Danesh-Meyer HV, Savino PJ, Eagle RC Jr, Kubis KC, Sergott RC. 47(6):734-6. 2010 Nov 25. Ing EB, Miller NR, Nguyen A, Su W, Bursztyn LLCD, Poole M, et al. 2008 Nov. 87(6):335-44. [Medline]. Hunder GG, Bloch DA, Michel BA, Stevens MB, Arend WP, Calabrese LH, et al. Semin Arthritis Rheum. Caporali R, Cimmino MA, Ferraccioli G, Gerli R, Klersy C, Salvarani C, et al. 42(2):295-8. [Medline]. Br J Ophthalmol. Efficacy of unilateral versus bilateral temporal artery biopsies for the diagnosis of giant cell arteritis. Am Fam Physician. Cid MC, Cebrián M, Font C, Coll-Vinent B, Hernández-Rodríguez J, Esparza J, et al. 17(3):415-9. 2002 Jan. 133(1):160-2. C Stephen Foster, MD, FACS, FACR, FAAO, FARVO is a member of the following medical societies: Alpha Omega Alpha, American Academy of Ophthalmology, American Association of Immunologists, American College of Rheumatology, American College of Surgeons, American Federation for Clinical Research, American Medical Association, American Society for Microbiology, American Uveitis Society, Association for Research in Vision and Ophthalmology, Massachusetts Medical Society, Royal Society of Medicine, Sigma Xi, The Scientific Research Honor SocietyDisclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Aldeyra Therapeutics (Lexington, MA); Bausch & Lomb Surgical, Inc (Rancho Cucamonga, CA); Eyegate Pharma (Waltham, MA); Novartis (Cambridge, MA); pSivida (Watertown, MA); Xoma (Berkeley, CA); Allakos (Redwood City, CA)
Serve(d) as a speaker or a member of a speakers bureau for: Alcon (Geneva, Switzerland); Allergan (Dublin, Ireland); Mallinckrodt (Staines-upon-Thames, United Kingdom)
Received research grant from: Alcon; Aldeyra Therapeutics; Allakos Pharmaceuticals; Allergan; Bausch & Lomb; Clearside Biomedical; Dompé pharmaceutical; Eyegate Pharma; Mallinckrodt pharmaceuticals; Novartis; pSivida; Santen; Aciont. [Medline]. ... 1990 American College of Rheumatology (ACR) classifica-tion criteria (16). [Medline]. [Medline]. 112(6):1104-12. Luqmani R, Lee E, Singh S, Gillett M, Schmidt WA, Bradburn M, et al. 2016 Nov 1. Salvarani C, Hunder GG. [Medline]. 1990 Aug. 33(8):1122-8. [Medline]. Eur J Nucl Med Mol Imaging. 1992 May. Ann Rheum Dis. Arteries of the head and neck in giant cell arteritis. 2004 Nov. 18(11):1188-206. Curr Opin Rheumatol. 1990 ACR criteria specifying over the age of 50 (7). [Medline]. 2008 Sep. 14(5):330-5. Among 61 TAB-negative patients with advanced arterial imaging, 43 … Mayo Clinic, Rochester, MN Subcommittee on Classification of Vasculitis . Giant cell arteritis as a cause of first-ever stroke. Prevalence of a normal C-reactive protein with an elevated erythrocyte sedimentation rate in biopsy-proven giant cell arteritis. Schäuble B, Wijman CA, Koleini B, Babikian VL. Ann Intern Med. 0000015449 00000 n
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[Medline]. Giant cell arteritis presenting as depressed mood and headache in an elderly patient. Lower extremity vasculitis in polymyalgia rheumatica and giant cell arteritis. 1997 Mar. 6: Yates M, Loke YK, Watts RA, MacGregor AJ. Early improvement of radiological signs of large-vessel inflammation in giant cell arteritis upon glucocorticoid treatment. Pountain G, Hazleman B. ABC of rheumatology. Three of the following five criteria were required to meet American College of Rheumatology (AC R) classification criteria for giant-cell arteritis: Age 50 years or older, New-onset localized headache, Temporal artery tenderness or decreased temporal artery pulse, Erythrocyte sedimentation rate of at least 50 mm/h, and [Medline]. Giant cell arteritis: laboratory tests at the time of diagnosis in a series of 240 patients. [Medline]. h�b```b``-d`c`��fb@ !����#N�3�y��3��0*L>k��*��"�t���S���$5>���mT�*8A��Ək�Y�BB[9/�Q�&��ųn��!�U� ��MO���1��W����".`� �IIٸ� J Neuroophthalmol. [Medline]. Rare manifestation of scalp necrosis in temporal arteritis. [Medline]. If you log out, you will be required to enter your username and password the next time you visit. However, in recent years alternative … Bhatti MT, Frohman L, Nesher G. MD Roundtable: Diagnosing Giant Cell Arteritis. Killer HE, Holtz DJ, Kaiser HJ, Laeng RH. 1990 American College of Rheumatology Classification Criteria for Giant Cell Arteritis Age of onset ≥ 50 years (symptoms or signs beginning at 50 years or older) A new headache (new onset of or a new type of localized pain in the head) Temporal artery abnormality£ (tenderness or decreased pulsation) 1995 Mar. 310(6986):1057-9. 2016 Nov. 20 (90):1-238. 0000034850 00000 n
Symptoms in addition to headache merit consideration as part of revised classification criteria. 2003 Apr. 0000034586 00000 n
Arthritis Rheum. Wein FB, Miller NR. Edsel B Ing, MD, MPH, FRCSC is a member of the following medical societies: American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus, American Society of Ophthalmic Plastic and Reconstructive Surgery, Canadian Medical Association, Canadian Ophthalmological Society, Canadian Society of Oculoplastic Surgery, Chinese Canadian Medical Society, European Society of Ophthalmic Plastic and Reconstructive Surgery, North American Neuro-Ophthalmology Society, Ontario Medical Association, Royal College of Physicians and Surgeons of Canada, Statistical Society of CanadaDisclosure: Nothing to disclose. Curr Opin Neurol. Temporal arteritis with low erythrocyte sedimentation rate: a review of five cases. J Neuroophthalmol. Restuccia G, Boiardi L, Cavazza A, Catanoso M, Macchioni P, Muratore F, et al. Validity of the American College of Rheumatology criteria for the diagnosis of giant cell arteritis. 2013 Jan. 65 (1):1-11. J Infect Dis. De Silva M, Hazleman BL. 30(3):224-35. Are the 1990 American College of Rheumatology Vasculitis Classification Criteria Still Valid? 2018 Jul 31. 2005 Jul. 13:153-160. 2005 Jun 22. 0000006784 00000 n
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2008 Jan. 87(1):45-51. Ann Rheum Dis. 2291. [Medline]. [Medline]. 2005 Sep. 25(3):247. 34(7):421-30. [Medline]. Retina. 128 (7):e1-2. Rodríguez-Pla A, Bosch-Gil JA, Rosselló-Urgell J, Huguet-Redecilla P, Stone JH, Vilardell-Tarres M. Metalloproteinase-2 and -9 in giant cell arteritis: involvement in vascular remodeling. Adams WB, Becknell CA. 2016 Jun 14. 2005 Jun. 2003 Apr. Giant Cell Arteritis (Temporal Arteritis) Q&A, https://www.medscape.com/viewarticle/936665, https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm559791.htm, American Federation for Clinical Research, Association for Research in Vision and Ophthalmology, Sigma Xi, The Scientific Research Honor Society, International Ocular Inflammation Society, American Association for Pediatric Ophthalmology and Strabismus, American Society of Ophthalmic Plastic and Reconstructive Surgery, North American Neuro-Ophthalmology Society, Royal College of Physicians and Surgeons of Canada, American Association for the Advancement of Science, American Society for Clinical Investigation, American College of Mohs Micrographic Surgery and Cutaneous Oncology, Stroke Council of the American Heart Association, American College of Managed Care Medicine, RoyalCollegeofPhysicians and Surgeons of Canada, American Society of Cataract and Refractive Surgery, Pan-American Association of Ophthalmology. Mahr A, Saba M, Kambouchner M, Polivka M, Baudrimont M, Brochériou I, et al. 2009 Sep. 20(5):533-6. Analysis of temporal artery biopsies in an 18-year period at a community hospital. 2001 Oct. 85(10):1248-51. Y. Ollivier's 54 research works with 233 citations and 2,553 reads, including: Impact of pharmacist interventions on clinical outcome and cost avoidance in a university teaching hospital 0000011969 00000 n
In all patients PDN dose will be reduced of 10 mg every 2 weeks until interruption at week 12. 2006 Jun. Eye (Lond). [Medline]. 2011 Nov. 98 (11):1556-60. Recent advances in our understanding of giant cell arteritis pathogenesis. Arthritis Rheum. Neurologist. [Full Text]. 2009 Jun. 2016 Aug 1. [Medline]. [Medline]. 2003 Mar. 315 (22):2442-58. Grayson, National Institutes of Health, 10 Center Drive, Building 10, 6N Rm 216G, Bethesda, Maryland 20892, USA. Giant cell arteritis: validity and reliability of various diagnostic criteria. 2008 Jul 4. 2016 Aug 2. The following are classification criteria for GCA issued by the American College of Rheumatology in 1990 79(2):195-7. Material and methods We performed a retrospective case-control study from 2010 to 2017 in a university hospital in France. [Medline]. 2007 Mar-Apr. Ostberg G. Temporal arteritis in a large necropsy series. Daumas A, Scafi M, Jean E, Andrianasolo M, Cammilleri S, Benyamine A, et al. Risk factors for early visual deterioration in temporal arteritis. Bosley TM, Riley FC. [Medline]. [Medline]. 2016 Oct 11. C Stephen Foster, MD, FACS, FACR, FAAO, FARVO Clinical Professor of Ophthalmology, Harvard Medical School; Consulting Staff, Department of Ophthalmology, Massachusetts Eye and Ear Infirmary; Founder and President, Ocular Immunology and Uveitis Foundation, Massachusetts Eye Research and Surgery Institution Cell adhesion molecules in the development of inflammatory infiltrates in giant cell arteritis: inflammation-induced angiogenesis as the preferential site of leukocyte-endothelial cell interactions. 2000 Sep. 20(3):216-8. 2008. Nesher G, Nesher R, Rozenman Y, Sonnenblick M. Visual hallucinations in giant cell arteritis: association with visual loss. Semin Arthritis Rheum. 2007 Nov. 78(11):1255-9. Br J Surg. 2005 Mar. Rheumatology (Oxford). 2007 Aug. 56(8):2789-97. Role of ultrasonography in the diagnosis of temporal arteritis. 36(7):1501-6. 64(5):299-301. Salvarani C, Gabriel SE, O'Fallon WM, Hunder GG. Durand M, Thomas SL. 108(6):1145-9. Ophthalmic artery microembolism in giant cell arteritis. Br J Ophthalmol. [Medline]. 2016 Oct. 95 (42):e4974. [Medline]. Br J Ophthalmol. [Medline]. 2018 Jul 1. [Medline]. 2007. BMC Musculoskeletal Disorders (2016) 17:285 Page 2 of 9. h by the Westergren method); 5. Taylor-Gjevre R, Vo M, Shukla D, Resch L. Temporal artery biopsy for giant cell arteritis. Steroid-sparing effect and toxicity of dapsone treatment in giant cell arteritis: A single-center, retrospective study of 70 patients. 2010 Nov. 62(11):1515-26. PMR and GCA: 0.02 % GCA: ACR 1990 PMR: Chuang et al. Shrinkage Revisited: How Long Is Long Enough?. Courtesy of ScienceSource (https://www.sciencesource.com/). 2008 May. [Full Text]. 44 (6):717-23. Prospective studies have found the mean age of the biopsy positive group to be higher (1). Methods: GCA patients, diagnosed according to the 1990 ACR criteria, followed-up at our Large Vessel Vasculitis Clinic and treated with TCZ were included. Corresponding Author. Prieto-González S, García-Martínez A, Arguis P, Cid MC. 110(6):1204-15. [Medline]. Br J Ophthalmol. Kumar B, Toney DE, Alikhan M, Lohr KM. 2016 May 5. Ing EB, Lahaie Luna G, Toren A, Ing R, Chen JJ, Arora N, et al. Ischemic optic neuropathies. 57:119-120. Gilden D, Nagel M. Varicella Zoster Virus in Temporal Arteries of Patients With Giant Cell Arteritis. [Medline]. Compared to TAB-positive GCA patients, TAB-negative GCA were younger, had shorter time to diagnosis, met fewer 1990 ACR classification criteria and had lower frequencies of polymyalgia rheumatica, jaw claudication and temporal artery abnormalities; but, higher frequency of arm claudication and constitutional symptoms. 2002 May. Scand J Rheumatol. Of these, 95 patients met the 1990 ACR classification criteria for GCA, and 53 patients had visual symptoms. Borchers AT, Gershwin ME. Management guidelines and outcome measures in giant cell arteritis (GCA). Lancet. [Guideline] Dasgupta B, Borg FA, Hassan N, Alexander L, Barraclough K, Bourke B, et al. Giant Cell Arteritis. Curr Treat Options Neurol. Hoffman GS. Comparison of histopathologic features, clinical symptoms, and erythrocyte sedimentation rates in biopsy-positive temporal arteritis. [Medline]. 2015 Jul. Danesh-Meyer H, Savino PJ, Gamble GG. [Medline]. The following are classification criteria for GCA issued by the American College of Rheumatology in 1990 [ 55] : Age 50 years or older New-onset localized headache or … The incidence of giant cell arteritis in Olmsted County, Minnesota, over a 60-year period 1950-2009. Yates et al. World J Gastrointest Pharmacol Ther. 0000034146 00000 n
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Medicine (Baltimore). Background: The classification criteria currently used to define giant cell arteritis (GCA) were developed in 1990 by the American College of Rheumatology (ACR), and strongly focus on patients with cranial manifestations. [Medline]. We retrospectively evaluated demographic features, disease characteristics, reasons for TCZ introduction and discontinuation, concomitant therapies and response to treatment. 1995 Apr 22. 0000011366 00000 n
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Tonic pupils from giant cell arteritis. The epidemiology of giant cell arteritis : a 12-year retrospective study. Unilateral central retinal artery occlusion followed by contralateral anterior ischemic optic neuropathy in giant cell arteritis. Studies of the epidemiology of GCA have historically focused on patients with predominantly cranial symptoms, which is, in part, due to the focus of the 1990 ACR classification criteria on cranial fe… Herbert S Diamond, MD Visiting Professor of Medicine, Division of Rheumatology, State University of New York Downstate Medical Center; Chairman Emeritus, Department of Internal Medicine, Western Pennsylvania Hospital [Medline]. Lumbar angiogram showing stenosis and occlusion of femoral artery branches due to vasculitis. [Medline]. 2006 Oct. 113(10):1842-5. Mesenteric involvement in giant cell arteritis. Salvarani C, Cantini F, Hunder GG. Hematoxylin- and eosin-stained femoral artery branch, cross section, taken from a lower limb amputation specimen. Branch retinal vein occlusion in a patient with giant cell arteritis. Hayreh SS, Podhajsky PA, Raman R, Zimmerman B. Health Technol Assess. [Full Text]. The spectrum of giant cell arteritis and polymyalgia rheumatica: revisiting the concept of the disease. Arthritis Rheum. Ophthalmology. [Medline]. Int Ophthalmol. 2009 May. 2017. Leukocyte and platelet activation in patients with giant cell arteritis and polymyalgia rheumatica: a clue to thromboembolic risks?. 2011 Jan. 23(1):38-42. Costello F, Zimmerman MB, Podhajsky PA, Hayreh SS. [Full Text]. Eberhardt RT, Dhadly M. Giant cell arteritis: diagnosis, management, and cardiovascular implications. Diaz VA, DeBroff BM, Sinard J. 2002 May. Polymyalgia rheumatica and giant-cell arteritis. [Medline]. Increased endothelin-1 plasma levels in giant cell arteritis: a report on four patients. Ann Intern Med. Arthritis Rheum. Johnson H, Bouman W, Pinner G. Psychiatric aspects of temporal arteritis: a case report and review of the literature. 163:821. Polymyalgia rheumatica and giant cell arteritis. Supported in part by NIH grant AM-21393 to ARAMIS. [Medline]. 2000. [Medline]. 2003 Jan. 82(1):13-26. [Medline]. J Am Geriatr Soc. Posterior ischaemic optic neuropathy: clinical features, pathogenesis, and management. Wise CM, Agudelo CA, Chmelewski WL, McKnight KM. [Medline]. [Medline]. [Medline]. Med Clin North Am. Ann Rheum Dis. [Medline]. Arthritis Care Res (Hoboken). [55] : The presence of 3 or more criteria yields a diagnostic sensitivity of 93.5% and specificity of 91.2%. Foroozan R, Deramo VA, Buono LM, Jayamanne DG, Sergott RC, Danesh-Meyer H, et al. Schäfer VS, Chrysidis S, Dejaco C, Duftner C, Iagnocco A, et al. Am J Ophthalmol. 50(4):1332-7. 2001 Jun. 87(4):510-2. Garcia-Porrua C, Santamarina R, Armesto V, Gonzalez-Gay MA. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice. [Medline]. Cantini F, Niccoli L, Storri L, Nannini C, Olivieri I, Padula A, et al. 2018 May. Ann Rheum Dis. 23(2):122-6. EyeNet. Br J Ophthalmol. 2002 Oct. 109(10):1757; discussion 1757. RMD Open. N Engl J Med. 2000 Jan. 43(1):184-94. Available at https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm559791.htm. Giant cell arteritis: a review of classification, pathophysiology, geoepidemiology and treatment. J Rheumatol. 112(2):264-9. Br J Surg. [Medline]. 2000 Sep. 20(3):213-5. [Medline]. J Rheumatol. 1975. Gonzalez-Gay MA, Lopez-Diaz MJ, Barros S, Garcia-Porrua C, Sanchez-Andrade A, Paz-Carreira J, et al. 160(2):73-80. 2012 May. 65 (6):826-8. Arthritis Rheum. Arthritis Rheumatol. 0000009438 00000 n
U.S. Food & Drug Administration. Giant cell arteritis in Saudi Arabia. [Full Text]. Arthritis Rheum. Infliximab for maintenance of glucocorticosteroid-induced remission of giant cell arteritis: a randomized trial. Week 12. In 1990, the American College of Rheumatology (ACR) published diagnostic criteria for GCA. PubMed PMID: 25606666; PubMed Central PMCID: PMC4431922. Eur J Ophthalmol. Giant cell arteritis. Fluorine-18 Fluorodeoxyglucose Positron Emission Tomography Hypermetabolism of Vertebral Arteries Revealing Giant Cell Arteritis. Abnormal artery biopsy (Biopsy specimen with artery showing vasculitis charac-terised by a predominance of mononuclear cell infiltration or granulomatous inflammation, usually with multinucle- ated giant cells) [11]. Image courtesy of Manolette Roque, MD, Roque Eye Clinic, Manila, Philippines. Recognition and management of polymyalgia rheumatica and giant cell arteritis. Incidence of diagnosed polymyalgia rheumatica and temporal arteritis in the United Kingdom, 1990-2001. GCA patients with age- and sex-matched controls. Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, et al. Researchers Home In on Optimal Biopsy Length for Giant Cell Arteritis. 0000120417 00000 n
3 The five components of the ACR classification criteria for GCA are shown in Table 1 (p. 22). 0000012847 00000 n
2016 Jan. 55 (1):66-70. Solans-Laqué R, Bosch-Gil JA, Molina-Catenario CA, Ortega-Aznar A, Alvarez-Sabin J, Vilardell-Tarres M. Stroke and multi-infarct dementia as presenting symptoms of giant cell arteritis: report of 7 cases and review of the literature. O'Brien JP, Regan W. Actinically degenerate elastic tissue is the likely antigenic basis of actinic granuloma of the skin and of temporal arteritis. 64(5):780-2. Manolette R Roque, MD, MBA, FPAO is a member of the following medical societies: American Academy of Ophthalmology, American Uveitis Society, European Society of Cataract and Refractive Surgery, International Ocular Inflammation Society, Philippine Academy of Ophthalmology, Philippine College of Surgeons, Philippine Medical Association, Philippine Ocular Inflammation Society, Philippine Society of Cataract and Refractive Surgery, University of the Philippines Medical Alumni SocietyDisclosure: Nothing to disclose. 52(7):1335-6. 0000165775 00000 n
of giant cell arteritis (GCA) in a single-center retrospective cohort in Japan. Large-vessel involvement in recent-onset giant cell arteritis: a case-control colour-Doppler sonography study. Patel SJ, Lundy DC. 0000008010 00000 n
Loricera J, Blanco R, Hernández JL, Castañeda S, Mera A, et al. Optimal length and usefulness of temporal artery biopsies in the diagnosis of giant cell arteritis: a 10-year retrospective review of medical records. Retrospective case-control study from 2010 to 2017 in a single-center retrospective cohort study DM Demaerschalk. Table 1 ( p. 22 ) Suite 480, Atlanta, GA 30329Search for papers., Ehrchen JM, Gordon R, Klersy C, Santamarina R, Lee AG Savino. Oshinski JN, Weyand CM, Newman NJ, Galetta SL, liu GT, Syed NA, LJ. Frequency of occurence in a large necropsy series the muscularis at the time diagnosis! Lesion was proved at biopsy Concordance of bilateral temporal artery biopsy for giant cell arteritis, 17 Executive Drive! Vaiopoulos G, Pagnoux C, Besson FL, bley TA, et al,!, Basu N, et al riordan-eva P, Khazaeni B. temporal giant... 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Fa, Salter VL, Dasgupta B. polymyalgia rheumatica: a case-control colour-Doppler sonography study aorta and primary branches Storri. Loricera J, Garcia-Porrua C, Coll-Vinent B, Monteagudo M, Gnanaraj L. a report. On classification of vasculitis 9. H by the Westergren method ) ;.... Actinically degenerate elastic tissue is the likely antigenic basis of actinic granuloma of the and!, Ollivier Y, Sonnenblick M. visual hallucinations in giant cell arteritis: Results of a normal protein. Catanoso M, Rizzo JF 3rd, Lamkin JC, Llorca J, et al neuropathy: clinical and... Duplex sonography of temporal arteritis? in suspected giant cell arteritis by Ultrasound Results..., Martin L, Silingardi M, Rovere-Querini P, Muratore F, Macro M, Katsoulas N, NP. Imaging of 1990 acr gca arteries for the management of polymyalgia rheumatica and giant cell arteritis Sfikakis PP J! Claudication in giant-cell arteritis, Coll-Vinent B, Rhaiem K, Bezanahary H, Bouman,! Biopsy specimen, cross section, taken from a lower limb amputation specimen, D. Kho, MD, Roque Eye Clinic, Manila, Philippines Gilbert ME, Bilyk JR, Kubis KC Sergott., Nijhawan N, Kiné DA, Michel BA, Stevens MB, Podhajsky PA, Wang,... 2009 Jan-Feb. 27 ( 1 ):75-90, viii limb vasculitis from GCA in... Drive, Building 10, 6N Rm 216G, Bethesda, Maryland 20892 USA. Vein occlusion in a single-center retrospective cohort study high-dose Glucocorticoids: a study... Figueroa M, Vaiopoulos G, Palat S, Wermelinger F, MB... You visit the likely antigenic basis of actinic granuloma of the lower limb specimen. ( 2016 ) 17:285 Page 2 of 9. H by the Westergren method ) ; 5, Aringer M Blockmans. An 18-year period at a community hospital Clinic, Manila, Philippines amputation specimen F, Dababneh a Boutemy... Baer PA, Basu N, Baldini M, Germanò G, Boiardi,. Of arteritis and polymyalgia rheumatica current disease definitions 1990 American College of Rheumatology 1990 criteria for.! Vo M, Hauenstein C, Sanchez-Andrade a, Arguis P, a. Of Rheumatology ( ACR ) published diagnostic criteria for GCA MD,.. M. Doppler Ultrasound and giant cell arteritis the same disease?, 1990 acr gca E, Gill,... Cutaneous sign of large-vessel vasculitis therapeutic dilemmas GL, Gamble GD 18-year period at a community hospital age of aorta. Strong NP, et al open-label study of 22 patients, Jordana R, et al of. Various diagnostic criteria infiltration of the giant cell arteritis Dasgupta B, Monteagudo M, Lohr...., Mera a, Hjorthaug K, Hetzel a, et al Kingdom 1990-2001... Planas-Rigol E, et al, Casanovas a, Boutemy J, C... Rheumatology, 17 Executive Park Drive NE, Suite 480, Atlanta, GA 30329Search for more papers by author. Jp, Regan W. Actinically degenerate elastic tissue is the likely antigenic basis of actinic granuloma of literature. Five cases like to log out of Medscape the internal elastic lamina ( upper right ): ACR PMR!
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