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1.
Dermatol Ther ; 35(2): e15229, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34820974

RESUMO

Carboxytherapy has been used in the treatment of autoimmune skin diseases such as psoriasis and morphea. Carboxytherapy has antioxidant effects, and leads to better tissue oxygenation, and release of growth factors. In this article, we decided to evaluate efficacy of combined carboxytherapy and narrowband-ultraviolet B (NB-UVB) compared to NB-UVB alone in the treatment of vitiligo. This is a prospective, split-body double-blind comparative study performed in patients with generalized stable vitiligo in acral areas and extremities referred to dermatology clinic of Afzalipour hospital in Kerman University of Medical Sciences. NB-UVB was performed three times a week in non-consecutive days for 4 months. In each patient, one lesion was randomly treated with carboxytherapy (weekly sessions for total of 16 sessions). Efficacy of treatment was evaluated by percentage of repigmentation of the lesions. Chi-square test and analysis of variance test (ANOVA) were used to compare efficacy of treatment based on demographic features of the patients and clinical features of the lesions, respectively. Twenty-eight patients with mean age of 32.35 ± 7.37 years old completed the study. At the end of the treatment, 37% of the patients in combination therapy group demonstrated more than 75% improvement compared to 0% in the monotherapy group (p = 0.001). There was no significant difference between either demographic features of the patients (age, sex, and skin phototypes) or duration of disease with efficacy of the treatment in both groups. Combination of carboxytherapy with NB-UVB leads to higher percentage of repigmentation and patients' satisfaction compared to monotherapy with NB-UVB.


Assuntos
Terapia Ultravioleta , Vitiligo , Adulto , Terapia Combinada , Humanos , Estudos Prospectivos , Pele/patologia , Resultado do Tratamento , Terapia Ultravioleta/efeitos adversos , Vitiligo/diagnóstico , Vitiligo/tratamento farmacológico , Vitiligo/radioterapia , Adulto Jovem
2.
Dermatol Ther ; 35(2): e15226, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34820993

RESUMO

Cutaneous homeostasis can be modulated by sleep. Although there is little evidence about the efficacy of medications topically applied in the morning compared to those administered in the evening, they are commonly prescribed to be used overnight. Poor sleep may affect the tegument, but its repercussion on dermatological therapy is not clear. This communication aims to carry out an overview on the relationship between sleep and the skin, particularly in respect of the effectiveness of topical substances during the night versus the day; and the possible impact of sleep dysregulation on these treatments. Features related to this external organ, involving hydration, blood flow, and the permeability of the superficial barrier have physiological variations in sleep period. Our hypothesis is that sleep loss could alter drug absorption in the dermis and impair the success of the treatment. This can depend on the integrity of the mechanical skin barrier, and the enzymatic process after drug penetration, which may be influenced by the circadian rhythm. We raise the role of sleep disturbance in relation to skin aging and the cutaneous microbiota. The organ integrity and local immunology can be guided by sleep distress, which can modify the control of dermatological diseases. Future comparative analyses are warranted to explore the possible changes of the integumentary system influenced by circadian rhythm, and interference in response to topical dermal treatments. We emphasize the importance of sufficient sleep to improve the clinical management of several dermatosis and cosmetic complaints that need percutaneous therapeutics.


Assuntos
Distúrbios do Início e da Manutenção do Sono , Transtornos do Sono-Vigília , Humanos , Regeneração , Pele , Sono/fisiologia , Transtornos do Sono-Vigília/tratamento farmacológico , Transtornos do Sono-Vigília/etiologia
4.
Dermatologie (Heidelb) ; 73(7): 563-574, 2022 Jul.
Artigo em Alemão | MEDLINE | ID: mdl-35925205

RESUMO

The imaging of changes to the skin, the subcutis and especially the regional lymph nodes by high-resolution ultrasound is an integral part of routine dermatological diagnostics. This is mainly done with electronic scanners operating at frequencies between 7.5 and 20 MHz (conventional ultrasound diagnostics). In addition, there are very high-frequency ultrasound systems (frequencies up to 100 MHz) that are used for special scientific questions. Ultrasound diagnostics has a number of advantages over other cross-sectional imaging techniques but is more dependent than these on the individual experience of the examiner. Structured training and continuing education are therefore essential for ultrasound diagnostics, also in dermatology. The following overview describes the most important indications for conventional sonography in dermatology in addition to the physical, technical and administrative principles.


Assuntos
Dermatologia , Dermatologia/métodos , Linfonodos/diagnóstico por imagem , Pele/diagnóstico por imagem , Ultrassonografia/métodos
5.
BMC Med Genomics ; 15(1): 175, 2022 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-35933451

RESUMO

Sulfur mustard (SM) is an alkylating and forming chemical that was widely used by Iraqi forces during the Iran-Iraq wars. One of the target organs of SM is the skin. Understanding the mechanisms involved in the pathogenesis of SM may help better identify complications and find appropriate treatments. The current study collected ten SM-exposed patients with long-term skin complications and ten healthy individuals. Proteomics experiments were performed using the high-efficiency TMT10X method to evaluate the skin protein profile, and statistical bioinformatics methods were used to identify the differentially expressed proteins. One hundred twenty-nine proteins had different expressions between the two groups. Of these 129 proteins, 94 proteins had increased expression in veterans' skins, while the remaining 35 had decreased expression. The hub genes included RPS15, ACTN1, FLNA, HP, SDHC, and RPL29, and three modules were extracted from the PPI network analysis. Skin SM exposure can lead to oxidative stress, inflammation, apoptosis, and cell proliferation.


Assuntos
Substâncias para a Guerra Química , Doença Enxerto-Hospedeiro , Gás de Mostarda , Veteranos , Substâncias para a Guerra Química/toxicidade , Humanos , Gás de Mostarda/toxicidade , Proteômica , Pele
6.
Mediators Inflamm ; 2022: 6206883, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35909660

RESUMO

Atopic dermatitis (AD) is a chronic skin inflammatory disease associated with immune abnormalities and disrupted skin barrier function. Mesenchymal stem cells (MSCs) have been suggested as an alternative therapeutic option in AD. Stem cells from human exfoliated deciduous teeth (SHEDs) are a unique postnatal stem cell population with high immunomodulatory properties. The aim of this study was to explore the effects of SHEDs on AD in the BALB/c mouse model induced by 2,4-dinitrochlorobenzene (DNCB). SHEDs were administrated intravenously or subcutaneously, and clinical severity, histopathological findings, skin barrier function, and organ indexes were evaluated. Skin tissue cytokine mRNA levels and serum cytokine protein levels were further analysed. SHED administration significantly alleviated AD clinical severity, including dermatitis scores, ear thickness, scratching behaviour, and infiltration of mast cells. In addition, disrupted skin barrier function and enlarged spleens were restored by SHED administration. Further, SHED treatment reduced the levels of IgE, IgG1, and thymic stromal lymphopoietin (TSLP) in the serum and the modulated expression of Th1-, Th2-, and Th17-associated cytokines in skin lesions. In conclusion, SHEDs attenuated AD-like skin lesions in mice by modulating the immune balance and skin barrier function. SHEDs could be a potential new treatment agent for AD.


Assuntos
Dermatite Atópica , Animais , Citocinas/metabolismo , Dermatite Atópica/tratamento farmacológico , Dinitroclorobenzeno , Modelos Animais de Doenças , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Pele/metabolismo , Células-Tronco/metabolismo , Dente Decíduo
7.
J Immunol Res ; 2022: 8286498, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35910853

RESUMO

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that affects multiple systems. Its clinical manifestation varies across patients, from skin mucosa to multiorgan damage to severe central nervous system involvement. The exosome has been shown to play an important role in the pathogenesis of autoimmune diseases, including SLE. We review the recent knowledge of exosomes, including their biology, functions, mechanism, and standardized extraction and purification methods in SLE, to highlight potential therapeutic targets for SLE.


Assuntos
Exossomos , Lúpus Eritematoso Sistêmico , Humanos , Lúpus Eritematoso Sistêmico/terapia , Pele
8.
Int J Hyperthermia ; 39(1): 1017-1025, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35912525

RESUMO

INTRODUCTION: This study aims to investigate the feasibility of a noninvasive handheld electroporation pulses delivery device (EPDD) for electroporation-based treatment (EBT) of skin superficial lesions through numerical analysis and animal study. METHODS: Finite element analysis was performed to investigate the performance of the EPDD. The electric field, temperature, EI and TI were calculated under pulse voltages of 600, 800, and 1000 V. A mouse subcutaneous tumor model was established to evaluate the performance of the EPDD through histopathology and survival analyses. RESULTS: The electrical field strength increased from 151 (600 V) to 252 V/cm (1000 V) in the skin and from 1302 (600 V) to 2171 V/cm (1000 V) in the tumor. The volume of EI grew and reached a plateau at the 165th pulse, whereas the maximum volume of EI increased with higher voltage. The growth tendency of TI differed between groups, and it was higher in the high-voltage group (HVG) than in the low-voltage group. Histopathological analysis showed that the depth and range of the ablation area could be controlled by adjusting pulse voltage. Survival analysis showed that the survival of the HVG was better than that of the low-voltage and the control group (p < 0.01). CONCLUSIONS: The results demonstrate that the EPDD is feasible, safe, and effective for skin EBT. The volume of EP tissue injury can be controlled by adjusting the pulse voltage, pulse number, and other parameters. The proposed noninvasive handheld EPDD can be a potential therapeutic tool for EBT of superficial skin lesions in the future.


Assuntos
Eletroporação , Pele , Animais , Modelos Animais de Doenças , Eletroporação/métodos , Camundongos
9.
Sci Rep ; 12(1): 13185, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35915131

RESUMO

Multiple human sensory systems exhibit sensitivity to spatial and temporal variations of physical stimuli. Vision has evolved to offer high spatial acuity with limited temporal sensitivity, while audition has developed complementary characteristics. Neural coding in touch has been believed to transition from a spatial to a temporal domain in relation to surface scale, such that coarse features (e.g., a braille cell or corduroy texture) are coded as spatially distributed signals, while fine textures (e.g., fine-grit sandpaper) are encoded by temporal variation. However, the interplay between the two domains is not well understood. We studied tactile encoding with a custom-designed pin array apparatus capable of deforming the fingerpad at 5 to 80 Hz in each of 14 individual locations spaced 2.5 mm apart. Spatial variation of skin indentation was controlled by moving each of the pins at the same frequency and amplitude, but with phase delays distributed across the array. Results indicate that such stimuli enable rendering of shape features at actuation frequencies up to 20 Hz. Even at frequencies > 20 Hz, however, spatial variation of skin indentation continues to play a vital role. In particular, perceived roughness is affected by spatial variation within the fingerpad even at 80 Hz. We provide evidence that perceived roughness is encoded via a summary measure of skin displacement. Relative displacements in neighboring pins of less than 10 µm generate skin stretch, which regulates the roughness percept.


Assuntos
Percepção do Tato , Humanos , Pele , Tato/fisiologia
10.
PLoS One ; 17(8): e0272169, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35917312

RESUMO

Microneedle patches are a promising source for transdermal diffusion of macromolecules and are designed to painlessly penetrate the skin. In this study, a biodegradable chitosan microneedle patch to deliver meloxicam for managing pain in cattle was tested. The potential of reuse of the polymeric solution to fabricate the patches, optimization of fabrication, morphological analysis of the microneedle patch and analysis of preservation of the chemical composition after sterilization were evaluated. In-vitro analysis consisted of studying in-vitro penetration mechanical properties, compression testing analysis of microneedle patch, and in-vitro drug release analysis. In-vivo studies were performed to analyze the dissolution capability of the microneedle patch. Results regarding the physical characteristics, chemical composition, and mechanical properties confirmed that rheological properties of the chitosan solution, present significant differences over time, demonstrating that reusing the solution on the fourth day results in failure patches. Morphological characteristics and chemical composition studies revealed that the process of sterilization (ethylene oxide gas) needed for implanting the patches into the skin did not affect the properties of microneedle patches. In-vitro studies showed that approximately 33.02 ± 3.88% of the meloxicam was released over 7 days. A full penetration of the microneedles into the skin can be obtained by applying approximately 3.2 N. In-vivo studies demonstrated that microneedle patches were capable of swelling and dissolving, exhibiting a dissolution percentage of more than 50% of the original height of microneedle after 7 days. No abnormal tissue, swelling, or inflammation was observed in the implanted area. The results of this work show that chitosan biodegradable microneedle patches may be useful to deliver meloxicam to improve pain management of cattle with positive effects for commercial manufacturing.


Assuntos
Quitosana , Administração Cutânea , Animais , Bovinos , Quitosana/química , Sistemas de Liberação de Medicamentos/métodos , Meloxicam/farmacologia , Agulhas , Dor/tratamento farmacológico , Dor/veterinária , Manejo da Dor , Pele , Adesivo Transdérmico
11.
Zhonghua Nei Ke Za Zhi ; 61(8): 883-892, 2022 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-35922212

RESUMO

Psoriatic arthritis is a chronic systemic autoimmune disease, characterized by psoriasis skin lesions and inflammation of the spine and joint. It has complicated clinical manifestations and individual variations. Nearly half of the patients will have joints erosion in two years, which is crippling. The severity of the skin and joint disease frequently do not correlate with each other. Currently, the understanding of the disease is insufficient in China with the lack of standardized diagnosis and treatment. Therefore, researchers from the Chinese Rheumatology Association formulated this specification based on the diagnosis and management experience together with guidelines at home and abroad. The specification summarizes the present situation of domestic diagnosis and treatment, aiming to standardize the diagnosis process and treatment protocols of psoriatic arthritis. Furthermore, it can reduce misdiagnosis and missed diagnosis, as well as improve the prognosis.


Assuntos
Artrite Psoriásica , Psoríase , Reumatologia , Artrite Psoriásica/diagnóstico , Artrite Psoriásica/terapia , China , Humanos , Prognóstico , Psoríase/diagnóstico , Pele
12.
Dermatol Surg ; 48(8): 797-801, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35917259

RESUMO

BACKGROUND: Sebaceous adenocarcinoma (SAC) mostly occurs in the elderly, and SAC in young and middle-aged population is inadequately investigated. OBJECTIVE: To explore the clinical features and prognosis of young and middle-aged adults with SAC. MATERIALS AND METHODS: Patients with skin SAC between ages 18 and 59 years from the Surveillance, Epidemiology, and End Results database (1975-2016) were eligible for this study. RESULTS: Seven hundred thirty-nine cases were identified. The proportion of extraocular SAC in the nonelderly increased from 1975-2005 to 2006-2016 ( p = .001), male predominance was observed in overall patients whereas female predominance in Asian population, and young patients had more head and neck SAC than middle-aged patients ( p = .014). The prognosis of young patients was better than middle-aged patients ( p = .004). Other independent prognostic factors included sex, marital status, tumor size, surgery, chemotherapy, and multiple primary cancer history. CONCLUSION: An increasing proportion of extraocular SAC was observed in young and middle-aged patients, and the young developed more head and neck SAC than the middle-aged. Female predominance was found in Asian population, and female patients had better prognosis. Younger age and married status indicated better prognosis, and around 20% of young and middle-aged patients might have poorer survival because of Muir-Torre syndrome.


Assuntos
Adenocarcinoma Sebáceo , Síndrome de Muir-Torre , Neoplasias das Glândulas Sebáceas , Adenocarcinoma Sebáceo/patologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Neoplasias das Glândulas Sebáceas/epidemiologia , Neoplasias das Glândulas Sebáceas/patologia , Neoplasias das Glândulas Sebáceas/terapia , Pele/patologia , Adulto Jovem
13.
Dermatol Surg ; 48(8): 802-808, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35917260

RESUMO

BACKGROUND: Blue light is the most energetic portion of the visible light spectrum. Recent awareness of its ubiquity and potential has led to greater developments in therapeutic uses. OBJECTIVE: Provide up-to-date information on the effects of blue light on the skin, with a focus on the benefits and its place in therapeutic modalities within dermatology. MATERIALS AND METHODS: A systematic review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for articles related to blue light's effect on the skin and therapeutic modalities using blue light. This search resulted in 223 unique results with 60 articles selected for review. RESULTS: Therapeutic modalities using blue light have been proven to be effective as a monotherapy or component of a comprehensive treatment plan for common dermatologic diseases such as actinic keratosis, acne, cutaneous infections, and psoriasis, and early reports support its use in disseminated superficial actinic porokeratosis and actinic cheilitis. CONCLUSION: The benefits and treatment applications of blue light have proven effective in multiple forms and uses. In the correct setting, blue light can be a useful tool to the practicing dermatologist for many common and sometimes refractory skin diseases while remaining low-risk and convenient. Further standardization and monitoring should be pursued to determine the most appropriate use.


Assuntos
Ceratose Actínica , Fotoquimioterapia , Poroceratose , Humanos , Ceratose Actínica/tratamento farmacológico , Luz , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Pele
15.
AAPS PharmSciTech ; 23(6): 212, 2022 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-35918472

RESUMO

Squamous cell carcinoma (SCC) represents 20% of cases of non-melanoma skin cancer, and the most common treatment is the removal of the tumor, which can leave large scars. 5-Fluorouracil (5FU) is a drug used in the treatment of SCC, but it is highly hydrophilic, resulting in poor skin penetration in topical treatment. Some strategies can be used to increase the cutaneous penetration of the drug, such as the combination of liposomes containing penetration enhancers, for instance, surfactants, associated with the use of microneedling. Thus, the present work addresses the development of liposomes with penetration enhancers, such as sorbtitan monolaurate, span 20, for topical application of 5-FU and associated or not with the use of microneedling for skin delivery. Liposomes were developed using the lipid film hydration, resulting in particle size, polydispersity index, zeta potential, and 5-FU encapsulation efficiency of 88.08 nm, 0.169, -12.3 mV, and 50.20%, respectively. The presence of span 20 in liposomes potentiated the in vitro release of 5-FU. MTT assay was employed for cytotoxicity evaluation and the IC50 values were 0.62, 30.52, and 24.65 µM for liposomes with and without span 20 and 5-FU solution, respectively after 72-h treatment. Flow cytometry and confocal microscopy analysis evidenced high cell uptake for the formulations. In skin penetration studies, a higher concentration of 5-FU was observed in the epidermis + dermis, corresponding to 1997.71, 1842.20, and 2585.49 ng/cm2 in the passive penetration and 3214.07, 2342.84, and 5018.05 ng/cm2 after pretreatment with microneedles, for solution, liposome without and with span 20, respectively. Therefore, herein, we developed a nanoformulation for 5-FU delivery, with suitable physicochemical characteristics, potent skin cancer cytotoxicity, and cellular uptake. Span 20-based liposomes increased the skin penetration of 5-FU in association of microneedling. Altogether, the results shown herein evidenced the potential of the liposome containing span 20 for topical delivery of 5-FU.


Assuntos
Fluoruracila , Neoplasias Cutâneas , Hexoses , Humanos , Lipossomos/metabolismo , Tamanho da Partícula , Pele/metabolismo , Absorção Cutânea , Neoplasias Cutâneas/tratamento farmacológico , Neoplasias Cutâneas/metabolismo
16.
Med Sci Monit ; 28: e936713, 2022 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-35918878

RESUMO

BACKGROUND Accurate estimation of burn depth is crucial for correct treatment decision making. Bromelain-based enzymatic debridement (ED) may improve clinical assessment of burn depth. Laser Doppler imaging (LDI) provides a valuable indicator of burn depth by analyzing microcirculation within tissue beds. This study aimed to evaluate bromelain-based enzymatic debridement combined with laser Doppler imaging and healing of 42 wounds in 19 patients with mixed second- and third-degree thermal burns. MATERIAL AND METHODS We included 42 wounds in 19 patients with mixed deep dermal and full-thickness thermal burns. All patients were treated with eschar-specific removal agent for ED. The perfusion of each wound after ED was assessed using LDI. Healing time was estimated by 2 experienced burn surgeons and marked by the observation of epithelization. The usefulness of the LDI performed after ED in predicting healing time was estimated. The findings were analyzed to determine a cut-off value for LDI that indicates if a burn will heal spontaneously. RESULTS We observed that burn wounds with higher mean perfusion healed faster. The analysis showed a strong relationship between perfusion after ED and healing time (Spearman rank correlation coefficient=-0.803). A mean perfusion greater than 296.89 indicated that the wound could heal spontaneously and does not require skin grafting. CONCLUSIONS LDI examination of an already debrided wound allows for a reliable assessment of perfusion at an early stage of treatment. The use of a safe and effective debridement method in conjunction with a non-invasive diagnostic tool could improve burn management.


Assuntos
Bromelaínas , Queimaduras , Bromelaínas/farmacologia , Bromelaínas/uso terapêutico , Queimaduras/diagnóstico por imagem , Queimaduras/terapia , Desbridamento/métodos , Humanos , Lasers , Pele , Cicatrização
18.
Cell Stem Cell ; 29(8): 1161-1180, 2022 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-35931028

RESUMO

Fibroblasts are highly dynamic cells that play a central role in tissue repair and fibrosis. However, the mechanisms by which they contribute to both physiologic and pathologic states of extracellular matrix deposition and remodeling are just starting to be understood. In this review article, we discuss the current state of knowledge in fibroblast biology and heterogeneity, with a primary focus on the role of fibroblasts in skin wound repair. We also consider emerging techniques in the field, which enable an increasingly nuanced and contextualized understanding of these complex systems, and evaluate limitations of existing methodologies and knowledge. Collectively, this review spotlights a diverse body of research examining an often-overlooked cell type-the fibroblast-and its critical functions in wound repair and beyond.


Assuntos
Fibroblastos , Cicatrização , Matriz Extracelular/patologia , Fibroblastos/patologia , Fibrose , Humanos , Pele/patologia , Cicatrização/fisiologia
19.
Facial Plast Surg Clin North Am ; 30(3): 291-300, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35934431

RESUMO

Photoaging is a complex process of skin changes associated with chronic ultraviolet exposure. Prevention with photoprotection and treatment with topical retinoids are the core components of a topical antiaging regimen. Other topicals such as hydroquinone, vitamin C, niacinamide, and alpha hydroxyl acid can be added based on specific concerns. However, caution must be used with some of these products as the stability and absorption are major considerations. A simple topical regimen will reduce irritability and enhance compliance.


Assuntos
Rejuvenescimento , Envelhecimento da Pele , Humanos , Retinoides/uso terapêutico , Pele
20.
Facial Plast Surg Clin North Am ; 30(3): 301-308, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35934432

RESUMO

Hyaluronic acid (HA) is the most common dermal filler in use. It improves wrinkles and volume loss not only by filling and volumizing but also by hydrating the injected area with its water affinity. It is a naturally occurring component of skin, and there is a negligible risk of immunologic or allergic reaction with injection. It is rapidly degraded by the injection of hyaluronidase, thus creating an ideal injectable material that is low risk and reversible. Its duration of effect may be longer than expected based on bioavailability of the HA product due to collagen synthesis or fibroblast stimulation.


Assuntos
Técnicas Cosméticas , Preenchedores Dérmicos , Envelhecimento da Pele , Preenchedores Dérmicos/efeitos adversos , Humanos , Ácido Hialurônico/efeitos adversos , Hialuronoglucosaminidase/uso terapêutico , Reologia , Pele
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