Comprehensive Wound Care for Malignant Wounds

  • Brooke E. Corbett
  • Nina R. Blank
  • Alina MarkovaEmail author
Part of the Updates in Clinical Dermatology book series (UCD)


Malignant wounds (MW) are a rare complication of advanced cancer in which tumor cells infiltrate and erode through the skin. MW can be extremely distressing to patients given their high burden of symptoms, which include malodor, exudate, bleeding, pain, shame, low self-esteem, and social isolation. Treatment goals focus on improving patients’ quality of life. Management of MW requires highly individualized, multidisciplinary care based on the symptom burden, psychosocial impact, and personal values of the patient. This chapter provides an overview of the major symptoms of MW and comprehensively reviews management discussed in the literature. Evidence regarding palliative cancer-directed therapies for MWs is also discussed.


Malignant wounds Malignant fungating wounds Fungating wounds Cutaneous metastases Chronic wounds Wound care Palliative care Wound exudate Wound drainage Wound malodor Wound exudate Wound pain Wound dressings Quality of life 


  1. 1.
    Alexander S. Malignant fungating wounds: epidemiology, aetiology, presentation and assessment. J Wound Care. 2009;18(7):273–4, 276–8, 280.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Lookingbill DP, Spangler N, Helm KF. Cutaneous metastases in patients with metastatic carcinoma: a retrospective study of 4020 patients. J Am Acad Dermatol. 1993;29(2 Pt 1):228–36.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Lookingbill DP, Spangler N, Sexton FM. Skin involvement as the presenting sign of internal carcinoma. A retrospective study of 7316 cancer patients. J Am Acad Dermatol. 1990;22(1):19–26.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Maida V, Corbo M, Dolzhykov M, Ennis M, Irani S, Trozzolo L. Wounds in advanced illness: a prevalence and incidence study based on a prospective case series. Int Wound J. 2008;5(2):305–14.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Probst S, Arber A, Faithfull S. Malignant fungating wounds: a survey of nurses’ clinical practice in Switzerland. Eur J Oncol Nurs. 2009;13(4):295–8.CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Maida V, Ennis M, Kuziemsky C, Trozzolo L. Symptoms associated with malignant wounds: a prospective case series. J Pain Symptom Manag. 2009;37(2):206–11.CrossRefGoogle Scholar
  7. 7.
    Marcoval J, Moreno A, Peyri J. Cutaneous infiltration by cancer. J Am Acad Dermatol. 2007;57(4):577–80.CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Naylor W. Malignant wounds: aetiology and principles of management. Nurs Stand. 2002;16(52):45–53; quiz e54, 56.CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    McDonald A, Lesage P. Palliative management of pressure ulcers and malignant wounds in patients with advanced illness. J Palliat Med. 2006;9(2):285–95.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Tilley C, Lipson J, Ramos M. Palliative wound care for malignant fungating wounds: holistic considerations at end-of-life. Nurs Clin North Am. 2016;51(3):513–31.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Beh SY, Leow LC. Fungating breast cancer and other malignant wounds: epidemiology, assessment and management. Expert Rev Qual Life Cancer Care. 2016;1(2):137–44.CrossRefGoogle Scholar
  12. 12.
    Grocott P, Cowley S. The palliative management of fungating malignant wounds--generalising from multiple-case study data using a system of reasoning. Int J Nurs Stud. 2001;38(5):533–45.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Alexander S. Malignant fungating wounds: key symptoms and psychosocial issues. J Wound Care. 2009;18(8):325–9.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Lo SF, Hayter M, Hu WY, Tai CY, Hsu MY, Li YF. Symptom burden and quality of life in patients with malignant fungating wounds. J Adv Nurs. 2012;68(6):1312–21.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Gibson S, Green J. Review of patients’ experiences with fungating wounds and associated quality of life. J Wound Care. 2013;22(5):265–6, 268, 270–2, passim.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Lo SF, Hu WY, Hayter M, Chang SC, Hsu MY, Wu LY. Experiences of living with a malignant fungating wound: a qualitative study. J Clin Nurs. 2008;17(20):2699–708.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Dolbeault S, Flahault C, Baffie A, Fromantin I. Psychological profile of patients with neglected malignant wounds: a qualitative exploratory study. J Wound Care. 2010;19(12):513–4. 516, 518–21.Google Scholar
  18. 18.
    Lazelle-Ali C. Psychological and physical care of malodorous fungating wounds. Br J Nurs. 2007;16(15):S16–24.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Merz T, Klein C, Uebach B, Kern M, Ostgathe C, Bukki J. Fungating wounds – multidimensional challenge in palliative care. Breast Care (Basel). 2011;6(1):21–4.CrossRefGoogle Scholar
  20. 20.
    Alexander SJ. An intense and unforgettable experience: the lived experience of malignant wounds from the perspectives of patients, caregivers and nurses. Int Wound J. 2010;7(6):456–65.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Browne N, Grocott P, Cowley S, Cameron J, Dealey C, Keogh A, Lovatt A, Vowden K, Vowden P. Woundcare Research for Appropriate Products (WRAP): validation of the TELER method involving users. Int J Nurs Stud. 2004;41(5):559–71.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Grocott P. Developing a tool for researching fungating wounds. World Wide Wounds. 2001;1–17.Google Scholar
  23. 23.
    Schulz V, Kozell K, Biondo PD, Stiles C, Martins L, Tonkin K, Hagen NA. The malignant wound assessment tool: a validation study using a Delphi approach. Palliat Med. 2009;23(3):266–73.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Naylor W. Part 2: Symptom self-assessment in the management of fungating wounds. World Wide Wounds. 2002;
  25. 25.
    Alexander S. Malignant fungating wounds: managing malodour and exudate. J Wound Care. 2009;18(9):374–82.CrossRefPubMedPubMedCentralGoogle Scholar
  26. 26.
    Chrisman CA. Care of chronic wounds in palliative care and end-of-life patients. Int Wound J. 2010;7(4):214–35.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Naylor W. Part 1: Symptom control in the management of fungating wounds. World Wide Wounds. 2002.Google Scholar
  28. 28.
    Shirasu M, Nagai S, Hayashi R, Ochiai A, Touhara K. Dimethyl trisulfide as a characteristic odor associated with fungating cancer wounds. Biosci Biotechnol Biochem. 2009;73(9):2117–20.CrossRefPubMedPubMedCentralGoogle Scholar
  29. 29.
    O’Brien C. Malignant wounds: managing odour. Can Fam Physician. 2012;58(3):272–4; e141–3.PubMedPubMedCentralGoogle Scholar
  30. 30.
    Young CV. The effects of malodorous fungating malignant wounds on body image and quality of life. J Wound Care. 2005;14(8):359–62.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Woo KY, Sibbald RG. Local wound care for malignant and palliative wounds. Adv Skin Wound Care. 2010;23(9):417–28; quiz 429–30.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Fromantin I, Seyer D, Watson S, Rollot F, Elard J, Escande MC, De Rycke Y, Kriegel I, Larreta GV. Bacterial floras and biofilms of malignant wounds associated with breast cancers. J Clin Microbiol. 2013;51(10):3368–73.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Tandler S, Stephen-Haynes J. Fungating wounds: management and treatment options. Br J Nurs. 2017;26(12 Suppl):S6–S14.CrossRefPubMedPubMedCentralGoogle Scholar
  34. 34.
    Dunford CE. Treatment of a wound infection in a patient with mantle cell lymphoma. Br J Nurs. 2001;10(16):1058, 1060, 1062, 1064–5.CrossRefGoogle Scholar
  35. 35.
    Sealby N. The use of maggot therapy in the treatment of a malignant foot wound. Br J Community Nurs. 2004;9(3):S16–9.CrossRefGoogle Scholar
  36. 36.
    Lin Y, Amin M, Donnelly AFW, Amar S. Maggot debridement therapy of a leg wound from Kaposi’s sarcoma: a case report. J Glob Oncol. 2015;1(2):92–8.CrossRefPubMedPubMedCentralGoogle Scholar
  37. 37.
    Jones M, Thomas S. A case history describing the use of sterile larvae (maggots) in a malignant wound. World Wide Wounds. 1998; February.Google Scholar
  38. 38.
    Kalemikerakis J, Vardaki Z, Fouka G, Vlachou E, Gkovina U, Kosma E, Dionyssopoulos A. Comparison of foam dressings with silver versus foam dressings without silver in the care of malodorous malignant fungating wounds. J BUON. 2012;17(3):560–4.PubMedPubMedCentralGoogle Scholar
  39. 39.
    Lund-Nielsen B, Adamsen L, Kolmos HJ, Rørth M, Tolver A, Gottrup F. The effect of honey-coated bandages compared with silver-coated bandages on treatment of malignant wounds-a randomized study. Wound Repair Regen. 2011;19(6):664–70.CrossRefGoogle Scholar
  40. 40.
    da Costa Santos CM, de Mattos Pimenta CA, Nobre MRC. A systematic review of topical treatments to control the odor of malignant fungating wounds. J Pain Symptom Manag. 2010;39(6):1065–76.CrossRefGoogle Scholar
  41. 41.
    Bower M, Stein R, Evans TR, Hedley A, Pert P, Coombes RC. A double-blind study of the efficacy of metronidazole gel in the treatment of malodorous fungating tumours. Eur J Cancer. 1992;28A(4–5):888–9.CrossRefPubMedPubMedCentralGoogle Scholar
  42. 42.
    Finlay IG, Bowszyc J, Ramlau C, Gwiezdzinski Z. The effect of topical 0.75% metronidazole gel on malodorous cutaneous ulcers. J Pain Symptom Manag. 1996;11(3):158–62.CrossRefGoogle Scholar
  43. 43.
    Kalinski C, Schnepf M, Laboy D, Hernandez L, Nusbaum J, McGrinder B, Comfort C, Alvarez O. Effectiveness of a topical formulation containing metronidazole for wound odor and exudate control. Wounds. 2005;17(4):84–90.Google Scholar
  44. 44.
    Kuge S, Tokuda Y, Ohta M, Okumura A, Kubota M, Ninomiya S, Sawamura S, Makuuchi H, Tajima T, Mitomi T. Use of metronidazole gel to control malodor in advanced and recurrent breast cancer. Jpn J Clin Oncol. 1996;26(4):207–10.CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Watanabe K, Shimo A, Tsugawa K, Tokuda Y, Yamauchi H, Miyai E, Takemura K, Ikoma A, Nakamura S. Safe and effective deodorization of malodorous fungating tumors using topical metronidazole 0.75% gel (GK567): a multicenter, open-label, phase III study (RDT.07.SRE.27013). Support Care Cancer. 2016;24(6):2583–90.CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Ashford R, Plant G, Maher J, Teare L. Double-blind trial of metronidazole in malodorous ulcerating tumours. Lancet. 1984;1(8388):1232–3.CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    George R, Prasoona TS, Kandasamy R, Cherian R, Celine T, Jeba J, Murali S, Mathew D. Improving malodour management in advanced cancer: a 10-year retrospective study of topical, oral and maintenance metronidazole. BMJ Support Palliat Care. 2017;7(3):286–91.PubMedPubMedCentralGoogle Scholar
  48. 48.
    Alexander S. Malignant fungating wounds: managing pain, bleeding and psychosocial issues. J Wound Care. 2009;18(10):418–25.CrossRefPubMedPubMedCentralGoogle Scholar
  49. 49.
    Tamai N, Mugita Y, Ikeda M, Sanada H. The relationship between malignant wound status and pain in breast cancer patients. Eur J Oncol Nurs. 2016;24:8–12.CrossRefPubMedPubMedCentralGoogle Scholar
  50. 50.
    Gallagher R. Management of painful wounds in advanced disease. Can Fam Physician. 2010;56(9):883–5, e315–7PubMedPubMedCentralGoogle Scholar
  51. 51.
    World Health Organization. Cancer pain relief: with a guide to opioid availability. 2nd ed. Geneva: World Health Organization; 1996. Available at:
  52. 52.
    Chuang C, Fonger E, Roth R, Campbell M. Challenges with accruing a study of topical opioid for painful malignant wounds: lessons learned. J Palliat Med. 2016;19(6):586.CrossRefPubMedPubMedCentralGoogle Scholar
  53. 53.
    Finlayson K, Teleni L, McCarthy AL. Topical opioids and antimicrobials for the management of pain, infection, and infection-related odors in malignant wounds: a systematic review. Oncol Nurs Forum. 2017;44(5):626–32.CrossRefPubMedPubMedCentralGoogle Scholar
  54. 54.
    Smith MT, Wyse BD, Edwards SR, El-Tamimy M, Gaetano G, Gavin P. Topical application of a novel oxycodone gel formulation (tocopheryl phosphate mixture) in a rat model of peripheral inflammatory pain produces localized pain relief without significant systemic exposure. J Pharm Sci. 2015;104(7):2388–96.CrossRefPubMedPubMedCentralGoogle Scholar
  55. 55.
    LeBon B, Zeppetella G, Higginson IJ. Effectiveness of topical administration of opioids in palliative care: a systematic review. J Pain Symptom Manag. 2009;37(5):913–7.CrossRefGoogle Scholar
  56. 56.
    Maida V. Medical cannabis in the palliation of malignant wounds-a case report. J Pain Symptom Manag. 2017;53(1):e4–6.CrossRefGoogle Scholar
  57. 57.
    Lee JJ, Girouard SD, Carlberg VM, Mostaghimi A. Effective use of mirtazapine for refractory pruritus associated with carcinoma en cuirasse. BMJ Support Palliat Care. 2016;6(1):119–21.CrossRefPubMedPubMedCentralGoogle Scholar
  58. 58.
    Wiechert AC, Garrett LA, Lin G, Goodman A. Management of a skin metastasis in a patient with advanced ovarian cancer. Gynecol Oncol Case Rep. 2012;2(4):124–6.CrossRefPubMedPubMedCentralGoogle Scholar
  59. 59.
    Demling RH, De Santi L. Topical doxepin significantly decreases itching and erythema in the healed burn wound compared to oral antihistamines. J Burn Care Rehabil. 2002;23:S81.CrossRefGoogle Scholar
  60. 60.
    Demling RH, De Santi L. Topical doxepin significantly decreases itch and erythema in the chronically pruritic burn scar. Wounds. 2003;15:195–200.Google Scholar
  61. 61.
    Demierre MF, Taverna J. Mirtazapine and gabapentin for reducing pruritus in cutaneous T-cell lymphoma. J Am Acad Dermatol. 2006;55(3):543–4.CrossRefPubMedPubMedCentralGoogle Scholar
  62. 62.
    Ahuja RB, Gupta R, Gupta G, Shrivastava P. A comparative analysis of cetirizine, gabapentin and their combination in the relief of post-burn pruritus. Burns. 2011;37(2):203–7.CrossRefPubMedPubMedCentralGoogle Scholar
  63. 63.
    Song JS, Tawa M, Chau NG, Kupper TS, LeBoeuf NR. Aprepitant for refractory cutaneous T-cell lymphoma-associated pruritus: 4 cases and a review of the literature. BMC Cancer. 2017;17(1):200.CrossRefPubMedPubMedCentralGoogle Scholar
  64. 64.
    Torres T, Fernandes I, Selores M, Alves R, Lima M. Aprepitant: evidence of its effectiveness in patients with refractory pruritus continues. J Am Acad Dermatol. 2012;66(1):e14–5.CrossRefPubMedPubMedCentralGoogle Scholar
  65. 65.
    Vincenzi B, Fratto ME, Santini D, Tonini G. Aprepitant against pruritus in patients with solid tumours. Support Care Cancer. 2010;18(9):1229–30.CrossRefPubMedPubMedCentralGoogle Scholar
  66. 66.
    Santini D, Vincenzi B, Guida FM, Imperatori M, Schiavon G, Venditti O, Frezza AM, Berti P, Tonini G. Aprepitant for management of severe pruritus related to biological cancer treatments: a pilot study. Lancet Oncol. 2012;13(10):1020–4.CrossRefPubMedPubMedCentralGoogle Scholar
  67. 67.
    He A, Alhariri JM, Sweren RJ, Kwatra MM, Kwatra SG. Aprepitant for the treatment of chronic refractory pruritus. Biomed Res Int. 2017;2017:4790810.PubMedPubMedCentralGoogle Scholar
  68. 68.
    Spratt DE, Gordon Spratt EA, Wu S, DeRosa A, Lee NY, Lacouture ME, Barker CA. Efficacy of skin-directed therapy for cutaneous metastases from advanced cancer: a meta-analysis. J Clin Oncol. 2014;32(28):3144–55.CrossRefPubMedPubMedCentralGoogle Scholar
  69. 69.
    Kahler KC, Egberts F, Gutzmer R. Palliative treatment of skin metastases in dermato-oncology. J Dtsch Dermatol Ges. 2013;11(11):1041–5. quiz 1046Google Scholar
  70. 70.
    Lu YF, Lin YC, Chen KH, Shueng PW, Yeh HP, Hsieh CH. Image-guided intensity-modulated radiotherapy for refractory bilateral breast cancer in a patient with extensive cutaneous metastasis in the chest and abdominal walls. Onco Targets Ther. 2016;9:3025–30.PubMedPubMedCentralGoogle Scholar
  71. 71.
    Lai YL, Chang HH, Huang MJ, Chang KH, Su WH, Chen HW, Chung CH, Wang WY, Lin LH, Chen YJ. Combined effect of topical arsenic trioxide and radiation therapy on skin-infiltrating lesions of breast cancer-a pilot study. Anti-Cancer Drugs. 2003;14(10):825–8.CrossRefPubMedPubMedCentralGoogle Scholar
  72. 72.
    Plesnicar S, Rudolf Z. Combined BCG and irradiation treatment of skin metastases originating from malignant melanoma. Cancer. 1982;50(6):1100–6.CrossRefPubMedPubMedCentralGoogle Scholar
  73. 73.
    Gaudy C, Richard MA, Folchetti G, Bonerandi JJ, Grob JJ. Randomized controlled study of electrochemotherapy in the local treatment of skin metastases of melanoma. J Cutan Med Surg. 2006;10(3):115–21.CrossRefPubMedPubMedCentralGoogle Scholar
  74. 74.
    Byrne CM, Thompson JF, Johnston H, Hersey P, Quinn MJ, Michael Hughes T, McCarthy WH. Treatment of metastatic melanoma using electroporation therapy with bleomycin (electrochemotherapy). Melanoma Res. 2005;15(1):45–51.CrossRefPubMedPubMedCentralGoogle Scholar
  75. 75.
    Seyed Jafari SM, Jabbary Lak F, Gazdhar A, Shafighi M, Borradori L, Hunger RE. Application of electrochemotherapy in the management of primary and metastatic cutaneous malignant tumours: a systematic review and meta-analysis. Eur J Dermatol. 2018;28(3):287–313.PubMedGoogle Scholar
  76. 76.
    Morrison SA, Hill SL, Rogers GS, Graham RA. Efficacy and safety of continuous low-irradiance photodynamic therapy in the treatment of chest wall progression of breast cancer. J Surg Res. 2014;192(2):235–41.CrossRefGoogle Scholar
  77. 77.
    Cuenca RE, Allison RR, Sibata C, Downie GH. Breast cancer with chest wall progression: treatment with photodynamic therapy. Ann Surg Oncol. 2004;11(3):322–7.CrossRefGoogle Scholar
  78. 78.
    Spaner DE, Miller RL, Mena J, Grossman L, Sorrenti V, Shi Y. Regression of lymphomatous skin deposits in a chronic lymphocytic leukemia patient treated with the toll-like receptor-7/8 agonist, imiquimod. Leuk Lymphoma. 2005;46(6):935–9.CrossRefGoogle Scholar
  79. 79.
    Steinmann A, Funk JO, Schuler G, von den Driesch P. Topical imiquimod treatment of a cutaneous melanoma metastasis. J Am Acad Dermatol. 2000;43(3):555–6.PubMedGoogle Scholar
  80. 80.
    Asakura M, Miura H. Imiquimod 5% cream for the treatment of nasal lesion of metastatic renal cell carcinoma. Dermatol Ther. 2011;24(3):375–7.CrossRefPubMedPubMedCentralGoogle Scholar
  81. 81.
    Henriques L, Palumbo M, Guay MP, Bahoric B, Basik M, Kavan P, Batist G. Imiquimod in the treatment of breast cancer skin metastasis. J Clin Oncol. 2014;32(8):e22–5.CrossRefPubMedPubMedCentralGoogle Scholar
  82. 82.
    Adams S, Kozhaya L, Martiniuk F, Meng TC, Chiriboga L, Liebes L, Hochman T, Shuman N, Axelrod D, Speyer J, Novik Y, Tiersten A, Goldberg JD, Formenti SC, Bhardwaj N, Unutmaz D, Demaria S. Topical TLR7 agonist imiquimod can induce immune-mediated rejection of skin metastases in patients with breast cancer. Clin Cancer Res. 2012;18(24):6748–57.CrossRefPubMedPubMedCentralGoogle Scholar
  83. 83.
    Salazar LG, Lu H, Reichow JL, Childs JS, Coveler AL, Higgins DM, Waisman J, Allison KH, Dang Y, Disis ML. Topical imiquimod plus nab-paclitaxel for breast cancer cutaneous metastases: a phase 2 clinical trial. JAMA Oncol. 2017;3(7):969–73.CrossRefPubMedPubMedCentralGoogle Scholar
  84. 84.
    Florin V, Desmedt E, Vercambre-Darras S, Mortier L. Topical treatment of cutaneous metastases of malignant melanoma using combined imiquimod and 5-fluorouracil. Investig New Drugs. 2012;30(4):1641–5.CrossRefGoogle Scholar
  85. 85.
    Leonard R, Hardy J, van Tienhoven G, Houston S, Simmonds P, David M, Mansi J. Randomized, double-blind, placebo-controlled, multicenter trial of 6% miltefosine solution, a topical chemotherapy in cutaneous metastases from breast cancer. J Clin Oncol. 2001;19(21):4150–9.CrossRefPubMedPubMedCentralGoogle Scholar
  86. 86.
    Goto H, Omodaka T, Yanagisawa H, Yoshikawa S, Yoshida Y, Yamamoto O, Kiyohara Y. Palliative surgical treatment for cutaneous metastatic tumor is a valid option for improvement of quality of life. J Dermatol. 2016;43(1):95–8.CrossRefPubMedPubMedCentralGoogle Scholar
  87. 87.
    Dabiri G, Damstetter E, Phillips T. Choosing a wound dressing based on common wound characteristics. Adv Wound Care (New Rochelle). 2016;5(1):32–41.CrossRefGoogle Scholar
  88. 88.
    Powers JG, Higham C, Broussard K, Phillips TJ. Wound healing and treating wounds: chronic wound care and management. J Am Acad Dermatol. 2016;74(4):607–25; quiz 625–6.CrossRefPubMedPubMedCentralGoogle Scholar
  89. 89.
    Wound Care Shop. Accessed: October 12, 2018; Available from:

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Brooke E. Corbett
    • 1
  • Nina R. Blank
    • 2
    • 3
  • Alina Markova
    • 2
    Email author
  1. 1.Department of DermatologyUniversity of Wisconsin Hospitals and ClinicsMadisonUSA
  2. 2.Dermatology Service, Department of MedicineMemorial Sloan Kettering Cancer CenterNew YorkUSA
  3. 3.Department of DermatologyWeill Cornell Medical CollegeNew YorkUSA

Personalised recommendations