Day 1 :
- Importance of Corpo-Scientific Interaction
Location: Aspin I
American Health and Beauty, USA
Keith Veseleny is the editor of American Health and Beauty.com an online magazine aimed towards consumers interested in cosmetic surgery and aesthetic procedures. He investigates aesthetic trends and technologies. He has attend almost every industry conference.
Objectives: Device manufacturers and the media are trying to commodify all aesthetic procedures. If a doctor can't find a way to stand out, they can only compete by price. Using PR & Social Media, a doctor can inexpensively define themselves as an expert in a niche, commanding a premium. Methods: Use a blog or micro-blog to frequently share valuable information about the niche you have chosen. Be controversial whenever possible. Focus your energies on keeping all your content on your own website or blog and then sharing that information on social media or question/answer sites. The goal is to build your professional brand, differentiate yourself and your practice from the competition and to be the expert in your market area. Results: Substantial increase in traffic, being known as an expert in your market Conclusions: SEO isn't dead, but it is transforming into a fresh content business. By frequently (weekly or better) updating/adding content to your blog or website, and then using social media to share that information you will establish yourself as a niche expert in your market to both your patients and the search engines.
- Track 1: Dermatological Diseases
Track 3: Clinical Dermatology
Track 4: Surgical Dermatology
Track 5: Cosmetic Dermatology
Location: Aspin I
Madalene C.Y. Heng
UCLA School of Medicine, USA
Brown University, USA
UCLA School of Medicine, USA
Title: Targeting the DNA damage response pathways in the repair of acute thermal and ultraviolet light injury
Time : 12:20-12:40
Madalene C. Y. Heng MD, FRACP, FACD, FAAD is clinical professor of Medicine/Dermatology UCLA School of Medicine. She was chief, Division of Dermatology at the UCLA San Fernando Valley Program from 1979 to 2003. Dr Heng is a reviewer of multiple journals including the Journal of the American Academy of Dermatology, International Journal of Dermatology, British Journal of Dermatology, Lancet (London), Molecular Pharmaceutics, among others. With more than 130 publications including 76 publications in peer-reviewed journals on topics such as phosphorylase kinase activity in psoriasis and photodamaged skin, Dr Heng is able to link treatment of disease to their pathophysiology. Dr Heng is the developer of curcumin gel.
Damage to the DNA resulting in double stranded breaks in the DNA (DSB) triggers the DNA damage response or DDR. This results in cell cycle arrest, associated with DNA Damage Response (DDR) pathways channeling repair enzymes to the damaged DNA histones. The presence of the DSBs is sensed by a multifunctional sensor complex (MRN). MRN complexes can bind to the exposed DNA ends directly and unwind the DNA ends in an ATP-dependent manner. This is important for nucleotide excision of the damaged segments of DNA, and later replication of the nucleotides during DNA repair. The DDR pathway involves recruitment of multiple proteins to the damaged DNA sites, including checkpoint proteins 1 and 2, and ubiquitin kinases. All activities within the cell are put on hold (cell cycle arrest), while nucleotide excision and repair pathways are initiated. When the cell is too badly damaged, apoptosis is induced but this only occurs after many attempts at repair, and apoptosis is only induced by replication stress when repair fails to occur. Cell cycle arrest is inhibitory to rapid healing of tissues. Moreover, the intrinsic repair processes are slow and laborious, and do not return the tissues to pre-injury levels. When large segments of the DNA are damaged, or if the damage involves both strands of the DNA, replication errors occur, producing a potentially premalignant cell. Curcumin is a phytochemical with anti-inflammatory, anti-photodamage and anti-carcinogenic properties. Curcumin induces apoptosis through inhibition of DDR pathways, with rescue of the damaged cells from cell cycle arrest. In this paper, we describe curcumin signaling targets in the DDR pathways as a basis for the rapid repair with no residual scarring in acute injury such as burns and sunburn.
Brown University, USA
Time : 12:40-13:00
George Kroumpouzos, MD, PhD, FAAD, is Clinical Associate Professor of Dermatology at the Alpert Medical School of Brown University and former Instructor at the Department of Dermatology, Harvard Medical School. He is certified by both American and European Boards of Dermatology. Dr. Kroumpouzos’ expertise is in the fields of obstetric/gynecologic dermatology, adverse drug reactions, connective tissue disease, complex medical dermatology, and disorders of pigmentation. He is an editorial board member in three peer-reviewed dermatologic journals, and has published more than 50 peer-reviewed publications and book chapters. Dr. Kroumpouzos has delivered numerous lectures in the US and internationally. He has been the recipient of several scholarships and awards, including awards by the International Union against Cancer and the Dean’s teaching award at Alpert Medical School of Brown University.
Chronic inflammation in skin diseases with a Th1-associated cytokine profile that includes a high expression of tumor necrosis factor (TNF)-alpha, such as psoriasis, lichen planus (LP), and granuloma annulare (GA), may trigger DLP or be a consequence of it. The aforementioned diseases, as well as necrobiosis lipoidica diabeticorum and the granulomatous variant of chronic pigmented purpuric dermatosis, have been associated with DLP. Treatment of DLP has been associated with a clinical improvement in psoriasis, and TNF- inhibitors, which are helpful in psoriasis and GA, have shown beneficial effects on serum lipids. In a recent case-control study by the author that included 140 patients with GA, GA patients had 4 times the odds of developing DLP compared to controls. In the same study, the extent and annular lesion morphology of GA were associated with DLP. DLP is one of the components of metabolic syndrome (MetSyn), and MetSyn has been associated with psoriasis. Furthermore, psoriasis has been associated with other components of MetSyn, such as diabetes, and is a risk factor for cardiovascular disease (CVD). Modification of CVD factors is indicated in psoriasis patients. The relationship of other DLP-associated diseases, such as LP and GA, with MetSyn needs to be investigated, as well as whether these diseases may serve as a risk factor for CVD.
University of Foggia, Italy
Time : 13:40-14:00
Raffaele Rauso obtained his medical degree at 24 years, after that he performed a 5 years training in Cranio- Maxillo- Facial Surgery at the Second University of Naples (Italy), during that period he also performed 2 fellowships in Plastic Reconstructive and Cranio-Maxillo-Facial Surgery; one at the University of Basel (Switzerland), and another at the G.S.R. Insitute in Hyderabad (India). Once he became consultant in Cranio-Maxillo-Facial Surgery, he obtained a Master's degree in Aesthetic Surgery at the University of Milan. He has published several papers in the most reputed journals in Cranio-Facial and Plastic Reconstructive Aesthetic Surgery; He is reviewer for several scientific medical journals, and is full member of E.A.F.P.S. (European Academy of Facial Plastic Surgery), and E.A.C.M.F.S. (European Association for Cranio-Maxillo-Facial Surgeons). Nowadays is Associate Professor in Cranio-Facial deformities at the University of Foggia (Italy).
Nowadays facial wasting is considered a stigma of HIV-infection; well-known are the devastant effects on facial features of the drugs used for the highly active anti-retroviral therapy. Years after years, several techniques and filling devices have been proposed to restore facial features of these patients. Several authors stated that when facial wasting is associated with trunk lipohypertrophy (another side effect related to the drugs intake), structural fat graft is the best option achievable, because at the same time, removing the lipohypertrophied fat of the body, and using it to fill the face, let to reach a great improvement both at the face and the body. However, often and often, the injected fat can be resorbed in a very high percentage, so the use of dermal filler is quite frequent to help the physicians in treating these patients in removing facial wasting's stigma. Several fillers have been proposed for this purpose, however, HIV-infected patients presenting facial wasting are not like cosmetic patients seeking a little improvement, these patients need a treatment more reconstructive than cosmetic; this is why long lasting or permanent fillers are often used, and in these cases the physician need different skills. Furthermore, it is very important how these fillers act once injected, and if late side effects can be seen; so, only long follow-up let a physician, involved in this tretament, to really understand what works and what doesn't. The author presents what he learned by its own experince, in using fillers for facial wasting rehabilitation.
University of Medicine and Pharmacy, Romania
Title: New role for dermatologist today - Diagnostic and treatment for skin diseases and prevention for general diseases
Time : 14:00-14:20
Victor Gabriel Clatici was graduated from University of Medicine and Pharmacy, Carol Davila, in 1994 in Bucharest and in 1995 has started the resident program in Dermatology and Venereology. Since year 2000 have been working in the field of Dermatology, including private practice. In 2006 became Assistant Professor in Dermatology and Venereology at University of Medicine and Pharmacy, Carol Davila, Bucharest, Romania. Victor Gabriel Clatici was the first one who wrote in Romanian language about quality of life and psoriasis (2001) and about vaccines for sexually transmitted infections (2002). In the field of clinical research, Victor Gabriel Clatici was both Principal Investigator and National Coordinator for various types of clinical studies, respectively multicenter national and international studies. Victor Gabriel Clatici presented over 100 papers at International and National Congresses, published over 20 specialty articles in dermatology journals and was speaker, both national and international, for important multinational pharmaceuticals and cosmetics companies. He has a substantial and extensive experience in diagnosis and treatment of skin, hair, nails, mucous and sebaceous gland diseases and special interest in clinical research, skin cancer, sexually transmitted infections, photo protection and sunscreens, skin aging, acne and rosacea, quality of life in dermatology.
Lifestyle is an important negative factor in our beauty and general health. Pollution and stress, smoking and sedentary life style, sun exposure and use of tanning beds, diet full of sugar and fat and low in water, fibers and vitamins, improper skin care lead not only to accelerate the skin aging process but also to develop serious diseases like cancer (including skin cancer), diabetes mellitus, obesity, heart disease etc. As Dermatologists, we see every day acne in women and men over 30 years, sometimes over 40, melanoma at 20 years and too much non melanoma skin cancer in elderly. Also, we see obesity with acne in children and a lot of psychosomatic illness like psoriasis, alopecia and lichen planus. We are what we eat; so if we change our diet we will change our future and beauty. Quit smoking, change the daily habits, correct choose and use of photo protection methods, appropriate skin care are all methods easy with a lot of good results. As Dermatologist and Venereologist we can prevent a lot of serious diseases like skin cancer and other forms of cancer (including cancers triggered by HPV and prostate cancers), reduce the burden of obesity and diabetes mellitus type 2 and increase the quality of life of our patients. Also, we can make people, Look better, and grow up their satisfaction and happiness. So, I am proud to be a Dermatologist and bring good in the life of my patients!
Oslo University Hospital, Norway
Title: TCR V beta gene analysis in folliculotropic mycosis fungoides does not show antigen specific restriction
Time : 14:40-15:00
Panagiota Mantaka has been working as a specialist in dermatology and veneroloy since Januray 2009 working since then as a clinician (50%) and research fellow (50%) by performing her PhD thesis in the field of primary cutaneous lymphomas. She has already published some papers in the field of folliculotropic mycosis fungoides and presenting successfully in several EORTC/ISCL meetings (2010, 2012 and 2013) recently and in the past.
Folliculotropic mycosis fungoides (FMF) is a variant of cutaneous T cell lymphoma characterized by predominant infiltration of hair follicles by lymphoma cells. Folliculotropism may suggest that antigen-stimulation by particular antigens present in the hair follicle may contribute to the pathogenesis of FMF. To test this hypothesis, we identified the rearranged T-cell receptor (TCR) V beta genes in a series of 20 cases (21 samples) with clinically and histologically wellcharacterized FMF as well as 10 control cases (10 samples) of conventional mycosis fungoides (MF)1. The analysis was performed by using a multiplex PCR and BIOMED-2 primers3, followed by sequencing of the monoclonal PCR products. In 3 FMF patients different T-cell clones or additional to a persistent clonal T-cell rearrangements were found. In FMF no restriction of a specific TCR V beta gene family was demonstrated. Similarly, conventional MF showed non-restricted TCR V beta gene rearrangements, as has been demonstrated before. Our results indicate that FMF, as has been demonstrated for MF before, does not arise from TCR V beta-restricted T cells, including NKT cells. Whether antigenstimulation plays a role in the pathogenesis of FMF is still an open question, but our results do not indicate the involvement of restricted antigens.
University of California, USA
Time : 15:00-15:20
Chair of the San Francisco Dermatologic Society representing over 540 dermatologists in the Bay Area Fellow of the American Academy of Dermatology (AAD) Asst. Clinical Professor of Dermatology at University of California, San Francisco Advisory Board Member representing the San Francisco Bay Area for the AAD Member of the Council on Education and Maintenance of Certification for the AAD Faculty for the Skin Knowledge and Information Network for the AAD Professional Expert Evaluation Review Program Member for the AAD Symposium Director of the AAD national and summer academy meetings with a focus on pregnancy and hormonal therapy in dermatology Member of the Women's Dermatologic Society National Psoriasis Foundation American Contact Dermatitis Society North American Clinical Dermatologic Society Northern California Dermatologic Society Dermatology Foundation San Francisco Dermatologic Society Medical Dermatology Society.
Introduction & Objectives: As many as 40-80% of women receive at least one prescription drug during pregnancy. It is, therefore, crucial that pregnant women are offered appropriate counseling regarding the potential teratogenicity of medications. In this review, a new evidence-based medicine approach to evaluating medication risk is compared to international pregnancy classifications, providing clinicians with a powerful counseling tool. Material & Methods: A search of Medline database of articles pertaining to pregnancy classifications for medication risk was conducted. Results: Three of the most widely accepted international pregnancy classifications are the FASS (Swedish Catalogue of Approved Drugs), the US FDA (Food and Drug Administration), and the Australian system. One study compared the US and European systems, interviewing 934 physicians and pharmacists, and revealed that the European system was favored largely over the FDA system because: (1) The US focuses too much on animal data. (2) There is a readiness of the US system to label medications new to the market as class B (safe in pregnancy). Besides the FASS and FDA, there are alternative references to guide clinicians in choosing appropriate drug therapy in pregnancy. In the book, "Drugs During Pregnancy and Lactation: Treatment Options and Risk Assessment," a consortium of physicians active in teratological societies in the US and Europe, created a highly regarded system focused on an "Evidence-Based Medicine" (EBM) approach to counseling and advising patients. The EBM system divides pregnancy into three time intervals: the embryonic period (first trimester), fetal period (second and majority of third trimester), and peripartum (last month of pregnancy). There are five categories for assessment at each pregnancy time frame: 1 (drug of first choice), 2 (drug of second choice), S (single dose/low dosages are tolerable), T (potentially teratogenic/toxic), and C (contraindicated). Conclusions: This new EBM system is a preferable counseling tool for three reasons. First, it highlights differences of use/concern within a pregnancy. Second, it takes into consideration how long a medication has been used and what are available supporting data regarding safety. Third, it tends to be more reasonable and coincide with common sense. For example, most consider hydrocortisone to be a safer option than infliximab for psoriasis, but the FDA system indicates infliximab is a safer choice than hydrocortisone, likely due to paucity of animal studies. We hope that access to this comparison of safety classifications will provide clinicians with a powerful tool to use when counseling women of childbearing age who are pregnant or considering pregnancy in the future.
Tehran University of Medical Sciences, Iran
Title: Malignant cutaneous T-cell lymphoma among 1100 Iranian chemical victims, 2 decades after exposure to sulfur mustard: A long term investigation
Time : 15:35-15:55
Seyed Naser Emadi has completed his post graduate training of dermatology in Tehran University of medical sciences,Iran (2000-2004). His Professional Experience is to manage skin diseases amongst black people especially those who infected with HIV, AIDS and Cutaneous Leishmaniasis. He is a member of medicines without frontier since 2005 to now and has been worked in Kenya,Ghana, Zimbabve as a volunteer to serve needy people particularly HIV patients. He has published more than 15 papers in reputed journals (Arch Dermatol, CED, International Journal of Dermatology, DOJ). Now he is working on the case of Kaposi Sarcoma among HIV patients that referred to Mbagati District Hospital in Nairobi-Kenya.
Sulfur Mustard is a potent chemical warfare agent that was widely used during First World War and Iran-Iraq conflict. This vesicant agent has a lot of acute and chronic destructive influences on the skin, eye and respiratory system. SM via the alkilation of DNA and several cellular proteins (structural, cytoplasmic and enzymes) and cell nuclei; produce several toxic, mutagenic and carcinogenic effects. Methods: In this historical Cohort, a population of 1100 veterans with documented history of exposure to Sulfur Mustard during the period of 1982-88 (all have been under the close health monitoring program) were examined. Results: 1) The mean age of the patients was 43.3 ± 9.8 years) 12 cases amongst 1100 are found to have developed mycosis fungoides( CTCL) over the past years which was much higher than our expectation, while in general population prevalence of CTCL is 1.28/100,000/year for patient 70 to 79 years old. 3)The most common sites of lesions were folds, flexural and thin epidermis areas. (The same places that were most affected by SM-induced bulla during war time between 1982-1988). 4) Most of the patients had a past history of xerosis, chronic dermatitis and itching that begun shortly after exposure to SM 5- Most patients with CTCL presented with pigmentory and vascular changes (like SM scar). Finally, chemical weapons are very harmful to life hence blocking of production, prevention of use and immediate treatment and long term follow up of victims are the most important measures to be taken by all scientists.
Federal University of Maranhao, Brazil
Time : 15:55-16:15
Dimitre Luz Felipe da Silva is a medical student at Federal University of Maranhao, Brazil. In june 2012, he received a scholarship from the Brazilian government through the program Science Without Borders, studying at Cal. State Fullerton during the summer, where he received the prize Dean's list, and then, studying at Loyola University Chicago, where he is involved with the project "Psoriasis patient education study". Back in Brazil, he is heading the project "Social impact caused in patients with acne". He was president of the Dermatology League and received a scholarship for the project "Reconstructive Surgery in patients with skin cancer".
Introduction: The number of skin fillers has increased steadly, and the hyaluronic acid is the most common material used. The Teosyal product line is produced in Switzerland and was introduced in Europe in 2004. We report a case of delayed adverse effects to the product. We found no reports in the literature of adverse reactions to Teosyal. Case Report: A 58-year-old female patient, afterwards a bariatric surgery performed in october 2010, has presented with sagging malar after intense weight loss. She was submitted in 07/27/2011 to high density hyaluronic acid filler (Teosyal Ultimate). Past 14 days, she was satisfied with the results. However, after two months, the procedure area showed an edema and recurrent nodules at the sites of application, biggers in the right side. She remained without fever. Exams showed WBC: 5970, Bats: 3%, ESR: 40 and PCR: 5. The echography showed a nodule measuring 10X8mm in the right malar area, besides liquid, which has suggested an inflammatory reaction. It was prescribed prednisone 60mg daily with slowly reduction in 30 days, and clarithromycin for 14 days, for empirical coverage of atypical mycobacteriosis; after performed 2 sessions of intralesional corticosteroids, the answer was still unsatisfactory. After 13 days, she was submitted to a new ultrasound that presented granulomatous reaction with possible 18X19X8mm in right malar and initial signs of liquefaction. Guided puncture of the nodule right malar, with negative Gram stain. In face of the evolution of the nodules, the patient was admitted in the hospital for further investigation. It was prescribed ampicillin-sulbactam after empirical conclusion from the infectious disease department. The culture was negative for common germs. Although no concrete evidence of infection, the nodules partially regressed after 2 days of ampicillin-sulbactam. The patient didn't allow the lesion biopsy due being afraid of getting a scar, despite the insistence of the medical staff. The patient was discharged with a prescription of amoxicillin-clavulanate; after 30 days, she was back without inflammatory signs in the application area, however the 1 cm nodules were still present and translucent in eyelid-cheek transition which resembled accumulation of hyaluronic acid. We opted for infiltration of Hyalozima 30U at each node, with total regression.
Muath A.H. Eideh is 6th year medical student. He will graduate in June 2013 from faculty of medicine, Al-Quds University, Palestine. He is interested in doing medical research especially in dermatology.
Introduction: Acne is usually considered a disorder of adolescence, and a number of studies have examined the prevalence and the causes of this condition in the adolescent population. The aims of our study are to identify the main causes of acne, and what factors make it scar and also to take some information about treatment, and social impact of acne. Methods: Across sectional observation design conducted in Al-Quds University students. Total of 100 students completed questionnaires, the questionnaires consisted of general questions about the life style and nutrition; also consisted of many questions about the causes of acne, severity, treatment, and the social impact of acne. The finding of the study was discussed with other results. Statistical package for social science (spss) version 16 was used for data entry and analysis. Results/findings: Acne was found in 57.8% of the studied sample, female have more chance to develop acne then men, 69.9% of acne people in our sample are female. Regarding the causes of acne, 96.6% of the studied sample have acne during stress, in 76.3% of acne people have a family history of acne, in 71.7% of females have acne during menstrual cycle, in 79.6% of acne people their acne increase and become scare after eating fatty food, in 76.8% also their acne increase after scratching it, and after shaving acne increase in 73.2% of the acne people. In addition to that, in 49.2% of the acne people their acne was concentrated in the face, only 8.5% in the back, and 42.4% in more than one region. In most acne people 26.7% of their acne was moderately distributed and only 8.5% have severe acne. According to the treatment, 42.4% have visited a doctor, and only few people19.2% that have large improvement after treatment, 34.6% of acne people say that the cost of treatment including drugs is expensive, and for 42.3% the cost of treatment was moderate. Acne affect people lifestyle in 56.00% of acne people, 45.7% fell depression and upset because of acne. Conclusions: Stress, menstrual cycle, and family history are the major causes for acne, and there are many factors that increase the severity of acne, also we can conclude that acne affect people lifestyle.
Saint Louis University, USA
Time : 16:35-16:55
Syed I. Rahman is a third year medical student at Saint Louis University Medical School who has published. He is working with Dr. Elaine Siegfried, certified pediatric dermatologist, who serves on the Editorial Advisory Board of Dermatology Times as well as on a number of professional organizations. She is author or co-author of more than 80 original papers, abstracts, and book chapters.
Methotrexate has been used to treat inflammatory skin conditions; however, there is limited data with regard to pharmacokinetic, dosage adjustment, and clinical response. The methotrexate polyglutamate (MTX PG3) assay was developed as a marker to measure methotrexate activity in-vivo in determining the optimal therapeutic range in patient management. Our objective was to evaluate the methotrexate polyglutamte assay in assessing whether the measurable methotrexate metabolite correlates with a clinical response in pediatrics patients with inflammatory skin diseases treated with methotrexate. A retrospective chart review was performed on 47 children from SSM Cardinal Glennon Children's Medical Center with a median age of 8 yrs. (range, 2-17 yrs.) and mean treatment duration of 363.42 days over a 24 month period. MTX PG3 levels were recorded from the MTX PG3 assay. Clinical treatment was evaluated using a Physician Global Assessment scale (0= clear, 1= almost clear, 2= mild, 3= moderate, and 4= severe) re-classified into 0= poor/fair and 1= good/excellent. Patients were categorized into responders, defined as patients changing from poor/fair to good/excellent, and non-responders, defined as patients remaining at poor/fair. Late-responders, defined as children responding after 12 months, were compared with non-responders using mean maximum and mean percent change in MTX PG3 levels. Data was analyzed using statistical t-tests. 47 patients were stratified into two groups: responders 38/47 (81%) and non-responders 9/47 (19%). Responders and non-responders had a mean MTX PG3 level of 31.5 and 22.3, respectively, p=0.138. Late-responders and non-responders had a mean change of 42.6% and 19.1% and mean maximum of 41.9 and 22.3 MTX PG3 levels, respectively, p=0.01. This study has been limited primarily by a small sample size. MTX PG3 levels do not correlate with clinical response between responders and non-responders. However, amongst late and non-responders, MTX PG3 assay remains a viable test in adjusting dosage in association with clinical response. In the end, MTXPG3 levels are more predictive for late than early responders.
17:30-18:30 Cocktails sponsored by Journal of Clinical & Experimental Dermatology Research @ Hickory