Skip to main content

Disorders of Melanin Pigmentation

  • Living reference work entry
  • First Online:
Braun-Falco´s Dermatology
  • 86 Accesses

Abstract

Melanin is the most important endogenous pigment of the skin. It is generated by special cells, the melanocytes, which originate from the neural crest. It is produced within special organelles, the melanosomes. By means of these organelles, the melanin is transferred to neighboring keratinocytes. This complex process of melanogenesis is genetically determined but also regulated by exogenous stimuli, especially UV radiation. Disturbances in melanin pigmentation have significant consequences for affected individuals. The spectrum of diseases caused by defective function of melanin pigmentation is very broad and ranges from circumscribed, generalized to universal congenital or acquired hypopigmentation and hyperpigmentation of the skin. As skin color by melanin determines the identity of an individual in the given socio-cultural context, disorders of pigmentation can lead to significant psychosocial consequences.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

References

Basics

  • Chen H, Weng QY, Fisher DE (2014) UV signaling pathways within the skin. J Invest Dermatol 134:2080–2085

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Slominski A, Tobin DJ, Shibahara S, Wortsman J (2004) Melanin pigmentation in mammalian skin and its hormonal regulation. Physiol Rev 84:1155–1228

    Article  CAS  PubMed  Google Scholar 

  • Sturm RA, Duffy DL (2012) Human pigmentation genes under environmental selection. Genomes Biol 13:248

    Article  CAS  Google Scholar 

  • Yamaguchi Y, Hearing VJ (2014) Melanocytes and their diseases. Cold Spring Harb Perspect Med 4:a017046

    Google Scholar 

Hypermelanoses

  • Amyere M, Vogt T, Hoo J et al (2011) KITLG mutations cause familial progressive hyper- and hypopigmentation. J Invest Dermatol 131:1234–1239

    Article  CAS  PubMed  Google Scholar 

  • Argos M, Kalra T, Rathouz PJ et al (2010) Arsenic exposure from drinking water, and all-cause and chronic-disease mortalities in Bangladesh (HEALS): a prospective cohort study. Lancet 24:252–258

    Article  CAS  Google Scholar 

  • Batycka-Baran A, Baran W, Hryncewicz-Gwozdz A et al (2010) Dowling-Degos disease: case report and review of the literature. Dermatology 220:254–258

    Article  PubMed  Google Scholar 

  • Baykal C, Buyukbabani N, Akinturk S et al (2006) Prurigo pigmentosa: not an uncommon disease in the Turkish population. Int J Dermatol 45:1164–1168

    Article  PubMed  Google Scholar 

  • Habbema L, Halk AB, Neumann M et al (2017) Risks of unregulated use of alpha-melanocyte-stimulating hormone analogues: a review. Int J Dermatol 56:975–980

    Article  PubMed  Google Scholar 

  • Hanneken S, Rütten A, Pasternack SM et al (2010) Systematic mutation screening of KRT5 supports the hypothesis that Galli-Galli disease is a variant of Dowling-Degos disease. Br J Dermatol 163:197–200

    Article  CAS  PubMed  Google Scholar 

  • Hanneken S, Rütten A, Eigelshoven S et al (2011) Morbus Galli-Galli. Klinische und histopathologische Untersuchung anhand einer Fallserie von 18 Patienten. Hautarzt 62:842–851

    Article  CAS  PubMed  Google Scholar 

  • Hong SP, Ahn SY, Lee WS (2008) Linear and whorled nevoid hypermelanosis: unique clinical presentations and their possible association with chromosomal abnormality inv (9). Arch Dermatol 144:415–416

    Article  PubMed  Google Scholar 

  • Kaufman BP, Aman T, Alexis AF (2018) Postinflammatory hyperpigmentation: epidemiology, clinical presentation, pathogenesis and treatment. Am J Clin Dermatol 19:489–503

    Article  PubMed  Google Scholar 

  • Kohli I, Chaowattanapanit S, Mohammad TF et al (2018) Synergistic effects of long-wavelength ultraviolet A1 and visible light on pigmentation and erythema. Br J Dermatol 178:1173–1180

    Article  CAS  PubMed  Google Scholar 

  • Kwon SH, Na JI, Choi JY et al (2019) Melasma: updates and perspectives. Exp Dermatol 28:704–708

    Article  PubMed  Google Scholar 

  • Lee AY (2015) Recent progress in melasma pathogenesis. Pigment Cell Melanoma Res 28:648–660

    Article  CAS  PubMed  Google Scholar 

  • Li M, Yang L, Li C et al (2010) Mutational spectrum of the ADAR1 gene in dyschromatosis symmetrica hereditaria. Arch Dermatol Res 302:469–476

    Article  CAS  PubMed  Google Scholar 

  • Lugassy J, McGrath JA, Itin P et al (2008) KRT14 haploinsufficiency results in increased susceptibility of keratinocytes to TNF-α-induced apoptosis and causes Naegeli-Franceschetti-Jadassohn syndrome. J Invest Dermatol 128:1517–1524

    Article  CAS  PubMed  Google Scholar 

  • Park JY, Park JH, Kim SJ et al (2017) Two histopathological patterns of postinflammatory hyperpigmentation: epidermal and dermal. J Cutan Pathol 44:118–124

    Article  PubMed  Google Scholar 

  • Passeron T, Genedy R, Salah L et al (2019) Laser treatment of hyperpigmented lesions: position statement of the European Society of Laser in Dermatology. J Eur Acad Dermatol Venereol 33:987–1005

    Article  CAS  PubMed  Google Scholar 

  • Sarkar R, Ranjan R, Garg S et al (2016) Periorbital hyperpigmentation: a comprehensive review. J Clin Aesthet Dermatol 9:49–55

    PubMed  PubMed Central  Google Scholar 

  • Sarkar R, Ailawadi P, Garg S (2018) Melasma in men: a review of clinical, etiological, and management issues. J Clin Aesthet Dermatol 11:53–59

    PubMed  PubMed Central  Google Scholar 

  • Satter E, Rozelle C, Sperling L (2016) Prurigo pigmentosa: an under-recognized inflammatory dermatosis characterized by an evolution of distinctive clinicopathological features. J Cutan Pathol 43:809–814

    Article  PubMed  Google Scholar 

  • Shankar K, Godse K, Aurangabadkar S et al (2014) Evidence-based treatment for melasma: expert opinion and a review. Dermatol Ther 4:165–186

    Article  Google Scholar 

  • Sorlin A, Maruani A, Aubriot-Lorton MH et al (2017) Mosaicism for a KITLG mutation in linear and whorled nevoid hypermelanosis. J Invest Dermatol 137:1575–1578

    Article  CAS  PubMed  Google Scholar 

  • Stuhrmann M, Hennies HC, Bukhari IA et al (2008) Dyschromatosis universalis hereditaria: evidence for autosomal recessive inheritance and identification of a new locus on chromosome 12q21-q23. Clin Genet 73:566–572

    Article  CAS  PubMed  Google Scholar 

  • Wang ZQ, Si L, Tang Q et al (2009) Gain-of-function mutation of KIT ligand on melanin synthesis causes familial progressive hyperpigmentation. On J Hum Genet 84:672–677

    Article  CAS  Google Scholar 

  • Zhang C, Li D, Zhang J et al (2013) Mutations in ABCB6 cause dyschromatosis universalis hereditaria. J Invest Dermatol 133:2221–2228

    Article  CAS  PubMed  Google Scholar 

Hypomelanoses

  • Barnard E, Liu J, Yankova E et al (2016) Strains of the Propionibacterium acnes type III lineage are associated with the skin condition progressive macular hypomelanosis. Sci Rep 24:31968

    Article  CAS  Google Scholar 

  • Boniface K, Jacquemin C, Darrigade AA et al (2018) Vitiligo skin is imprinted with resident memory CD8 T cells expressing CXCR3. J Invest Dermatol 138:355–364

    Article  CAS  PubMed  Google Scholar 

  • Cavalié M, Ezzedine K, Fontas E et al (2015) Maintenance therapy of adult vitiligo with 0.1% tacrolimus ointment: a randomized, double blind, placebo-controlled study. J Invest Dermatol 135:970–974

    Article  PubMed  CAS  Google Scholar 

  • Eun SH, Kwon HS, Ju HJ et al (2020) Low-fluence CO2 fractional laser in the treatment of idiopathic guttate hypomelanosis: a pilot study. Br J Dermatol 82:485–486

    Article  Google Scholar 

  • Ezzedine K, Eleftheriadou V, Whitton M et al (2015) Vitiligo. Lancet 386:74–84

    Article  PubMed  Google Scholar 

  • Hamzavi I, Jain H, McLean D et al (2004) Parametric modeling of narrowband UV-B phototherapy for vitiligo using a novel quantitative tool: the vitiligo area scoring index. Arch Dermatol 140:677–683

    Article  PubMed  Google Scholar 

  • Huizing M, Helip-Wooley A, Westbroek W et al (2008) Disorders of lysosome-related organelle biogenesis: clinical and molecular genetics. Annu Rev Genomics Hum Genet 9:359–386

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Jin Y, Andersen G, Yorgov D et al (2016) Genome-wide association studies of autoimmune vitiligo identify 23 new risk loci and highlight key pathways and regulatory variants. Nat Genet 48:1418–1424

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kamaraj B, Purohit R (2014) Mutational analysis of oculocutaneous albinism: a compact review. Biomed Res Int 2014:905472

    Google Scholar 

  • Kaplan J, De Domenico I, Ward DM (2008) Chediak-Higashi syndrome. Curr Opin Hematol 15:22–29

    Article  CAS  PubMed  Google Scholar 

  • Larsabal M, Marti A, Jacquemin C et al (2017) Vitiligo-like lesions occurring in patients receiving anti-programmed cell death-1 therapies are clinically and biologically distinct from vitiligo. J Am Acad Dermatol 76:863–870

    Article  PubMed  Google Scholar 

  • Loredana Asztalos M, Schafernak KT et al (2017) Hermansky-Pudlak syndrome: report of two patients with updated genetic classification and management recommendations. Pediatr Dermatol. 34 638–646

    Google Scholar 

  • Minocha P, Choudhary R, Agrawal A et al (2017) Griscelli syndrome subtype 2 with hemophagocytic lympho-histiocytosis: a case report and review of literature. Intractable Rare Dis Res 6:76–79

    Article  PubMed  PubMed Central  Google Scholar 

  • O'Keefe GA, Rao NA (2017) Vogt-Koyanagi-Harada disease. Surv Ophthalmol 62:1–25

    Article  PubMed  Google Scholar 

  • Pingault V, Ente D, Dastot-Le Moal F et al (2010) Review and update of mutations causing Waardenburg syndrome. Hum Mutat 31:391–406

    Article  CAS  PubMed  Google Scholar 

  • Rani S, Kumar R, Kumarasinghe P et al (2018) Melanocyte abnormalities and senescence in the pathogenesis of idiopathic guttate hypomelanosis. Int J Dermatol 57:559–565

    Article  CAS  PubMed  Google Scholar 

  • Relyveld GN, Menke HE, Westerhof W (2007) Progressive macular hypomelanosis: an overview. Am J Clin Dermatol 8:13–19

    Article  PubMed  Google Scholar 

  • Saleem MD (2019) Biology of human melanocyte development, piebaldism, and Waardenburg syndrome. Pediatr Dermatol 36:72–84

    Article  PubMed  Google Scholar 

  • Tovar-Garza A, Hinojosa JA, Hynan LS et al (2019) Addition of oral minipulse dexamethasone to narrowband ultraviolet B phototherapy and topical steroids helps arrest disease activity in patients with vitiligo. Br J Dermatol 180:193–194

    Article  CAS  PubMed  Google Scholar 

  • Tulic MK, Cavazza E, Cheli Y et al (2019) Innate lymphocyte-induced CXCR3B-mediated melanocyte apoptosis is a potential initiator of T-cell autoreactivity in vitiligo. Nat Commun 10:2178

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Ullah F, Schwartz RA (2019) Nevus depigmentosus: review of a mark of distinction. Int J Dermatol 58:1366–1370

    Article  PubMed  Google Scholar 

  • van Geel N, Lommerts J, Bekkenk M et al (2016a) Development and validation of the vitiligo extent score (VES): an international collaborative initiative. J Invest Dermatol 136:978–984

    Article  PubMed  CAS  Google Scholar 

  • van Geel N, Lommerts J, Bekkenk M et al (2016b) Development and validation of the vitiligo extent score (VES): an international collaborative initiative. J Invest Dermatol 136:978–984

    Article  PubMed  CAS  Google Scholar 

  • van Geel N, Grine L, De Wispelaere P et al (2019) Clinical visible signs of disease activity in vitiligo: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol 33:1667–1675

    Article  PubMed  Google Scholar 

  • Van Gele M, Dynoodt P, Lambert J (2010) Griscelli syndrome: a model system to study vesicular trafficking. Pigment Cell Melanoma Res 22:268–282

    Article  CAS  Google Scholar 

  • Whitton M, Batchelor JM, Leonardi-Bee J et al (2016) Evidence-based management of vitiligo: summary of a Cochrane systematic review. Br J Dermatol 174:962–969

    Article  CAS  PubMed  Google Scholar 

First Describer

  • Bardach H, Gebhart W, Luger T (1982) Genodermatose bei einem Brüderpaar: Morbus Dowling-Degos, Grover, Hailey-Hailey oder Galli-Galli? Hautarzt 33:378–383

    CAS  PubMed  Google Scholar 

  • Beguez César A (1943) Neutropenia cronica maligna familial con granulaciones atipicas de los leucocitos. Bol Soc Cubana Pediatr 15:900–922

    Google Scholar 

  • Brocq L (1923) L'erythrose pigmentée péri-buccale. Presse Med 31:727–728

    Google Scholar 

  • Casala AM, Alezzandrini AA (1959) Vitiligo, poliosis, unilateral con retinitis pigmentaria y hypoacusia. Arch Agrent Dermatol 9:449

    Google Scholar 

  • Chédiak M (1952) Nouvelle anomalie leucocytaire de charactère constitutionel et familial. Rev Hematol (Paris) 7:362–367

    Google Scholar 

  • Chernosky ME, Anderson DE, Chang JP et al (1971) Familial progressive hyperpigmentation. Arch Dermatol 10:581–591

    Article  Google Scholar 

  • Civatte A (1923) Poikilodermie réticulée pigmentaire du visage et du cou. Ann Dermatol Syph 6:605–620

    Google Scholar 

  • Convit J, Kerdel-Vegas F, Rodriguez G (1961) Erythema dyschromicum perstans, a hitherto undescribed skin disease. J Invest Dermatol 36:457–462

    Article  Google Scholar 

  • Costa OC (1951) Leucopathie symétrique progressive des extremités. Ann Dermatol Syph 78:452–454

    CAS  Google Scholar 

  • Cronkhite LS, Canada WJ (1955) Generalized intestinal polyposis: an unusual syndrome of polyposis, pigmentation, alopecia and onychotropia. N Engl J Med 252:1011–1015

    Article  PubMed  Google Scholar 

  • Cross HE, McKusick VA, Breen W (1967) A new oculocerebral syndrome with hypopigmentation. J Pediatr 70:398–406

    Article  CAS  PubMed  Google Scholar 

  • Cummings K, Cottel W (1966) Idiopathic guttate hypomelanosis. Arch Dermatol 93:184–186

    Article  CAS  PubMed  Google Scholar 

  • Degos R, Ossipowski B (1954) Dermatose pigmentaire réticulées des plis. Ann Dermatol Syph 81:147–151

    CAS  Google Scholar 

  • Degos R, Civatte J, Belaich S (1978) La pigmentation maculeuse eruptive idiopathique. Ann Dermatol Venerol 105:177–182

    CAS  Google Scholar 

  • Dowling GD, Freudenthal W (1938) Acanthosis nigricans. Proc R Soc Med 31:1147–1150

    CAS  PubMed  PubMed Central  Google Scholar 

  • Falabella R, Escobar CE, Carrascal E et al (1988) Leucoderma punctatum. J Am Acad Dermatol 18:485–494

    Article  CAS  PubMed  Google Scholar 

  • Fowler T (1786) Medical reports of the effects of arsenic, in the cure of agues, remitting fevers, and periodic headaches. Together with a letter from Dr. Arnold, of Leicester, and another from Dr. Withering. Johnson & Brown, London

    Google Scholar 

  • Franceschetti A, Jadassohn W (1954) A propos de "l'incontinenti pigmenti" limitation de deux syndromes differents figurant sous le même terme. Dermatologica 108:1–28

    Article  CAS  PubMed  Google Scholar 

  • Griscelli C, Durandy A, Guy-Grand D et al (1978) A syndrome associating partial albinism and immunodeficiency. Am J Med 65:691–702

    Article  CAS  PubMed  Google Scholar 

  • Guillet G, Helenon R, Gauthier Y et al (1988) Progressive macular hypomelanosis of the trunk: primary acquired hypopigmentation. J Cutan Patho 15:286–289

    Article  CAS  Google Scholar 

  • Harada E (1926) Beiträge zur klinischen Kenntnis von nichteitriger Choroiditis. Nippon Ganka Gakkai Zasshi 30:356–361

    Google Scholar 

  • Hauss H, Supreme Lean H (1958) Dermatopathia pigmentosa reticularis. Dermatol Wochenschr 138:1337

    Google Scholar 

  • Hermansky F, Pudlak P (1959) Albinism associated with hemorrhagic diathesis and unusual pigmented reticular cells in the bone marrow: report of two cases with histochemical studies. Blood 14:162–169

    Article  CAS  PubMed  Google Scholar 

  • Higashi O (1954) Congenital gigantism of peroxidase granules. Tohoku J Exp Med 59:315–322

    Article  CAS  PubMed  Google Scholar 

  • Hoffmann E, Habermann R (1918) Arzneiliche und gewerbliche Dermatosen durch Kriegsersatzmittel (Vaseline Schmieröl) und eigenartige Melanodermatitiden. Dtsch Med Wochenschr 4:261–264

    Article  Google Scholar 

  • Ichikawa T, Hiraya Y (1933) Über eine noch nicht beschriebene Pigmentanomalie, Dyschromatosis universalis hereditaria Toyama, Ichikawa und Hiraga. Jpn J Dermatol Urol 34:360–364

    Google Scholar 

  • Kalter D, Griffiths S, Hirokawa K (1988) Linear and whorled nevoid hypermelanosis. J Am Acad Dermatol 19:1037–1044

    Article  CAS  PubMed  Google Scholar 

  • Kitamura K, Akamatsu S, Hirokawa K (1953) Eine besondere Form der Akropigmentation: Akropigmentatio reticularis. Hautarzt 4:152–156

    CAS  PubMed  Google Scholar 

  • Klein D (1947) Albinisme partiel (leucisme) accompagné surdi-mutité, d’ostéomyodysplasie, de raideurs articularis congénitales. Arch Julius Klaus Stift Vererbungsforsch Sozialanthropol Rassenhyg 22:336

    CAS  PubMed  Google Scholar 

  • Komaya G (1924) Symmetrische Pigmentanomalie der Extremitäten. Arch Dermatol Syph 147:389–393

    Article  Google Scholar 

  • Koyanagi Y (1929) Dysakusis, Alopecie und Pollinosis bei schwerer Uveitis nicht traumatischen Ursprungs. Klin Monatsbl Augenheilkd 82:194–211

    Google Scholar 

  • Lesser E (1884) Anomalien der Hautfärbung. In: von Ziemssen H (ed) Handbuch der speziellen Pathologie und Therapie, Bd 14/2, Handbuch der Hautkrankheiten. Vogel, Leipzig, S 161–200 (Albinismus partialis: 182–184)

    Google Scholar 

  • Margolis E (1962) A new hereditary syndrome sex-linked deaf mutism associated with total albinism. Acta Genet Statist Med 12:12–19

    CAS  PubMed  Google Scholar 

  • Mason HS (1959) Structure of melanins. In: Gordon M (ed) Pigment Cell Biol. Academic Press, New York, pp 563–583

    Chapter  Google Scholar 

  • Matsumoto S (1923) Leucopathia punctate et reticularis symmetrica. Acta Dermatol 2:191–197

    Google Scholar 

  • Meirowsky E (1909) Über Pigmentbildung in vom Körper losgelöster Haut. Frankfurter Z Pathol 2:438–448

    Google Scholar 

  • Morgan J (1786) Some accounts of motley colored or pye negro and mulatto boy. Trans Am Phil Soc 2:392–395

    Article  Google Scholar 

  • Naegeli O (1927) Familiärer Chromatophorennaevus. Schweiz Med Wochenschr 57:48

    Google Scholar 

  • Nagashima M, Ohshiro A, Shimizu N (1971) A peculiar pruriginous dermatosis with gross reticular pigmentation. Jpn J Dermatol 81:38–39

    Google Scholar 

  • Pearson K, Nettleship E, Usher CH (1911) A monograph on albinism in man; Draper's company research memoirs, biometric series VI. Dula, London

    Google Scholar 

  • Ramirez CO (1957) Los cenicientos, problem clinic. Memoria del Primer Congresso Centroamericano de Dermatologie, San Salvador, pp 122–130

    Google Scholar 

  • Raper HS (1927) The tyrosinase reaction VI. Production from tyrosine of 5, 6-dihydropindole and 5,6-dihydroxyindole-2-carboxylic acid – the precursors of melanin. Biochem J 21:89–96

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Riehl G (1917) About a strange melanosis. Vienna Klin Wochenschr 30:780–781

    Google Scholar 

  • Ruiz-Maldonado R, Tamayo L, Fernandez-Diez J (1978) Universal acquired melanosis. The carbon baby. Arch Dermatol 114:775–778

    Article  CAS  PubMed  Google Scholar 

  • Steinbrinck E (1948) Über eine neue Granulationsanomalie der Leukozyten. Dtsch Arch Klin Med 193:577–581

    Google Scholar 

  • Tietz W (1963) A syndrome of deaf-mutism associated with albinism showing dominant autosomal inheritance. On J Hum Genet 15:259–264

    CAS  Google Scholar 

  • Vogt A (1906) Frühzeitiges Ergrauen der Zilien und Bemerkungen über den sog. plötzlichen Eintritt dieser Veränderung. Klin Monatsbl Augenheilkd 44:228–242

    Google Scholar 

  • Waardenburg P (1948) Dystophia punctorum lacrimalium, blepharophimosis and patiële irisatrophie bij ein doofstomme. Ned Tijdschr Geneeskd 92:3463

    CAS  PubMed  Google Scholar 

  • Wende GW, Baukus HH (1919) A hitherto undescribed generalized pigmentation of the skin appearing in infancy in brother and sister. J Cut Dis 37:685–701

    Google Scholar 

  • Westerhof W, Beemer FA, Cormane RH et al (1978) Hereditary congenital hypopigmented and hyperpigmented macules. Arch Dermatol 114:931–936

    Article  CAS  PubMed  Google Scholar 

  • Witkop CJ Jr (1979) Depigmentations of the general and oral tissues and their genetic foundations. Ala J Med Sci 16:330–333

    CAS  PubMed  Google Scholar 

  • Woolf C, Dolowitz DA, Aldous HE (1965) Congenital deafness associated with piebaldness. Arch Otolaryngol 82:244–250

    Article  CAS  PubMed  Google Scholar 

  • Zanardo L, Stolz W, Schmitz G et al (2004) Progressive hyperpigmentation and generalized lentiginosis without associated systemic symptoms: a rare hereditary pigmentation disorder in south-East Germany. Acta Derm Venereol 84:57–60

    Article  PubMed  Google Scholar 

  • Ziprkowski L, Krakowski A, Adarn A et al (1962) Partial albinism and deaf-mutism due to a recessive sex-linked gene. Arch Dermatol 86:530–539

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Markus Böhm .

Editor information

Editors and Affiliations

Section Editor information

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer-Verlag GmbH Germany, part of Springer Nature

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Böhm, M. (2021). Disorders of Melanin Pigmentation. In: Plewig, G., French, L., Ruzicka, T., Kaufmann, R., Hertl, M. (eds) Braun-Falco´s Dermatology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-58713-3_69-1

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-58713-3_69-1

  • Received:

  • Accepted:

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-58713-3

  • Online ISBN: 978-3-662-58713-3

  • eBook Packages: Springer Reference MedicineReference Module Medicine

Publish with us

Policies and ethics