Day 1 :
Keynote Forum
Edward Hochman
University of Connecticut School of Medicine, Farmington, CT 06032, USA
Keynote: Balancing Trainee Education and Patient Safety During Mohs Micrographic Surgery
Biography:
Edward Hochman completed his B.S. in Human Development from Cornell University. He is a 4th year medical student at the University of Connecticut School of Medicine in Farmington, CT.
Abstract:
Dermatologic surgeons working at academic centers are tasked with maintaining a ‘dual responsibility’ between providing teaching opportunities for residents and fellows while simultaneously providing excellent medical care. They have the additional task of promoting and enforcing patient safety with inexperienced residents and new fellows. In order to best fulfill this responsibility, attending surgeons must utilize control strategies that maintain patient safety while allowing trainees to operate with a degree of autonomy that encourages active learning. Based on the trainee’s knowledge and preparation, the dermatologic surgeon can adjust the level of control in favor of more direct control. This process is termed “bargaining.” Skillfully “bargaining” is also important because it allows the attending dermatologic surgeon to pre-empt common surgical missteps from arising. Importantly, during the “bargaining” period the attending surgeon should inform the trainee if there are steps of the procedure that are not appropriate for the trainees skill level and that will require case takeover so that the trainee does not feel punished intraoperatively when takeover occurs. This poster identifies common control strategies and control dilemmas in dermatologic surgery with the hope that understanding these strategies and dilemmas will help to improve dermatologic surgery curriculums and patient safety alike.
- Dermato-Oncology
Location: Chicago, USA
Session Introduction
Sheida Naderi-Azad
The potential of BRAF-targeted therapy combined with immunotherapy in melanoma
Title: The potential of BRAF-targeted therapy combined with immunotherapy in melanoma
Biography:
Sheida Naderi-Azad has completed her Bachelor of Science in Microbial and Environmental Pathophysiology from University of British Columbia and is currently an MD Candidate at the University of Toronto Faculty of Medicine. She has an expertise in immunodermatology, with a deep interest in melanoma immunotherapeutics, primary immunodeficiency diseases such as atopic dermatitis, and autoimmune conditions such as psoriasis. She has most recently completed a summer studentship at the Melanoma Clinic, Massachusetts General Hospital. She has had numerous published articles and presentations on melanoma therapeutics, anti-inflammatory conditions and dermatologic comorbidities such as mood disorders.
Abstract:
Statement of the Problem: Advanced melanoma involves metastasis to distant sites and is associated with poor long-term survival (Fisher et al., 2012). Current treatment options for melanoma include interleukin 2, targeted therapy (BRAFi, MEKi) and immunotherapy (CTLA4 antibody, PD1/PDL1 antibody). While targeted therapeutics can successfully block oncogenic signaling with high clinical response, they result in high relapse rates due to acquired resistance. Furthermore, while immunotherapeutics can induce durable responses, they have lower response rates due to immune evasion and suppression of effector function in tumour microenvironment. The purpose of this study is discuss the potential for combining immunotherapy and targeted therapy with the goal of achieving high response rates with prolonged duration. Methodology & Theoretical Orientation: To obtain these results, various search terms such as immunotherapy and targeted therapy were utilized. Furthermore, the articles were selected based on recency of publication as well as depth of detail regarding the specific immunologic mechanisms by combination therapies exert their effects. Findings: The results show that potential mechanisms of combinatorial activity of immunotherapy and targeted therapy include increasing antigen presentation, as well as improved lymphocyte homing and function. Yet it is important to note that long-term consequences of combinatorial therapeutics are uncertain, and clinical trials of combinations have resulted in adverse effects such as hepatotoxicity and intestinal perforation. Conclusion & Significance: Altogether, these results indicate a potential combination for BRAF-targeted therapy and immunotherapy in achieving long-term durable responses.
- Clinical Dermatology
Location: Chicago, USA
Session Introduction
DR. SOMIL SINGHAL
Medicine and Surgery Beijing Medical University
Title: Dermatophytosis And Its Prevelance From Patients Attending Hospitals Of Western And Asian Countries
Biography:
Somil Singhal has completed his Bachelor of Medicine and Surgery (MBBS) at the age of 25 years of age from Beijing Medical University, China and Post Doctoral Studies in Doctor of Medicine In Pathology from Rajiv Gandhi University of Health Sciences, Bangalore, India. Currently, he is working as Senior Consultant Pathologist in the Kriti Scanning And Diagnostic Center Private Limited at Kriti Scanning Group Of Institute, Allahabad, Uttar Pradesh India. He has attended various Conferences, CME’s and published Case studies, Dissertations in reputed journals like IJLSSR, Index Copernicus, Poland Journal of Dermatology and is the life member of Indian Medical Association, Allahabad Medical Association and Association Of Pathological Society Of India. Besides this, he had worked as a ex .resident in AIIMS Trauma Center in the department of emergency medicine, ex. Cardiac resident at Fortis Hospital Okhla, Delhi, ex. Senior Resident in Ashwini Rural Medical College, Solapur, Maharashtra, ex. Senior resident at Maharaja gruop Od hospital, New Delhi, India and attended various ITO and blood bank camps for service to the society
Abstract:
Background :
Dermatophytosis is a disease across globe with major public health problem almost causing mobidity.
Objectives :
To study the prevelance of fungi spectrum which are implicated in causing infections.
Method :
Skin mostly of exposed surface weretaken in study in brush biopsy scrapings were collected from 400 patients and eveluated under microscope with various special stains including microbiological culture for identifying their characters.
Result:
Tinea Capitis was the predominant manifestation consisting of 60% of cases. Among 159 patients with Tinea Capatis 80% were in age group of 5 – 20 years of age. Out of 308 study ,213 ( 67% - 98%) found positive for dermatophytosis microbiologically. Among 90 cases , Tinea Violaceum resresented in 45.5 % of non – dermatophytic molds.
Conclusion :
Failure of detection in a large number of clinical sample including limited clinical diagnosis from other skin manifestations should be evaluated with full clinical history including pathological findings under microscope. Dermatophytic fungi shows emerging important cases of dermatophytosis warning the implementation of epidemology across the country.
- plastic Surgery
Location: Chicago, USA
Session Introduction
Srikanth Kurapati MD MBA CPHQ
Q University of Alabama Birmingham, USA
Title: Understanding The Scar—The Most Human of Pathologies
Biography:
Srikanth Kurapati MD, MBA, CPHQ completed his MD, MBA at the University of Cincinnati College of Medicine at the age of 26 years. From there, he completed a residency in General Surgery at the University of Pittsburgh Mercy Hospitals in 2016. He acted as Clinical Instructor in General Surgery and Chief Resident in Quality Improvement and Patient Safety at Baylor College of Medicine in 2017, prior to starting his resdiency in Plastic and Reconstructive Surgery at the University of Alabama Birmingham. He is a Certified Professional in Healthcare Quality and Six Sigma Black Belt, with particular interest in the Economics of Healthcare delivery. His research works include application of statistical methods to increase efficiency in healthcare as well as clinical research in abdominal wall reconstruction and rhinoplasty techniques. In his spare time, he enjoys playing tennis, dabbling in art, and running in obstacle races.
Abstract:
Statement of the Problem: Scar formation is a requisite conclusion to every insult, trauma, or deviation from homeostatic physiology. Amazingly, the spectrum of wound healing is especially unique in humans. As such, the management of scarring runs the gamut of scientific rigor. We present a critical review of literature looking at the fundamental understanding of scar healing, appraise its future directions and controversies, as well as introduce our institution’s approach to managing complex scars. Methodology & Theoretical Orientation: This study was performed as a critical literature review using Pubmed™, searching for relevants works regarding scar management. Inclusion and exclusion criteria was necessarily unrestrictive to include all pathologies, genders and ages, but with focus on clinical impact. While this study cannot be an exhaustive representation, it is a critical analysis of the most impactful literature that supports our institution’s understanding of scar management. Findings: While there are emerging animal models approaching human physiology, scar hypertrophy and keloid formation remains uniquely human. Newer techniques and technologies in scar management including lasers, radiation, immunomodulators, and tension management are emerging; while other foundational techniques like silicone dressings and steroid therapy will continue to play a strong role in clinical management. We present our experience in a variety of pathologies and treatments to illustrate that scar hypertrophy and keloid formation is necessarily an entity that requires a practioner to be fascile in a multimodal approach. Conclusion and Significance: In order to offer your patient the most effective scar managment, it is necessary to understand when, why, and how to use the gamut of treatment modalities available. This review offers a critical apprasial of current techniques, and presents a university Plastic Surgery group’s evidence-based approach to treating scar hypertrophy and keloid formation.
- Advancements in Cosmetology and Dermatology
Location: Chicago, USA
Session Introduction
Dell’Avanzato Roberto
Medical Department of Espace Chenot Health Wellness Spa - L’Albereta Relais & Chateaux (Italy)
Title: ENDOLIFT and Ultherapy® for the best face, neck and body non-surgical lifting.
Biography:
Dell’Avanzato Roberto is Specialist in Surgery with an University Master in Aesthetic Medicine and Surgery; Professor of Laser and Laser Assisted Liposuction, San Marino University (San Marino); University Diploma in Laparoscopic Surgery, Louis Pasteur University of Strasbourg (France); Honorary Member of the Israel Academy of Beauty; Honorary Member of the Italian Academy of Beauty; Certificate of excellence awarded from The Pakistan Medical Association, for humanitarian services rendered to the burnt and scarred victims of Pakistan; Certificate of Merit awarded from the Combined Military Hospital of Islamabad (Pakistan), for humanitarian services.
Abstract:
Background: We evaluate the results after 13 years of Endolift Laser technique for the “soft” rejuvenation of face, neck and body, using a very thin optical fibre connected to a 1470nm diode laser, combined in the last years with Ultherapy® which allows in a single session to lift the muscles and the skin. Methods: We report our experience after more than 4000 areas treated with Endolift for the treatment of skin laxity of the face, neck and the body. A 200-300 micron fiber is used for the face and the neck; a 400-600 micron fiber is used for the body. The fiber is easily inserted, without incisions under the skin directly in the superficial hypo-derma. After Endolift, a Ultherapy® session is performed. Results: The areas of skin laxity of the face, neck and body, can benefits from the possibility that the Endolift Laser has to retract the skin and remodel the derma, activate the collagen production, stimulate the neo-angiogenesis. Ultherapy® helps to obtain the maximum result possible working more deeply the middle and deep hypo-derma up to the muscular fascia, permitting to obtain an immediate and a longterm lifting. Conclusions: Endolift laser combined with Ultherapy® is the the best non-surgical treatment for the areas of muscular and skin laxity of the face and the neck.