17^th European Dermatology Congress March 1-3, 2018 Paris, France

Elena Funieru is DMD and pursuing PhD at University Politehnica of Bucharest and Carol Davila University of Medicine and Pharmacy in Romania. She studies the effect of dental alloys and other dental materials on oral mucosa and the link between them and oral lichen planus. She has published 9 papers in reputed journals

Burning mouth syndrome (BMS) is an oral pathological condition when patients complain about pain at least 4-6 months a year in the absence of any lesions. The pain may be accompanied by a burning sensation on the oral mucosa. The main scope of this study is to find if there any connections between BMS and some dental materials (e.g. alloys, acrylate, etc.) from dental restorations, dental crowns, dental implants and other dental prostheses. The sample consisted of 85 patients with BMS who also had at least one crown, restoration or prosthesis. Another 19 patients were part of a control group. All the patients were tested for allergic reactions using dental screening kit (chemo-technique diagnostics, Sweden) recommended by international contact dermatitis research group (ICDRG). The 31 haptens contained in the kit were applied using special patches (chemo-technique diagnostics IQ Ultra chambers) attached to the same region of the posterior thorax skin. The results show that almost 52% patients from the main sample exposed positive results for the allergens included in the kit compared with only 15% from the control group. Women involved in the study exposed more allergic reactions (39%) than men (13%). As conclusion, it seems like there is a link between BMS and dental restoration, crowns or prostheses, which depends on the allergic response to the material from which they are made from.

Lely Nurjanti Graduated as Dermatoveneorologist from Airlangga University-dr Soetomo General Hospital Surabaya East Java Indonesia in September, 2005. She Had been being working as Dermatoveneorologist at Dermatoveneorologist Department of Abdul Wahab Syahranie General Hospital Samarinda East Kalimantan since 2006. She is also the Coordinator of Dermatoveneorologist Medical Faculty Education Programme at Dermatoveneorologist Department of Abdul wahab Syahranie General Hospital-Mulawarman University Samarinda East Kalimantan Indonesia in 2007. She is the Secretary of Dermatoveneorologist Continuing Education Organization for East kalimanatan Indonesia in 2008.

Introduction: Acne vulgaris was very common self-limiting disease, affected approximately 85% of adolescence that was defined as a chronic inflammation of pilosebaceous units. It was characterized (diagnosed) by the formation of comedones (as primarily acne lesion), erythematous papules and pustules, less frequently nodules and pseudocyst and was accompanied by scarring in some cases that caused psychosocial problems. Cunliffe classified the severity of acne vulgaris into 4-types based on the kind and number of acne lesions: Mild, moderate, severe and very severe. Four major factors were involved in the etiopathogenesis: Follicular hyperkeratinization, increased sebum production, abnormality of microbial flora and inflammation process. The goal of therapy was removed plugging of the pillar drainage; reduced sebum production; treated bacterial colonization; prevented from scaring. The complications were acne scar, persistent hyperpigmentation, pyogenic granuloma formation, persistent swelling, Gram-negative bacteria folliculitis, bacterial and fungal folliculitis as secondary infection, resistances to antibiotics. The purpose of this case report was to share experience in treating very severe comedonal acne vulgaris because of the chronicity course of acne vulgaris was difficult to be eradicated and there were many resistances problems to antibiotics in some literatures and journals. Case Presentation: It was a very severe (4th grade) closed comedonal acne vulgaris that was complicated by Staphylococcus epidermidis and Pityrosporum ovale folliculitis in 16 years old atopic history girl based on anamnesis, clinical finding and laboratory examination. And this case was treated by 4x TCA 10% chemical peeling at 2-weeks intervals, 2-weeks antibiotic and 10 days Ketokonazole after the result of culture and laboratory examination were positive. Result: The result was good. There was significant improvement in clinical stage (4th grade to 1st grade acne vulgaris), decreased the count of comedones, diminished papules-pustules and inflammation, no scar and post-inflammatory hyperpigmentation were occurred. Discussion: TCA 10% was superficial chemical peeling, considered as adjunctive therapy to the first line acne therapy. Retinoids and antibiotic and TCA was the first line therapy for acne scar and skin rejuvenation. TCA was cheap and safe because of no systemic absorption, had keratolytic effect (comedolytic action) and anti-inflammatory effect (bactericidal action). It could be combined to antibiotics and antifungal therapy and solved resistance problems to antibiotic and antifungal in acne therapy.

Mabel Duarte Alves Gomides is a Dermatologist, Member of the Brazilian Society of Dermatology and an Assistant Doctor at the Dermatology Department of the Federal University of Uberlandia, Brazil.

Epidermolytic palmoplantar keratoderma (EPPK), Vorner type (EPPK, OMIM 144200), rare autosomal dominant genodermatosis, first described by Vorner in 1901, is the most common form of diffuse keratoderma characterized clinically by total area of hyperkeratosis on palms and soles. It is usually due to a dominant mutation in the keratin 9 gene (KRT9), located in chromosome 17, which is specific for the palmoplantar skin. A two-year-old boy presenting hyperkeratosis of palms and soles since the first month of birth, were noticed diffuse hypertrophic plaques with yellowish keratosis and fissures limited to palms and soles and distinct erythematous margin at the border of normal-appearing skin. A punch biopsy of the palms showed epidermolysis in spinous and granular layers, hyperkeratosis and irregular clumped keratohyalin granules. EPPK integrates a complex group of uncommon keratodermas, mainly based on the morphologic and topographical characteristics and associated systemic alteration. It is the most frequent form of such diseases and usually appears during the first weeks or months after birth, characterized by diffuse thickening of the skin of palms and soles with well-circumscribed erythematous borders. The disease may be followed by other ones, above all neoplasias, probably arises due to segregation of oncogenes. Histopathologically, EPPK presents the characteristic features of epidermolytic hyperkeratosis and vacuolar cytolysis in the upper spinous and granular layers, large irregularly shaped keratohyalin granules and hyperkeratosis and electron microscopy shows vacuolization of keratinocytes of the granular layer and clumping of keratin filaments. It is differentiated from other palmoplantar keratodermas by lack of other cutaneous findings and by the presence of histologic features of epidermolytic hyperkeratosis. Currently, there are few therapeutic resources, which are mostly symptomatic. RNA interference strategies are being investigated as an approach to allele-specific gene silencing for dominant-negative keratin diseases.

Tamine Kehdi is Resident in Dermatology at the Federal University of Uberlandia/MG, Brazil

Introduction: Langerhans cell histiocytosis (LCH) is a disease related to clonal proliferation of myeloid dendritic cells with morphological, immunophenotypic and ultrastructural similarities to Langerhans cells. Histiocyte Society (1987) reclassified LCH into a chronic disseminated, chronic multifocal, chronic focal and unrecognized disease. Case report: Female, 6 years old, white, no pathological background or use of medicine, with several infiltrated papules, erythematous violaceous plaques and other residual hypochromic in trunk and limbs, with progressive increase of the disease for three years. The anatomopathological examination revealed infiltrate lymphoid of polyclonal T-cells (CD4+ and CD8+), non-granulomatous histiocytic and dendritic cells similar to LCH (S100+, CD1a+, CD68+). Systemic investigation was performed and despite the extent of cutaneous involvement, pure cutaneous LCH was confirmed, with partial response to therapy with Vinblastine and Prednisone. Findings: LCH presents exaggerated proliferation of clonal dendritic cells with accumulation of different tissues, specially bones (80%), skin (33%) and histiocytosis (25%). It determines a variable clinical presentation according to the disease’s stage, location and degree of involvement of organs and systems and can evolve from the pure cutaneous involvement to multisystemic disease (MS). The clinical evolution is unpredictable, going from spontaneous resolution to fast progression and death. From 30 to 40% of patients develop irreversible sequel from the disease or treatment, with alterations such as endocrinal, neurological, orthopedic, oral and tumoral. In general, cutaneous lesions are the first signs of LCH, manifesting as seborrheic dermatitis and refractory dermatitis: Diaper area, exudative suggestive of candidiasis or atopic. Discussion: The final diagnosis is made by clinical manifestations with immunohistochemical and histological findings of inflammatory infiltrate composed of eosinophils, histiocytes, lymphocytes and immature myeloid dendritic cells in great numbers with similar gene expression to LCH cells (Birbeck granules CD1a+, CD207). Therapeutic options should be particularized by the extent and severity of the disease.

Carole Gard is the Director of Pharmaceutical Affairs at Horus Pharma, a pharmaceutical company based in France. She is a Pharmacist and has been working for 13 years in this company specialized in ophthalmological and dermatological products. Her area of expertise, rigor and passion lead her to manage many R&D projects in order to develop preservative free and innovative therapeutic products.

Statement of the Problem: The stratum corneum is subject to an osmotic gradient, impacting its barrier function. The aim of our study was to: Establish conditions for the induction of an efficient osmotic stress (OS) after Sorbitol (S) treatment in human epidermal keratinocytes (HEK); Evaluate the expression of OS-associated genes by qPCR; Determine the potential of an active formulation (AF) to induce osmoprotective effects in OS-treated cells using microarrays; Identify molecular pathways involved in the response and validate the modulated expression of AF-induced genes using qPCR. Methodology & Theoretical Orientation: HEK were treated with S at concentration between 25-300 mM in media and cell growth-migration (IncuCyte®) was performed to define optimal concentration of OS (100-200 mM). RNAs were extracted and retrotranscribed from HEK: Non-treated, S-treated, AF pre-treated with S (200 mM) and without S for 8-24 hours. Gene expression profiles were deduced from microarrays (Agilent technology) and AF-modulated genes are analyzed with PredictSearch™ to identify molecular pathways. Modulation of gene expression was confirmed by qPCR. Findings: In line with other studies, stress induced-genes (IER3-HSPA2-HSPH1), skin differentiation (AQP3-IVL-S100A9) and repression of pro-inflammation (IL1b-IL8) was observed in S-treated keratinocytes. AF was able to decrease the stress induced-genes and AQP3 expression. Additionally, among AF induced-genes, several of them (GCLC-GPX2-TALDO1) are involved in glutathione synthesis and its reduction. Conclusion & Significance: Our results suggested that AF elicits an osmoprotection activity as well as antioxidant effects against OS through the strong positive regulation of various genes involved in glutathione synthesis and its reduction.

Chloe Gandoin is a Pharmacist with a Master’s degree in Regulatory Affairs. She is working for a pharmaceutical company based in France, specialized in ophthalmology and dermatology. She puts her expertise on developing innovative products in order to improve patient wellbeing. Her research challenge is to find preservative free therapeutical product in the dermatology area in particular in atopic dermatitis.

Aim: The aim of this study is to investigate the emollient activity of a new product (DM17) on human living skin explants. Markers of stratum corneum organization, composition and function such as aquaporin-3, filaggrin and ceramides were used in this study. The ratio of exposed 850 cm-1 and buried tyrosine 830 cm-1 residue in a protein was also analyzed. Methodology & Theoretical Orientation: A total of 21 explants from a 64-year-old Caucasian woman after abdominal plasty were kept in BIO-EC’s explants medium culture in a humidified, 5% CO2 atmosphere at 37 °C: 3 explants were controls for day-0 (D0) and 18 were either topically treated (N=9) or not treated (N=9) with DM17 (Horus Pharma, France) at D0+3h, D0+6h and D6. General explant morphology was assessed using Goldner’s Masson trichome on histological sections. Immunostaining for aquaporin-3, filaggrin and ceramides was performed using polyclonal/monoclonal specific antibodies; and digital imaging was done using light microscopy. Raman spectroscopy was performed using a confocal microscope and after spectrum normalization, the 850/830 cm-1 ratio, corresponding to exposed/buried tyrosine forms in the living epidermis and papillary dermis, were calculated. Findings: General morphology was comparable across all explants, except at D6, when DM17 treatment induced a thicker and more laminated stratum corneum. DM17 treatment increased aquaporin-3, filaggrin and ceramides expression in the stratum corneum compared to non-treated controls at all timepoints. Also, the 850/830 cm-1 ratio increased at all timepoints in the living epidermis and papillary dermis compared to non-treated controls. Conclusion & Significance: The DM17 product improved stratum corneum organization, composition and barrier function (increase of the ceramide and filaggrin expression), also skin hydration (increase of AQP3, filaggrin expression and increase of the ration between exposed and buried tyrosine) suggesting an emollient activity.

Nelly Herfina Dahlan is a dermatologist atAbunawas Hospital Kendari, Indonesia

Acne vulgaris is an inflammatory form of the skin, around the pilosebaceous units. Propionibacterium acnes are the most recognized bacteria as a key factor for the development of acne. To overcome the problem of antibiotic resistance, herbal plants have been studied as alternative treatment for acne, such as noni fruit. The purpose of this study was aimed to identify the inhibitory effect and minimum inhibitory concentration (MIC) of ethanol extract of noni fruit (Morinda citrifolia L.) against the growth of P. acnes by in vitro method. This study was a quasi-experimental with post-test only control group design. Antibacterial effect was measured by disk diffusion (Kirby Bauer) method. Concentrations of tests used were 75%, 50%, 25%, 12.5% and 6.25%, Clindamycin as positive control and sterile distilled water as negative control. Minimum inhibitory concentration (MIC) was determined by measuring the clear zone formed and then compared with the inhibition zone of Clindamycin in millimeter. MIC seen from the noni fruit (Morinda citrifolia L.) was 25% concentration with inhibitory zone diameter formed was 16.58 mm. The largest inhibitory zone diameter was at 75% concentration with inhibitory zone diameter formed was 16.75 mm. In conclusion, ethanol extract of noni fruit had an antibacterial effect on P. acnes by in vitro method.

Yan Li is an Attending Physician of Department of Dermatology in Beijing Friendship Hospital, Capital Medical University. Her research focuses in dermatology and contact allergy, cosmetology laser and immunological dermatology. She was the Member of Medical Cosmetology of China Society of Integrated Traditional Chinese and Western Medicine. She was graduated from Peking University of Health Science Center and received Doctor of Medicine in 2009. She has published more than 30 papers in reputed journals.

The aim of the study was to investigate the efficacy and safety of Halometasone cream to treat chronic generalized eczema and the effects of Halometasone cream on serum cortisol (COR) levels. 60 consecutive outpatients diagnosed with chronic generalized eczema between January and April 2017 were included and divided into groups A, B and C with a lesion area of 30-40%, 41-50% and 51-60%, respectively. Groups A, B and C were treated with Halometasone cream with a daily dose of 15 g, 20 g and 30 g for 7-14 days, respectively. 10 patients were randomly selected from each group for serum COR measurement at days 0, 7 and 14. On day 14, group B had significantly higher cure rate (47.1%) than groups A (17.9%) and C (13.3%) and significantly higher effectiveness rate (82.4%) than group C (40.0%) (all P<0.05). Serum COR levels were not affected in group A but were reduced significantly in groups B and C on days 7 and 14 (all P<0.05). No adverse reaction was observed. Halometasone cream appeared to relieve chronic generalized eczema effectively and safely. High dosage (≥20 g daily for 14 days) may temporarily reduce endogenous COR production substantially, although it may be more effective.