Day 1 :
Keynote Forum
Alisha Booms
Midwestern University, USA
Keynote: The Presentation of Cutaneous Sarcoidosis
Biography:
Abstract:
Sarcoidosis is an autoimmune, granulomatous disease that affects multiple body systems. Commonly, patients present with dyspnea, cough, painful joints, and lymphadenopathy. Sarcoidosis is frequently discovered through additional workup, involving chest CT showing hilar lymphadenopathy and consolidations or masses within the lungs. However, the primary presentation of sarcoidosis may be with cutaneous skin lesions. Our patient had a known history of sarcoidosis and presented to the clinic with two cutaneous nodules located on the lower back and right thigh. Biopsies were performed on both lesions and results were significant for cutaneous sarcoidosis on pathology. Subsequently a chest CT was completed, which was suggestive of pulmonary sarcoidosis, and the patient was referred to pulmonology. Cutaneous manifestations may be the initial presenting manifestation of sarcoidosis, as seen in our patient. Up to 20-35% of patients diagnosed with sarcoidosis have cutaneous manifestations and this may occur without other systemic involvement, such as dyspnea or cough.1 Due to the absence of other systemic symptoms that may increase clinical suspicious for sarcoidosis, it is imperative for physicians to recognize the cutaneous nodules and to keep sarcoidosis on their differential diagnosis for further workup. The absence of typical presenting symptoms can delay diagnosis and treatment in these patients, making the recognition and biopsy of cutaneous lesions crucial for diagnosis of cutaneous sarcoidosis.
Keynote Forum
Samuel Peek
Incredible Marketing, USA
Keynote: Artificial intelligence is changing healthcare - A digital marketing revolution.
Biography:
Sam launched Incredible Marketing in Orange County, California, along with several team members that were just as fed up with the status quo as he was. A polarizing figure, Mr. Peek has a diverse background that gives him a distinct advantage to understanding what makes the medical aesthetic industry thrive and the foresight to ensure you’re always thinking in a proactive way, not reactive. He has become a trusted figure in the healthcare marketing space for his results-oriented and no-nonsense approach to digital communication strategies. Sam frequently speaks at industry meetings in the United States, Australia, and around the world
Abstract:
Introduction: Artificial intelligence is no longer just a dream for the future. Current artificial intelligence can curate new content, help you lower your cost to acquire new patients, cost per conversion, and determine where to allocate your budget wisely among marketing tactics. Utilizing the tools at your disposal will help you get ahead now, leaving others to face insurmountable barriers later.
METHOD: In this presentation, Artificial Intelligence is Changing Healthcare - A Digital Marketing Revolution, we will discuss instances of AI technology being used effectively in our industry. From there, we will discuss the magnitude of AI technology and what it means for our industry. Then taking a look into the future, we will discuss what is on the horizon for AI technology and how you can use AI on a small scale to give your practice a competitive edge.
Results: By creating unique experiences on the fly for specific people, conducting predictive analysis and generating sales using tools that can more accurately predict human interactions than we can, we have created a self-contained system that brings in new leads, nourishes them and also learns from the failures to create individually custom and curated experiences as we advance.
Conclusion: Time is money, and AI is the new face of productivity; when you need to analyze data and spot trends on immense scales, there is no substitute for what AI offers (Higher Efficiency = Better ROI).
- Clinical Dermatology
Location: Webinar
Session Introduction
Gyoo Huh
Sungkyunkwan University School of Medicine, Korea
Title: Extramammary Paget Disease Secondary to Urothelial Carcinoma; A Case Report
Biography:
Huhgyoo graduated School of Medicine, Yonsei University
He has worked as reident in Kangbuk samsung hospital, Sungkyunkwan University School of Medicine, Department of Dermatology since 2019
Abstract:
Extramammary Paget disease (EMPD) is a rare adenocarcinoma which can be primary or secondary to an underlying malignancy. 20-30 % of patients are estimated to associated with visceral malignancy. Secondary EMPD is most commonly extended from anorectal or urothelial carcinoma. When the lesion involves perianal or periurethral area, a thorough search for internal malignancies should be performed. Immunohistochemistry (IHC) is necessary to differentiate between primary and secondary disease.
We report a case of a 71-year-old male with EMPD secondary to urothelial carcinoma. He presented with 8-month history of erythematous patch on urethral meatus. The lesion was diagnosed with herpes viral infection 6-months ago. It had not shown improvement since he treated with antiviral therapy. He has medical history of urothelial carcinoma of bladder for which he had radical cystectomy 3-years ago. Histopathologic findings demonstrated pagetoid cells in the epidermis. IHC staining showed positive for CK 7, CK 20 and CAM 5.2, but negative for S-100. The patient was diagnosed with secondary EMPD with an underlying urothelial carcinoma. The lesion was managed with urethrectomy and partial penectomy. There is no sign of recurrence after a month of treatment.We recommend that careful evaluation of skin lesion on periurethral area should be done when the dermatologists encounter with the patient who had history of urothelial carcinoma.
Hyeon Jeong Park
Sungkyunkwan University School of Medicine, Korea
Title: Superficial CD34+ Fibroblastic Tumor on the Plantar Foot
Biography:
Park Hyeon Jeong graduated School of Medicine, Chosun university medical department.
she has worked as reident in Kangbuk samsung hospital, Sungkyunkwan University School of Medicine, Department of Dermatology since 2018
Abstract:
Fibroblastic mesenchymal tumors show a spectrum of biological behavior, from benign to malignant. We here in report our experience of a distinctive features of superficial CD34-positive fibroblastic tumor (SCPFT), which is a newly described neoplasm, previously undescribed low-grade fibroblastic tumor of the superficial soft tissues.
A 45-year-old man presented with subcutaneous nodular lesion on the mid foot area of the right sole. The lesion was near the area of skin graft of the foot, which undergone traumatic amputation by traffic accident 40 years ago. The right foot MR examination revealed 2.0 x 1.6 x 0.8 cm sized enhancing mass involving skin and subcutaneous layer. After total excision with supralesional flap surgery, the histopathological study of the 1.9 x 1.8 x 0.5 cm sized mass revealed some nodular growing pattern of atypical spindle cell proliferative lesion with distinctive angiomatosis, moderate nuclear atypia, admixed some inflammatory cells in fibro-fatty tissue, and mitotic figures of 1/10 HPFs. The CD34 stain showed diffusely positive reaction for the lesion, and the expression of Ki-67 protein was very low. Finally, the patient was diagnosed with SCPFT.
To date, 42 cases of SCPFT have been reported. The actual incidence rate of this entity is likely much higher due to the lack of sufficient recognition of this tumor. Herein, we report a rare case of the SCPFT to enhance the recognition and diagnostic level of the disease.
Jin Seop Kim
Sungkyunkwan University School of Medicine, Korea
Title: Erosive Pustular Dermatosis of the Scalp Arising on the Long-standing Burn Scars : A Report of Three Cases
Biography:
Kim Jin Seop graduated School of Medicine, Wonkwang University
He has worked as resident in Kangbuk samsung hospital, Sungkyunkwan University School of Medicine, Department of Dermatology since 2020
Abstract:
Erosive pustular dermatosis of the scalp (EPDS) is clinically characterized by a chronic eruption of scalp pustules, erosions and crusts that leads to scarring alopecia. Previous literatures have reported association between EPDS and predisposing factors like skin atrophy and trauma. However, EPDS after childhood burn has never been reported.
Three female patients were presented with erosions, crusts, and painful ulceration on the burn scars of the scalp that occurred in childhood. To exclude malignancy on old burn scars, we performed punch biopsies. In all cases, histopathological examination showed inflamed crust, ulcer, acanthosis and neutrophilic infiltration. Based on the clinical and histopathological features, EPDS has diagnosed. Treatment with clobetasol propionate and 0.1% tacrolimus oint has effect on regression of inflammatory sign.
Although the exact pathogenesis of EPDS is unknown, aberrant wound healing response including insufficient blood flow, necrosis, or even autoimmunity has been suggested. Healed burn scar is more vulnerable to continued inury, because it has less elastic covering. Repetitive irritation might trigger an autoimmune reaction to unknown skin antigens. Because EPDS has common and nonspecific clinical presentation, EPDS could be misdiagnosed. We have suggested when clinicians encounter erosive dermatosis in long standing burn scar, clinicians should consider EPDS in differential diagnosis.
Nusrat Gaffoor Bholah
East Lancashire NHS Hospitals Trust, United Kingdom
Title: Outcomes of Virtual Dermatology Assessments, during the COVID-19 Pandemic, in a Primary Care Setting in the UK.
Biography:
Dr. Nusrat Gaffoor Bholah has completed her Undergraduate Medicine degree in Trinity College Dublin in 2019. She has worked as a foundation trainee doctor in the East Lancashire NHS Hospitals Trust in the United Kingdom. She has a keen interest in the field of Dermatology. She has undertaken placements and multiple projects in this area.
Abstract:
AccuRx is a virtual consultation platform, used in over 7000 General Practices in the UK1. Due to a reduced need for face-to-face reviews, and in light of the COVID-19 pandemic, our practice has adopted accuRx for Dermatological assessments. We report its impact on the volume of subsequent face-to-face appointments and its ability reach to a definitive diagnosis. Searches were conducted on EMIS for patients aged 4 to 40 years, with clinical codes ‘eczema’/‘psoriasis’/‘rash’/‘skin’ between 01/11/19 to 31/01/20 for the Pre-COVID-19 group and between 01/11/20 to 31/01/21 for the COVID-19 group. 25 patients were randomly selected from each group. All pre-COVID-19 reviews were face-to-face. Those not using accuRx for their consultation were excluded from the COVID-19 group. 16%(4/25) of patients required a further face-to-face appointment within 3 months of initial presentation, for the same dermatological problem, in the pre-COVID-19 group, compared to 4%(1/25) in the COVID-19 group. A definitive diagnosis was reached at first assessment in 96%(24/25) of patients in the pre-COVID-19 group compared to 84%(21/25) in the COVID-19 group.
AccuRx may reduce the number of face-to-face appointments which has clear advantages during a pandemic. However, this reduction may also be attributable to reduced availability of face-to-face appointments in Primary care and reluctance of vulnerable patients seeking healthcare interactions during this time. Moreover, consultations using this platform are less likely to result in a definitive Dermatological diagnosis, compared to face-to-face reviews. This may be related to the quality of images reviewed on the platform.
Yeon Gu Choi
Sungkyunkwan University School of Medicine, Korea
Title: A case of metastatic renal cell carcinoma with intramuscular mass on the forearm
Biography:
Choi Yeon Gu graduated School of Medicine, Yonsei University. He has worked as resident in Kangbuk samsung hospital, Sungkyunkwan University School of Medicine, Department of Dermatology since 2019
Abstract:
Renal cell carcinoma (RCC) is a rare cancer with 2.3% of occurrence in Korea. The cutaneous metastasis occurs in 3.3% RCC patients. After diagnosis, additional metastasis is found at about 90%, and the mean survival duration is 10.9 months. Cutaneous metastases of RCC present as erythematous or reddish purple round nodules of varying sizes with rapid growth.
A 88-year-old male presented with a solitary, well-demarcated, slowly growing, 2.5 x 2.0cm sized, deep-seated firm mass on the left flexor forearm since 3 years ago. Ultrasonography revealed extremely hypervascular mass with rich supplying vessels. Magnetic resonance imaging revealed 1.6 x 1.6 x 3.3cm sized, high T2-weighted signal intensity mass with internal septa at brachioradialis muscle. On the basis of histopathologic examination, atypical, pleomorphic, oval to spindle-shaped nuclei, clear with abundant cytoplasm with alveolar pattern were observed within unencapsulated, lobulated mass. In immunohistochemical analysis, tumor cells were positive for PAX8, CD10, CK, EMA and Vimentin. Ultrasonography on urinary tract revealed a lesion suspected of RCC, thought to be primary tumor. The patients transferred to another hospital without further evaluation.
The patient showed a peculiar clinical symptom, and the primary tumor was diagnosed from the metastatic lesion. Thus, we report rare case with a metastatic RCC with intramuscular mass on forearm.