23 ^rd Asia-Pacific Dermatology Conference October 26-28, 2017 Osaka, Japan

Biography:

Lakmali Pathiraja has completed her MD in Dermatology from University of Colombo. She is working as a Consultant Dermatologist in a rural area of her country and serves large number of poor patients in this area. She has done many research studies and given speeches at both local and international conferences and symposia.

Abstract:

Ethnic origin influences the structure of the skin. Similarly, various environmental, cultural and social factors related to ethnicity have a great impact on the skin. People of Indian, Sri Lankan, Pakistani and Malaysian origin belong to dark Asian ethnic skin type. Although, a large proportion of subjects belong to this category, literature is limited except for a few studies that focus on pigmentation. Asian skin is pigmented, has larger sweat glands and is smooth and shows minimal signs of aging, but conversely has weaker barrier function upon chemical or mechanical challenge. Furthermore, they hold higher risk of pigmentary side effects following procedures carried out on their skin. Traditional skin concerns of various ethnic groups will enhance the modern treatment of various skin types. Sri Lankan indigenous medicine has close affinity to Ayurveda, but has its own unique properties. The island has unique pedigrees, which hold ancient medical secrets that are mainly in the form of manuscripts are passed down from generation to generation. Thousands of years of history have made it evident that this system can cure any physical or mental illness. Plant and herbal products have been used for ages for cutaneous treatment, skin care and aesthetic purposes. Sri Lanka has a rich collection of medicinal plants, including many endemic species. Consideration of these factors will enhance the effectiveness of current skin treatments on this particular ethnic skin type.

Biography:

Mohan Arumugam is currently a lecturer and physician, with the dermatology unit, department of internal medicine, at the National University of Malaysia (Universiti Kebangsaan Malaysia).  He completed his post graduate studies in doctor of internal medicine in 2016.  He graduated with a degree in Nutrition and Community Health before pursuing medical studies.  Upon completing medical studies, from Universiti Putra Malaysia, in 2003, he held the positions of medical and health officer and medical officer, in various Malaysian Ministry of Health hospitals.  In 2008, he initiated the dermatology clinic at Hospital Serdang, while serving as a medical officer.  It was this assignment that sparked his interest in dermatology.  His research interests in medicine include: Autoimmune skin disorders; Atopic dermatitis; Immunology in nutrition and medicine.

Abstract:

Introduction: Atopic Dermatitis (AD) is a chronic relapsing skin disease. Lower levels of vitamin D have been associated with severity of atopic dermatitis. Results in previous studies have not been consistent. Factors affecting vitamin D status such as body mass index (BMI) and sun exposure were not always assessed.

Aim & Methodology: It is a case-control study with 38 cases and 38 matched controls to determine the relationship between vitamin D status and AD and the association between sun exposure and dietary intake with vitamin D status. Appropriate selection criteria, blood sampling and validated questionnaire for AD severity, (SCORAD) were used.

Results: 15 (39.5%) mild AD, 17 (44.7%) moderate and 6 (15.8%) severe AD. Serum Vitamin D levels did not correlate with AD severity. Serum Vitamin D was significantly lower in AD [15.9(9.9-24.0) ng/ml] than controls [17.3(14.4-27.2) ng/ml, p=0.028]. There was a statistically significant association between Vitamin D and case-controls. [χ2 (2)=20.041, p<0.001]. Vitamin D was sufficient in 16 (42.1%) AD; 15 (39.5%) controls, insufficient in 7 (18.4%) AD; 22 (57.9%) controls and deficient in 15 (39.5%) AD; 1 (2.6%) control. Sun exposure was similar in both groups. Cases had significantly higher dietary vitamin D intake [1.5(0.6-3.1) vs 0.6 (0.3-1.0) µg]. AD had higher odds for Vitamin D deficiency; OR 17.52 (95% CI: 1.4-212.7; p=0.025). There were statistically significant differences in sun exposure index and serum vitamin D between different ethnic groups and gender, in general.

Biography:

Abstract:

Molluscum contagiosum is a common skin infection caused by Molluscum contagiosum virus and often occurs in children at school age. The modalities of treatment are many but not a single therapy has consensus approval for the treatment of molluscum contagiosum in children. Mechanical destruction is associated with pain and not tolerated by children. We reported a 9-year-old boy with multiple lesions on his face for 3 months. Dermatology examination demonstrated multiple typical dome-shaped, pearly-white umbilicated papules on infraorbita, nasolabial and forehead region. Histopathology examination showed intracytoplasmic inclusions bodies. Patient was given topical anesthesia to some lesions for 60 minutes, then vaseline to the surrounding skin of the lesions to be treated, followed by 80% TCA application with toothpick applicator until white frost appeared. Patient described only a stinging sensation and generally tolerated the application well. We then advised the parents to apply 10% KOH solution to each remaining lesion twice daily with a cotton-tipped applicator. At a one-month follow-up, we found complete clearance with hypopigmentation of lesions applied with 80% TCA and no changes of lesions applied with 10% KOH solution. Management using TCA is more painful and leaves hypopigmented patch that will resolve in a short time, whereas KOH is safer and painless but takes longer time to treat therefore parents might prefer TCA application due to faster resolution.

Biography:

Chao Yuan has received her PhD from Université Bourgogne Franche-Comté (UBFC).She is the Principle Investigator of the clinical trials in Skin and Cosmetic Research Department in Shanghai Skin Disease Hospital. She is a Committee Member in Cosmetology group in Chinese Society of Dermatology and also a Committee Member in Allergy Group in Shanghai Medical Association Branch of Allergy. She has published more than 25 papers in reputed journals in both Chinese and English

Abstract:

The pathogenesis of acne is multifactorial. While the sequence of events involved in acne pathogenesis have not yet been fully established, the strong co-relationship between the presence of acne and growth of the microorganism Propionibacterium acnes has led to suggestions that P. acnes is an important microbial driver for acne. Recent studies have also shown an increased level of Staphylococcus epidermidis co-relating with acne. As reported separately, we have shown that the plant derived monoterpenes of thymol and terpineol act synergistically with cutaneous antimicrobial lipids against a wide range of bacteria. To better understand the impact of thymol and terpineol on acne microbiome, a clinical study was conducted involving 30 acne volunteers aged 18-30 years and 30 healthy volunteers of the same demographic. The acne volunteers were given a facial cleanser containing thymol and terpineol to use twice daily for four weeks, while the healthy volunteers were given a mild facial cleanser. Baseline results showed a change in microbial ecology in acne subjects, with a significant increase of P. acnes and S epidermidis as compared to healthy subjects. Over the 4-week clinical study, acne subjects who used the facial cleanser containing thymol and terpineol demonstrated a reduction in P. acnes and S epidermidis levels and a concurrent reduction in acne counts. These results show that thymol and terpineol can normalize the level of P. acnes and S epidermidis in acne to a state that is closer to health, leading to a reduction in acne symptom.

Biography:

Abstract:

Tuberculosis is caused by Mycobacterium tuberculosis and Mycobacterium bovis. An attenuated strain of Mycobacterium bovis, Bacille Calmette Guerin (BCG) may occasionally be responsible. The most common manifestation is lung infection, while cutaneous tuberculosis is relatively uncommon and accounts for 1% of extrapulmonary tuberculosis. The skin may be infected via hematogenous spread, direct inoculation or auto-inoculation. Tuberculosis verrucosa cutis is a form one of tuberculosis cutis that has a clinical feature of a typical form of solitary and multiple hyperkeratotic lesion, warts may also form plaques and often being suspect as warts. The diagnosis of clinically against tuberculosis verrucosa cutis is difficult and must be confirmed by histopathology, tuberculin skin test and clinical response to anti-tuberculosis therapy. Reported a case of a child aged 11 years who were diagnosed with tuberculosis verrucosa cutis, confirmed by tuberculin test and acid-fast bacilli culture. Skin biopsy examination results may be considered for tuberculosis verrucosa cutis. Patient is given anti-tuberculosis first category therapy and it showed clinical improvement after treatment.

Biography:

Sumayyah Ismail Alrefaie has completed her MBBS from King Abdulaziz University and presently a Teaching Assistant at Department of Dermatology in King Abdulaziz University Hospital, KSA. She is interested in dermatology researches and presented at local conferences and other published in well-known journals.

Abstract:

Background: Acne vulgaris is a very common disease and several modalities are used to manage the condition. Among those is Complementary Alternative Medicine (CAM). This study aims to evaluate the prevalence of CAM usage among acne vulgaris patients and to determine possible factors associated with its adoption over the prescribed modern medicines.

Methods: A cross-sectional survey, conducted during an acne awareness campaign at King Abdulaziz University Hospital (KAUH), in Jeddah, Saudi Arabia. The survey was conducted between January 21^st and 28^th 2016.

Results: A total of 658 subjects were interviewed of which 68% were female. 72% reported a positive past-history of acne. The most common acne type described was Comedonal and face was the site most frequently affected (90.7%). Among all acne sufferers, 77% admitted using CAM. Honey was the most common CAM type used by 53.4%, followed by yogurt (43.4%). Both gender and past history of side effects to medical treatment were associated with CAM use, but the levels of education were not associated.

Conclusion: CAM users were mainly middle-aged females; their high levels of education did not lower the CAM adoption rates. Their choices could have been driven by cultural beliefs and boundaries embedded in the community.

Biography:

Chung-Ching Chu has graduated from National Taiwan University with a BS in Life Science. She has obtained her MS degree in Immunology from Imperial College, London and then proceeded to complete her PhD in Immunology from St. John’s Institute of Dermatology, King’s College London. She has over 10 years’ experience in human immunology research and has published in journals such as Blood, Seminars in Immunology and Journal of Experimental Medicine. She is presently a Senior Research Manager in Unilever R&D Shanghai, working to advance the science of skin biology and the efficacy of personal care products.

Abstract:

Acne is a multifactorial skin condition that has long been associated with changes in bacteria colonization. Cutaneous lipids, including certain free fatty acids derived from human sebaceous triglycerides and free long-chain sphingoid bases released from stratum corneum ceramides are potent and broad-acting antimicrobials contributing to skin’s self-disinfecting property and host innate defense. Dysregulated expression of skin’s antimicrobial lipids has been reported in acne condition and may be implicated in microbial dysbiosis. Here we report that long-chain sphingoid bases including C18 sphingosine, C18 phytosphingosine and C18 sphinganine, as well as sapienic acids (C16:1D6), the dominant sebaceous antimicrobial fatty acids, displayed potent antimicrobial efficacy against Propionibacterium acnes. Combination of cutaneous antimicrobial lipids with the plant derived monoterpenes of thymol and terpineol demonstrated a synergistic anti-P. acnes efficacy. Both the C18 sphingoid bases and sapienic acids perturbed the integrity of microbial cell membrane; a mechanism of action resembles that of thymol and terpineol. In contrast, no direct antimicrobial synergy was observed between cutaneous antimicrobial lipids and the skin-acting acne control agents such as salicylic acids and 6-[3-(1-adamantyl)-4-methoxyphenyl]-2-naphthoic acid. Our results demonstrated a potential synergistic antimicrobial benefit of thymol and terpineol with skin surface lipids to manage P. acnes and thereby aid in acne control.

Biography:

Tatiana Pecova has completed her PhD in Jessenius Faculty of Medicine, Comenius University in Slovakia, where she works as a Resident and part-time Assistant Lecturer. She has published 23 papers, including international and current content magazines and was awarded with two honorary scholarships (PSO-2016 and EADV-2017 Michael Hornstein Memorial Scholarship). Her current research focuses on biologic treatment of psoriasis and STIs.

Abstract:

Anti-TNF-alpha treatment is indicated for the moderate to severe chronic plaque psoriasis. Apart from its therapeutical benefits, there are adverse effects to be considered, mainly infectious complications. TNF-alpha cytokine plays important role in formation and maintenance of granuloma; therefore, its inhibitors pose a risk for granulomatous infections and reactivation of latent tuberculosis. The author analyzed the group of 190 patients from Slovakia treated with TNF inhibitors as compared to other biologics. To assess the latent form of tuberculosis, IGRA (interferon-gamma release assay) test was performed before biologic treatment and once a year after it is beginning-according to guidelines and TBNET consensus. 3% of patients had permanently positive IGRA test and in 28% of patients treated by TNF inhibitors, conversion of IGRA test appeared with negative test before treatment and positive test after administration of biologics. No active tuberculosis was detected. The average time of IGRA conversion was 3 years after beginning of treatment. The only statistically significant predictor was age and increase in one year was associated with 5.8% increase of risk of IGRA conversion. Regarding other infectious complications, the most common infections in patients treated with biologics were respiratory and HPV infections.

Biography:

Dr Tingsong Lim has actively involved in many academic research and training in Asian facial and body aesthetics, clinical application of fillers’ rheology, facial overfilled syndrome, pigmentary disorders, laser medicine and regenerative medicine. Graduated from Tohoku University School of Medicine under the Monbusho Scholarship, Dr Lim speaks 4 languages (English, Mandarin, Malay, Japanese) fluently, and has been a frequent speaker and trainer regionally and internationally. Medical Director of Clique Clinic, Dr Lim has a private practice in Kuala Lumpur, Malaysia.

Abstract:

As hyaluronic acid fillers is widely available in the market, the trend to flood the face with large volume of fillers became a common practice in the industry. However, such practice is not only impractical and not cost-effective, it can be also very dangerous, as it could lead to higher chances of vascular complications and facial overfilled syndromes. This masterclass reveals the science and art of injectology, exploring the many rheologies of fillers, and how to make use of such knowledge to deliver a more cost-effective and safer injection techniques

Biography:

Zahra Ayu Lukita Sari has completed her Medical degree from Sriwijaya University, School of Medicine. Presently, she is a student in Dermatology & Venereology, Sriwijaya University School of Medicine.

Abstract:

Keloid is benign hyperplasia of dermal collagen which may or may not be preceded by injury in susceptible person. Keloids are refractory to treatment most of the times. Intralesional corticosteroid, topical retinoic acid, topical imiquimod cream, surgery, cryotherapy, laser and silicon sheeting are mainly used for treatment. Fractional ablative laser is a new laser treatment modality that create numerous microscopic thermal injury zone controlled width, depth and density that are surrounded by a reservoir of spared epidermal and dermal tissue, allowing of rapid repair of laser-induced thermal injury. Multiple studies demonstrate that laser pretreatment of the skin can increase the permeability and depth of penetration of topical drug molecule. Laser assisted drug delivery is an evolving technology with potentially broad clinical application. Ablative fractional laser treatment creates vertical channels that might assist the delivery of drug into skin. Combination same-session therapy with ablative fractional laser and triamcinolone acetonide offers a good combination caused assisted delivery of drug. We reported a case of keloid in child who previously had burn wound in his left arm, 14 months ago. The lesion improved in reduction of keloid size and Vancouver Scar Scale (VSS) after therapy with fractional ablative laser followed by triamcinolone acetonide application. Fractional ablative laser mediates the delivery of drugs through the microthermal zone. In this particular case, fractional ablative laser followed by triamcinolone acetonide application is well tolerated with no apparent side effects. Further studies are needed to determine the drug delivery efficacy in fractional ablative laser therapy.

Biography:

Abstract:

Fordyce spots are heterotopic sebaceous glands that can be located at the lip’s vermilion border or the oral mucosa. Fordyce is also known as Fordyce granules or Fordyce glands, completely normal variant, harmless and painless. They occur in 70-80% adults. Clinically, Fordyce spot presents a tiny, white or yellowish and focally grouped papule. Since Fordyce spots are normal variation of anatomy, no treatment indicated but many patients with Fordyce spots have emotional stress. So far, a variety of therapeutic procedures have been reported with varying success and recurrence rate. A 29^th years old male patient presented with complaints of multiple, confluents, whitish spots in the vermillion border of his lips. Dermatological examination showed multiple pin head sized, whitish to yellowish papules on the vermillion border of upper and lower lips, yellowish bunch-like lobules on dermoscopic examination. Histopathological examination results revealed Fordyce granules at labial region and there is no sign of malignancy. We offered an electrocautery for this case to minimize bleeding. Treatment of Fordyce spots can easily performed with electrocautery with good improvement and minimal side effects. After 2 weeks treatment, complete re-epithelization and no residual Fordyce spot in the treated area was observed. There is no side effect found and dermoscopic examination showed less of yellowish bunch-like lobules.

Biography:

Dr Tingsong Lim Medical Director of Clique Clinic Dr Tingsong Lim has actively involved in many academic research and training in Asian facial and body aesthetics, clinical application of fillers’ rheology, facial overfilled syndrome, pigmentary disorders, laser medicine and regenerative medicine. Graduated from Tohoku University School of Medicine under the Monbusho Scholarship, Dr Lim speaks 4 languages (English, Mandarin, Malay, Japanese) fluently, and has been a frequent speaker and trainer regionally and internationally. Medical Director of Clique Clinic, Dr Lim has a private practice in Kuala Lumpur, Malaysia

Abstract:

Tear trough is the groove or valley that begins at the inner corner of the eyes, and travels down across the cheek. Together with nasojugal groove, they are often blamed for periorbital tiredness and aged appearance. However, treating tear trough with hyaluronic acid fillers is very challenging and could lead to distortion of the normal facial contour. Anatomical structure of the tear trough and nasojugal groove is being explored. Structural changes of the infra-orbital area with aging were studied and postulated. Patients previously had fillers done at the tear trough were given hyaluronidase at the tear trough. The pre- and post-treatment photos where shown to randomly selected strangers. Scores were given based on attractiveness and normality of the face. Tear trough together with nasojugal groove are both normal anatomical structure of the face. Survey showed that most examiners preferred the photos of those without fillers in their tear troughs. Treatments of tear trough with fillers could end up in alteration of facial topography. In fact, it would not improve the appearance of an aging face. The necessity of tear trough treatment might need to be reconsidered.

Biography:

Alireza Nasoori is currently a PhD candidate at Hokkaido University, Japan with background on integrative medicine, tissue regeneration and wound treatment by maggot therapy.

Abstract:

Maggot therapy has proved its efficacy for treating wounds. Debridement of the wound bed is crucial for wound healing and also for preparing the wound bed before grafting. Here, we present a rapid and efficient debridement of an extensive electrical wound by the use of Lucilia sericata larvae. After about 4 times of maggot therapy, the patient could successfully receive skin autograft. For this study, we applied the larvae that were reared and disinfected in the lab. Provision of the facilities to maintain suitable conditions (such as appropriate humidity and temperature) is influential for obtaining good results from maggot therapy for wound healing.

Biography:

Yulia Farida Yahya has completed her PhD from Airlangga University and her specialization from Hasanuddin University School of Medicine. Presently, she is the Head of Program Dermatology & Venereology in Medical Faculty of Sriwijaya University. She has published 14 papers in local and international journals of repute.

Abstract:

Acral lentiginous melanoma (ALM) is an uncommon cutaneous malignant tumor which may arise on the toe-nail and occur commonly in age 60-70 years old. ALM is a very rare disease in Asian countries, especially Indonesia and it is potentially lethal probably due to late detection. We reported a rare case in 14 years old girl with ALM, the chief complaint are hyperpigmented, thickness of 0.2 cm plaque with raised edge, irregular surface, overlying crust around lateral of left thumb nail 2×1.5 cm and black patches on nail plate 0.2×0.4 cm. The lesion is itchy sometimes, painful when stroked and odorless discharge. Past history revealed it has appeared around 6 years ago as a very small hyperpigmented papule and enlarging since 6 month ago, lymph node involvement was absent, no history of any trauma prior to the appearance of the lesion. After her first visit to our outpatient clinic, she never came again for control. A year later, she has discovered it is a malignant tumor after the tumor was amputated followed by biopsy from excised tumor by a surgeon in another hospital. Pathologic examination result was a suggestive malignant melanoma. Three months ago, she was admitted in internal inpatient ward of Mohammad Hoesin General Hospital Palembang with abdominal malignant lymphoma and treated with chemotherapy and after undergo 5 times of chemotherapy, she has passed away. In this case, due to delayed diagnosis of ALM can lead to worse prognosis, indicated the importance of earlier diagnostic, management, strict observation and routine follow-up after excision.