Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 6th International Conference on Clinical and Experimental Dermatology Chicago,Illinois, USA.

Day 3 :

  • Track 1: Dermatological Diseases
    Track 2: Aesthetic Dermatology
Location: Vienna
Speaker

Chair

Omeed Memar

Northwestern University School of Medicine
USA

Speaker

Co-Chair

Eric Huang

University of California
USA

Session Introduction

Omeed Memar

Northwestern University
USA

Title: Low level laser treatment for hair loss

Time : 11:15-11:35

Speaker
Biography:

Omeed Memar has completed his MD and PhD at the University of Texas and Dermatology Residency at University of Illinois School of Medicine. He is a premier hair transplant Surgeon. He has published many papers in reputed journals, patented numerous inventions and has been serving as an Editorial Board Member of repute.

Abstract:

Male pattern androgenetic alopecia (AAl) and female pattern hair loss (FPHL) are chronic conditions which causes social and psychological distress. In AAl hair recedes bilaterally from the anterior to posterior scalp and the vertex, while in FHPL hair thins diffusely on the entire crown and then sides without anterior receding . The treatment options are limited. One option is Low Level Laser Therapy. Here, I will review Low Level Laser Therapy (LLLT), which emits a monochromatic and coherent beam in the red or near infrared wavelength. The logic behind the use of LLLT comes from observation of paradoxical hypertrichosis while attempting laser hair removal, especially in skin color. The mechanism of this is unknown.

Eric Huang

University of California
USA

Title: Precision skin microbiome using skin probiotic bacteria against pathogens

Time : 11:35-11:55

Speaker
Biography:

Eric Huang has been an Assistant Professor at Department of Dermatology, University of Alabama, Birmingham for four years. He is currently a Professor at Department of Dermatology, University of California, San Diego. In the past nine years at UCSD, his research focuses on the development of vaccines and probiotics for treatments of various skin diseases including acne vulgaris and S. aureus infection. His results demonstrate that carbohydrate fermentation of the human skin microbiome functions as the innate immunity against pathogens. Many skin probiotic bacteria have been isolated in his lab and developed as bacteriotherapy for treatments of skin disorders.

Abstract:

Microbial imbalance with the over-growth of microbes in the human skin microbiome is termed “skin dysbiosis”. We have demonstrated that many skin (probiotic) bacteria in the human skin can exploit the skin endogenous carbohydrates to undergo fermentation and produce short-chain fatty acids (SCFAs) to rein in the over-growth of microbes in the skin. Our approach here is to selectively amplify the fermentation activity of probiotic bacteria to rebalance the skin dysbiosis. Various selective fermentation initiator (SFIs) including carbohydrate analogs have been used to exclusively trigger the fermentation of skin probiotic bacteria. The concept of using SFIs to enhance the probiotic activity of skin bacteria against pathogens will be applied for development of post-antibiotic adjuvant therapy for treatment of skin disorders. Two disease models Acne vulgaris and Staphylococcus aureus (S. aureus) infection] are used to test the efficacy of SFIs. We envision that precision microbiome approaches using SFIs are able to specifically intensify the probiotic ability of skin bacteria, produce SCFAs to “beat” out its pathogen competitors and reduce inflammation via the inhibition of histone deacetylase (HDAC). The SFIs will be developed as “antibiotic adjuvants” and tested their ability to reduce the effective dose of topical antibiotics for treatment of skin disorders and minimize the non-specific killing effect of antibiotics on skin commensals. When successful, SFIs will be the first antibiotic adjuvants that are designed based on natural strategy (fermentation) of human skin commensals.

Reza F Ghohestani

Texas Institute of Dermatology, USA

Title: Workshop on Challenging cases in RheumDerm

Time : 11:55-12:55

Speaker
Biography:

Reza Fredrick Ghohestani completed his Internship in Surgery at Penn and Derm residency at Thomas Jefferson University. He received his Master’s in Cutaneous Biology & Pharmacology and PhD in Skin Immunobiology from Claude Bernard University, Lyon. Dr. Ghohestani served as the principle Investigator and team leader for many years at various Academic Institutes. He is a former chief of dermatology of University of Texas and Editor of European Journal of Dermatology. Dr. Ghohestani outstanding work and dedication to excellence have earned him numerous honors and international awards for his dermatology research including the American Skin Assoc. & Derm Found Awards. Dr. Ghohestani is director of Texas Institute of Dermatology.

Abstract:

Many diseases initially present with skin manifestations and may often have an overlap with rheumatologic symptoms and diseases. Patients who have cutaneous features of autoimmune and connective tissue diseases have been a challenge for both Dermatologists and Rheumatologists. Selected challenging cases with combined Dermatologic and Rheumatologic manifestations will be presented and different aspects of diagnosis, natural course and treatment will be discussed.

Farrokh Khosravi

Texas Institute of Dermatology
USA

Title: Workshop on Challenging cases in RheumDerm

Time : 11:55-12:55

Speaker
Biography:

Farrokh Khosravi has completed his Fellowship of Rheumatology in Shiraz University of Medical Sciences. He is a part time Assistant Professor of Medicine. His field of interest is autoimmune skin diseases and he has published papers in the field of Behcet's disease and Multicentric Reticulohistiocytosis in reputed journals and served as a Reviewer for Journal of Hormozgan University of Medical Sciences and Rheumatology Research Journal.

Abstract:

Many diseases initially present with skin manifestations and may often have an overlap with rheumatologic symptoms and diseases. Patients who have cutaneous features of autoimmune and connective tissue diseases have been a challenge for both Dermatologists and Rheumatologists. Selected challenging cases with combined Dermatologic and Rheumatologic manifestations will be presented and different aspects of diagnosis, natural course and treatment will be discussed.

Speaker
Biography:

Sammy Francis Murday has graduated from Heinrich-Heine-University Medical School in Duesseldorf, Germany. During his studies he was a Scholarship Student at the University of the Witwatersrand, Johannesburg and Tongji Medical School, Shanghai. He is a Dermatologist in the Department of Dermatology at Klinikum Dortmund; a Teaching Hospital of University of Muenster and works in the field of laser medicine

Abstract:

Evidence based medicine is the process of systematically reviewing, evaluating and using clinical research findings to aid the delivery of best clinical care to patients. Over the past decades lasers became very popular in the field of aesthetic medicine and many approaches are available. Although the numbers of treated patients and indications to treat are high; the number of valuable clinical studies is limited. To decipher the different levels of evidence available for laser treatments, we performed an analysis of current studies and reviews. Since there are many aesthetic indications for laser treatment we focused on the distinct field of hair removal and searched for data from the Chochrane library, PubMed and Medline. Photoepilation is approximately one of the most common medical applications of Laser medicine and has a big economical impact. The use of lasers for hair removal has been approved by FDA in 1996. Until today about 21 randomized controlled trials and five systematic reviews are published. Although randomization processes and presentation of methods are mainly poor and follow-ups are short in time best evidence can be stated for the diode and alexandrite lasers followed by Nd:YAG lasers and IPL. Nevertheless there is no satisfying evidence for permanent hair removal but only for hair reduction. Further high quality studies are required to improve the levels of evidence. In the future EBM could help to communicate expectations and outcomes with patients. Thereby patient dissatisfaction, side effects and malpractice could be reduced

Speaker
Biography:

Sevil Alan has received her PhD from Ege University, Turkey during the period of 1993-1999. She completed her Dermatology Residency at the Adana Numune Education and Research Hospital in Adana, Turkey. Currently, she is working as a Dermatologist in Akdeniz University School of Medicine, Turkey. She is a member of editorial board of journals like SM Dermatology, Dermatology & Pigmentation Disorders, and International Journal of Clinical Dermatology & Research (IJCDR). She is serving as a Reviewer for journals like JAMA Dermatology, International Research Journal of Public and Environmental Health, International Medical Journal of Sifa University. She has authored many research articles.

Abstract:

GDF-15 (Growth Differentiation Factor-15)/ Macrophage inhibitory cytokine-1 (MIC-1) is a member of the transforming growth factor β (TGF-β) superfamily. TGF-β/bone morphogenetic protein/growth differentiation factor family proteins are important regulators of cellular physiological processes, including cell survival, proliferation, differentiation, migration, and apoptosis. GDF-15 is has been reported to exhibit both tumorigenic and antitumorigenic activities. GDF-15 is regulated by p53 and highly expressed in melanoma cells. Furthermore GDF-15 is associated with oxidative stress, inflammation and histamine-induced melanogenesis. Some studies showed that GDF-15 level is increased in patients with systemic sclerosis and is related with the extent of skin sclerosis. Therefore measurement of serum GDF-15 may be useful for risk stratification in early disease stage. In the future, GDF-15/MIC-1 may be suitable for development as a serum diagnostic and is a possible target for the treatment of benign and malign skin diseases.

Speaker
Biography:

Andrew Leask has completed his BSc from the University of British Columbia and PhD from the University of Chicago and postdoctoral studies from Stanford University School of Medicine. He was staff scientist at FibroGen and University College London. He has published more than 130 peer reviewed journals, has an h factor of 47 and is Managing Editor of Journal of Cell Communication and Signaling and on the editorial board member of several other journals.

Abstract:

Melanoma, the second most common invasive cancer in young adults, is highly metastatic: ~5% of patients diagnosed with metastatic melanoma survive for 5 years after diagnosis. 40–60% of all cutaneous melanoma patients possess mutations in BRAF; in these patients, tumors shrink in response to the BRAF inhibitors. However, patients develop resistance to these drugs, necessitating the development of alternative therapeutic targets. The matricellular protein connective tissue growth factor (CCN2) is overexpressed in melanoma; however, how CCN2 contributes to melanoma progression is unclear. Herein, we use melanoma cell lines and mice which CCN2 is deleted in the tumor stroma to demonstrate that loss of CCN2 in the tumor microenvironment impedes melanoma invasion. Specifically, loss of CCN2 in melanoma cells diminished their ability to invade through collagen in vitro, and loss of fibroblast-derived CCN2 decreased metastases of melanoma cells from the skin to the lungs in vivo. CCN2-deficient B16(F10) cells showed reduced expression of periostin; addition of recombinant periostin rescued the in vitro invasion defect of these cells. Analysis of CCN2-deficient mice confirmed loss of periostin expression in the absence of CCN2. CCN2 and periostin mRNA levels are positively correlated with each other and with the stromal composition of human melanoma lesions but not BRAF mutations. These results are consistent with the idea that metastatic ability results from CCN2-mediated interactions between tumor cells and the stroma. CCN2 promotes invasion and metastasis via periostin and should be further evaluated as a possible therapeutic target for BRAF inhibitor-resistant melanoma.

Speaker
Biography:

Arpi Avetisyan is a Research Associate at Nairian CJSC; an Armenia based all natural cosmetics manufacturer. Her primary responsibility in the company is technology development for production and scientific research in the field of herbal cosmetics. She is interested in safe use of various herbs and essential oils to address diverse cosmetology issues. Before joining Nairian CJSC, she was a Researcher at the Institute of Chemical Physics of NAS of Republic of Armenia. She has obtained her MS degree in Chemistry from Yerevan State University, Yerevan, Armenia.

Abstract:

Several components of essential oil distilled from the flowers of Rosa damascene Mill L, were reported to have anti-bacterial, antioxidant and relaxant properties. This is the reason why, apart from the fragrance industry, this oil is being widely used in cosmetics and pharmacopeia. As with any essential oil, the content and composition of it can change significantly, depending on the cultivation methods and terroir. The purpose of this research is to determine the chemical composition and to test biological activities of essential oil distilled from damask rose flowers cultivated in Armenia at an exceptionally high elevation of 1600 m above sea level. The essential oil was obtained by hydro-distillation method in a Clevenger type apparatus and its chemical composition was determined by HP GC-MS setup. As a result of analysis, the main compounds of obtained essential oil were determined to be citronellol (22.28%), nonadecane (15.09%), caryophyllene (10.82%), heneicosane (9.21%), farnesol (6.34%) and citral (6.15%). The antioxidant activity of the essential oil samples was measured through conducting DPPH assay. Minimal inhibition concentrations for both microbiological and anti-fungal properties were measured using the same agar diffusion method. The amount of this oil that can be safely used in cosmetic products was evaluated according to dermal maximum values for its constituents according to "Essential Oils Safety".

  • Poster Presentation
Speaker
Biography:

John Zade was graduated with an Honorary Bachelors of Science from Binghamton University and he is currently pursuing his Medical degree. He is a Research Fellow at Columbia University and Mount Sinai in the Department of Dermatology. He is the author of two pending medical patents and has co-authored published papers in reputed journals.

Abstract:

The injection of soft tissue augmentation products or fillers is now a commonplace aesthetic procedure. When the American Society for Aesthetic Plastic Surgery (ASAPS) conducted a survey in 2014 of the most common non-surgical procedures in the United States, it found the injection of hyaluronic acid (HA) fillers was the second only to botulinum toxin injections. Hyaluronic acids have a superior safety profile when compared with other soft tissue augmentation products because they exhibit minimal tissue reactivity while being reversible with commercially available hyaluronidase preparations. As such, the storage of HA fillers has come under scrutiny in recent years and the use of these products past their expiration date has come to light. While not uncommon, reuse of HA fillers after opening or past their expiration date is not recommended by manufacturers and has led to controversy since the science behind these practices is infrequently studied. In our study, we cultured 17 used and unused HA fillers from syringes that were stored in recommended conditions but had passed their expiration dates (range of 9 months to 3 years). Analysis did not reveal a single case of bacterial growth in any of our samples. However, more studies are needed before conclusive statements can be drawn from these data. In addition, samples were not analyzed for physical degradation that may reduce the filler’s in vivo effectiveness.

  • Track 3: Skin Infection
    Track 4: Dermatological Oncology
Location: Vienna
Speaker

Chair

Iona Weir

Decima Health Ltd
New Zealand

Speaker

Co-Chair

Andrew Leask

University of Western Ontario
Canada

Session Introduction

Farah Rukhsana Abdulla

University of Chicago
USA

Title: The association of Staphylococcus aureus and mycosis fungoides/Sezary syndrome

Time : 14:20-14:40

Speaker
Biography:

Farah Rukhsana Abdulla has completed her MD from Northeastern Ohio Medical University, Dermatology Residency and Dermatopathology Fellowship at the University of Cincinnati, Cutaneous Lymphoma Fellowship at Stanford University School of Medicine and a Science and Technology Policy Fellowship with the American Association for the Advancement of Science. She is the Director of the Cutaneous Lymphoma Clinic at the University of Chicago.

Abstract:

Mycosis fungoides (MF) and Sezary Syndrome (SS) are the two most common types of cutaneous T-cell lymphoma. They are both neoplastic diseases with the phenotype of a T-helper cell, expressing CD4+ and CD45RO+. The classic presentation of MF is patches and plaques on the skin that can evolve into tumors with visceral involvement being rare. Sezary syndrome generally presents with erythroderma, significant blood involvement and lymphadenopathy. While MF is an indolent disease in its early stages, histologic transformation to a large cell subtype (t-MF) is associated with an aggressive clinical course resulting in shortened survival as is Sezary Syndrome. However, due to the compromised skin barrier associated with erythroderma in general, infection is the leading cause of death rather than increased tumor burden. The most common infection is Staphylococcus aureus. However, not all causes of erythroderma are associated with an increased risk of infection. In particular, MF/SS has a TH2 cytokine profile and thus is associated with a decrease in antimicrobial peptides predisposing patients to Staphylococcus aureus colonization as seen in atopic dermatitis. While this bacterium is accepted as a dangerous pathogen in patients with CTCL, its role in causing T-cell expansion is not well accepted. Staphylococcal sepsis and colonization of the skin are associated with disease progression, including worsening erythroderma as well as pruritus, increased white blood cell counts and high lactate dehydrogenase. Staphylococal enterotoxins may not only take advantage of the compromised immune barrier but stimulate the immune dysregulation leading to worsening disease as well.

Speaker
Biography:

Andrew Leask has completed his BSc from the University of British Columbia and PhD from the University of Chicago and Postdoctoral studies from Stanford University School of Medicine. He was a Staff Scientist at FibroGen and University College London. He has published more than 130 peer reviewed journals, has an h factor of 47 and is Managing Editor of Journal of Cell Communication and Signaling and the Editorial Board Member of several other journals.

Abstract:

Melanoma, the second most common invasive cancer in young adults, is highly metastatic: ~5% of patients diagnosed with metastatic melanoma survive for 5 years after diagnosis. 40-60% of all cutaneous melanoma patients possess mutations in BRAF; in these patients, tumors shrink in response to the BRAF inhibitors. However, patients develop resistance to these drugs, necessitating the development of alternative therapeutic targets. The matricellular protein connective tissue growth factor (CCN2) is overexpressed in melanoma; however, how CCN2 contributes to melanoma progression is unclear. Herein, we use melanoma cell lines and mice in which CCN2 is deleted in the tumor stroma to demonstrate that loss of CCN2 in the tumor microenvironment impedes melanoma invasion. Specifically, loss of CCN2 in melanoma cells diminished their ability to invade through collagen in vitro and loss of fibroblast derived CCN2 decreased metastases of melanoma cells from the skin to the lungs in vivo. CCN2 deficient B16(F10) cells showed reduced expression of periostin; addition of recombinant periostin rescued the in vitro invasion defect of these cells. Analysis of CCN2 deficient mice confirmed loss of periostin expression in the absence of CCN2. CCN2 and periostin mRNA levels are positively correlated with each other and with the stromal composition of human melanoma lesions but not BRAF mutations. These results are consistent with the idea that metastatic ability results from CCN2 mediated interactions between tumor cells and the stroma. CCN2 promotes invasion and metastasis via periostin and should be further evaluated as a possible therapeutic target for BRAF inhibitor-resistant melanoma.

Maurice Efana Asuquo

University of Calabar
Nigeria

Title: Squamous cell carcinoma in a tropical setting

Time : 15:00-15:20

Speaker
Biography:

Maurice Efana Asuquo is a Professor/Chief Consultant Surgeon at the University of Calabar, University of Calabar Teaching Hospital, (UCTH), Nigeria. He has served as the Head of Department of Surgery, University of Calabar, Dean, Faculty of Medicine and Dentistry and Provost College of Medical Sciences. His major research interest is dermatological oncology. He is currently the Head of the Oncology unit of UCTH, Nigeria. He has attended several international and local conferences, presented several papers on dermatological oncology. He has over 80 publications to his credit.

Abstract:

Background: In Sub-Saharan Africa, squamous cell carcinoma (SCC) is reported to be commoner than other skin malignancies. This is in sharp contrast with the experience in North America and Europe where basal cell carcinoma (BCC) is reported to be the commonest skin cancer. The risk factors vary with geographic region and race. This study sought to evaluate the current pattern, possible risk factors and management outcomes in the authors setting and proffer solutions improved outcomes. Method: Patients who presented with histologic diagnosis of SCC at the University of Calabar Teaching Hospital, (UCTH), Calabar, Nigeria from 2013 to 2015 were prospectively studied and compared with total number of patient with skin malignancies seen over the same period. Results: In total, 10 patients (4 male, 6 female; M:F ratio 1:1.5) whose ages ranged from 7-65 years (mean 43.7 years) were seen. They comprised 47.6% of total skin malignancy seen in the study period. Nine (90%) were darkly pigmented while one patient was an albino. Three (30%) patients presented with Marjolin’s ulcer (MU) affecting the limbs (1 upper, 2 lower limb) while 7 (70%) were non Marjolin’s. In the later subset, the albino presented with multiple lesions (left post auricular and upper back). Three (30%) patients all females presented with anal cancers. The youngest patient aged 7 years presented with auricular polyp. The other 2 (20%) patients presented with scalp ulcers. All the patients with MU were due to chronic traumatic ulcers; their ages ranged from 27-55 years (mean 45.3 years). The latency period was from 6-11 years (mean 8.3 years). Patients were offered a combination of surgery (excision, skin grafting/flaps and amputation), chemotherapy and radiotherapy. The outcomes were poor due to advanced primary lesions at presentation with one hospital mortality in a patient with an extensive scalp ulcer. Conclusion: The clinical pattern of SCC in our setting revealed that patients were in 2 subsets: Marjolin’s and non Marjolin’s. The risk factor in the MU group appears to be chronic traumatic ulcer. In the non Marjolin’s group, solar radiation was attributed to be the risk factor in the albino patient while others were non-solar. Socio-cultural beliefs, ignorance and poverty were remarkable underlying issues. Education highlighting the possible risk factors, early presentation, diagnosis and treatment will improve outcomes with a decrease in the health care cost of SCC.

Speaker
Biography:

Arpi Avetisyan is a Research Associate at Nairian CJSC; an Armenia based all natural cosmetics manufacturer. Her primary responsibility in the company is technology development for production and scientific research in the field of herbal cosmetics. She is interested in safe use of various herbs and essential oils to address diverse cosmetology issues. Before joining Nairian CJSC, she was a Researcher at the Institute of Chemical Physics of NAS of Republic of Armenia. She has obtained her MS degree in Chemistry from Yerevan State University, Yerevan, Armenia.

Abstract:

Several components of essential oil distilled from the flowers of Rosa damascene Mill L, were reported to have anti-bacterial, antioxidant and relaxant properties. This is the reason why, apart from the fragrance industry, this oil is being widely used in cosmetics and pharmacopeia. As with any essential oil, the content and composition of it can change significantly, depending on the cultivation methods and terroir. The purpose of this research is to determine the chemical composition and to test biological activities of essential oil distilled from damask rose flowers cultivated in Armenia at an exceptionally high elevation of 1600 m above sea level. The essential oil was obtained by hydro-distillation method in a Clevenger type apparatus and its chemical composition was determined by HP GC-MS setup. As a result of analysis, the main compounds of obtained essential oil were determined to be citronellol (22.28%), nonadecane (15.09%), caryophyllene (10.82%), heneicosane (9.21%), farnesol (6.34%) and citral (6.15%). The antioxidant activity of the essential oil samples was measured through conducting DPPH assay. Minimal inhibition concentrations for both microbiological and anti-fungal properties were measured using the same agar diffusion method. The amount of this oil that can be safely used in cosmetic products was evaluated according to dermal maximum values for its constituents according to "Essential Oils Safety".

Sowmya Naga Dogiparthi

Chettinad Health City
India

Title: Cutaneous manifestations of diabetic peripheral neuropathy

Time : 15:55-16:15

Speaker
Biography:

Sowmya Naga Dogiparthi has completed her MBBS and MD in Dermatology, Venereology, and Leprosy in 2014 from Sri Ramachandra Medical University, India. She worked as Junior Resident in Department of Endocrinology at SRU. She has completed a degree in Cosmetelogy from Stanley Medical College & Hospital and holds a Diploma in Fellowship in Aesthetic Medicine from Institute of Laser and Aesthetic Medicine, India. She presented multiple posters and oral presentations in the field of Dermatology and has one national publication.

Abstract:

There is a rise in number of people diagnosed with diabetes. Diabetes is a common manifestation in modern Indian society because of industrial development and drastically changing lifestyles. Diabetic neuropathies are microvascular disorders that are associated with diabetes mellitus. Among the various forms of diabetic neuropathy, the most common is diabetic peripheral neuropathy. The disease if neglected leads to chronic manifestations of ulcer formation and finally leading to amputations. Hence the aim of this study is to document these cutaneous changes and create an early awareness in the importance of controlling diabetes. The study consisted of 205 patients with type 2 DM. Participant’s neuropathy status was determined based on Neuropathy Disability Score and Diabetic Neuropathy Symptom Score (DNSS). 112 (55%) patients with severe DNSS. 101 (49%) patients with moderate Neuropathy Disability Score (NDS) and 75 (37%) with severe NDS. Among the skin changes documented, the common changes seen in the patients are: Peripheral hair loss in 185 (90.2%), xerosis in 168 (82%), anhydrosis in 162 (79%), plantar fissures in 136 (66.3%), ulcer in 80 (39%), among ulcers, the common presentation of Grade-1 (superficial ulcers-55 (26.8%), callus in 73 (35.6%), previous ulcers in 36 (17.6%) patients. Common nail changes documented were onychomycosis in 165 (80.5%) and onychauxis in 53 (25.8%) patients. The other parameters documented were anatomical foot changes, type of foot wear and working nature of the participants. In conclusion, it is important to control glycemic levels in the initial stages of diabetes.

Speaker
Biography:

Ujjwala Kulkarni is currently pursuing her PhD in reputed medical school in Mumbai. She has completed Master in Pharmacology from Baroda Medical College affiliated to M.S. University, Gujarat. She has worked as a Lecturer in Department of Pharmacology for 7 years and taught basic pharmacology to undergraduate medical student. She also got GSMC Regional Fellowship in Foundation of Advance Instruction in Medical Education and Research (FAIMER Fellowship) for innovative project in medical education. She also has a experience in BA/BE study. She published 7 papers in reputed journals.

Abstract:

BACKGROUND: Psoriasis is a chronic skin disorder with no cure. Very few studies have been published to reflect the impact of established pharmacotherapy on psoriasis patients, perception as well as satisfaction with the treatment in India. METHODS: The present study intended to find out the quality of life of chronic plaque psoriasis patients, using psoriasis disability index (PDI) and to find out the patient satisfaction towards the given pharmacotherapy, using a pre-validated structured patient satisfaction questionnaire. The study was initiated in the Department of Dermatology after taking a permission from the Institutional Ethics Committee, for a period of one and a half years. Patients (n=72) were enrolled after taking a written informed consent. Demographic data were collected. Psoriasis Area Severity Index (PASI) scores were calculated to grade the clinical severity of psoriasis in the patients. Two different questionnaires viz., Psoriasis disability index (PDI) to evaluate the quality of life and a pre-validated and structured patient satisfaction questionnaire (PSQ) to evaluate the satisfaction of the patients towards the given treatment were used. RESULTS: 50% of the psoriatic patients on treatment showed overall satisfaction towards the given treatment. 24% wanted a change in their current therapy. The correlations of PDI with PASI and PSQ with PASI were analysed by Spearman rank test. The PASI is moderately correlated with daily activity (r=0.43, p<0.0001), personal relation (r=0.47, p<0.001), leisure (r=0.44, p<0.0001) and weakly correlated with treatment (0.22, 0.02). The total PDI and PASI scores are strongly correlated with each other (r=0.76, p<0.0001). The PSQ did not show any correlation with PDI and PASI. CONCLUSION: 50% patients remained dissatisfied with the treatment as their quality of life did not improve. Therefore, psoriasis should be treated with a holistic and integrative approach by the physician along with frequent patient counselling. PSQ showed no

Speaker
Biography:

Sanjita has graduated from National Pirogov Memorial Medical University, Ukraine and pursued her Post graduation in Dr. Balabhai Nanavati Hospital and Research centre, Mumbai, India. She has contributed immensely to the field of Dermatology and Cosmetology and Serving ELSEVIER India, a premier publishing organization. She has published papers in reputed journals and has presented her research topics globally in various conferences. She is also associated to the Editorial Board of a journal of repute and she is a part of the Scientific Advisory Board for a leading pharmaceutical company in India.

Abstract:

Background: Periorbital rejuvenation is described as the restoration of a youthful skin around the eyes. Aging around the eyes manifest as: Crows feet, eyelid rhytides, skin laxity, eye bags and periorbital hypermelanosis. Expensive treatment modalities (peels for hypermelanosis, surgery for skin laxity/eye bags, botulinum toxin injections for crow’s feet) are individually available. Lack of a single efficacious cost effective modality led us innovate a treatment modality which took care of all the symptoms simultaneously. Aim & Objectives: To evaluate the efficacy of 3.8 MHz radiofrequency (RF) device in a non ablative mode for periorbital rejuvenation. Methodology: The study was carried out in a tertiary care centre of a teaching institution in eastern India after obtaining an informed consent from each subject and an ethical committee clearance from the institution. 18 female patients between 25 to 35 years were enrolled in the study by purposive sampling. Each of them presented with diversing complaints of aging around the eyes. They were evaluated by a blinded observer. Clinical photographs, the Fitzpatrick wrinkle classification and a self satisfaction survey (using a 9 point rating scale) were the methods of assessment. Each subject underwent 8 weekly treatment sessions of non ablative RF therapy using a 3.8MHz RF device with a 5 mm ball electrode. They were followed up for 6 months post treatment. Results: Evaluation of the obtained data by the blinded observer, showed progressive improvement in wrinkle scores at 1, 3, 6 months intervals. The photographs revealed a marked reduction in periorbital hypermelanosis, eye bags and skin laxity. The self evaluation scale also showed improving satisfaction. Conclusion: 3.8 MHz RF device using a 5 mm ball electrode is a safe and cost effective device for periorbital rejuvenation. Limitations: The only noted limitation was transient erythema lasting for a few hours following each RF treatment.

Speaker
Biography:

Aymen El Gendy has completed his MBBCh from Zagazig University, Banha Faculty of Medicine in 1983. He has received his MSc and his MD in Dermatology and Venereology in 1988 and 1992 respectively from the same University and Faculty. He is currently the Consultant of Dermatology in Saudi Airlines Medical Services Center. He has published several papers on Psoriasis in reputed journals. He is a Member of the International Society of Dermatology, The Egyptian Society of Dermatology and the Saudi Society of Dermatology.

Abstract:

Psoriasis is a common chronic immune-mediated inflammatory disorder affecting 2-3% of the population. Psoriasis is associated with a variety of psychological difficulties including poor self-esteem, social stigmatization, anxiety, depression and suicidal ideation. Psoriasis is associated with substantial impairment of health-related quality of life (HRQOL). Some studies estimated that around one-quarter of patients in dermatology practices has a psychiatric disorder. Significantly elevated concentrations of TNF-α have been observed in the plasma of patients with psoriasis and in patients with major depression. TNF-α has been implicated in the pathogenesis of both psoriasis and depression. In humans, administration of TNF-a blockers such as etanercept (Enbrel), infliximab (Remicade) and adalimumab (Humira) and IL-12/23 inhibitors have been found to improve depression that accompany psoriasis.

  • Track 5: Clinical and Medical Dermatology
    Track 6: Dermatology: Therapies and Advances
    Track 7: Diagnostic Techniques in Dermatology
Location: Vienna
Speaker

Chair

Farrokh Khosravi

Texas Institute of Dermatology
USA

Speaker

Co-Chair

Svyatenko Tetyana

Center of Dermatology and Cosmetology
Ukraine

Session Introduction

Farrokh Khosravi

Texas Institute of Dermatology, USA

Title: Drug-induced fracture, role of osteoporosis and sarcopenia: What's new?

Time : 11:15-11:35

Speaker
Biography:

Farrokh Khosravi has completed his Fellowship of Rheumatology in Shiraz University of Medical Sciences. He is a part time Assistant Professor of Medicine. His field of interest is autoimmune skin diseases and he has published papers in the field of Behcet's disease and Multicentric Reticulohistiocytosis in reputed journals and served as a Reviewer for Journal of Hormozgan University of Medical Sciences and Rheumatology Research Journal.

Abstract:

In this talk recent advances in understanding of drug induced fractures will be discussed. Fractures are the serious problem of the aged population, which is responsible for significant amount of morbidity and mortality. Any attempt to prevent or decrease incidence of fractures will save lives. Drugs increase Osteoporosis and Sarcopenia which both have a role in increasing fracture incidence. Sarcopenia is characterized by progressive and generalized loss of muscle mass and strength.

Speaker
Biography:

Leonard B Weinstock has completed his MD at the Rochester University School of Medicine and Gastroenterology Fellowship at Washington University. His research revolves around extra-intestinal manifestations of SIBO (including rosacea, restless legs syndrome, fibromyalgia and chromic pelvic pain syndromes), control of systemic inflammation and intestinal dysbiosis. He has published more than 80 chapeters, papers and abstracts. His academic position is Associate Professor of Clinical Medicine and Surgery at Washington School of Medicine in St. Louis and he is the President of Specialists in Gastroenterology.

Abstract:

Background: Rosacea is associated with Crohn’s disease, liver disease, chronic pancreatitis, achlorhydria, Helicobacter pylori and recently with idiopathic small intestinal bacterial overgrowth (SIBO). Two publications demonstrated that rifaximin, a non-absorbed, gut-directed antibiotic for SIBO led to improvement in facial rosacea. Ocular manifestations occur in up to 58% of rosacea patients and include dry eyes, foreign body sensation, photosensitivity, eyelid inflammation, neovascularization and corneal ulcers. Methods: Patients who had been diagnosed with ocular rosacea by four ophthalmologists were referred for SIBO testing using the lactulose breath test (LBT). All were refractory to rosacea therapy. An open-label, IRB-approved trial of rifaximin 550 mg/3x/day for 10-14 days was performed in LBT-positive subjects. Ten and twenty days after ending rifaximin, subjects were queried if their eye symptoms had marked, moderate or mild improvement or if they were unchanged. Results: Twenty four patients (21F/3M), mean age 59 with facial involvement in 4 were tested. The LBT was positive in 9/24 (38%). LBT-positive subjects had chronic gastrointestinal symptoms in 63% vs., 33% in LBT-negative subjects. Rifaximin was prescribed to 9 LBT-positive subjects. Insurance denied the prescription in one subject. One subject was lost was to follow up. Improvement in ocular rosacea symptoms was marked (4), moderate (1) and mild (2). Conclusions: Rifaximin therapy led to improvement in ocular rosacea in the setting of SIBO. Dysregulation of the innate immune system as a result of gastrointestinal inflammation could lead to an increase in systemic cytokines and microbial antigens/antibodies in the skin and eyelids leading to activation of rosacea.

Svyatenko Tetyana

Center of dermatology and kosmetology,Dniepropetrovsk
Ukraine

Title: Cutaneous sarcoidosis

Time : 11:55-12:15

Speaker
Biography:

Professor Svyatenko Tetyana has completed her PhD at the age of 27 years from Bogomolets National Medical University (Kiev, Ukraine), has completed her Professor at the age 35 from Bogomolets National Medical University (Kiev, Ukraine). She is the director of Center Dermatology and Cosmetology of Professor Sviatenko. She is professor of Dermatovenerology department of Dniepropetrovsk state Medical Academy, Ukraine. She has published more than 300 papers in scientific journals and has been serving as an editorial board member of repute. Participant and speaker at more than 200 scientific congresses and symposia in Ukraine and abroad. Founded a school for atopic patients in Dnepropetrovsk region.

Abstract:

The skin is affected in 20-25% of all cases and is very important in the diagnosis, prognosis and course of sarcoidosis. In recent years the number of cases of sarcoidosis increased in Ukraine. We are observed men, born in 1967, complained about skin rash in the area of the upper third of the back slightly itching. The process progresses slowly(2 years). He was treated with the diagnosis: multiple warts? Lichen planus? – without effects. Patient also has a history of atopic dermatitis, androgenetic hair loss. The parents and close relatives are healthy. Physical condition was satisfactory. Pathological skin process is localized on the upper back. Rush is represented by single knots, up to 2 - 5 mm in diameter, multiple scattered and confluent lesions up to 3 cm in diameter, the colour red and pink, with telangiectasias, soft-elastic consistency, the surface smooth and shiny. On diascopy symptom of "dust", the phenomenon of "cape". Blood test results: normal range. Punch biopsy was provided. Histological investigation shown epidermis without changes, multiple epithelioid - cell granulomas are determined in papillary and reticular dermis with the presence of single giant polynuclear cells. Granulomas have clear boundaries, with the presence of single lymphocytes around some of them. When painting on Alcian blue PAS + cells of fungi have been identified. The basement membrane is within norm. No dermal mucin. The diagnosis: Cutaneous sarcoidosis. In our opinion, the case described introduce certain interest in the daily practice of a physician - clinician.This condition is rare and difficult to diagnose.

Speaker
Biography:

Dr. Ylfete A. Shatri - Muçaj, a clinical dermatovenerology and pharmacology specialist for specialization of clinical pharmacology is one of the first generations for basic specialization in this field in Balkans. She finished post-graduation and specialization studies in the University of Novi Sad. Currently, she works in UCC in Prishtina from 1981; as a specialist of clinical pharmacology she has treated for 4 years patients with chemotherapy near Internal Clinic – Department of Hematology in UCC. She led for many years the laboratory for magisterial preparations in the Center Pharmacy and Dermatovenerology Clinic near CUU in Prishtina. She worked for some years in the Institute of Biochemistry near Diagnostic Center of CUU. Since 2001 she is working as a Clinical Dermatovenerologist and Pharmacologist in KDV and now leads Dermatological polyclinic and laboratory for magisterial preparations for several skin diseases and and aesthetic issues by which she treats patients in the polyclinic “GENTIANA GreLorGen”. She participated in many conferences and congresses in region and Europe with several scientific works in the field of clinical Dermatology, Oncology and Pharmacology and also as a lecturer of chemotherapy in the National Congress of Oncologists in Prishtina. She is a member of EADV and Kosovo Association of Dermatovenerologists and Oncologists.

Abstract:

The changes in the skin in the form of brown spots (hyperpigmentation) at humans, pose an aesthetic problem but also more a health problem/issue. Hyperpigmentation is presented in most of cases in the face region, but they do not spare other body also. During my research and the treatment of my patients, in my professional experience I have gone through patients with hyperpigmentation with different etiologies. Hyperpigmentation have multiethiology (conclusion). In the most of cases, they are signs that indicate and support us to find many internal disorders of the body and organism, just as an ID reaction to many diseases as: Endocrine (hormonal disorder), fungal infections, autoimmune disease (Morphea), therapeutic (either systemic or local), application of cosmetic preparations, and combined. In the time period July 2010 – 2015, in the clinic “GENTIANA GreLorGen” in Prishtina (Republic of Kosova), there have been treated in total 378 patients for various forms of hyperpigmentation, from whom, 34 male (9%) and 344 female (91%). These patients, in this research have been categorized in groups based in the etiology: Group I: Patients with Endocrine etiology (hormonal disorders); Group II: Patients with Autoimmune disease etiology; Group III: Patients with Mycotic (fungal) infections etiology; Group IV: Patients with Local and systemic therapeutics etiology; Group V: Patients with Cosmetic etiology; Group VI: Patients with different/combined etiology. Depending on the hyperpigmentation etiology, beside the local therapy with magisterial preparations, proper field specialists have been consulted as: Endocrinologist, Gynecologist, Cardiologist, and Rheumatologist. In addition, beside the local treatment with magisterial preparations as personal cream: ALBA-HYNOGEN, ALBAHYNOGEN M2, LORGEN SUN DAY, PREVITA-GEN, DEPEOR-KET, DEPEOR-GEN, ITRA-PEN, LOTTI FLU GEN, JORA-XH, PERIORB GEN, ANTISEP-CONT, ANTISEP-V; Patients have been treated with additional physical therapy as: MKDB (Micro dermo abrasion) combined with therapy. Conclusion: Hyperpigmentation treatment requires a proper multidisciplinary research and diagnostification, depending on its etiology and appearance

Vesna Grivcheva-Panovska

University Saints Cyril and Methodius
Macedonia

Title: Innovative therapeutic approach of hereditary angioedema

Time : 13:15-13:35

Speaker
Biography:

Vesna Grivcheva-Panovska has received her Tenured Professorship in Dermatology in 2013 at University Saints Cyril and Methodius in Skopje, Macedonia. She is the Head of the Unit of Allergy and Clinical Immunology at the University Clinic of Dermatology and she is In-charge of Clinical Diagnostics. She has been working in the field of HAE since 1984, publishing numerous papers in international journals and took active participation in six international scientific projects.

Abstract:

Hereditary angioedema (HAE) is a rare genetic, life-threatening disease. Patients affected by HAE most of the time are without visible signs of the disease, besides the attacks, which can be brutal, painful and lethal. Several therapeutic approaches have been developed and used with various success, recombinant human C1INH (rhC1INH) being the most innovative current approach. Recombinant human C1INH is a purified derivative from rabbit milk which expresses the gene that encodes the synthesis of C1INH. The amino acid sequence of the recombinant form is identical to the human C1INH. C1INH is single-chain plasma glycoprotein with a molecular mass of 73,650 belonging to the super-family of serine protease inhibitors in plasma. C1INH is the only known inhibitor of activated plasma subcomponents C1s and C1r of the complementary component 1 of the complementary cascade classical pathway. Furthermore, C1INH inhibits the Manan-associated serine protease 2 (MASP2) of the lectin pathway of the complement. Additionally, it is the main inhibitor of the activated factor XII, factor XI and kallikrein of the plasma contact system. The rhC1INH was primarily developed for treatment of acute angioedema attacks in patients with HAE due to C1INH activity deficiency. The rhC1INH inhibitory potential of target proteases C1s, kallikrein, factor XIa and factor XIIa is highly comparable to the endogenous human C1 esterase inhibitory potential in vitro. Additional data of the efficacy are obtained by multiple analysis of primary efficacy sensitivity end point as well as the results of secondary and explorative efficacy.

G Wiselin Jiji

Dr. Sivanthi Aditanar College of Engineering
India

Title: Diagnosis of dermatological lesions using intelligent techniques

Time : 13:35-13:55

Speaker
Biography:

G Wiselin Jiji has completed his PhD from Anna University and Postdoctoral studies from University Medical Centre, Hamburg, Germany. She is the Research Director of Computer Science & Engineering in Dr. Sivanthi Aditanar College of Engineering, Tiruchendur. She has published more than 55 papers in reputed journals and has been serving as an Editorial Board Member of repute. She had completed 14 research projects in the area of Bio Medical imaging, Pattern Recognition and Remote Sensing Images. Her area of interest is neural network, image processing & medical imaging. She has received 12 National Awards and got HRD fellowship from Indian Council for Medical Research, New Delhi.

Abstract:

Identifying dermatological diseases is a challenging task nowadays. The Architecture employed three phases of operation to perform efficient skin lesion diagnosis. In the first phase, segmentation of Lesion region is calculated. Second Phase carries Color, Texture and shape feature vectors extraction. Iteratively calculated SVM weight values to all combination of feature sets and selected feature sets having highest significant p-map value. Third phase is employed by multi-class PSO Classification technique. Experiments on 20 classes of 1450 images are analyzed and results are evaluated using receiver operating characteristic (ROC) curve, which proved that the proposed architecture is highly contributed to computer-aided diagnosis of skin lesions. Our empirical evaluation has a superior retrieval and diagnosis performance when compared to other works.

Sushruth G Kamoji

Belagavi Institute of Medical Sciences
India

Title: Psychological impact, treatment beliefs and outlook towards acne

Time : 13:55-14:15

Speaker
Biography:

Sushruth G Kamoji graduated (MBBS) from Jawaharlal Nehru Medical College, Belgaum and went on to pursue his Post Graduate Diploma in Dermatology from the prestigious Madras Medical College, Chennai. After completing his Post Graduation, Dr Sushruth G. Kamoji went on to do his Fellowship in Dermato-Surgery from the renowned Post Graduate Institute of Medical Sciences (PGIMER), Chandigarh. Dr Sushruth now works as a Resident Dermatologist at a Govt. medical college – Belgaum Institute of Medical Sciences, Belgaum.

Abstract:

Background: Acne vulgaris is a chronic inflammatory disease affecting majority of the adolescent population. It has been shown to have a severe impact on the psychosocial well being of a person. Objectives: To assess the psychological impact of acne vulgaris, to analyze their beliefs and outlook about treatment of acne. Materials & Methods: A total of 390 cases of acne attending a government tertiary hospital and private skin clinic were analyzed. After obtaining their consent each of them were handed a self administered questionnaire and their grade of acne noted by the investigator. Patients were analyzed using Cardiff Acne Disability Index for their psychological impairment and another set of questions to determine their beliefs on cause, monthly budget for treatment and preference for topical and oral medications in treatment of acne. Results: Out of 390 cases 194 (49.7%) were males and 196 (50.3%) were females. Majority (364-93.33%) of them were students. Of these 390 cases, 321 (82.3%) had either Grade-1 or Grade-2 acne while there were only 9 cases of Grade-4 acne. With regard to the CADI scores 59 cases had a score of >8, signifying psychological impact on due to acne. However, the overwhelming majority (84.87%) had a CADI score <8. This is in contradiction to most studies conducted worldwide. A large number of respondents said that they had acne on and off but persistent acne for more than a year was noted in 121 (31%) cases. Despite this 206 (52.82%) cases had never sought treatment for acne. In the remainder of 184 patients (47.17%) who took treatment, 82 of them had used the medication based on an advertisement, friend’s suggestion or an over the counter product. It was quite naturally that 110 (59.78%) cases were not satisfied with the treatment. Even though 102 cases were treated by doctors only 50 had been explained about the usage of medicines and course of the disease which is very important to maintain adherence in acne therapy. When questioned about the cost of therapy, 136 (34%) respondents said they would not want to spend more than INR 300 per month for treatment of acne. 144 (37%) patients said they wished to use only a night cream for their treatment. 276 (71%) patients considered, dermatologist was the right person to treat acne followed by their family doctor (13.58%). Acne was considered to be a cosmetic problem by 149 (38.2%). 214 (54.87%) cases felt their acne was due to hormones. 169 (43.33%) cases attributed their flare in acne to stress.

Speaker
Biography:

Umit Tursen has graduated from Gazi University as Medical Doctor. He has completed the Residency period of Dermatology in Ankara University, Faculty of Medicine and Department of Dermatology during 1995-1999. He has been working in Mersin University, School of Medicine, and Department of Dermatology since 2000. He is the Professor of Mersin University, School of Medicine, and Dermatology Department. He has published more than 80 papers in reputed journals, also books and serving as an Editorial Board Member of repute. He won Behcet’s Disease Research Award of “The scientific and technical research council of Turkey (TUBITAK)” in 1999.

Abstract:

Ingrown toenail is an often painful clinical condition that usually affects the big toe. Chemical matricectomy with phenol has a low recurrence rate and good cosmetic results. However, it produces extensive tissue destruction that can result in drainage and delayed healing. Alternatives such as sodium hydroxide and trichloroacetic acid (TCA) have therefore come into vogue. A total of 39 patients with 56 ingrown toenail edges underwent chemical matricectomy with 90% TCA after partial nail avulsion. In most of the patients, adverse effects such as postoperative pain and drainage were minimal. One patient who underwent matricectomy had recurrence in a single nail edge (1.8%) at 12 months follow-up. No recurrence was observed among 38 patients during the mean follow-up period. This was considered to be statistically significant (P<0.001). Partial nail avulsion followed by TCA matricectomy is a safe, simple and effective method with low rates of postoperative morbidity and high rates of success.

Speaker
Biography:

Farrokh Khosravi has completed his Fellowship of Rheumatology in Shiraz University of Medical Sciences. He is a part time Assistant Professor of Medicine. His field of interest is autoimmune skin diseases and he has published papers in the field of Behcet's disease and Multicentric Reticulohistiocytosis in reputed journals and served as a Reviewer for Journal of Hormozgan University of Medical Sciences and Rheumatology Research Journal.

Abstract:

In this talk recent advances in understanding of drug induced fractures will be discussed. Fractures are the serious problem of the aged population, which is responsible for significant amount of morbidity and mortality. Any attempt to prevent or decrease incidence of fractures will save lives. Drugs increase Osteoporosis and Sarcopenia which both have a role in increasing fracture incidence. Sarcopenia is characterized by progressive and generalized loss of muscle mass and strength.

Speaker
Biography:

Thomas de Aquino Paulo Filho completed his graduate course in Medicine from Rio Grande do Norte University in Brazil in 1982 and Post-graduate course at Sao Paulo University in 1985. He lived for ten years in Rio de Janeiro Brazil where he worked with public health with Leprosy and Sexual Transmitted Diseases. In 1994, he began to work at Department of Clinical Medicine and Dermatology at Onofre Lopes Hospital in Natal, Brazil and at Rio Grande do Norte University as Assistant Professor of Dermatology. He has published an Atlas of Cutaneous Cytology in 2007 for Brazilian Society of Dermatology and article on Derm101 website on Dermatology Practical and Conceptual Journal in October, 2014. He has worked with Cutaneous Cytopathology since 1986, collecting slides from tumoral and inflammatory-granulomatous cutaneous diseases. Recently, he has showed the importance of differential diagnosis between pigmented basal cell carcinoma and melanoma using Tzanck test.

Abstract:

Unfortunately, the cytopathology exam of the skin is not practiced by physicians in general dermatology. To take a fragment of the skin is very easy technique by cutaneous biopsy. In 1947, Dr. Tzanck in France had introduced the study of cutaneous cytology by publishing the view of pemphigus cells. Cutaneous cytology is an excellent, practical and cheap diagnosis method. We can take a correct diagnosis in few minutes. It is a complementary test comparing with histopathology test. Many cutaneous diseases can be diagnosed quickly by this exam with high accuracy. In 1960 in Brazil, Dr. Estevam Almeida Neto was a pioneer at Sao Paulo University, Department of Dermatology when he published a thesis on Leprosy Cytology during his doctorate course. While I was doing my Residence in Dermatology at Sao Paulo University, Dr. Estevam Almeida Neto had taught me Cutaneous Cytology and the process to take sample slides for examination. In my speech, I intend to show the importance of this exam and my experience for many years.

Speaker
Biography:

Yuzhi Jiang has completed his PhD from The Second Military Medical University, China and Post-doctoral Studies from School of Medicine, Shanghai Jiao Tong University, China. He has published more than 15 papers in reputed journals.

Abstract:

The dermal tissues are composed of collage fibers and have been researched many years. The composite and three dimensional structure of collagen protein, collagen fibrils, collagen fiber has been clarified, however, the three dimensional structure of the extracellular matrix of dermal tissues has not been known, which impede the development of skin tissue engineering and skin regeneration. For example, the current skin tissue engineering products use the non-woven structure as the scaffold, which confirmed unsatisfactory after clinic usage. The other question is how the collagen fibers wove into the normal ECM during ontogeny and after wound healing is still unknown. This research will focus on the exact three dimensional mesoscopic structures of dermal tissues and would like to uncover the mechanism of the knit of collagen fibers, provide the golden standard to evaluate the skin tissue engineering product and regulate the wound healing.

Biography:

Avner Shemer has received his Medical Degree from Tel Aviv University, Israel. He has completed his Internship at Rambam Hospital, Haifa and received Training in Mycological Laboratory in Ramban Hospital and Guy’s Hospital, London. He has over 100 publications and recently published his new book “Superficial Mycoses” which offers an extensive and practical overview in the topic of superficial mycoses.

Abstract:

Introduction: Onychomycosis is a fungal infection of the nail plate and nail bed. Onychomycosis treatment options include oral and topical antifungal agents, devices and mechanical treatments such as nail avulsion or debridement. Methods: Participants were allocated into one of three treatment arms: Holes with combined oral and topical terbinafine, holes with topical terbinafine and topical terbinafine. An automatic device was used to drill two horizontal lines of holes just proximal to the border between the diseased and healthy portions of the nail with a diameter of 1.8-2 mm apart. Participants in Group-1 were instructed to take 250 mg of terbinafine per day for two weeks and participants in Groups-1, 2 and 3 were instructed apply terbinafine 1% spray. At each visit, nail specimens were collected and the percentage of infected nail that appeared healthy and clear was measured by a trained dermatologist. Results: A total of 98 people participated in this study (106 infected nails). Approximately 61% of the sample had 50% involvement and 38.7% had 75% involvement. There were no significant differences in baseline characteristics between treatment groups (Ps>0.05). The holes with topical terbinafine arm (Group-2) had the highest compliance rate, 95.6%, compared to 73.9% in the holes with oral and topical terbinafine (Group-1) and 73.7% in the topical terbinafine only arm (Group-3) and this difference was significant (P=0.013). The average percent clear nail in each treatment was well tolerated. Overall, nail drilling appears to be a safe and effective addition to onychomycosis treatment.

Biography:

Liyan Xi has completed her MD and PhD from Chinese Academy of Medical Sciences, Peking Union Medical College. She is the Vice-Chairperson of Chinese Society for Medical Mycology and the Vice-Chairperson of the Committee of Guangdong Medical Society for Dermatologist. She has published 51 scientific papers in reputed journals and has been serving as an Editorial Board Member of many journals focused on Medical Mycology and Dermatology.

Abstract:

Chromoblastomycosis as a chronic, cutaneous and subcutaneous infection has been reported more than 600 cases in China, but it has not been known to cause outbreaks until now. Several dematiaceous fungi are involved with the disease etiology, Cladophialophora carrionii is the most common agent in the North China, while Fonsecaea monophora instead of F. pedrosoi and F. nubica is the most common agent in the southern region. Infection commonly initiated after the etiologic agents gain through puncture wounds and mostly involved extremities of the males. Clinically, the lesions are polymorphic, including plaque, tumoral, cicatricial, verrucous, pseudo-vacuole, eczymatous and mixed type, which should be differentiated from some diseases associated with similar manifestation. The factors related to successful therapy for chromoblastomycosis might be pathogens, manifestations and severity. The common treatments include chemical therapy (systemic antifungal agents single used or combined) and physical methods, such as surgery, thermotherapy and cryotherapy. Patients with mild type of lesions could be treated successfully with systemic antifungal mono-therapy or combined therapy. But it is extremely difficult to eradicate severe lesions which are recalcitrant and disabling. Photodynamic Therapy (PDT) as a minimally invasive approach combines a non-toxic photoactivatable dye as photosensitizer with harmless visible light of correct wavelength to generate reactive oxygen or molecules that are toxic to target cells. It has recently been applied to the drug-resistant or recalcitrant chromoblastomycosis and showed considerable effects with promising future.

Speaker
Biography:

Wajieha Saeed has completed her FCPS from College of Physicians & Surgeons Pakistan, Pakistan. She is a Senior Registrar at Dermatology Department, Mayo Hospital, Lahore and she is a Member of Pakistan Association of Dermatologist.

Abstract:

Acne has a prevalence of more than 90% in adolescents and persists into adulthood in almost 12-14% of cases with psychological and social stress of high intensity. There are many treatment options available for acne scars. Carbon dioxide (CO2) ablative fractional resurfacing is a new modality in laser techniques, for acne scars with more effectiveness and low side effect profile. An analytical experimental study was carried out at KEMU/Mayo Hospital, Lahore. Thirty patients of either sex with skin phototype IV & V, having moderate to severe atrophic scars were enrolled. Pre-treatment assessment of acne scars severity was done using Goodman & Boran qualitative scarring grading system. Patients were treated at 4 weeks internal with a maximum of 5 sessions. Follow up was done one month after the last session. Objective assessment was obtained at each session and graded according to percentage reduction in acne scars on a 4 point scale as excellent (>75% reduction), good (50-70% reduction), fair (25-50% reduction) and poor (<25% reduction). Side effects were noted at each session. Digital photographs were taken at the baseline, at each session and at follow up and were compared. The mean age of the patients was 21.6±2.2 years. There were 10 (33.33%) male and 20 (66.66%) female patients. A significant improvement in atrophic scars was observed. 12 (40%) patients showed good efficacy and 18 patients had fair efficacy. Erythema and edema followed by mild crusting was seen in all patients, which are cleared in 3-7 days with topical antibiotic. Very few patients developed post inflammatory hyper pigmentation.

Biography:

Yan Zheng is a Professor, Chief Physician, and Doctoral Tutor. She has completed her Bachelor's degree from the Department of Clinical Medicine, Xi'an Medical University and Doctor's degree from the Department of Dermatology, Second Affiliated Hospital of Xi'an Jiaotong University and did Postdoctoral Research for 2 years. She has published and received more than 70 papers, among which over 30 were SCI papers (Journal of Investigative Dermatology, Nature Communications, Experimental Dermatology, Immunology, BJD, Plos one, Dermatology, EJD, etc) and was quoted by the world authoritative magazine (Nature Review Immunology, the IF : 30). She is also the Reviewer of BJD, PloS One and IJD. As Deputy Editor or involved Editor, she has participated in the writing 7 books.http://dermatology.conferenceseries.com/abstract-submission.php

Abstract:

Cutaneous squamous cell carcinoma (cSCC) is one of the most common skin malignant tumors with an increasing incidence. Studies have shown that Yes-associated protein (YAP) participates in the development of a variety of tumors as an oncogene, but its role in cSCC has not been reported. In this study, we showed by immunohistochemistry that YAP expression was elevated in cSCC samples of different stages versus the normal skin and was well correlated with the progression of the disease. Down-regulation of YAP in cSCC cell lines A431 and SCL-1 inhibited cell proliferation by inducing a G1/S growth arrest, promoted apoptosis and reduced invasion and migration abilities in vitro. Conversely, overexpression of YAP promoted cell proliferation and protected cells against basal and chemodrug-induced apoptosis. These oncogenic effects of YAP were associated with activation of RAS protein and its downstream AKT and ERK signaling. Using a mouse xenograft model, we further demonstrated that YAP depletion inhibited cSCC tumor growth in vivo. Our results suggested that YAP is involved in the carcinogenesis and development of cSCC and may serve as a biomarker or therapeutic target of this disease.

Biography:

Abstract:

Background & Objectives: Leg ulcers are chronic wounds with varied causes and great medical impact. Management is complex and is associated with high costs for both patients and public health services, especially in low income-countries. In this study, we investigate the effect of autologous platelet rich fibrin (PRF) on healing of chronic non healing ulcers. Methods: A total of 37 patients with chronic non healing ulcers attending dermatology outpatient clinic were included in study population. A total of 43 ulcers were treated with PRF dressings. The patients were followed up on weekly basis for three months. Swab cultures were taken upon initial visit and then on weekly basis. The judgment criteria’s were the relative regression of the wound surface area and relative reduction of sloughy tissue. Results: Mean healing time was 35±4 days. 76.5% of ulcer became sterile during first week. Conclusion: PRF is simple and an effective treatment for chronic non healing ulcers leading to significant reduction in the time of healing. This study also strongly supports antibacterial effect of platelet rich products. Being autologous, PRF is safe and can be prepared without any sophisticated instruments with minimal cost and hence reducing the economic burden. Limitations: Diversity in the sites and causes of ulcers. Analysis to validate that the composition of PRF did not differ from case to case was not carried out.

  • Track 8 :Dermatological Oncology
    Track 9: Cosmetic Dermatology
    Track 10: Dermatopathology
Speaker

Chair

Drazen M Jukic

University of Florida
USA

Speaker

Co-Chair

Shaofeng Yan

Dartmouth Hitchcock Medical Center
USA

Speaker
Biography:

Drazen M Jukic is a private practice Dermatopathologist in Savannah GA. He maintains active digital Dermatopathology consultation service and serves as a Telepathology Consultant for VISN 8 and James A. Haley VA Hospital, Tampa, Florida and is a Member of Advisory Board of Castle Biosciences, Inc. He also maintains a consultation service via his company Advanced Digital Anatomic Pathology Technologies (ADAPT) and as a Medical Officer in Digipath, Inc. In the past, he served as a Director of dermatopathology fellowship, University of Pittsburgh (for 10 years), Medical Advisory Board at Digipath and was a Founding Member of a clinical team at Omnyx, LLC. He is a Visiting Associate Professor, School of Medicine of University of Zagreb, Croatia. His area of expertise includes immunohistochemistry, cutaneous lymphomas and molecular pathology as it pertains to dermatopathology.

Abstract:

Two of the applications of digitized medicine as applied to the dermatology are poised to change the practice as we know it today, namely teledermatology and teledermatopathology. The implementation of teledermatology has seen a huge interest, especially when applied with the patient in mind. Some business models have focused on delivery of the care to the underserved areas (areas without adequate dermatology coverage) and others have been implemented as patient initiated consultations. However, if the biopsies are done, it is questionable where does the pathology end up and who is actually reading the biopsies, potentially skewing the interpretation and allowing for a diagnostic bias. On the other hand, although well accepted and utilized, conventional dermatopathology workflow is not ideal, especially if viewed in light of the increasing demands in terms of reporting, turnaround time and patient safety. Implementation of telepathology in any surrounding is a challenge, though, as most pathologists trained to use current systems are comfortable with standard, glass based pathology and are resistant to adopting new approaches to workflow without evidence of an immediate benefit. Furthermore, telepathology has not been adequately explored for evaluation of specific diagnostic features in dermatopathology, which is often a single person operation, thus not allowing for additional opinion or real time quality assurance. By employing telepathology, real time remote case review and delayed image review as well as second opinions, additional subspecialty reviews, sign out collaborations and expert reviews can be easily conducted. In some cases, this is the only way these imperative procedures can be accomplished, especially considering their time sensitive nature. In the future, one would hope to see a combined teledermatology/teledermatopathology system for delivery of the optimal care for a dermatologic patient.

Speaker
Biography:

Shaofeng Yan is the Director of the Dermatopathology Section and Dermatopathology Fellowship Program at Dartmouth Hitchcock Medical Center. She has received MD from Peking Union Medical College and PhD from University of Washington. She has received Anatomic and Clinical Pathology Residency Training at Dartmouth Hitchcock Medical Center and Dermatopathology Fellowship Training at Harvard Dermatopathology Fellowship Program. She became a Faculty Member of Dartmouth Hitchcock Medical Center in 2006. Since then she has published in the field of Dermatopathology. She has been serving as Editorial Board Member and Reviewer for different journals

Abstract:

Histological and immunohistochemical (IHC) studies have been used to evaluate metastatic melanoma in sentinel lymph nodes (SLN). Occasionally, isolated IHC positive (IHC+) cells have been identified in SLN without atypical cells seen on H&E stained sections. We previously reported isolated IHC+ cells in lymph nodes from patients without melanoma. The aim of this study is to evaluate the prognostic significance of these IHC+ cells in SLN from melanoma patients, compared to patients with negative SLN and patients with SLN positive for metastatic melanoma. 826 melanoma patients who received a sentinel lymph node biopsy between 2000 and 2012 were identified from a tertiary medical center. Among them, 125 had metastatic disease in SLN, 639 had negative SLN and 60 had rare IHC+ cells in SLN without atypical cells seen on H&E sections. Within the SLN+ group, 51 had metastatic deposits <0.2 mm, 44 had deposits >2 mm and 30 had deposits between 0.2 and 2 mm. A control group was created by selecting 125 patients from the 639 negative SLN group to match the positive SLN group, based on age and sex. With a mean follow-up time of 58.8 months, the disease specific survival of patients with rare IHC+ cells in SLN was similar to patients with negative SLN and patients with tumor deposits less than 0.2 mm (P=0.19), but was significantly different from those with metastatic deposits between 0.2 mm and 2 mm and those with deposits >2 mm (P<0.0001). Further studies with longer follow up are needed.

Bertha Baum

Hollywood Dermatology & Cosmetic Specialists
USA

Title: Ultraviolet fluorescent tattoo facilitates accurate identification of biopsy sites

Time : 9:50-10:15

Speaker
Biography:

Bertha Baum has built a reputation as a Cosmetic Dermatologist by providing leading-edge treatments, dedicated and personalized patient care and excellent aesthetic results throughout her career. She is often asked to share her expertise to the English and Spanish-speaking media about the latest advancements in skin care technologies. She has collaborated in several publications, in world renowned dermatological journals and books with her research. She remains committed to the highest standards of patient care and actively involved in several professional organizations. She is proud to treat patients of all ages and skin types and has experience in cosmetic, general, surgical and pediatric dermatology. She is a proud alumna of the University of Miami with a Bachelor of Science in Neuroscience Summa Cum Laude, received her Medical degree from the Nova Southeastern University College of Osteopathic Medicine. Upon graduation, she has completed an Internship in Westchester Hospital, as well as a Residency in Dermatology at the NSU COM Larkin Community Hospital, where she was Chief Resident during her last year.

Abstract:

Background: Cutaneous biopsy sites are often difficult to discern or are frequently misidentified when patients present for treatment of skin cancers. This frustrating situation can lead to delays in treatment and wrong site surgeries. Current methods aiming to prevent this situation are not perfect. Objective: This study seeks to determine the efficacy of ultraviolet-fluorescent tattoos in facilitating the correct identification of suspected non-melanoma skin cancer biopsy sites. Methods: In this prospective cohort, 51 shave biopsy sites were tattooed with ultraviolet-fluorescent ink in a series of 31 patients suspected of having a cutaneous malignancy. At the time of follow up, the ability of the patient and the physician to identify the correct site with and without ultraviolet illumination of the tattoo was recorded. Visibility of the tattoo was graded before and after treatment. Results: Patients could not positively identify their biopsy site in 35% of cases. In 7% of cases, physicians could not confidently identify the site without the aid of ultraviolet illumination. In conjunction with tattoo illumination, physicians confidently identified the site in 100% of the cases. No adverse events occurred. Conclusion: Ultraviolet-fluorescent tattoos offer a safe and reliable means of accurately marking cutaneous biopsy sites.

Speaker
Biography:

Drazen M Jukic is a private practice Dermatopathologist in Savannah GA. He maintains active digital Dermatopathology consultation service and serves as a Telepathology Consultant for VISN 8 and James A. Haley VA Hospital, Tampa, Florida and is a Member of Advisory Board of Castle Biosciences, Inc. He also maintains a consultation service via his company Advanced Digital Anatomic Pathology Technologies (ADAPT) and as a Medical Officer in Digipath, Inc. In the past, he served as a Director of dermatopathology fellowship, University of Pittsburgh (for 10 years), Medical Advisory Board at Digipath and was a Founding Member of a clinical team at Omnyx, LLC. He is a Visiting Associate Professor, School of Medicine of University of Zagreb, Croatia. His area of expertise includes immunohistochemistry, cutaneous lymphomas and molecular pathology as it pertains to dermatopathology.

Abstract:

Two of the applications of digitized medicine as applied to the dermatology are poised to change the practice as we know it today, namely teledermatology and teledermatopathology. The implementation of teledermatology has seen a huge interest, especially when applied with the patient in mind. Some business models have focused on delivery of the care to the underserved areas (areas without adequate dermatology coverage) and others have been implemented as patient initiated consultations. However, if the biopsies are done, it is questionable where does the pathology end up and who is actually reading the biopsies, potentially skewing the interpretation and allowing for a diagnostic bias. On the other hand, although well accepted and utilized, conventional dermatopathology workflow is not ideal, especially if viewed in light of the increasing demands in terms of reporting, turnaround time and patient safety. Implementation of telepathology in any surrounding is a challenge, though, as most pathologists trained to use current systems are comfortable with standard, glass based pathology and are resistant to adopting new approaches to workflow without evidence of an immediate benefit. Furthermore, telepathology has not been adequately explored for evaluation of specific diagnostic features in dermatopathology, which is often a single person operation, thus not allowing for additional opinion or real time quality assurance. By employing telepathology, real time remote case review and delayed image review as well as second opinions, additional subspecialty reviews, sign out collaborations and expert reviews can be easily conducted. In some cases, this is the only way these imperative procedures can be accomplished, especially considering their time sensitive nature. In the future, one would hope to see a combined teledermatology/teledermatopathology system for delivery of the optimal care for a dermatologic patient.

Speaker
Biography:

Stephen M Mastorides is the Chief of Pathology and Laboratory Medicine Service of the James A Haley Veterans Hospital in Tampa, Florida for the past ten years. He is a skilled Pathologist with many years of experience in management specializing in the introduction of new and advanced technologies into the clinical laboratory. As Chief, he has helped to develop the Tampa VA Molecular Diagnostics Center of Excellence, which provides molecular testing services for numerous medical centers in the VISN 8 including the Orlando VAMC, North Florida/South Georgia VAMC, Miami VAMC and Bay Pines VAMC. He also oversees a large inpatient and outpatient phlebotomy service which draws over 700 patients and 2100 specimens per day. His research focuses on investigating advanced laboratory technologies including but not limited to telepathology, molecular diagnostics, diagnostic nanotechnologies and practical implementation of genomic and proteomic testing. He is also the Site Director of the Million Veteran Program (CSP #G002).

Abstract:

Healthcare managers and pathologists have been tasked to find solutions to improve pathology workflow and provide all patients with access to specialty pathologists. As a result, the James A. Haley Veterans’ Hospital established a Telepathology Center of Excellence. Telepathology is defined as electronic multimedia communication between an acquisition site and a remote site pathologist for the purpose of primary diagnosis and second opinion consultations. The James A. Haley Veterans’ Hospital Telepathology Center of Excellence has identified requirements for interoperable telepathology systems and pioneered a solution for dermatopathology which works integrated with our Computerized Patient Record System (CPRS). The Apollo Robotic Telepathology Workstation, utilized in our system, is a dynamic telepathology system designed utilizing a multi tiered open system software solution. Apollo Path Picture Archiving and Communication Systems (PACS) manage images from all laboratory imaging devices and related hardware. The telepathology objectives include: Expediting referrals to experts and specialists, improving telehealth workload capture, enhancing secondary reading for diagnostic verification, peer review and quality assurance as well as group discussion and education during clinical pathological conferences (tumor board). The implementation deployed Apollo systems to Bay Pines VA Medical Center (St. Petersburg, FL) and the VA Caribbean Healthcare System (San Juan, PR). Both systems are live and used for second opinion diagnostic dermatopathology consultations (Dermatopathologist is at James A. Haley Veterans’ Hospital). This system implementation has brought quicker, more accurate diagnoses across VISN 8 and the results of the implementation provide useful information to healthcare managers and decision makers who must find a more efficient way to provide care to our nation’s Veterans.

Speaker
Biography:

Kate Ross has completed her Medical degree from the Florida State College of Medicine. She has completed a Dermatology Residency at the University of South Florida. She has her board certification in Dermatology from the American Board of Dermatology. She currently works at LA Plastic Surgery & Dermatology in private practice in Sarasota and Bradenton, FL. She also spends 1 day a week seeing patients at the James A Haley VA Hospital in Dermatology. She is an Associate Clinical Faculty Member at the Florida State College of Medicine.

Abstract:

This presentation will give an overview of a few available telemedicine systems currently in use in a private practice setting and compare these to the telehealth system currently being used at the VA hospital. It will further discuss how one practice is integrating teledermatology into day to day business to make patient care easier and more HIPAA compliant. I will explore how one VA is using telehealth to improve consultation between dermatology and non-dermatology practitioners. This will finish with a review of the barriers to widespread use of these systems in a busy practice as well as limitations of use in the governmental systems. Finally we will visit new features being promised by telemedicine companies in the years to come.

Srdjan Prodanovich

EZDERM, LLC
USA

Title: Digital pathology
Speaker
Biography:

Srdjan Prodanovich, MD, FAAD has completed his medical school and dermatology residency at the University of Miami School of Medicine in Miami, Florida. He is actively practicing Dermatology in Naples, Florida and is a CEO of EZDERM, LLC (ezderm.com), a premier software company that develops state of the art medical record systems. He has published multiple research papers.

Abstract:

Pathology plays an essential role in healthcare. While still relying on glass slide microscopy and paper reports, digitalization of modern healthcare calls for a better delivery method of pathology results. Digital pathology can significantly improve patient care outcomes by allowing instant access of pathology images to multiple members of the patient care team.

Speaker
Biography:

Kate Ross has completed her Medical degree from the Florida State College of Medicine. She has completed a Dermatology Residency at the University of South Florida. She has her board certification in Dermatology from the American Board of Dermatology. She currently works at LA Plastic Surgery & Dermatology in private practice in Sarasota and Bradenton, FL. She also spends 1 day a week seeing patients at the James A Haley VA Hospital in Dermatology. She is an Associate Clinical Faculty Member at the Florida State College of Medicine.

Abstract:

This presentation will give an overview of a few available telemedicine systems currently in use in a private practice setting and compare these to the telehealth system currently being used at the VA hospital. It will further discuss how one practice is integrating teledermatology into day to day business to make patient care easier and more HIPAA compliant. I will explore how one VA is using telehealth to improve consultation between dermatology and non-dermatology practitioners. This will finish with a review of the barriers to widespread use of these systems in a busy practice as well as limitations of use in the governmental systems. Finally we will visit new features being promised by telemedicine companies in the years to come.

Speaker
Biography:

Daniel Schramek has completed his MSc from University of Vienna and Sydney, PhD in Genetics from University of Vienna and an Executive MSc in Technology Management (NYU) always with highest distinction and undertook his Postdoctoral studies as Emerald Foundation Young Investigator with Elaine Fuchs at the Howard Hughes Medical Institute at the Rockefeller University in New York. Currently, he leads his lab for Functional Cancer Genomics at the Lunenfeld-Tanenbaum Research Institute and is an Assistant Professor at the Department of Molecular Genetics//Faculty of Medicine/University of Toronto. He has published over 25 papers in reputed journals such as Nature, Science, Cell or Nature Genetics.

Abstract:

Mining the wealth of genomic data for personalized cancer therapies poses one of the biggest challenges for translational cancer research today and is predicated on weeding out ‘bystander’ mutation and identifying the ‘driver’ mutations and pathways responsible for initiating tumorigenesis and metastasis. We thus developed a novel RNAi methodology that allows us to simultaneously screen hundreds of putative human cancer genes directly in vivo using various mouse models of cancer. Importantly, this method tests gene function within the native tissue architecture, stromal cues and immune system. First, we focused on Head & Neck squamous cell carcinomas (HNSCCs), which represent the 6th most common cancer with a mortality >50%. Using ultrasound-guided in utero injections of lentiviral particles, we selectively delivered shRNAs to the single-layered surface ectoderm of living E9.5 mouse embryos, where stem cells stably incorporate and propagate the desired genetic alterations (RNAi) into adulthood in a mosaic fashion. This allowed us to identified seven novel tumor suppressors including Myh9, which encodes non-muscle myosin IIA. Mechanistically, we uncovered that myosin IIA’s function is manifested not only in conventional actin-related processes but also in regulating p53 activation. Clinically, low Myh9 expression stratifies HNSCCs patients with poorest survival. We have now expanded our technology to various other epithelial cancer models, included CRISPR-mediated gene-editing and started with negative screening to elucidate physiological regulators of oncogenic growth further highlighting the utility of direct in vivo screening to integrate human cancer genomics and mouse modeling for rapid and systematic discovery of cancer driver mutations and novel cancer vulnerabilities.

Maciej Pawlikowski

AGH-University of Science and Technology
Poland

Title: Biomineralization of selected skin cancers
Speaker
Biography:

Abstract:

Analysis of skin cancers was conducted on materials obtained from an Oncology Clinic. The samples represented mostly Carcinoma basocellulare solidum. Histological preparations were made from the skin samples and used for histological observation, as well as for selecting pieces for further research using scanning microscope connected with chemical analysis (EDS method). Scanning microscopes Jeol 540 and 560, made in Japan, were used. Special attention was paid to areas of increased mineralization. It was observed that mineralization within the cancerous areas is of dual nature. Hidden mineralization manifests only as increased levels of certain elements in the chemical analysis of tissue. SEM observations indicate that the hidden mineralization consists of elements embedded in biological structures of tissue. It does not create mineralgrains or crystals in tissue. It can only be detected using sensitive chemical methods. Next to the hidden mineralization, organic-mineral micro-grains containing increased amounts of elements were observed. We may assume that those are the result of evolution (further mineralization) of the hidden mineralization, which may remain on the hidden level or evolve into the form that may be observed microscopically (SEM). Uneven distribution of the increased amounts of tested elements in the aforementioned forms confirms that they are mostly organic-mineral grains. Conducted research, which proves the presence of mineralization in cancerous tissue, shows the need for discussion: what is the order of the observed phenomena? Does the local tissue mineralization cause the modification of certain cells into their cancerous form, or do cancerous tissues have predisposition to concentrating certain elements? Co-existing of both phenomena is also possible, which hinders the interpretation of obtained results. Further research is necessary to understand this important problem.

  • Track 10: Teledermatology

Session Introduction

Stephen M. Mastorides

James A Haley Veterans Hospital
USA

Title: Telepathology: Current status and perspectives for use in dermatopathology
Speaker
Biography:

Stephen M. Mastorides is the Chief of Pathology and Laboratory Medicine Service of the James A Haley Veterans Hospital in Tampa, Florida for the past ten years. Stephen M. Mastoridesis a skilled Pathologist with many years of experience in management specializing in the introduction of new and advanced technologies into the clinical laboratory. As Chief, he has helped to develop the Tampa VA Molecular Diagnostics Center of Excellence, which provides molecular testing services for numerous medical centers in the VISN 8 including the Orlando VAMC, North Florida/South Georgia VAMC, Miami VAMC and Bay Pines VAMC. He also oversees a large inpatient and outpatient phlebotomy service which draws over 700 patients and 2100 specimens per day. His research focuses on investigating advanced laboratory technologies including but not limited to telepathology, molecular diagnostics, diagnostic nanotechnologies and practical implementation of genomic and proteomic testing. He is also the Site Director of the Million Veteran Program (CSP #G002).

Abstract:

Healthcare managers and pathologists have been tasked to find solutions to improve pathology workflow and provide all patients with access to specialty pathologists. As a result, the James A. Haley Veterans’ Hospital established a Telepathology Center of Excellence. Telepathology is defined as electronic multimedia communication between an acquisition site and a remote site pathologist for the purpose of primary diagnosis and second opinion consultations. The James A. Haley Veterans’ Hospital Telepathology Center of Excellence has identified requirements for interoperable telepathology systems and pioneered a solution for dermatopathology which works integrated with our Computerized Patient Record System (CPRS). The Apollo Robotic Telepathology Workstation, utilized in our system, is a dynamic telepathology system designed utilizing a multi tiered open system software solution. Apollo Path Picture Archiving and Communication Systems (PACS) manage images from all laboratory imaging devices and related hardware. The telepathology objectives include: Expediting referrals to experts and specialists, improving telehealth workload capture, enhancing secondary reading for diagnostic verification, peer review and quality assurance as well as group discussion and education during clinical pathological conferences (tumor board). The implementation deployed Apollo systems to Bay Pines VA Medical Center (St. Petersburg, FL) and the VA Caribbean Healthcare System (San Juan, PR). Both systems are live and used for second opinion diagnostic dermatopathology consultations (Dermatopathologist is at James A. Haley Veterans’ Hospital). This system implementation has brought quicker, more accurate diagnoses across VISN 8 and the results of the implementation provide useful information to healthcare managers and decision makers who must find a more efficient way to provide care to our nation’s Veterans.