><term>Human</term><term>Lymphedema</term><term>Nail(anatomy)</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Lymphoedème</term><term>Ongle</term><term>Dermatologie</term><term>Homme</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background Secondary lymphoedema is characterized by lymphatic stasis that is often the result of a lymph node lesion. At advanced stages it may cause trophic changes in the skin. However, the presence of changes in the nail unit has not been reported to date. Objectives The aim of this study was to determine the presence of nail abnormalities in cases of secondary lymphoedema. Methods This was a prospective study, conducted on patients with unilateral secondary lymphoedema. A comparative clinical and dermoscopic examination and 20-MHz high-resolution ultrasound imaging of the affected limb and the contralateral limb were performed. Results Thirty-three patients were included. On physical examination, hyperkeratosis of the lateral nail folds, friability of the nail surface, 'ragged' proximal nail folds and cuticle and apparent leuconychia were observed more frequently on the lymphoedematous limb. The ultrasound study of the nails of the thumb and the big toe did not reveal any differences in thickness of the different structures of the nail between the lymphoedema side and the opposite side. The nail matrix was longer on the lymphoedema side. Conclusions Our study showed mild changes in the nail unit compatible with the xerosis often associated with severe lymphoedema. However, the study also showed frequent evidence of 'ragged' cuticles, which in these patients at high risk of erysipelas are entry points for bacteria. This should be taken into account when counselling patients with limb lymphoedema in order to prevent erysipelas.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0007-0963</s0></fA01><fA02 i1="01"><s0>BJDEAZ</s0></fA02><fA03 i2="1"><s0>Br. j. dermatol. : (1951)</s0></fA03><fA05><s2>164</s2></fA05><fA06><s2>4</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Changes in the nail unit in patients with secondary lymphoedema identified using clinical, dermoscopic and ultrasound examination</s1></fA08><fA11 i1="01" i2="1"><s1>LE FOURN (E.)</s1></fA11><fA11 i1="02" i2="1"><s1>DUHARD (E.)</s1></fA11><fA11 i1="03" i2="1"><s1>TAUVERON (V.)</s1></fA11><fA11 i1="04" i2="1"><s1>MARUANI (A.)</s1></fA11><fA11 i1="05" i2="1"><s1>SAMIMI (M.)</s1></fA11><fA11 i1="06" i2="1"><s1>LORETTE (G.)</s1></fA11><fA11 i1="07" i2="1"><s1>VAILLANT (L.)</s1></fA11><fA11 i1="08" i2="1"><s1>MACHET (L.)</s1></fA11><fA14 i1="01"><s1>Department of Dermatology, CHRU Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>3 aut.</sZ><sZ>4 aut.</sZ><sZ>5 aut.</sZ><sZ>6 aut.</sZ><sZ>8 aut.</sZ></fA14><fA14 i1="02"><s1>Lymphology Unit, CHRU Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>3 aut.</sZ><sZ>5 aut.</sZ><sZ>7 aut.</sZ></fA14><fA14 i1="03"><s1>University François Rabelais de Tours</s1><s2>Tours</s2><s3>FRA</s3><sZ>4 aut.</sZ><sZ>6 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></fA14><fA14 i1="04"><s1>UMR INSERM U930, ERL 3106</s1><s2>Tours</s2><s3>FRA</s3><sZ>4 aut.</sZ><sZ>7 aut.</sZ><sZ>8 aut.</sZ></fA14><fA20><s1>765-770</s1></fA20><fA21><s1>2011</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>1043</s2><s5>354000189797820120</s5></fA43><fA44><s0>0000</s0><s1>© 2011 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>24 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>11-0250838</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>British journal of dermatology : (1951)</s0></fA64><fA66 i1="01"><s0>GBR</s0></fA66><fC01 i1="01" l="ENG"><s0>Background Secondary lymphoedema is characterized by lymphatic stasis that is often the result of a lymph node lesion. At advanced stages it may cause trophic changes in the skin. However, the presence of changes in the nail unit has not been reported to date. Objectives The aim of this study was to determine the presence of nail abnormalities in cases of secondary lymphoedema. Methods This was a prospective study, conducted on patients with unilateral secondary lymphoedema. A comparative clinical and dermoscopic examination and 20-MHz high-resolution ultrasound imaging of the affected limb and the contralateral limb were performed. Results Thirty-three patients were included. On physical examination, hyperkeratosis of the lateral nail folds, friability of the nail surface, 'ragged' proximal nail folds and cuticle and apparent leuconychia were observed more frequently on the lymphoedematous limb. The ultrasound study of the nails of the thumb and the big toe did not reveal any differences in thickness of the different structures of the nail between the lymphoedema side and the opposite side. The nail matrix was longer on the lymphoedema side. Conclusions Our study showed mild changes in the nail unit compatible with the xerosis often associated with severe lymphoedema. However, the study also showed frequent evidence of 'ragged' cuticles, which in these patients at high risk of erysipelas are entry points for bacteria. This should be taken into account when counselling patients with limb lymphoedema in order to prevent erysipelas.</s0></fC01><fC02 i1="01" i2="X"><s0>002B08</s0></fC02><fC02 i1="02" i2="X"><s0>002B12B04</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Lymphoedème</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Lymphedema</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Linfedema</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Ongle</s0><s5>07</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Nail(anatomy)</s0><s5>07</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Uña</s0><s5>07</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Dermatologie</s0><s5>08</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Dermatology</s0><s5>08</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Dermatología</s0><s5>08</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Homme</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Human</s0><s5>10</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Hombre</s0><s5>10</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Pathologie de l'appareil circulatoire</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Cardiovascular disease</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Aparato circulatorio patología</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Pathologie des vaisseaux lymphatiques</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Lymphatic vessel disease</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Linfático patología</s0><s5>38</s5></fC07><fN21><s1>171</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>France</li></country><region><li>Centre-Val de Loire</li><li>Région Centre</li></region><settlement><li>Tours</li></settlement></list><tree><country name="France"><region name="Centre-Val de Loire"><name sortKey="Le Fourn, E" sort="Le Fourn, E" uniqKey="Le Fourn E" first="E." last="Le Fourn">E. Le Fourn</name></region><name sortKey="Duhard, E" sort="Duhard, E" uniqKey="Duhard E" first="E." last="Duhard">E. Duhard</name><name sortKey="Lorette, G" sort="Lorette, G" uniqKey="Lorette G" first="G." last="Lorette">G. Lorette</name><name sortKey="Lorette, G" sort="Lorette, G" uniqKey="Lorette G" first="G." last="Lorette">G. Lorette</name><name sortKey="Machet, L" sort="Machet, L" uniqKey="Machet L" first="L." last="Machet">L. Machet</name><name sortKey="Machet, L" sort="Machet, L" uniqKey="Machet L" first="L." last="Machet">L. Machet</name><name sortKey="Machet, L" sort="Machet, L" uniqKey="Machet L" first="L." last="Machet">L. Machet</name><name sortKey="Maruani, A" sort="Maruani, A" uniqKey="Maruani A" first="A." last="Maruani">A. Maruani</name><name sortKey="Maruani, A" sort="Maruani, A" uniqKey="Maruani A" first="A." last="Maruani">A. Maruani</name><name sortKey="Maruani, A" sort="Maruani, A" uniqKey="Maruani A" first="A." last="Maruani">A. Maruani</name><name sortKey="Samimi, M" sort="Samimi, M" uniqKey="Samimi M" first="M." last="Samimi">M. Samimi</name><name sortKey="Samimi, M" sort="Samimi, M" uniqKey="Samimi M" first="M." last="Samimi">M. Samimi</name><name sortKey="Tauveron, V" sort="Tauveron, V" uniqKey="Tauveron V" first="V." last="Tauveron">V. Tauveron</name><name sortKey="Tauveron, V" sort="Tauveron, V" uniqKey="Tauveron V" first="V." last="Tauveron">V. Tauveron</name><name sortKey="Vaillant, L" sort="Vaillant, L" uniqKey="Vaillant L" first="L." last="Vaillant">L. Vaillant</name><name sortKey="Vaillant, L" sort="Vaillant, L" uniqKey="Vaillant L" first="L." last="Vaillant">L. Vaillant</name><name sortKey="Vaillant, L" sort="Vaillant, L" uniqKey="Vaillant L" first="L." last="Vaillant">L. Vaillant</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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