Day :
- Acute Dermatological Diseases | Cosmetic and Aesthetic Dermatology | Clinical Immunology | Traditional Chinese Dermatology
Location: Londres
Chair
Lazaros I Sakkas
University of Thessaly, Greece
Co-Chair
Ranjan J Perera
Sanford Burnham Prebys Medical Discovery Institute, USA
Session Introduction
Danka Svecova
Comenius University in Bratislava, Slovakia
Title: Mother-to-child transmission of syphilis
Biography:
Danka Svecova is presently a Professor of Dermatovenerology, Head of Bullous Disorders Unit, Department of Dermatovenerology, University Hospital and Faculty of Medicine, Comenius University, Slovakia. She is a Board Member of Committee for Dermatovenerology and Immunology dissertation for PhD at Comenius University and a Member of Committee for Probation of Specialization for Dermatovenerology at Comenius University and University of JP Safarik in Kosice. She has participated in research on Skin Allergology and Immunology under the supervision of Professor Akira Ohkawara at Hokkaido University in Sapporo, Japan. She wrote two monographs about blistering disorders-Pemphigus vulgaris autoimmune disease and Pemphigus.
Abstract:
Background: Untreated syphilis in pregnancy can lead to serious complications for a fetus, including stillbirth and neonatal death, premature delivery, low birth weight, or congenital anomalies and active congenital syphilis in a neonate. The WHO estimated that 1.86 million cases of syphilis occur globally each year among pregnant women and a sizable proportion of cases go untreated. Worldwide, it is estimated that maternal syphilis is responsible for between 713600 and 15750 cases of congenital syphilis.
Objective: The aim of the study was to evaluate the epidemiological trends in incidence rates of mother-to-child transmission of syphilis, syphilis in women of reproductive age and pregnant women in the antenatal care program over two decades, to find a basis for preventive measures and to evaluate the epidemiological trends in European countries.
Material & Methods: Case series data of confirmed syphilis was used to evaluate the incidence rates over the period 1991-2014 in Slovakia.
Results: During the monitored period, 101 cases of mother-to-child transmitted syphilis were detected. The rate increased in 1996, corresponding to 33.3 per 100,000 live births and discovered discordance in antenatal care program. The rates of syphilis in women of reproductive age showed increased rate in 2001, corresponding to 10.44 per 100000 populations. Pregnant women reported the highest rate in 2000, corresponding to 3.24 per 1000 pregnant women population. Syphilis notification rates in all three groups showed increased trend in the first decade following with decreased trend in the second decade. The high increase in rate notification among pregnant women in 2011 (0.37) decreasing up to 0.11 in 2014 was followed with decreasing of mother-to-child transmission.
Conclusion: Mother-to-child transmission of syphilis poses public health problem and requires comprehensive surveillance in all countries. In general, the active maternal syphilis in developed countries is rare. However, mother-to-child transmission of syphilis is not portable in all European countries resulting in an underestimated incidence of mother-to-child transmission of syphilis. Data of the study registered that the last years 2011-2014 showed improvement in antenatal care program corresponding with decrease rate of mother-to-child transmission of syphilis; however, the rate of syphilis is increasing in population. The basis to improve the epidemiologic situation in mother-to-child transmission of syphilis results in the requirement of effective improvement of antenatal care program in pregnant women.
Elena Funieru
University Politehnica of Bucharest, Romania
Title: The relationship between burning mouth syndrome and dental materials
Biography:
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.
Abstract:
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.
Ling Zhang
NSFC Foundation, China
Title: Persistent ERK activation by the histamine H4 receptor in spinal neurons underlies chronic itch
Biography:
Ling Zhang is a Professor and Principle Investigator at Department of Neurobiology, Tongji University School of Medicine. She has received her PhD degree at Fudan University in 2005. After that, she pursued her Postdoctoral Fellowship at Pain Medical Center of Brigham and Women’s Hospital, Harvard Medical School.
Abstract:
Transient extracellular signal-regulated kinase (ERK) activation through H1 receptor in the spinal cord triggers histamine-induced acute itch. However, whether persistent ERK activation plays an important role in chronic itch development remains unclear. This study investigated the role of spinal ERK activation in chronic itch. Results showed that repetitive 2,4-dinitrofluorobenzene (DNFB) painting in the nape of mice evoked not only induced scratching but also sustained, spontaneous scratching. In addition, DNFB induced itching rather than nociception, as demonstrated using a cheek model. Furthermore, ERK was persistently activated in the spinal cord of DNFB treated- mice and intrathecal inhibition of pERK suppressed both the spontaneous itching and ERK activation. ERK activation was observed in neurons but not in glia cells as chronic itch developed. Finally, DNFB-induced spontaneous itching behavior and ERK activation were largely inhibited by the histamine H4 receptor antagonist JNJ7777120, but not by H1 receptor antagonist chlorpheniramine. Our results indicate that persistent ERK activation via the histamine H4 receptor in spinal neurons underlies DNFB-induced chronic itch.
Biography:
Shery Mounir William Labib is a certified Cosmetic Dermatologist and Owner of “Skin Klinic”, Cairo, Egypt. She has obtained her Bachelor’s degree from Ain Shams University, Cairo in 2007 where she did her Residency and her Master’s degree in 2012.
Abstract:
Methotrexate is an immunosuppressive agent that acts as a folic acid analog which competitively inhibits dihydrofolate reductase enzyme. Methotrexate comes after Prednisolone as one of the most commonly prescribed systemic drugs in dermatology. Methotrexate as an intra-lesional drug was used in treatment of skin tumors as cutaneous squamous cell carcinoma and keratoacanthoma with satisfactory results. Also, several studies used intra-lesional methotrexate (IL-MTX) in treatment of hypertrophic scars/keloids either alone or as an adjuvant to surgery. In addition nail psoriasis was successfully treated with IL-MTX. Same as systemic MTX intake, pre-treatment investigations must be done (complete blood count, liver and kidney function tests and pregnancy test) to exclude any hematological abnormalities, renal insufficiency and risks of hepatotoxicity. For hypertrophic scars and keloids, IL-MTX not only improves thickness and flexibility of scar tissue but also decrease vascularity which results in better functional, aesthetic and psychological impact on the patient. Using IL-MTX is a good treatment modality in treating various skin tumors. It is very promising in hypertrophic scars and keloids. However, more studies are needed to standardize its use.
Wenjie Wang
Soochow University, China
Title: Proteomic profiling of zinc-induced skin cell proliferation: Activation of β-catenin pathway
Biography:
Wenjie Wang started woking as a PhD student at the age of 30 years at Soochow University in 2014. She has published more than 8 papers in reputed journals
Abstract:
Zinc is an essential micronutrient that plays important roles in protein structure, catalysis, and gene regulation. It is required for the homeostasis of human skin. However, the effect of zinc on skin cell proliferation and its underlying mechanisms remain elusive. We found that exposure to zinc for 30 min was sufficient to induce significant cell proliferation in human keratinocyte HaCaT and the fibroblast WS1 cells. To investigate the molecular changes underlying zinc-induced cell proliferation, we analyzed protein expression in the control and zinc-treated cells via iTRAQ protein profiling and identified 16 upregulated and 64 downregulated proteins between zinc-treated and the control HaCaT cells (fold-change > 1.2). Through bioinformatic analysis, common motifs that associated with transcriptional factors or co-activators were identified, including β-catenin, YY1 and E2F1. Among them, the β-catenin pathway was further investigated. Zinc induced the nuclear translocation of β-catenin and increased β-catenin-responsive luciferase activity in skin cells. The growth advantage of zinc was abrogated by siRNA targeting β-catenin or XAV-939, an inhibitor of the β-catenin pathway. Moreover, zinc-induced resistance to H2O2 was significantly decreased by XAV-939. Taken together, our findings illustrate the molecular changes by zinc-induced proliferation and that β-catenin mediates the pro-proliferative role of zinc in skin cells.
Amani Saad
University of London, UK
Title: Evidence- based approach on how to maintain best results after CO2 fractional laser treatment
Biography:
Amani Saad is an MSc student in Aesthetic Medicine at Queen Mary University of London. She is also member of American Academy of Aesthetic Medicine.
Abstract:
One of the greatest challenges in the aesthetic medical field is how to maintain the good results obtained by laser resurfacing and rejuvenation of skin to the greatest extents and also how to minimize the side effects caused by these techniques to the lowest extents in order to achieve best performance.
Strict skincare regimen and sun avoidance care should be taken for at least six months after laser treatment. Many cosmeceuticals can be used at the meantime to maintain the good results obtained by the laser resurfacing, to avoid recurrence of the old hyperpigmentation and to prevent photodamage effects of the sunlight on the newly generated skin. When is the optimum time to begin using sunscreens and other cosmeceuticals? What are the most effective cosmeceuticals in these cases?
Are cosmeceuticals really effective in maintaining good results obtained by the laser resurfacing? Questions to be discussed subjectively in this article.
Evidence -based study is done comprehensively to enlighten best postoperative treatment and strategies to be done in order to achieve best performance by the CO2 laser resurfacing treatment.
Lazaros I Sakkas
University of Thessaly, Greece
Title: ANA-specific antigen recognition in patients with psoriatic arthritis and psoriasis
Biography:
Lazaros I Sakkas is currently working as a Professor of Medicine and Rheumatology, Chairman of Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly. He is also an Adjunct Assistant Professor at Temple University School of Medicine, Philadelphia, PA, USA (Jun 2003to till date) and has worked as an Adjunct Professor at Center for Molecular Medicine, Old Dominion University, Norfolk, VA, USA (2010-2017). He is the President at the Institute for Rheumatic Diseases (2011 to till date) and Co-Editor of the Mediterranean Journal of Rheumatology.
Abstract:
Introduction: Antinuclear antibodies (ANAs) may be detected in psoriatic arthritis (PsA) and psoriasis (Ps) but the antigen-specificities have not been defined. International Consensus on ANA patterns (ICAP) has reported 14 ANA immunofluorescence (IF) patterns and commercial molecular-based multiplex assays were developed to assist ICAP’s IF ANA testing.
Aim: To identify ANA specificities in Ps and PsA using a recently developed multiplex immunoassay specifically designed for ANA.
Material & Methods: A total of 70 patients (38 female) with Ps (n=36) or PsA (n=34) and 50 demographically matched normal controls (NCs) were tested by an ANA line immunoassay containing 23 different antigens: dsDNA, nucleosomes, histones, SS-A, Ro-52, SS-B, nRNP/Sm, Sm, Mi-2α, Mi-2β, Ku, CENP A, CENP B, Sp100, PML, Scl-70, PM-Scl100, PM-Scl75, RP11, RP155, gp210, PCNA and DFS70.
Results: Overall, reactivity to at least 1 against antigen was found in 23/70 patients (32.9%) compared to 6/50 (12%) NCs (p=NS; Ps vs PsA, p=NS). Specifically, the ICAP-related abs in Ps/PsA patients were as follows: AC-1:4.3%; AC-2:10%; AC-3:0.7%; AC-4:11.4%; AC-5:0.7%; AC-6:0.7%; AC-8:2.8%, and AC-10: 2.1%, while in NCs ICAP-related abs were as follows: AC-2:4%; AC-4:4%, AC-3:2%; AC-8:2% and AC-11:2% pattern. There was no statistically difference for the presence of ICAP between Ps and PsA and between Ps/PsA and NCs.
Conclusion: Testing for ANA specificities does not reveal a dominant ANA target in PsA and Ps.
Biography:
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.
Abstract:
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.
- Cosmetic Dermatology | Skin Cancer | Bacterial Skin Diseases | Research in Dermatology
Location: Holiday Inn Paris – Marne La Vallée
Chair
Lazaros I Sakkas
University of Thessaly, Greece
Co-Chair
Ranjan J Perera
Sanford Burnham Prebys Medical Discovery Institute, USA
Session Introduction
Idrianti Idrus
Hasanuddin University, Indonesia
Title: Scrofuloderma mimicking squamous cell carcinoma
Biography:
Idrianti Idrus is a student in Dermatology and Venereology Department in Hasanuddin University, Indonesia
Abstract:
Skrofuloderma also known as tuberculosis colliquativa cutis, is a subcutaneous tuberculosis that forms a cold abscess and secondary damage to the skin surface with skin lesions resemble the appearance of squamous cell carcinoma which is the second most common form of skin cancer. Skrofuloderma often experiences delays in diagnosis in both developing and industrialized countries today. A case of skrofuloderma was reported in a 44-year-old woman with massive lesions on her neck and mandibular region resembling squamous cell carcinoma and a history of soft tissue tumor on submandibular disease. Diagnosis based on anamnesis, physical examination and investigation in the form of tuberculin test showed positive results and histopathology. Patient treated with anti-tuberculosis drugs (OAT) as the primary choice of skrofuloderma therapy and showing shrinkage of lesion after completing one cycle therapy.
Wen-Shan Chen
Taichung Veterans General Hospital, Taiwan
Title: Imatinib-induced pemphigus foliaceus in a patient with gastrointestinal stromal tumor
Biography:
Wen-Shan Chen is working as Professor of Geology, Taiwan University, previously he was working as associate professor at Department of Geology, National Taiwan University.
Abstract:
A 59-year-old man was diagnosed one-year-ago with a gastrointestinal stromal tumor (GIST) and liver metastasis. Since the diagnosis, he has been under an oral, Imatinib 400 mg daily treatment without any concomitant medications or special health food. A half year into the treatment, he was presented to our dermatology clinic due to progressing, non-pruritic scaly eroded eruptions over his upper back and abdomen. An incisional skin biopsy taken from the lesion over his back revealed a subcorneal cleft with acantholysis, along with dyskeratotic cells in the granular layer of the epidermis. Direct immunofluorescence revealed remarkable intercellular deposits of both immunoglobulin G (IgG) and C3 within the upper epidermis, but without the deposits of IgM and IgA. Indirect immunofluorescence showed circulating IgG anti-intercellular substance antibodies at a titer of 1:160. A careful correlation between the clinical and pathologic pictures suggested a diagnosis of Imatinib-induced pemphigus foliaceus (PF). In summary, to the best of our knowledge, this is the ï¬rst case of Imatinib-induced PF ever reported in literature. We strongly believe that any observation of scaly, erytheamtous maculopapules in patients under Imatinib treatment should alarm the caring physicians, in light of the increasing popularity of prescribing this novel anticancer drug.
Yaghubi E
Tehran University of Medical Sciences, Iran
Title: L-carnitine supplementation in pemphigus vulgaris: A randomized controlled trial
Biography:
Yaghubi E is a student of public health sciences in Nutrition in Department of cellular and molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran. Her field of interests is lifestyle/diet in the prevention of cardiovascular and inflammatory diseases. Clinical/nutrition effects in relation to autoimmune diseases.
Abstract:
Background: Pemphigus Vulgaris (PV) is an autoimmune blistering disease of skin and mucus membranes. The first-line treatment for PV involves corticosteroids and immunosuppressive agents, which can cause various side-effects.Objective: The aim of this study was to investigate the impact of oral L-carnitine supplementation on oxidative stress index (OSI) and antioxidant capacity in patients suffering from PV. Methods: In this clinical study, 52 PV patients were enrolled and randomly assigned to receive either 2g L-carnitine (n=26) or placebo (n=26) for 8 weeks. The serum levels of carnitine, OSI, total oxidative capacity (TOC) and total ant-oxidative capacity (TAC) were measured before and after intervention. Data were analyzed by student t-test, paired t-test and analysis of covariance. Results: only 47 participants [LC group (n=24) and placebo group (n=23)] completed the trial. LC intake significantly decreased serum OSI (p<0.05). There were considerable increases in serum levels of TAC and carnitine. However, no significant difference was demonstrated in TOC serum between the LC and placebo groups. Additionally, within-group comparisons indicated a remarkable increase in serum carnitine (p<0.001) and a significant decrease in OSI (p=0.003) and TOC (p=0.01) in the supplemented group. No harmful effects were observed during the study. Conclusion: This is the novel study to examine the beneficial impacts of LC supplementation on inflammatory mediators in patients with PV. To confirm these results, further trials are warranted.
Shima Jahani
Tehran University of Medical Sciences, Iran
Title: Aloe vera effects on acute and chronic wound healing: A systematic review
Biography:
Shima Jahani is currently a Medical student at Tehran University of Medical Sciences and was honored to win Bronze Medal in National Olympiad of Informatic.
Abstract:
Although using Aloe vera is an ancient and traditional way for improving the wound healing process, clinical and molecular evidence still remained unclear. Up to now, several studies have assessed the efficacy of Aloe vera on healing. Systematic review on in vitro and in vivo studies including animal studies and clinical trials was conducted to determine the Aloe vera molecular interactions in damaged tissues and its effectiveness in clinic. We electronically searched related studies in PubMed, Cochrane Library and Scopus from 1918 till September 2017. Only papers discussing on healing activity of Aloe vera, aloe-derived products and a combination of Aloe vera and other dressings as a treatment of acute wounds specifically caused by lesions (in animal studies) or in post-surgery patients were included. There were no restrictions on any language of publication. Reviewer extracted data on study characteristics, patient characteristics, gross morphology of the intervention, frequency and duration and outcome measure. 41 studies were included in this review. In vitro studies showed that Aloe vera boosted the time and quality of wound healing by stimulating MMP 2, 3 and 9 vascular endothelial growth factor, transforming growth factor and even total collagen activity. In vivo studies demonstrated a significant difference in wound healing between control groups and aloe treated ones. Cumulative evidence on in vivo and in vitro studies ends to confirm that Aloe vera might be an effective intervention used in wound healing. Further, well-designed trials with adequate information should be conducted to determine the effectiveness of Aloe vera or its products.
Iraldo Bello Rivero
Center for Genetic Engineering and Biotechnology, Cuba
Title: HeberFERON as a therapeutic option for the treatment of advance and high risk basal cell carcinomas
Biography:
Iraldo Bello Rivero has completed his Masters in Chemistry at I.I.Mechnikov National University, Odessa, Ukraine and PhD from Havana University. He carried out Fellowships with Dr. Michel Aguet (1988) at Institute of Immunology and Virology, Zurich, Switzerland; with Dr. Erik Lundgren (1994) at Department of Molecular Biology, Umea University, Sweden and with Dr. Marco Soria (1995) at Department of Biological and Technological Research, San-Raffaele Scientific Institute, Italy. He was the Head of Clinical Trial Laboratory at CIGB (1994-2005). He has published more than 30 papers in reputed journals and received Cuban Academy of Sciences Awards (1990, 2006) and Public Health National Award (Cuba) in 2010 and 2016.
Abstract:
Methodology & Theoretical Orientation: The administration of the IFNs was performed perilesionally using doses from 3.5 to 10.5 MUI, 3 times a week for 3 weeks. PK/PD studies were conducted. All the patients included in the studies gave their consent for participation and the studies were approved by the ethics committees of the participating institutions and CECMED.
Findings: Clinical studies of HeberFERON revealed that this formulation generated a faster anti-tumor response than the IFNs separately, as well as a greater number of complete responses, which agrees with the results of the PK/PD that demonstrated a superior biological potency of HeberFERON. The follow-up studies of patients with BCC or SCCS who obtained complete responses (CR) showed that these remain at 5 years free of tumor and that the rate of appearance of new lesions decreased by 8 times. The aesthetic results of these treatments are very favorable and the use of the product is safe. A global analysis of 245 patients with BCC treated with HeberFERON shows a disease control of 98.6% with 61.9% CR and 88.4% objective response. BCC patients received intramuscular treatment with HeberFERON with encouraging results and improved quality of life.
Conclusion & Significance: HeberFERON is a new formulation of IFNs with curative capacity for non-melanoma skin tumors, with very favorable aesthetic results, safe and easy to use
Biography:
Abstract:
Background: Acrochordons have an irregular or smooth surface and most commonly located on eye lids, neck, axillae, trunk, groin and on the lumbar area. There are a few case reports of giant acrochordons including one reported on male external genitalia.
Case Report: A 50-year-old man with a pedunculated mass, diameter 9 cm, arising from right scrotum for 3 years ago. Body mass index is 27.3 kg/m2 and there was no pain, redness and no ulceration. The lesion was totally removed with CO2 laser under local anesthesia. Diagnosis was confirmed by histopathological examination.
Conclusion: The predisposing factor in this patient is obesity. Acrochordon can be removed with electrodesiccation, curved or serrated blade scissors, cryotherapy or even laser surgery. CO2 laser surgery under local anesthesia in this patient was cosmetically acceptable by simple procedure.