Day 3 :
- Track 9: Skin Infections and Prevention
Track 10: Clinical and Medical Dermatology
Location: Ground Ball Room B
Technische Universitaet Muenchen
Zahide Eris Eken
Istanbul Bilim University School of Medicine, Turkey
Assistant Prof. Dr. Zahide Eris Eken was born in Aksaray, Turkey. She graduated from Istanbul University Cerrahpasa Faculty of Medicine as Medical Doctor. She completed the residency period of Dermatology in Istanbul Bezmi Alem Vakıf University, Faculty of Medicine, and Department of Dermatology. She is working Istanbul Bilim University, Faculty of Medicine, Sisli Florence Nightingale Hospital, and Department of Dermatology as a Assistant Prof.
Hair loss is a frequently seen embarrassing problem faced by people of all age groups and ethnicity. Factors that cause hair loss are genetic, environmental, pathological and psychological. Various treatment and cosmetic procedures gaining importance in the treatment of hair loss over time. Mesotherapy and PRP are also procedures that used in hair loss. There are a few studies about these techniques and their efficacy in relation with hair loss therapy. But these procedures have received a lot of publicity in the media and internet about its role in hair loss and androgenetic alopecia. Mesotherapy and PRP injections are made directly into the skin with mesogun or by hand once in 2-4 weeks. In hair loss some physicians use both of these procedures. Mesotherapy and PRP techniques and their uses in hair loss discussed in this presentation.
Mahatma Gandhi Mission Institute of Health Sciences
Title: Transepidermal administration of tranexamic acid for treating melasma- A randomised double blind placebo controlled study
Time : 09:20-09:40
Karishma Hemmady has completed her MD in Dermatology from MGM Institute of Health Science from Mumbai, India in 2014. She has also completed her Diploma in practical Dermatology from Cardiff University, UK in 2013. She is a Specialist Registrar in the Department of Dermatology at MGM Hospital, and a board member and consulting dermatologist at Ultra Derm Clinic, Pune, Maharashtra, India. Being research oriented, she has presented and published more than 10 papers in reputed journals and conferences.
INTRODUCTION- Melasma is an acquired condition that presents as tan to brown hyperpigmented macules which coalesce to form patches on the forehead, cheeks, nose and chin resulting in cosmetic concern to patients. A clinical trial of intradermal injections of tranexamic acid for melasma proved to be efficacious. We postulate the use of microneedling system, like dermaroller TM, to increase efficacy of tranexamic acid delivery by creating micro-channels may be utilised for treating melasma. AIMS AND OBJECTIVES- • To study the safety and efficacy of transepidermal administration of tranexamic acid 100mg/ml in treatment of melasma. • To compare MASI scores, evaluated by a blinded investigator, at pre-treatment, week 2, week 4, and week 8. • To evaluate physician global assessment, by a blinded investigator, at pre-treatment, week 2, week 4, week 8. • To compare patient global assessment at pre-treatment, week 2, week 4 and week 8. • To report any adverse effects of the procedure and treatment. MATERIAL AND METHODS- Twenty patients, who fulfilled the inclusion criteria, were recruited for the split face prospective trial lasting 8 weeks. The test and control sides of the face of all subjects were randomised and one side received tranexamic acid 100mg/ml while the other side received placebo (normal saline solution.), after creating micro-channels with dermaroller. The procedure was repeated at weekly intervals. All patients were photographed prior to starting the procedure (base line photographs) and then at weekly intervals prior to the procedure. MASI scoring was evaluated at each follow up prior to commencing the procedure. RESULT-A total of 20 patients were enrolled for the study. There were no drop outs in the study and no adverse effects to the treatment modality were reported. There was a decreasing trend in the MASI results, which was evaluated by the blinded investigator, as the treatment continued on the test site as compared to placebo which remained static. The physician global assessment scores showed no significance in the placebo site however there was significant improvement in the test sites. The global assessment scores of the patients showed an improvement (p-value 0.001) in the test site as compared to the placebo sites which showed no significant trend (p-value more than 0.05). CONCLUSION- Transepidermal delivery of 100mg/ml tranexamic acid with microneedling is a new and promising procedure to treat melasma.
Jundishapour University of Medical Sciences
Time : 09:40-10:00
Nooshin Bagherani completed general medicine at Arak University of Medical Sciences, followed by training in Dermatology from Jundishapour University of Medical Sciences. She is also bachelor of law and student of oil engineering. She is one of the founders of the Association of the Students and Graduates of Markazi Province in Arak. Now she is the founder and Editor of "The World's Greatest Dermatology Atlas". She has authored more than 20 publications in peer-reviewed journals, one textbook and one chapter in another
Introduction and objective: Acne scars are extremely bothersome to patients and often challenging to treat. Regarding texture, they are divided into the scars with normal texture and the scars with atrophic texture. The acne scars with atrophic texture consist of ice pick, boxcarand rolled scars. Topical, physical, surgical, and light modalities, alone or in combination have been administered in the treatment of acne scars with variable results. Herein, for the first time I introduced serum injection therapy as a novel effective therapeutic option for the atrophic acne scars. Material and method: In this study, the patients with atrophic acne scars were selected among the patients had referred to my private dermatology office. After describing the process of the study, a written consent was acquired from them. I administered 0.9% sodium chloride serum in this study. After local anesthesia with lidocaine, the serum was injected intra- and sub-dermally in the regions of acne scars and skin pores. The amount of serum for injection was determined based on the severity of scars, so that it over-corrected the scars and widespread to the neighboring regions. In every session, before the procedure, photographs were taken from the patients. This process was done weekly for 5 weeks and topical alpha hydroxy acid-containing agents were prescribed beside this procedure. In every session, I objectively and subjectively assessed the results of treatment regarding the type of acne scar. In this study, for evaluating the response I used a visual score including in: scores1-3 as poor response, 4-6 as moderate response,7-9 as good response, and 10-12 as significant response.The subjective evaluation was acquired by questioning about the general success of treatment from the patients. For the objective evaluation, the photographs were observed. This observation included the assessment of response according to the type of acne scar. For every case, the objective and subjective scores in every session and the mean of these scoresafter the last session were considered for assessment of the response. At the end, the data was analyzed by the SPSS software. Result: Among the 12 cases studied, 10 (83.3%) cases were female and 2 (16.7%) cases were male. The minimum and maximum ages of patients were 18 and 56 years, respectively. Among the subjects, 6 (50%)and 1 (8.3%) patientshad unsuccessfully undergone laser therapy and microdermabrasion for treating their acne scars, respectively.Isotretinoin was simultaneously administered in 4 (33.3) patients with the active acne. The ice pick, boxcar and rolled scars, and large pores were seen in 4 (33.3%), 10 (83.3%), 8 (66.7%) and 6 (50%) of patients, respectively. The patients had Fitzpatrick's skin types of III and IV. After the first and fifth sessions, the mean subjective response scores were 7.1±1.2 and 10.2±1.08, respectively.In the objective assessment, the mean score responses were 6.7±1.5, 7.2±2.02, 7.0±1.8, and 7.2±1.01 for the ice pick, boxcar, rolled scars and pores, respectively. After the fifth session, these scores were 10.0±0.9, 10.9±1.01, 10.4±1.3, and 10.3±1.3, respectively.The response was better in the acne patients under oral isotretinoin therapy in comparison with other cases, but it was not statistically significant. No statistically significant difference in the response was reported regarding the age, gender, skin type, and severity of acne scar. The patients reported skin lightening and tightening, decreasing of wrinkles and eminent cheeks as side profits of this procedure. Mild ecchymosis was the only side effect was seen in about one third of patients. Conclusion: My study revealed that the response to serum therapywas significant in the large pores and all types of the atrophic acne scars. In comparison with the severe acne scar, the patients with mild and moderate scars showed better responses. This study showed that the serum injection therapy can be an effective therapeutic option for the atrophic acne scars with no significant side effects. In addition, my study revealed that this procedure can successfully be used in thetreatment of patients suffering from the large skin pores.
Time : 10:00-10:20
Hesham M Ahmad has completed his M.D. at the age of 25years and Ph.D. at the age of 32 years from Minia University, Minia, Egypt. He did his postdoctoral studies at Thomas Jefferson University School of Medicine, Philadelphia, PA, USA. He is the clinical director of Cocoon Medical Centre, Al-Ain, Abu Dhabi, U.A.E., a Dermatology and Aesthetic centre. He is also an assistant professor at Department of Dermatology at Minia University Hospital, Minia, Egypt. He has published more than 20 papers in reputed journals.
Many medications are available for treatment of scabies and pediculosis capitis including ivermectin. We compared the efficacy and safety of topical versus oral ivermectin in treatment of scabies and pediculosis capitis. A total of 62 patients with uncomplicated scabies and 62 patients with head lice infestation were included. Each group was further subdivided into: Group I received single topical application of 1% ivermectin and Group II received single dose of oral ivermectin. Treatment was repeated after one week for non responders and patients were evaluated weekly for 4 weeks. The clinical responses as well as side effects were reported weekly. The results of this study show that both topical and oral ivermectin demonstrate high efficacy and tolerability in treatment of scabies and pediculosis capitis. However, a single treatment of pediculosis capitis with topical ivermectin provides significantly higher cure of infestation and faster relief of pruritus than oral ivermectin. In addition, whether topical or oral ivermectin is used to treat scabies or head lice, a second dose is required in some cases to ensure complete eradication.
- Young Researchers Forum
Location: Ground Ball Room B
Xinyi Du, 27, graduated from Medicine at the University of Cambridge, UK in 2012. She is completing her training in general internal medicine in London, and is currently based at the Royal Marsden Hospital. She has an interest in public health and medical education and is additionally completing a Masters in Clinical Education at King’s College, London. Dr Douglas Maslin, 27, graduated with distinction from Medicine at the University of Cambridge, UK in 2012. He is an academic clinical fellow in medicine at Addenbrooke’s hospital, currently working clinically in oncology, while also researching cancer stem cell behaviours within the Cambridge biomedical campus. His main interest is in the prevention of dermatological malignancies – particularly melanoma. Additionally, Douglas is an associate fellow of the higher education academy, a teaching bye-fellow of Downing College, and is currently completing a Masters in Translational Therapeutics.
Sunlight stimulates a multitude of important biological effects on skin, causing, amongst other pathological changes, photocarcinogenesis. Sunscreens are designed to provide protection against these harmful properties of ultraviolet radiation, and public health campaigns have been employed to encourage their use. Despite this, there has been a continued rise in the incidence and mortality of the most harmful skin cancer, malignant melanoma. Although public health campaigns and mathematical models suggest sunscreen use would reduce incidence of all skin cancers, including melanoma, research so far has not provided clear-cut evidence that this is true. One randomized controlled trial found the daily use of sunscreen over 4½ years significantly reduced the incidence of squamous cell carcinoma but not of basal cell carcinoma. More recent studies have had similar results – the risk of squamous cell carcinoma is decreased, but the results for basal cell carcinoma are equivocal. Furthermore, some early research on melanoma has even suggested, controversially, that the application of sunscreen may even increase the risk of melanoma. However, the presence of confounding factors such as the potential inappropriate application of sunscreen and increased time of UV exposure in sunscreen users are not fully accounted for within these studies. We will explore the available evidence on both the beneficial and harmful effects of sunscreen use with practical advice on how we might advise our patients to best protect themselves from photocarcinogenesis.
University of Helsinki
Title: The immunomodulatory and prognostic role ofindoleamine-2,3-dioxygenase-1 in cutaneous T-cell lymphomas
Time : 10:50-11:05
Pilvi Maliniemi is currently a graduate student, who will be completing her PhD this year 2015 from the Medical Faculty of Helsinki University. She has already published eight (8) papers in reputed journals in the field of Mitochondrial Diseases and Molecular Oncology of Cutaneous T Cell Lymphomas.
Indoleamine-2,3-deoxygenase (IDO-1), catabolizing tryptophan(Trp) to kynurenine (Kyn), causes an immunosuppressive microenvironment in many neoplasias. In this study we identify the IDO-expressing cell subtypes in cutaneous T-cell lymphoma (CTCL) and determine the significance of serum Kyn/Trpcatabolite levels. IDO-1 mRNA and protein expression was studied in 68 FFPE skin samples of mycosis fungoides (MF), lymphomatoidpapulosis (LyP), lichen ruberplanus (LRP), and subcutaneous panniculitic-like T cell lymphoma (SPTL), and in three CTCL cell lines. For co-expression, anti-CD33 (myeloidderived suppressor cells, MDSC) and anti-CD163 (tumor-associated macrophages, TAM) antibodies were used. Levels of 14 Trp metabolites were measured in 69 patient and healthy control sera by liquid chromatography–tandem mass spectrometry (LC-MS/MS). The relative expression of IDO-1 mRNA was markedly elevated in MF and LyP samples compared to LRP and also in the MF-derived cell line MyLa compared to the CD30+ CTCL lines Mac-1 and Mac-2A. Interestingly, IDO was co-expressed by CD33+ MDSCs in MF and in LyP and by the CD163+ TAMS in SPTL. The increase of IDO also associated with the eleveted level of Treg cells in LyP as 50% of the cases studied showed a moderate or strong FoxP3 expression. Serum Kyn/Tryp ratios showed significant increase in MF (p<0.05) compared with those of healthy controls and correlated with MF activity. We show that IDO is produced by the MF cell line MyLa and by CD33+ MDSCs in MF and in LyP but instead by CD163+ TAMs in SPTL. FoxP3+ Tregs, abundant in LyP, may contribute to the indolent clinical behavior. Serum Kyn/Tryp ratio in MF associates to a progressive disease behavior and may be a useful clinical indicator.
Baba Farid University of Health Sciences
Title: Smash grafting in stable vitiligo: A case study of 30 cases in a tertiary care hospital in north India
Time : 11:05-11:20
Manjit Kaur has completed her MBBS from Baba Farid University of Health Sciences, Faridkot, India in 2006 and Masters in Dermatology & STDs from the same University at the age of 27 years. She stood first in Postgraduate University Examination. She has worked as a Senior Consultant at Kaya Skin Clinic for two years and as a Senior Resident at Government Medical College, Chandigarh for three years. She is a life member of IADVL, CSI and ACSI. She has presented papers in Award Paper session, Young Dermatologist Forum, free papers and Posters in national and regional dermatology conferences.
Vitiligo is an acquired, progressive depigmentation disorder of the skin and or mucous membranes of great cosmetic importance. Many new therapeutic options for vitiligo (both medical and surgical) have become available over the last decade. One among them is the smashed skin grafting or smash grafting which is a modification of split-thickness grafting. In this procedure, the graft undergoes smashing before being applied to the recipient site. Although it is a simple and effective procedure but very few people are doing it either due to lack of awareness or due to lack of published data. Objective of this study was to evaluate the effectiveness and safety of smash grafting in cases of stable vitiligo. Smash grafting was done in thirty cases of localized, stable, recalcitrant vitiligo in the present study. Patients were divided into group A (PUVA was given postoperatively) and group B (only sunlight exposure was given post operatively) and were followed up at four, eight, twelve weeks to assess repigmentation with the surrounding skin. In all 30 cases, repigmentation was observed from 3 weeks onwards and continued to increase on subsequent follow-ups. 76.66% of patients achieved more than 50% repigmentation at 12 weeks. Although number of study cases was small and also the follow up period was short (only 12 weeks), Smash grafting was found to be a simple, easy to learn and cost effective one stage procedur
Government Medical College and Hospital
Time : 11:20-11:35
Dr Pragati Gogia has completed her MBBS from Mauritian University with rank 3 in 1st professional and rank 1 in 3rd professional and distinction in anatomy and ENT. She is currently pursuing DNB dermatology from Government medical college and hospital, Chandigarh, India. She is a member of IADVL.
Reem Saeed Alshehri is graduated Medical Student, Faculty of Medicine, Tabuk University. She has a commitment and appreciation for mentoring and volunteering. She served as a Volunteer in Breast Cancer Convoy to the poor villages outside Tabuk. She has been participated in planning & organization for awareness programs for her University and community. She has completed two in-depth research studies, one being a study of the impact of phototherapy and a broader study on the quality of life in atopic dermatitis patients. She is a Member in Dermatology Student Club.
One of the most common conditions of the skin is Atopic dermatitis (AD) which usually occurs in infants but can also occur among children and adults. The predefined aim of the study was to analyze the affects of AD on the quality of life (QOL) of children or adults and to recognize the most affected areas of a patient’s life. QOL is an expansive concept and covers various dimensions of the human life that deals with the understanding of impacts that a disease can have on the QOL of an individual. It also tries to comprehend the outcomes associated with the treatment of patient and the burden of disease. Currently, the awareness regarding the measurement of QOL has augmented as it would be helpful for the physicians to have awareness regarding the patient’s views about their illness and its impact on their well being. In order to understand the impact of AD on the patient’s life and to understand whether the QOL of the public differs from that of the AD patient, evaluation of the QOL is imperative in the clinical field. The research in this regard is mandatory to make better decisions regarding resource allocation in dermatology to prevent it from suffering the consequences of lack of knowledge. Life threatening conditions as well as social and psychological consequences of this disease has not been documented yet but information regarding its impact on QOL will be helpful in overcoming this disease.