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Piquero-Casals J, Morgado-Carrasco D, Rozas-Muñoz E, Mir-Bonafé JF, Trullàs C, Jourdan E, Piquero-Martin J, Zouboulis CC, Krutmann J. Sun exposure, a relevant exposome factor in acne patients and how photoprotection can improve outcomes. J Cosmet Dermatol 2023; 22:1919-1928. [PMID: 36946555 DOI: 10.1111/jocd.15726] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 02/21/2023] [Accepted: 03/03/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Acne pathophysiology includes a complex interaction among inflammatory mediators, hyperseborrhea, alteration of keratinization and follicular colonization by Propionibacterium acnes. AIMS To describe the impact of the exposome on acne and how photoprotection can improve outcomes. METHODS A narrative review of the literature was carried out; searches with Google Scholar and Pubmed from January 1992 to November 2022 were performed. The keywords used were "acne," "sunscreens," "photoprotection," "cosmetics," "cosmeceuticals," "pathogenesis," "etiology," "exposome," "sunlight," "stress," "lack of sleep," "diet," "postinflammatory hyperpigmentation," "pollution," "exposome," "ultraviolet radiation," and "visible light." RESULTS Environmental factors such as solar radiation, air pollution, tobacco consumption, psychological stress, diverse microorganisms, nutrition, among others, can trigger or worsen acne. Solar radiation can temporarily improve lesions. However, it can induce proinflammatory and profibrotic responses, and produce post-inflammatory hyperpigmentation and/or post-inflammatory erythema. While photoprotection is widely recommended to acne patients, only four relevant studies were found. Sunscreens can significantly improve symptomatology or enhance treatment and can prevent post-inflammatory hyperpigmentation. Furthermore, they can provide camouflage and improve quality of life. Based on acne pathogenesis, optimal sunscreens should have emollient, antioxidant and sebum controlling properties. CONCLUSIONS The exposome and solar radiation can trigger or worsen acne. UV light can induce post-inflammatory hyperpigmentation/erythema, and can initiate flares. The use of specifically formulated sunscreens could enhance adherence to topical or systemic therapy, camouflage lesions (tinted sunscreens), decrease inflammation, and reduce the incidence of post-inflammatory hyperpigmentation/erythema.
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Affiliation(s)
- J Piquero-Casals
- Department of Dermatology, Clínica Dermatológica Multidisciplinar Dermik, Barcelona, Spain
| | - D Morgado-Carrasco
- Department of Dermatology, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain
| | - E Rozas-Muñoz
- Department of Dermatology, Hospital San Pablo, Coquimbo, Chile
| | - J F Mir-Bonafé
- Department of Dermatology, Hospital Son Llàtzer, Palma de Mallorca, Spain
| | - C Trullàs
- Innovation and Development, ISDIN, Barcelona, Spain
| | - E Jourdan
- Innovation and Development, ISDIN, Barcelona, Spain
| | - J Piquero-Martin
- Department of Dermatology, Instituto de Biomedicina, Universidad Central de Venezuela, Caracas, Venezuela
| | - C C Zouboulis
- Departments of Dermatology, Venereology, Allergology and Immunology, Dessau Medical Center, Brandenburg Medical School Theodor Fontane and Faculty of Health Sciences Brandenburg, Dessau, Germany
| | - J Krutmann
- IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
- Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany
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Toy J, Wan V, Lee DG, Liu C, Fleming P, Lynde C. Perspectives and knowledge of acne vulgaris among young adolescents. Pediatr Dermatol 2022; 40:308-311. [PMID: 36576107 DOI: 10.1111/pde.15230] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 12/09/2022] [Indexed: 12/29/2022]
Abstract
Acne occurs in up to 90% of young adolescents, but prior research has found that this population exhibits a limited understanding of acne and is vulnerable to myths and misinformation accumulated from family members, friends, and social media. We created a virtual presentation on skin hygiene, acne prevention, and acne-associated stigma for adolescent youth (aged 9-13) to improve acne health literacy, which was reviewed by three board-certified dermatologists. A descriptive cross-sectional study using data collected for quality improvement (n = 209, total) revealed that approximately half (n = 102/202, 50.5%) of all students believed that acne could not be treated with medications, only 34.0% (n = 67/197) believed acne could impact their mental health, and most students incorrectly believed that dirt buildup (n = 124/209, 59.3%) and poor hygiene (n = 125/209, 59.8%) were pathogenic for acne. Our results stress the necessity of early evidence-based educational interventions as a cornerstone to breaking self-perpetuating myths and misinformation that may lead to acne mismanagement, delayed access to healthcare, and permanent scarring later in life.
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Affiliation(s)
- Jeffrey Toy
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Vincent Wan
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Dong Goo Lee
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Chaocheng Liu
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Patrick Fleming
- Division of Dermatology, University of Toronto, Toronto, Ontario, Canada
| | - Charles Lynde
- Division of Dermatology, University of Toronto, Toronto, Ontario, Canada.,The Lynde Institute for Dermatology, Markham, Ontario, Canada
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Zdrada J, Odrzywołek W, Stolecka-Warzecha A, Wilczyński S, Błońska-Fajfrowska B. The influence of cosmetics dedicated to oily and acne-prone skin on skin parameters. J Cosmet Dermatol 2022; 21:6092-6099. [PMID: 35665586 DOI: 10.1111/jocd.15143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/24/2022] [Accepted: 06/02/2022] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Patient compliance with care recommendations is closely related to the role of cosmetics in delaying or preventing the side effects of medications used to treat acne. METHODS A total of 33 volunteers with symptoms of acne vulgaris were qualified for the study. The skin parameters were measured before the experiment, after the 4 and at the 8 weeks of use. The measurements were subject to moisturizing the skin and secretion of sebum and skin color. A skin acoustic parameters using high-frequency ultrasound (33 MHz) was also performed. The recorded images were used to determine the epidermal entrance echo thickness and echo density of dermis. RESULTS The results show a change in the value of skin parameters during the 8-week application of a specific skin care procedure. The secretion of sebum did not change significantly, there was a decrease in hydration, and the level of melanin and hemoglobin remained at the same level. The thickness of the epidermis entrance echo in the ultrasound image was thinned. CONCLUSION For many mild/moderate acne patients, cosmetics proven to be effective and well tested in clinical trials can offer a real benefit in reducing both inflammation, sebum production, melanin, and irritation, but should also be moisturizing.
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Affiliation(s)
- Julita Zdrada
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Wiktoria Odrzywołek
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Anna Stolecka-Warzecha
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Sławomir Wilczyński
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
| | - Barbara Błońska-Fajfrowska
- Department of Basic Biomedical Science, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Katowice, Poland
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Attia M, Ibrahim FA, Elsady MAE, Khorkhash MK, Rizk MA, Shah J, Amer SA. Cognitive, emotional, physical, and behavioral stress-related symptoms and coping strategies among university students during the third wave of COVID-19 pandemic. Front Psychiatry 2022; 13:933981. [PMID: 36186888 PMCID: PMC9523087 DOI: 10.3389/fpsyt.2022.933981] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background Stress is manifested by different physical, cognitive, emotional, and behavioral stress-related symptoms, and everyone experiences it uniquely. The COVID-19 Pandemic has tremendously affected university students' lives. So, we conducted this study to determine the stress frequency, causes, determinants, and related symptoms involving physical, cognitive, emotional, and behavioral traits and coping strategies among university students in Egypt during the third wave of the COVID-19 pandemic, 2021. Methods Cross-sectional study targeted 1,467 randomly selected undergraduate university students, representing all colleges from 30 universities in Egypt, through a validated self-administrated questionnaire. Results The total stress-related symptom score was statistically significant (p < 0.05), higher among females, married, living on campus, with a (B) GPA, and those who had both organic and psychological disorders. The top 10 prevalent physical symptoms were headaches, chronic fatigue, hair loss, low back pain, neck pain, shoulders and arm pain, ophthalmological symptoms, acne, shakiness of extremities, and palpitations, respectively. The most reported symptoms regarding the cognitive, emotional, and behavioral aspects were anxiety and racing thoughts, moodiness and irritability, and excessive sleeping, respectively. Nine hundred and thirty-seven (63.9%) reported that the COVID-19 pandemic badly affected their lives, either directly or indirectly. The study showed that the prevalence of stress among university students is more than 97%. One thousand and five (68.5%) preferred isolation as a relieving technique. Conclusion Stress and its related physical, cognitive, emotional, and behavioral symptoms are prevalent among university students. Most of the university students who were recruited reported that the COVID-19 pandemic badly affected their lives and used negative ways to deal with stress, like staying alone and sleeping too much. Positive ways to deal with stress, like seeing a therapist or meditating, were less common.
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Affiliation(s)
- Merna Attia
- Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | | | | | | | - Jaffer Shah
- New York State Department of Health, New York, NY, United States
| | - Samar A. Amer
- Department of Public Health and Community Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
- Member at Royal Colleague of General Practitioners [INT], London, United Kingdom
- Department of Mental Health Primary Care, Nova University, Lisbon, Portugal
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Yaqoob S, Saleem A, Jarullah FA, Asif A, Essar MY, Emad S. Association of Acne with Face Mask in Healthcare Workers Amidst the COVID-19 Outbreak in Karachi, Pakistan. Clin Cosmet Investig Dermatol 2021; 14:1427-1433. [PMID: 34675578 PMCID: PMC8504703 DOI: 10.2147/ccid.s333221] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/28/2021] [Indexed: 12/11/2022]
Abstract
Background In the wake of coronavirus (COVID-19) global alert, people have begun to practice safety measures in order to reduce the exposure to life-threatening disease. The largest at risk population is undoubtedly the frontline healthcare workers (HCWs) who are using personal protective equipment (PPE), essentially face masks, to battle against this deadly virus. This study was conducted with the prime intention to reveal an association between face mask and acne and measure the prevalence of acne amongst HCWs amidst COVID-19 outbreak in Karachi. Furthermore, this study aimed to identify the type of mask generating acne, locate the common sites, assess the severity and establish an association of mask use with the skin type. Methods This cross-sectional study was carried out at Medicare Cardiac and General Hospital, Jinnah Medical College Hospital, Jinnah Postgraduate Medical Centre and Jamal Noor Hospital located in Karachi, Pakistan. A total of 348 HCWs were interviewed, of which only 193 met the inclusion criteria. All information was recorded on a predesigned proforma and analyzed using SPSS 25.0. Results Among 193 participants, acne was prevalent in 103 (53.4%) participants with maximum cases reported in female HCWs, and in doctors (p<0.05). Out of 73 HCWs using N-95 masks, 46 (44.7%) developed acne, with a p-value of 0.036. Skin type and past history of acne also yielded statistically significant results. Among all the skin types, HCWs with oily skin (64, 62.1%) were prone to face resurgence of acne or new-onset acne. The most common sites of eruption of acne were along the cheeks (45.1%) followed by the nose (40.9%). Majority of the population suffered from mild acne. Moderate and severe acne eruption was particularly observed in those wearing N-95 and surgical masks. Conclusion The use of face masks is associated with high rates of acne eruption. Disseminating the guidelines and indications of World Health Organization (WHO) regarding proper use of mask, encouraging awareness among HCWs and following proper doffing and donning protocol as endorsed by Centers for Disease Control and Prevention (CDC) will possibly minimize the adverse reactions.
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Affiliation(s)
- Sadia Yaqoob
- Department of Medicine, Jinnah Medical and Dental College, Karachi, Pakistan
| | - Amna Saleem
- Department of Medicine, Jinnah Medical and Dental College, Karachi, Pakistan
| | | | - Areeba Asif
- Department of Medicine, Jinnah Medical and Dental College, Karachi, Pakistan
| | - Mohammad Yasir Essar
- Department of Dentistry, Kabul University of Medical Sciences, Kabul, Afghanistan
| | - Shaista Emad
- Department of Biochemistry, Sohail University, Karachi, Pakistan
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Adolescents' beliefs and perceptions of acne vulgaris: A cross-sectional study in Montenegrin schoolchildren. PLoS One 2021; 16:e0253421. [PMID: 34133464 PMCID: PMC8208562 DOI: 10.1371/journal.pone.0253421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/06/2021] [Indexed: 11/19/2022] Open
Abstract
Background Acne is a common chronic inflammatory skin disease with a high prevalence in adolescent and early adult years. The aim of this study was to assess the self-perceived beliefs of Montenegrin secondary school pupils regarding the acne aggravating and ameliorating factors. Methods This cross-sectional survey of the pupils was conducted during October and November 2020 in four randomly selected public secondary schools in Podgorica, Montenegro. All 500 pupils were asked to fill in a questionnaire that included questions on age, sex, presence of acne, perceived acne aggravating and ameliorating factors, and sources of their information about acne. Results A total of 500 pupils, 234 (46.8%) boys, and 266 (53.2%) girls, aged 14−17 years, participated in the study. Acne was self-reported in 249 (49.8%) pupils, whereas 251 (50.2%) did not report acne. Factors most often believed to aggravate acne were inadequate face washing (85.0%), hormones (84.0%), sweets (82.0%), greasy food (72.6%), makeup (71.2%), and stress (67.8%). Overall the most prevalent acne ameliorating factors were cosmetic treatment (80.4%), increased water consumption (77.6%), a diet change to a healthier food choice (77.4%), and being on school holidays (62.2%). Girls reported more frequently that genetics, stress, sweets consumption, inadequate face wash, and makeup are acne exacerbating factors, whilst cosmetic treatment, increased water consumption, smoking, and being on school holidays are acne ameliorating factors. Boys more frequently considered the benefit of losing weight. There was no statistically significant difference between pupils with and without acne in perceived factors, except for cosmetic treatment. Those with acne more frequently believed in the benefits of cosmetic treatment. Conclusions Many adolescents’ self-perceived beliefs about factors that aggravate and ameliorate acne are myths and misconceptions without evidence-based justification. More efforts are needed to educate pupils about the acne aggravating and ameliorating factors, its health-related consequences, and the treatment possibilities.
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Mizuno K, Sakaue H, Kohsaka K, Takeda H, Hayashi N, Sato T. An increase in normetanephrine in hair follicles of acne lesions through the sympatho-adrenal medullary system in acne patients with anxiety. J Dermatol 2021; 48:1281-1285. [PMID: 33963607 DOI: 10.1111/1346-8138.15935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 04/07/2021] [Accepted: 04/09/2021] [Indexed: 12/01/2022]
Abstract
Acne vulgaris, a chronic inflammatory skin disease, has been associated with not only sebaceous gland dysfunction but also various endogenous and exogenous stresses. Since sebaceous glands are under neuroendocrine control, including the hypothalamic-pituitary-adrenal axis and neuro-autocrine mechanisms, it remains unclear how psychological stress relates to the pathogenesis of acne. In this study, we investigated the relationship between psychological stress and catecholamine in acne lesions from 18 patients with mild or moderate acne. The State-Trait Anxiety Inventory (STAI) revealed that all patients were anxious, with six having low anxiety and 12 high anxiety. Salivary α-amylase activity (sAA), which is regulated by the sympatho-adrenal medullary (SAM) system, positively correlated with the STAI State Anxiety scores (STAI-S) and was significantly detectable in acne patients with high rather than low anxiety. In addition, the level of normetanephrine, but not metanephrine, both of which are catecholamine metabolites, in hair follicles of acne lesions also positively correlated with the STAI-S. Furthermore, the normetanephrine level was higher in patients with high rather than low anxiety, whereas there was no change in metanephrine in the hair follicles of the acne lesions. Moreover, neither the sAA nor metanephrine and normetanephrine in the acne lesions was related to acne severity in the patients. Thus, these results provide novel evidence that a SAM system-associated increase of normetanephrine level in hair follicles is involved in the acne pathology of patients with anxiety.
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Affiliation(s)
- Koji Mizuno
- Department of Biochemistry, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Hiroaki Sakaue
- Department of Biochemistry, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Keita Kohsaka
- Department of Biochemistry, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | - Hidetomo Takeda
- Department of Biochemistry, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
| | | | - Takashi Sato
- Department of Biochemistry, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Tokyo, Japan
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Dall'Oglio F, Nasca MR, Fiorentini F, Micali G. Diet and acne: review of the evidence from 2009 to 2020. Int J Dermatol 2021; 60:672-685. [PMID: 33462816 DOI: 10.1111/ijd.15390] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 11/17/2020] [Accepted: 12/02/2020] [Indexed: 01/11/2023]
Abstract
BACKGROUND Dietary habits may play a non-negligible role in the development, duration, and severity of acne, as shown in past critical review articles on such association. METHODS The aim of this systematic review is to supplement data available on scientific literature spanning the last 10 years by inserting the keywords "acne" or "acne vulgaris" and "diet", "nutrition", "food", "chocolate", "dairy", "whey protein", "fatty acid", or "drink" in the timeframe "January 2009-April 2020" within the PubMed database. RESULTS Fifty-three reviewed articles met eligibility criteria. They included 11 interventional clinical trials (seven randomized controlled trials and four uncontrolled open label studies) and 42 observational studies (17 case-control and 22 cross-sectional studies, and three descriptive studies). CONCLUSIONS This review reinforces the notion of a rapidly growing exponential trend of interest in this subject by the scientific community. Acne-promoting factors include high GI/GL food, dairy products, fat food, and chocolate, whereas acne-protective factors include fatty acids, fruit, and vegetable intake. The role played by specific dietary components pertaining to different foods, as done for milk (full-fat/whole, reduced-fat, low-fat/skim milk), dairy products (milk cream, ice cream, yogurt, cheese, etc.), or chocolate (cocoa, dark/milk chocolate), remains an unsolved issue and objective of future research.
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Prevalence of acne in Chinese college students and its associations with social determinants and quality of life: a population-based cross-sectional study. Chin Med J (Engl) 2021; 134:1239-1241. [PMID: 34018999 PMCID: PMC8143762 DOI: 10.1097/cm9.0000000000001292] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Kaliyadan F, Alsultan H, Alsaqer H. The effect of social media on treatment options for acne vulgaris. ACTA ACUST UNITED AC 2021. [DOI: 10.24911/ijmdc.51-1605689866] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Stamu-O'Brien C, Jafferany M, Carniciu S, Abdelmaksoud A. Psychodermatology of acne: Psychological aspects and effects of acne vulgaris. J Cosmet Dermatol 2020; 20:1080-1083. [PMID: 33031607 DOI: 10.1111/jocd.13765] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 09/21/2020] [Accepted: 09/28/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Acne is a chronic inflammatory skin condition seen commonly in adolescence and young adulthood. Despite being a frequent and nonthreatening life condition, acne has a significant psychological impact and comorbidity. AIMS This review will describe prevalence, common clinical features, different clinical presentations, differential diagnoses, and treatment recommendation. Special focus has been put on psychological aspects. METHODS We conducted a literature search on PubMed from January 2001 to June 2020 with the search terms of Acne vulgaris, psychological, adolescents, anxiety, suicide, mood disorders. Reference lists of identified articles were examined for further relevant studies. The search was limited to English language articles. No specified quality criteria were used for study inclusion. RESULTS The clinical manifestations of acne are very important in the differential diagnosis and its psychological implications. CONCLUSION Through this article, we conclude that despite being a frequent and nonthreatening life condition, acne has a significant psychological impact which requires effective treatment to improve the patient's skin and self-esteem.
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Affiliation(s)
- Caroline Stamu-O'Brien
- Department of Psychiatry, NYU School of Medicine, Woodhull Medical and Mental Health Center, Brooklyn, NY, USA
| | | | - Simona Carniciu
- Center of Research, Diagnosis and Treatment in Diabetes and Nutrition Diseases Corposana, Bucharest, Romania
| | - Ayman Abdelmaksoud
- Mansoura Dermatology, Venerology and Leprology Hospital, Mansoura, Egypt
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