Melanoma differential diagnosis: Difference between revisions

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Melanoma must be differentiated from other causes of skin lesions, such as:
Melanoma must be differentiated from other causes of skin lesions, such as:


*[[Angiokeratoma]]
*[[Angiokeratoma]]<ref name="pmid23697732">{{cite journal |vauthors=Dumitrache N, Neiderer K, Martin B, Dancho J |title=Angiokeratoma presenting as a melanoma: a case report |journal=J Am Podiatr Med Assoc |volume=103 |issue=3 |pages=241–2 |date=2013 |pmid=23697732 |doi= |url=}}</ref>
*[[Atypical fibroxanthoma]]*[[Basal cell carcinoma]] of the skin
*[[Atypical fibroxanthoma]]<ref name="pmid26881598">{{cite journal |vauthors=Pujani M, Hassan MJ, Jetley S |title=Atypical fibroxanthoma in a young female misdiagnosed clinically as a malignant melanoma--An unusual presentation |journal=J Cancer Res Ther |volume=11 |issue=4 |pages=1027 |date=2015 |pmid=26881598 |doi=10.4103/0973-1482.150353 |url=}}</ref>
*[[Dermatofibroma]]
*[[Basal cell carcinoma]] of the skin
*[[Dermatofibroma]]<ref name="pmid24256198">{{cite journal |vauthors=AlJasser MI, Martinka M, Kalia S |title=Dermatofibroma mimicking melanoma dermoscopically |journal=Clin. Exp. Dermatol. |volume=39 |issue=1 |pages=69–70 |date=January 2014 |pmid=24256198 |doi=10.1111/ced.12155 |url=}}</ref>
*Dermatofibroma protuberans
*Dermatofibroma protuberans
*[[Dysplastic nevus]]
*[[Dysplastic nevus]]<ref name="pmid9259954">{{cite journal |vauthors=Bahuau M, Vidaud D, Kujas M, Palangié A, Assouline B, Chaignaud-Lebreton M, Prieur M, Vidaud M, Harpey JP, Lafourcade J, Caille B |title=Familial aggregation of malignant melanoma/dysplastic naevi and tumours of the nervous system: an original syndrome of tumour proneness |journal=Ann. Genet. |volume=40 |issue=2 |pages=78–91 |date=1997 |pmid=9259954 |doi= |url=}}</ref>
*Epithelioid (Spitz) tumors
*Epithelioid (Spitz) tumors
*[[Halo nevus]]
*[[Halo nevus]]
*[[Histiocytoid hemangioma]]
*[[Histiocytoid hemangioma]]<ref name="pmid25500044">{{cite journal |vauthors=Uzzauto MT |title=Melanoma hidden in a hemangioma |journal=J. Am. Acad. Dermatol. |volume=72 |issue=1 Suppl |pages=S56–7 |date=January 2015 |pmid=25500044 |doi=10.1016/j.jaad.2014.07.011 |url=}}</ref>
*[[Keratoacanthoma]]
*[[Keratoacanthoma]]<ref name="pmid27805257">{{cite journal |vauthors=Wakimoto H, Harada K, Arai T, Maeda T, Irisawa R, Tsuboi R |title=Reduced expression of the ATP2A2 gene in vemurafenib-induced keratoacanthoma-like papules in a melanoma patient |journal=Int. J. Dermatol. |volume=56 |issue=2 |pages=e33–e35 |date=February 2017 |pmid=27805257 |doi=10.1111/ijd.13430 |url=}}</ref>
*[[Lentigo]]
*[[Lentigo]]<ref name="pmid29489150">{{cite journal |vauthors=Charifa A, Chen CSJ |title= |journal= |volume= |issue= |pages= |date= |pmid=29489150 |doi= |url=}}</ref>
*[[Lentigo maligna]]
*[[Lentigo maligna]]
*[[Metastasis]] of other primary tumors
*[[Metastasis]] of other primary tumors
*[[Mycosis fungoides]]
*[[Mycosis fungoides]]<ref name="pmid28543586">{{cite journal |vauthors=Imafuku K, Hata H, Yanagi T, Kitamura S, Inamura-Takashima Y, Nishimura M, Kitamura S, Moriwaki S, Shimizu H |title=Multiple skin cancers in patients with mycosis fungoides after long-term ultraviolet phototherapy |journal=Clin. Exp. Dermatol. |volume=42 |issue=5 |pages=523–526 |date=July 2017 |pmid=28543586 |doi=10.1111/ced.13121 |url=}}</ref>
*[[Oral candidiasis]]
*[[Oral candidiasis]]<ref name="pmid14561964">{{cite journal |vauthors=Gu GM, Epstein JB, Morton TH |title=Intraoral melanoma: long-term follow-up and implication for dental clinicians. A case report and literature review |journal=Oral Surg Oral Med Oral Pathol Oral Radiol Endod |volume=96 |issue=4 |pages=404–13 |date=October 2003 |pmid=14561964 |doi=10.1016/S1079210403003202 |url=}}</ref>
*[[Nerve sheath tumor|Peripheral nerve sheath tumor]]
*[[Nerve sheath tumor|Peripheral nerve sheath tumor]]
*[[Actinic keratosis|Pigmented actinic keratosis]]
*[[Actinic keratosis|Pigmented actinic keratosis]]<ref name="pmid28705516">{{cite journal |vauthors=Kelati A, Baybay H, Moscarella E, Argenziano G, Gallouj S, Mernissi FZ |title=Dermoscopy of Pigmented Actinic Keratosis of the Face: A Study of 232 Cases |journal=Actas Dermosifiliogr |volume=108 |issue=9 |pages=844–851 |date=November 2017 |pmid=28705516 |doi=10.1016/j.ad.2017.05.002 |url=}}</ref>
*[[Scar tissue]] or [[keloid]]
*[[Scar tissue]] or [[keloid]]
*[[Angioma|Sclerosing angioma]]
*[[Angioma|Sclerosing angioma]]<ref name="pmid26448544">{{cite journal |vauthors=Campagnoli TR, Medina CA, Singh AD |title=CHOROIDAL MELANOMA INITIALLY TREATED AS HEMANGIOMA: DIAGNOSTIC AND THERAPEUTIC CONSIDERATIONS |journal=Retin Cases Brief Rep |volume=10 |issue=2 |pages=175–82 |date=2016 |pmid=26448544 |doi=10.1097/ICB.0000000000000220 |url=}}</ref>
*[[Blue nevus|Sclerosing blue nevus]]
*[[Blue nevus|Sclerosing blue nevus]]<ref name="pmid28318130">{{cite journal |vauthors=Borgenvik TL, Karlsvik TM, Ray S, Fawzy M, James N |title=Blue nevus-like and blue nevus-associated melanoma: a comprehensive review of the literature |journal=ANZ J Surg |volume=87 |issue=5 |pages=345–349 |date=May 2017 |pmid=28318130 |doi=10.1111/ans.13946 |url=}}</ref><ref name="pmid28576220">{{cite journal |vauthors=Hussain A, Sidiropoulos M, Das S, Munoz DG, Nijhawan N |title=Orbital cellular blue nevus complicated by malignant melanoma |journal=Can. J. Ophthalmol. |volume=52 |issue=3 |pages=e111–e113 |date=June 2017 |pmid=28576220 |doi=10.1016/j.jcjo.2016.11.025 |url=}}</ref>
*[[Sarcoma]]
*[[Sarcoma]]
*Sebaceous carcinoma
*Sebaceous carcinoma<ref name="pmid29085717">{{cite journal |vauthors=Ribeiro F, Leocadia E, Macarenco RS, Lapins J, Huet P, Akay BN, Steiner D |title=Reticulated acanthoma with sebaceous differentiation mimicking melanoma |journal=Dermatol Pract Concept |volume=7 |issue=3 |pages=35–37 |date=July 2017 |pmid=29085717 |pmc=5661163 |doi=10.5826/dpc.0703a07 |url=}}</ref>
*[[Seborrheic keratosis]]
*[[Seborrheic keratosis]]<ref name="pmid28355453">{{cite journal |vauthors=Carrera C, Segura S, Aguilera P, Scalvenzi M, Longo C, Barreiro A, Broganelli P, Cavicchini S, Llambrich A, Zaballos P, Thomas L, Malvehy J, Puig S, Zalaudek I |title=Dermoscopic Clues for Diagnosing Melanomas That Resemble Seborrheic Keratosis |journal=JAMA Dermatol |volume=153 |issue=6 |pages=544–551 |date=June 2017 |pmid=28355453 |pmc=5540029 |doi=10.1001/jamadermatol.2017.0129 |url=}}</ref><ref name="pmid28915278">{{cite journal |vauthors=Braun RP, Ludwig S, Marghoob AA |title=Differential Diagnosis of Seborrheic Keratosis: Clinical and Dermoscopic Features |journal=J Drugs Dermatol |volume=16 |issue=9 |pages=835–842 |date=September 2017 |pmid=28915278 |doi= |url=}}</ref>
*Spindle cell squamous cell carcinoma
*Spindle cell squamous cell carcinoma<ref name="pmid24577111">{{cite journal |vauthors=Cohen DN, Lumbang WA, Boyd AS, Sosman JA, Zwerner JP |title=Spindle cell squamous carcinoma during BRAF inhibitor therapy for advanced melanoma: an aggressive secondary neoplasm of undetermined biologic potential |journal=JAMA Dermatol |volume=150 |issue=5 |pages=575–7 |date=May 2014 |pmid=24577111 |doi=10.1001/jamadermatol.2013.7784 |url=}}</ref>
*[[Squamous cell carcinoma]] of the skin
*[[Squamous cell carcinoma]] of the skin<ref name="pmid28947295">{{cite journal |vauthors=Boespflug A, Debarbieux S, Depaepe L, Chouvet B, Maucort-Boulch D, Dalle S, Balme B, Thomas L |title=Association of subungual melanoma and subungual squamous cell carcinoma: A case series |journal=J. Am. Acad. Dermatol. |volume=78 |issue=4 |pages=760–768 |date=April 2018 |pmid=28947295 |doi=10.1016/j.jaad.2017.09.038 |url=}}</ref>
*[[Hematoma|Traumatic hematoma]]
*[[Hematoma|Traumatic hematoma]]<ref name="pmid26333508">{{cite journal |vauthors=Tchernev G, Chokoeva AA, Wollina U, Lotti T |title=Persistent subungual and periungual hematoma versus melanoma: to cut it or to leave it? |journal=Dermatol Ther |volume=29 |issue=3 |pages=150–1 |date=May 2016 |pmid=26333508 |doi=10.1111/dth.12293 |url=}}</ref><ref name="pmid27745646">{{cite journal |vauthors=Deinlein T, Hofmann-Wellenhof R, Zalaudek I |title=Acral melanoma mimicking subungual hematoma |journal=J. Am. Acad. Dermatol. |volume=75 |issue=5 |pages=e181–e183 |date=November 2016 |pmid=27745646 |doi=10.1016/j.jaad.2016.02.1222 |url=}}</ref>
*[[Melanocytic nevus]] and other benign melanocytic lesions
*[[Melanocytic nevus]] and other benign melanocytic lesions<ref name="pmid28604751">{{cite journal |vauthors=Damsky WE, Bosenberg M |title=Melanocytic nevi and melanoma: unraveling a complex relationship |journal=Oncogene |volume=36 |issue=42 |pages=5771–5792 |date=October 2017 |pmid=28604751 |pmc=5930388 |doi=10.1038/onc.2017.189 |url=}}</ref>
*[[Nevus|Traumatized nevus]]
*[[Nevus|Traumatized nevus]]
*[[Venous lake]]
*[[Venous lake]]
*[[Vitiligo]]
*[[Vitiligo]]<ref name="pmid28317522">{{cite journal |vauthors=Rodrigues M |title=Skin Cancer Risk (Nonmelanoma Skin Cancers/Melanoma) in Vitiligo Patients |journal=Dermatol Clin |volume=35 |issue=2 |pages=129–134 |date=April 2017 |pmid=28317522 |doi=10.1016/j.det.2016.11.003 |url=}}</ref>


Oral melanoma must be differentiated from other mouth lesions such as oral candidiasis and aphthous ulcer
Oral melanoma must be differentiated from other mouth lesions such as oral candidiasis and aphthous ulcer

Revision as of 00:08, 3 January 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Serge Korjian M.D.

Overview

Melanoma must be differentiated from other causes of skin lesions, such as other skin cancers, premalignant skin tumors, and benign skin lesions.

Differential Diagnosis

Melanoma must be differentiated from other causes of skin lesions, such as:

Oral melanoma must be differentiated from other mouth lesions such as oral candidiasis and aphthous ulcer

Disease Presentation Risk Factors Diagnosis Affected Organ Systems Important features Picture
Diseases predominantly affecting the oral cavity
Oral Candidiasis
  • Denture users
  • As a side effect of medication, most commonly having taken antibiotics. Inhaled corticosteroids for the treatment of lung conditions (e.g, asthma or COPD) may also result in oral candidiasis which may be reduced by regularly rinsing the mouth with water after taking the medication.
  • Clinical diagnosis
  • Confirmatory tests rarely needed
Localized candidiasis

Invasive candidasis

Tongue infected with oral candidiasis - By James Heilman, MD - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=11717223.jpg
Herpes simplex oral lesions
  • Stress
  • Recent URTI
  • Female sex
  • The symptoms of primary HSV infection generally resolve within two weeks
Oral herpes simplex infection - By James Heilman, MD - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=19051042.jpg
Aphthous ulcers
  • Painful, red spot or bump that develops into an open ulcer
  • Physical examination
  • Diagnosis of exclusion
  • Oral cavity
  • Self-limiting , Pain decreases in 7 to 10 days, with complete healing in 1 to 3 weeks
By Ebarruda - Own work, CC BY-SA 3.0, httpscommons.wikimedia.orgwindex.phpcurid=7903358
Squamous cell carcinoma
Squamous cell carcinoma - By Luca Pastore, Maria Luisa Fiorella, Raffaele Fiorella, Lorenzo Lo Muzio - http://www.plosmedicine.org/article/showImageLarge.action?uri=info%3Adoi%2F10.1371%2Fjournal.pmed.0050212.g001, CC BY 2.5, https://commons.wikimedia.org/w/index.php?curid=15252632
Leukoplakia
  • Vulvar lesions occur independent of oral lesions
Leukoplakia - By Aitor III - Own work, Public Domain, https://commons.wikimedia.org/w/index.php?curid=9873087
Melanoma
Oral melanoma - By Emmanouil K Symvoulakis, Dionysios E Kyrmizakis, Emmanouil I Drivas, Anastassios V Koutsopoulos, Stylianos G Malandrakis, Charalambos E Skoulakis and John G Bizakis - Symvoulakis et al. Head & Face Medicine 2006 2:7 doi:10.1186/1746-160X-2-7 (Open Access), [1], CC BY-SA 2.0, https://commons.wikimedia.org/w/index.php?curid=9839811
Fordyce spots
Fordyce spots - Por Perene - Obra do próprio, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=19772899
Burning mouth syndrome
Torus palatinus
Torus palatinus - By Photo taken by dozenist, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=846591
Diseases involving oral cavity and other organ systems
Behcet's disease
Behcet's disease - By Ahmet Altiner MD, Rajni Mandal MD - http://dermatology.cdlib.org/1611/articles/18_2009-10-20/2.jpg, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=17863021
Crohn's disease
Agranulocytosis
Syphilis[25]
oral syphilis - By CDC/Susan Lindsley - http://phil.cdc.gov/phil_images/20021114/34/PHIL_2385_lores.jpg, Public Domain, https://commons.wikimedia.org/w/index.php?curid=2134349
Coxsackie virus
  • Symptomatic treatment
Hand-foot-and-mouth disease
Chicken pox
Chickenpox - By James Heilman, MD - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/w/index.php?curid=52872565
Measles
  • Unvaccinated individuals[26][27]
  • Crowded and/or unsanitary conditions
  • Traveling to less developed and developing countries
  • Immunocompromized
  • Winter and spring seasons
  • Born after 1956 and never fully vaccinated
  • Health care workers
Koplick spots (Measles) - By CDC - http://phil.cdc.gov/PHIL_Images/20040908/4f54ee8f0e5f49f58aaa30c1bc6413ba/6111_lores.jpg, Public Domain, https://commons.wikimedia.org/w/index.php?curid=824483

References

  1. Dumitrache N, Neiderer K, Martin B, Dancho J (2013). "Angiokeratoma presenting as a melanoma: a case report". J Am Podiatr Med Assoc. 103 (3): 241–2. PMID 23697732.
  2. Pujani M, Hassan MJ, Jetley S (2015). "Atypical fibroxanthoma in a young female misdiagnosed clinically as a malignant melanoma--An unusual presentation". J Cancer Res Ther. 11 (4): 1027. doi:10.4103/0973-1482.150353. PMID 26881598.
  3. AlJasser MI, Martinka M, Kalia S (January 2014). "Dermatofibroma mimicking melanoma dermoscopically". Clin. Exp. Dermatol. 39 (1): 69–70. doi:10.1111/ced.12155. PMID 24256198.
  4. Bahuau M, Vidaud D, Kujas M, Palangié A, Assouline B, Chaignaud-Lebreton M, Prieur M, Vidaud M, Harpey JP, Lafourcade J, Caille B (1997). "Familial aggregation of malignant melanoma/dysplastic naevi and tumours of the nervous system: an original syndrome of tumour proneness". Ann. Genet. 40 (2): 78–91. PMID 9259954.
  5. Uzzauto MT (January 2015). "Melanoma hidden in a hemangioma". J. Am. Acad. Dermatol. 72 (1 Suppl): S56–7. doi:10.1016/j.jaad.2014.07.011. PMID 25500044.
  6. Wakimoto H, Harada K, Arai T, Maeda T, Irisawa R, Tsuboi R (February 2017). "Reduced expression of the ATP2A2 gene in vemurafenib-induced keratoacanthoma-like papules in a melanoma patient". Int. J. Dermatol. 56 (2): e33–e35. doi:10.1111/ijd.13430. PMID 27805257.
  7. Charifa A, Chen C. PMID 29489150. Vancouver style error: initials (help); Missing or empty |title= (help)
  8. Imafuku K, Hata H, Yanagi T, Kitamura S, Inamura-Takashima Y, Nishimura M, Kitamura S, Moriwaki S, Shimizu H (July 2017). "Multiple skin cancers in patients with mycosis fungoides after long-term ultraviolet phototherapy". Clin. Exp. Dermatol. 42 (5): 523–526. doi:10.1111/ced.13121. PMID 28543586.
  9. Gu GM, Epstein JB, Morton TH (October 2003). "Intraoral melanoma: long-term follow-up and implication for dental clinicians. A case report and literature review". Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 96 (4): 404–13. doi:10.1016/S1079210403003202. PMID 14561964.
  10. Kelati A, Baybay H, Moscarella E, Argenziano G, Gallouj S, Mernissi FZ (November 2017). "Dermoscopy of Pigmented Actinic Keratosis of the Face: A Study of 232 Cases". Actas Dermosifiliogr. 108 (9): 844–851. doi:10.1016/j.ad.2017.05.002. PMID 28705516.
  11. Campagnoli TR, Medina CA, Singh AD (2016). "CHOROIDAL MELANOMA INITIALLY TREATED AS HEMANGIOMA: DIAGNOSTIC AND THERAPEUTIC CONSIDERATIONS". Retin Cases Brief Rep. 10 (2): 175–82. doi:10.1097/ICB.0000000000000220. PMID 26448544.
  12. Borgenvik TL, Karlsvik TM, Ray S, Fawzy M, James N (May 2017). "Blue nevus-like and blue nevus-associated melanoma: a comprehensive review of the literature". ANZ J Surg. 87 (5): 345–349. doi:10.1111/ans.13946. PMID 28318130.
  13. Hussain A, Sidiropoulos M, Das S, Munoz DG, Nijhawan N (June 2017). "Orbital cellular blue nevus complicated by malignant melanoma". Can. J. Ophthalmol. 52 (3): e111–e113. doi:10.1016/j.jcjo.2016.11.025. PMID 28576220.
  14. Ribeiro F, Leocadia E, Macarenco RS, Lapins J, Huet P, Akay BN, Steiner D (July 2017). "Reticulated acanthoma with sebaceous differentiation mimicking melanoma". Dermatol Pract Concept. 7 (3): 35–37. doi:10.5826/dpc.0703a07. PMC 5661163. PMID 29085717.
  15. Carrera C, Segura S, Aguilera P, Scalvenzi M, Longo C, Barreiro A, Broganelli P, Cavicchini S, Llambrich A, Zaballos P, Thomas L, Malvehy J, Puig S, Zalaudek I (June 2017). "Dermoscopic Clues for Diagnosing Melanomas That Resemble Seborrheic Keratosis". JAMA Dermatol. 153 (6): 544–551. doi:10.1001/jamadermatol.2017.0129. PMC 5540029. PMID 28355453.
  16. Braun RP, Ludwig S, Marghoob AA (September 2017). "Differential Diagnosis of Seborrheic Keratosis: Clinical and Dermoscopic Features". J Drugs Dermatol. 16 (9): 835–842. PMID 28915278.
  17. Cohen DN, Lumbang WA, Boyd AS, Sosman JA, Zwerner JP (May 2014). "Spindle cell squamous carcinoma during BRAF inhibitor therapy for advanced melanoma: an aggressive secondary neoplasm of undetermined biologic potential". JAMA Dermatol. 150 (5): 575–7. doi:10.1001/jamadermatol.2013.7784. PMID 24577111.
  18. Boespflug A, Debarbieux S, Depaepe L, Chouvet B, Maucort-Boulch D, Dalle S, Balme B, Thomas L (April 2018). "Association of subungual melanoma and subungual squamous cell carcinoma: A case series". J. Am. Acad. Dermatol. 78 (4): 760–768. doi:10.1016/j.jaad.2017.09.038. PMID 28947295.
  19. Tchernev G, Chokoeva AA, Wollina U, Lotti T (May 2016). "Persistent subungual and periungual hematoma versus melanoma: to cut it or to leave it?". Dermatol Ther. 29 (3): 150–1. doi:10.1111/dth.12293. PMID 26333508.
  20. Deinlein T, Hofmann-Wellenhof R, Zalaudek I (November 2016). "Acral melanoma mimicking subungual hematoma". J. Am. Acad. Dermatol. 75 (5): e181–e183. doi:10.1016/j.jaad.2016.02.1222. PMID 27745646.
  21. Damsky WE, Bosenberg M (October 2017). "Melanocytic nevi and melanoma: unraveling a complex relationship". Oncogene. 36 (42): 5771–5792. doi:10.1038/onc.2017.189. PMC 5930388. PMID 28604751.
  22. Rodrigues M (April 2017). "Skin Cancer Risk (Nonmelanoma Skin Cancers/Melanoma) in Vitiligo Patients". Dermatol Clin. 35 (2): 129–134. doi:10.1016/j.det.2016.11.003. PMID 28317522.
  23. Ann M. Gillenwater, Nadarajah Vigneswaran, Hanadi Fatani, Pierre Saintigny & Adel K. El-Naggar (2013). "Proliferative verrucous leukoplakia (PVL): a review of an elusive pathologic entity!". Advances in anatomic pathology. 20 (6): 416–423. doi:10.1097/PAP.0b013e3182a92df1. PMID 24113312. Unknown parameter |month= ignored (help)
  24. Andrès E, Zimmer J, Affenberger S, Federici L, Alt M, Maloisel F. (2006). "Idiosyncratic drug-induced agranulocytosis: Update of an old disorder". Eur J Intern Med. 17 (8): 529–35. Text "pmid 17142169" ignored (help)
  25. title="By Internet Archive Book Images [No restrictions], via Wikimedia Commons" href="https://commons.wikimedia.org/wiki/File:A_manual_of_syphilis_and_the_venereal_diseases%2C_(1900)_(14595882378).jpg"
  26. Feikin DR, Lezotte DC, Hamman RF, Salmon DA, Chen RT, Hoffman RE (2000). "Individual and community risks of measles and pertussis associated with personal exemptions to immunization". JAMA. 284 (24): 3145–50. PMID 11135778.
  27. Ratnam S, West R, Gadag V, Williams B, Oates E (1996). "Immunity against measles in school-aged children: implications for measles revaccination strategies". Can J Public Health. 87 (6): 407–10. PMID 9009400.


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