11^th Global Dermatologists Congress November 14-15, 2016 Dubai, UAE

Biography:

Dr Asmah Johar is a National Head of Dermatology Service,Senior Consultant Dermatologist at Department of Dermatology, Kuala Lumpur, Malaysia. She was the Committee member for Adolescent Health Technical Module for Ministry of Health Malaysia. 1997, Peer review for website site contents for Dermatology Diseases 2005 for adolescents.Committee member for Dermatology Drug Committee Ministry of Health since 2001 until now.She is the Secretary of Malaysian Society of Allergy and Immunology.

Abstract:

Background: After three decades of implementing multidrug therapy (MDT) consisting of rifampicin, dapsone and clofazimine in Malaysia, drug resistance pattern of Mycobacterium leprae is a growing concern as it may lead to failure of treatment and relapse of disease.

Objective: To determine the drug resistance pattern of Mycobacterium leprae in Malaysia

Methodology: Mouse footpad (MFP) culture of all skin biopsy samples from patients with borderline lepromatous and lepromatous leprosy sent to the Leprosy Unit, National Public Health Laboratory, Sungai Buloh between 1997-2013 were retrospectively studied.

Results: There were 638 MFP cultures performed. The mean age of patients was 41 years old (range: 6-88). The male:female ratio was 3.76:1.  Four-hundred-and-thirty-six patients (68.3%) were Malaysian. The rate of positive Mycobacterium leprae culture was 67% (427 of 638). The median Bacteriological index (BI) and Morphological index (MI) for those with positive culture were 4.0 and 2.8. The median BI and MI of those failed to grow in MFP were 3.6 and 1.7 respectively and they were significantly lower than those with positive culture (p≤0.001). Dapsone has the highest resistance rate of 55% (236 of 429). There were 425 MFP tested for clofazimine and 98(23%) were resistant to it. Rifampicin has the lowest resistance rate of 2.7% (11 of 403). There were no significant differences between the drug resistance pattern and the gender or the nationality of the patients.

Conclusion: More than half of our positive MFP cultures were resistant to dapsone; about a quarter were resistant to clofazimine and less than 3% were resistant to rifampicin. Monitoring of Leprosy resistant pattern is important as there are not much advances in treatment and important to detect early any changing pattern of resistant.

Biography:

Michel Ragy Hanna has completed his Master’s degree in Dermatology. He is currently working as an Associate Lecturer of Dermatology, Faculty of Medicine, Minia University, Egypt. He is also an External Graduate Student in Sanford-Burnham-Prebys Medical Discovery Institute, La Jolla, California, USA for his MD thesis. He has published 2 papers and serving as a Reviewer for International Journal of Dermatology and Journal of the European Academy of Dermatology and Venereology.

Abstract:

Hair follicle (HF) morphogenesis and regeneration depend on intensive and reciprocal interactions between epithelial and mesenchymal components. Currently, attempts to regenerate HFs depend on combining receptive epithelial and trichogenic dermal mesenchymal components and grafting them into an in vivo environment. Unfortunately human HF bulge stem cells (BSCs) are not suitable for this purpose because the isolation and propagation of human HF BSCs for tissue engineering purposes remains a challenge. Here we developed a strategy to differentiate human embryonic stem cells (hESCs) and induced pluripotent stem cells (hiPSCs) into CD200⁺/ITGA6⁺ BSCs that can reconstitute the epithelial components of the HF. Importantly, co-transplantation of hESCs or hiPSC-derived CD200⁺/ITGA6⁺ cells with trichogenic mice dermal cells into immunodeficient nude mice resulted in HF formation. Histological analysis revealed that the obtained HFs posses all HF lineages including the hair shaft and the inner and outer root sheaths. Human HF stem cell markers such as keratin-15 were detected in reconstituted HFs. The human origin of the epithelial cells in the new HFs was confirmed by positive reactivity for human-specific nuclear antigen. In this context derivation of functional HF BSCs capable of inducing a new hair formation suggest a major step toward developing cell-based treatments for alopecia.

Biography:

Anggana Rafika Paramitasari is a Dermatovenereology Resident of Sebelas Maret University, Surakarta, Indonesia.

Abstract:

Atrophic scarring is frequent complication of acne, resulted from aber­rant remodeling of the extracellular matrix (ECM) in pilosebaceous units of skin. Many combination of treatment is needed in lifting atrophic scar by inducting collagen synthesis. Human hair follicle stem cell (HHF-SC) has reported for having capability of fibroplasia induction. Culturing in conditioned medium will make this stem cell secreting factors known as secretome or exosome which is able to mimic the beneficial effects of stem cell therapy. To experimentally find the effect of human hair follicle conditioned medium (HHF-CM) as a combination of atrophic scar revision post acne vulgaris, first we measured grading of atrophic scar according to global acne scarring classification and skin elasticity using Elastometer™ in three patients. We gave topical anesthesia application 30-45 minutes before treatment, then we did subcision and microneedling. After that, we injected of HHF-CM in sites of scar. These patients were given topical antioxidant with HHF-CM after treatment. This procedure is re-applied after a month and we measured the improvement of acne scar grading. There as improvement in atrophic acne scar’s grading with this combination therapy within a month.

Biography:

Etty Farida Mustifah is currently a Dermatovenereology Resident in Faculty of Medicine Sebelas Maret University, Indonesia. She has published 3 papers in a national congress of dermatology and 1 paper in an international congress of dermatology.

Abstract:

Acne vulgaris is a common inflammatory pilosebaceous disease characterized by comedones, papules, pustules, inflamed nodules, superficial pus filled cysts and in extreme cases with canalizing and deep, inflamed, sometimes purulent sacs. Oral and topical treatment is available for acne, but some of them have side effect such as teratogenic. Human hair follicle stem cell (HHF-SC) has reported for having capability for reducing inflammation in wound healing. Culturing in conditioned medium will make this stem cell secreting factors known as secretome or exosome which is able to mimic the beneficial effects of stem cell therapy. Until now there are minimal reports about application of stem cell in acne treatment. To experimentally find the effect of combination injection and topical human hair follicle conditioned medium (HHF-CM) for acne vulgaris treatment, firstly we did the grading of acne using the Plewig and Kligman classification and then measured the skin trans-epidermal water loss (TEWL) with TEWAMETER^® in acne patients. We gave topical anesthesia application 30-45 minutes before treatment, then we did injection of HHF-CM in sites of acne. These patients were given topical antioxidant with HHF-CM daily after treatment. This injection procedure is re-applied after a month and we measured the improvement of acne grading. There was improvement of acne grading with this combination treatment within a month.

Biography:

 Ferry Arrochman is a residen of Dermatovenereology department and faculty of Medicine Sebelas Maret University Dr.Moewardi Goverment hospital, Surakarta, Indonesia.

Abstract:

Background: Basal cell carcinoma (BCC) is the most common cancer in human. It is estimated that over 1 million new cases occur each year in the united states. In indonesia the most common predilection of BCC are on cheeks and forehead (50%), nose and nasolabial fold (28%), periorbital (18%, perioral 5%. A wide range of different treatment has been described for the management of  BCC. The aim of treatment is to eradicate the tumor with acceptable cosmetic outcome to the patient. Stem cell have emerged as a key element of regenerative medicine therapies due to their inherent ability to differentiate into variety of cell phenotypes. Advanced Adipose Protein Extract derived from adipose tissue, is an example of the stem cell’s product that exerts different skin regenerative effects, such as antioxidant protection, anti wrinkling and as wound healing. This wound healing properties enables AAPE to be used as a treatment modality of post BCC excision.     

Objective: To evaluate the role of AAPE in wound healing and prevention of scar formation after BCC excision.

Case: This report follows a series of five BCC patients that are excised and afterwards, AAPE mixed with topical immunomodulator was applied to the lesions and covered with sterile gauze for 3 days. This process is repeated every 3 days and the reduction in lesion was measured for 1 month using comparison of photographs and the size of the lesion.

Conclusion: After follow up for 1 month there are excellent improvement of the lesion based on the photographs and the size. This case series prove that AAPE can be a modality treatment of wound healing post BCC excision.

Biography:

Ajayita Chanana is the President of Confederation of Wellness, Medical Tourism and Spas in India. She is a Gold Medalist Ayurvedic Doctor and Cosmetologist. She has been the Director of a Clinic in Chandigarh for 13 years. In her 13 years of practice she has successfully treated many patients both from India & abroad. She has successfully completed a Certificate Course in Non Surgical Aesthetic Treatment from Warsaw, Poland. Her articles have been published in leading newspapers. She is a TEDx Speaker too. She was adjudged the best Ayurvedic Entrepreneur of the year 2014 at the Pharmaleaders Award in Mumbai and was bestowed with International Health Care Excellence Award in 2008.

Abstract:

Background: Regeneration, maintenance and degeneration form the lifecycle of any living organism. Ageing is apparent when degeneration overtakes regeneration. Removal of toxins from the body (e.g., detoxification) will help to prevent premature failure of the organs. Creating conditions for the body to absorb optimum nutrition from the food we eat which allows the body to rebuild heal and rejuvenate. The imbalance between the synthesis and collagen breakdown is the primary cause of skin problems such as wrinkles. In stress, cortisol level increases. Increased levels of cortisol in persistent stress weaken the immune system of the body.

Method: In Ayurveda, first of all constitutional analysis called Prakriti Prikshan is done to analyze the predominant doshas. After judiciously analyzing the predominant doshas full body detoxification and mental detoxification is done.

Result: We conducted a study on ten patients in which we found a marked improvement in the blood pressure and other vital parameters in 3 weeks of consolidated treatment of panchakarma, breathing, exercises yoga and following ayurvedic life style. All the Ayurvedic Panchakarma Therapies brought the stress levels remarkably down as per the Hamilton Depression Rating Scale Ayurvedic panchakarma treatments are given to increase the rate of cell division and improves wrinkling. Improving dermal vasculature and stimulates new collagen deposition, restores the dermo-epidermal interphase which is undulated and improves the skin's water barrier properties. It also showed improvement in skin elasticity and firmness, increase in skin moisture and collagen synthesis and decrease in wrinkle depth. Ayurveda aims to reduce the destruction and promote the synthesis of stronger collagen fibers thus there was a marked improvement in the skin glow and texture.

Conclusion: This retrospective 6 month clinical study showing the effectiveness of these panchakarma therapies for ageing showed that they are very effective for treatment of mid face, jowls and wrinkled neck and skin tightening of facial areas. It also shows significant improvement for cellulite reduction.

Biography:

Abstract:

Background: Vitiligo is an acquired depigmentary condition caused by destruction of melanocytes in epidermis. It is of major social and cosmetic concern in India.

Aim: The purpose of the study was to find age of onset and sex incidence in vitiligo, role of hereditary factors, consanguineous marriage and association with other diseases.

Methods: 100 self reporting patients of vitiligo at any age and either sex, diagnosed on the basis of history and clinical examination were enrolled from OPD of MGM Hospital, Aurangabad. Patients were evaluated for age at onset, sex, role of hereditary factors and association with other diseases by a specially designed pro forma.

Results: In present study, out of 100 cases 57 (57%) female and 43 (43%) males with Female:Male ratio 1.3:1. There was practically not much difference in sex incidence. The lowest age of onset was 6 years and oldest age was 65 years. The mean age was 30 years. Majority of patients was from 25-35 years (30 cases). 27 (27%) cases give a definite family history, out of which 19 (70%) patients was the 1^st degree relative and 8 (30%) cases were 2^nd degree relative. The lower limb was commonest site of involvement in 44 (44%) patients. Majority of patients (68.3%) had multiple lesions. Diabetes mellitus was seen in 1 (1%), hypertension in 4 (4%), bronchial asthma in 1 (1%) and hypothyroidism in 1 (1%) patient.

Conclusions: Causes of vitiligo is still idiopathic. Hereditary factors hardly play any major role in manifestation of vitiligo.

Biography:

Joseph Sobanko is an Assistant Professor and Director of Dermatologic Surgery Education at the Hospital of the University of Pennsylvania. His research supported by the Dermatology Foundation, investigates the relationship between the altered physical appearance from oncologic, reconstructive and aesthetic procedures and the subsequent impact on patient reported outcomes such as quality of life. He is a founding Member and sits on the steering committee of IMPROVED (Measurement of Priority Outcome Variables in Dermatologic Surgery); a nationwide consortium of experts that is developing core outcome sets in dermatologic surgery. He is the primary or senior author on numerous leading scientific articles. He is also Co-Editor of a textbook dedicated to improving surgical safety and reducing occupational exposures (Safety in Office-Based Dermatologic Surgery, Springer Press 2015).

Abstract:

Statement of the Problem: The Skin Cancer Index (SCI) is a validated, patient-reported instrument used to measure quality of life (QOL) in skin cancer patients. Currently, the SCI does not have established clinical correlates nor are there validated benchmarks for normal scores. The Hospital Anxiety Depression Scale (HADS) is a validated instrument with previously established cut-offs to measure clinical anxiety and depression and has been used in a variety of diseases including previous studies of patients with skin cancer.

Aim: The objective of this study is to identify the relationship between the SCI and the HADS to create clinically meaningful cut-off scores for the SCI. These data may help to identify skin cancer patients who may benefit from counseling to both prevent and treat psychosocial distress.

Methodology & Theoretical Orientation: Cross-sectional study.

Findings: Analysis included 134 non-metastatic skin cancer patients. The SCI has a moderate inverse linear relationship with the HADS Anxiety subscale score (r=-0.39, p<0.001). In the ROC curve for the HADS cut-off of ≥8/21, previously established to signify suspicion for clinical anxiety, AUC was 0.6821 (95% CI 0.5750-0.7892). A cut-off score of ≤78 for the SCI showed a sensitivity of 84.4% and nearly 4 times greater risk (p<0.01, 95% CI 1.50-8.87) of having a HADS Anxiety score of ≥8.

Conclusion & Significance: The SCI can be used as a single instrument screening tool for clinical anxiety, allowing physicians to risk-stratify those patients more likely to have psychosocial distress. In comparison to the HADS, the SCI is shorter in length, thus increasing its practicality and also provides disease specific information about the impact of skin cancer on factors including emotional health, appearance concerns and social interaction.

Biography:

Dr. Sobanko is an Assistant Professor and Director of Dermatologic Surgery Education at the Hospital of the University of Pennsylvania. His research,supported by the Dermatology Foundation, investigates the relationship between the altered physical appearance from oncologic, reconstructive,and aesthetic procedures and the subsequent impact on patient reported outcomes such as quality of life. Dr.Sobanko is a founding member and sits on the steering committee of IMPROVED (Measurement of PRiority Outcome Variables in DermatologicSurgery) –a nationwide consortium of experts that is developing core outcome sets in dermatologic surgery.  He is the primary or senior authoron numerous leading scientific articles (Imadojemu,Sobanko,etal. JAMA Dermatol 2013;Sobanko et al Dermatol Surg 2015; Miller & Sobanko J Am Acad Dermatol 2015). He is also co-­editor of a textbook dedicated to improving surgical safety and reducing occupational exposures (Safety in Office-­â€based Dermatologic Surgery, Springer Press 2015).

Abstract:

Statement of the Problem: The Skin Cancer Index (SCI) is avalidated, patient-reported instrument used to measure quality of life (QOL) in skin cancer patients.1 Currently, the SCI does not have established clinical correlates nor are there validated benchmarks for normal scores. The Hospital Anxiety Depression Scale (HADS) is a validated instrument with previously established cut-offs to measure clinical anxiety and depression, and has been used in a variety of diseases including previous studies of patients with skin cancer.2-5 The objective of this study is to identify the relationship between the SCI and the HADS to create clinically meaningful cut-off scores for the SCI. These data may help to identify skin cancer patients who may benefit from counseling to both prevent and treat psychosocial distress.

Methodology & Theoretical Orientation: Cross-sectional study.

Findings: Analysis included 134 non-metastatic skin cancer patients. The SCI has a moderate inverse linear relationship with the HADS Anxiety subscale score (r=-0.39, p<0.001). In the ROC Curve for the HADS cut-off of ≥8/21, previously established to signify suspicion for clinical anxiety, AUC was 0.6821 (95% CI 0.5750-0.7892). A cut-off score of ≤78 for the SCI showed a sensitivity of 84.4% and nearly 4 times greater risk (p <0.01, 95% CI 1.50-8.87) of having a HADS Anxiety score of ≥8.

Conclusion & Significance: The SCI can be used as a singleinstrument screening tool for clinical anxiety, allowing physicians to risk-stratify those patients more likely to have psychosocial distress. In comparison to the HADS, the SCI is shorter in length, thus increasing its practicality, and also provides diseasespecific information about the impact of skin cancer on factors including emotional health, appearance concerns, and social interaction.

Biography:

Barbara Page has worked in Dermatology Nursing for over 27 years and 16 years of these were as a Specialist Dermatology Liaison Nurse. She was awarded an MBE in the new Years Honours list in recognition of work in this field. She continue in the field as a Dermatology Nurse Advisor, an Honorary Clinical Teacher, Dundee University School of Nursing & Health Sciences and Lecturer for NHS Education for Scotland. Special areas of interest are Eczema, Psoriasis and the Psychological impact of Skin Disease. She is currently Chair of the Psychodermatology sub group of the British Dermatological Nursing Group (BDNG) and represent BDNG as a committee member of Psychodermatology UK. Currently a Trustee of National Eczema Society; Honorary Member and Trustee of Primary Care Dermatology Society; Founder & Honorary Chair of Scottish Dermatological Nursing Society; Nurse Advisor to Skin Care Campaign Scotland; Past Secretary & Board Member of International Skincare Nursing Group. Have published widely and served on a wide range of Nursing Advisory Boards.

Abstract:

The World Health Organisation has identified low health literacy as a serious public health concern. This presentation will identify global issues within health literacy including influences on patient empowerment, quality of life, wastage and socio-economic costs. Patient empowerment is simply a process to help people gain control which includes people taking the initiative, solving problems, making decisions and can be applied to different setting in health & social care environment leading ultimately to self management. It is important for health care professionals to address health literacy in every patient consultation to ensure people have enough knowledge, understanding, skills and confidence to use health information and take an active role in their own well being.

Biography:

Polly has 30 years experience in dermatology nursing within NHS, Academia and Pharmaceutical Industry. She currently completing a PhD (health psychology), witin St Andrews University, Medical School. Her achievements include being appointed the first skin cancer nurse specialist in UK, appointed the first Dermatology Nurse Consultant in UK. She has over 50 publications in peer reviewed journals and books. Specialist areas of interest,: dermatology nursing research, professional development, skin cancer, inflammatory skin disease, psychosocial impact of skin disease and psychosocial aspects of care. Currently employed as Lead Nurse, Research and Development, NHS Fife

Abstract:

Poor adherence is a long standing problem in clinical dermatology. Poor adherence to clinical management programmes with dermatology topical treatments can have important quality, health and resource implications. This presentation will explore the issues surrounding poor adherence to topical treatments. The implications for management are discussed as are the strategies available in supporting patients (and their carers) utilising a bio-psycho-social approach. Key barriers to good adherence are identified, with communication and patient (mis)understanding being arguably the two most significant factors influencing concordance. Five dimensions of adherence are outlined to include disease, patient, treatment, socio-economic and health care system factors. Strategies for improving adherence using assessment tools and a stepped approach within the consultation process are presented as the way forward in improving adherence, patient experiences and helath care professional satisfaction

Biography:

Dr. Belkais Marwan graduated from Al Minia University in 1994, she obtained her Masters Degree in Dermatology in 1999. Dr Belkais worked as an Assistant Lecturer from 2000 till end of 2012 at Al Minia University, Egypt then for two and half years at Medcare Hospital from 2009 till 2011. She worked in a private clinic from April 2011 till December 2014 then she moved to her Clinic (Dermapremier Skin Clinic) on January 2015.

Abstract:

Getting rid of scars, especially when it comes to darker skin types, can be a challenge. Scars are natural parts of the body’s healing process after suffering from some sort of trauma or wound, such as from acne, a skin condition or surgery. The Fractional Microneedling (Dermapen) provide a solution to treat all kind of scars (Acne Scars, Varicella Scars, Stretch Marks, Atrophic and hypertrophic Scars) either alone or to be proceeded by TAC injection or 5-FU injection according to the type of the scar. Dermapen is an automated-microneedling therapy system that vertically pierces the skin to naturally stimulate collagen and elastin with minimal epidermal damage. The Dermapen’s automatic vibrating function increases the effectiveness of treatment by increasing absorption of products, while reducing pain and discomfort. Fractional micro delivery provides unparalleled collagen induction via fragmented delivery of needles into the epidermis and dermis. These micro injuries to the skin encourage the power of the body’s innate ability to re-grow and repair the skin through the physiology of collagen induction. There is increased local blood circulation too that will bring more nutrients and growth factors to the area we are treating. It stimulates an inflammatory reaction that encourages certain fibroblasts to come into the area to generate collagen. The body’s ability to remodel and heal itself is at the heart of this amazing technique and because the process never involves heat or thermal energy or unnecessary trauma, the skin can quickly heal with almost zero downtime.

Biography:

Rawan Khaild Al Mesned is currently a Medical Intern at King Saud University, College of Medicine.

Abstract:

Fordyce spots are enlarged sebaceous glands commonly found on the vermilion boarder of the lips and oral mucosa, they may occur on other body surfaces. There are frequently observed in adult males and clinically they presented as asymptomatic multiple whitish or yellowish papules. Despite Fordyce spots benign nature patients get concerned for cosmetic reasons. Few numbers of cases in the literature reported the effect of isotretinoin in treating Fordyce spots. Herein, we describe two patients with Fordyce spots of the lips treated successfully with isotretinoin. The first case is a 50 years old lady complaining of whitish spots over the upper and lower lips. The diagnosed was made based on clinical examination and treated with low dose of isotretinoin, which shows remarkable improvement without recurrence of the lesion. The second case is a 47 year female with whitish discoloration of the lower lips and got treated for several years as case of vitiligo without benefit. On clinical examination it showed classical picture of Fordyce spots and treated with isotretinoin and got improved by 70%. She followed up in the clinic for one year without any progression. In conclusion, we encourage dermatologists to use isotretinoin as one of the main therapeutic options for treating Fordyce spots because of it is good result and minimal side effects.

Biography:

Ghassan Adulrauf Niaz is a Medical Intern involved in several case reports like keratosis pilaris case report and the designer of the case-control study for psoriasis and vitamin D deficiency.

Abstract:

Erythromelanosis follicularis faciei is a rare sporadic condition of unknown etiology characterized by reddish-brownish patches and follicular papules that appear commonly on the face and rarely on the neck. Herein, we report a 16-year-old male who had asymptomatic facial skin lesions since early childhood. His family history revealed a similar case in his younger brother. His parents are not consanguineous. Skin examination revealed diffuse non-scaly brownish patches with erythematous background and multiple skin-colored, hypopigmented follicular papules on both cheeks. A summary of previous reports of erythromelanosis follicularis faciei in the literature will be presented in this report.

Biography:

Indah Julianto has completed her PhD in 2006 from Airlangga University School of Medicine in Surabaya, Indonesia. She has published several papers in reputed journals and has been serving as Editorial Board Member of repute for Indonesian dermatology journals. She is a frequent speaker regarding stem cells and its uses in international and national conferences since 2010. She also lectures about stem cells to various specialties in Sebelas Maret University, University of Indonesia and North Sumatera University.

Abstract:

Cutaneous wound healing is a serious worldwide problem that affects patients with various wound types, resulting from burns, diabetes and traumatic injuries. There is evidence that resident cells in non-healing wound bed are phenotypically altered, such as prolonged exposure to inflammatory cytokines, reactive oxygen intermediates and bacterial toxins, all these contribute to fibroblasts senescence and further suppression of the normal healing process. Standard therapeutic modalities in clinical practice include debridement, pressure offloading, dressing regimens, hyperbaric oxygen, antibiotics, and topical growth factors. However, even with most current therapies, more than 50 percent of chronic wounds remain refractory to treatment. During the past decade, fetal and adult tissue-derived mesenchymal stem cells have rapidly evolved from in vitro and animal studies into human trials as a therapeutic modality for a diverse group of clinical applications. Stem cell biology has gained remarkable interest in recent years, driven the hope and finding cures for numerous diseases including skin wound healing through transplantation medicine. Initially upon transplantation, these cells home to and differentiate within the injured tissue, contrary-wise, it now appears that only a small percentage of transplanted cells integrate and survive in the host tissue. Thus, the foremost mechanism by which stem cells participate in tissue repair seems to be related to their trophic factors. Indeed, stem cells provide the microenvironment with a wide range of growth factors, cytokines and chemokines, which can be broadly defined as stem cells secretome. The objective of this paper is to report the use of fetal and adult stem cells derived secretome as a treatment for many types of huge chronical non-healing ulcers.

Biography:

Zhi-qi Hu has completed his PhD from Sun Yat-sen Medical University. He is the Director of Plastic and Aesthetic Surgery Department of Nan Fang Hospital, an affiliated hospital of Southern Medical University. He has published more than 15 papers on hair medication in reputed journals.

Abstract:

Many factors can cause the sparse or absent of eyebrows. Eyebrow transplantation is a unique skill among hair transplant surgeons. To restore a natural-looking eyebrow, finer hair grafts close to the hairline serve as an ideal donor. Use of follicular unit extraction (FUE) to harvest hair located close to the hairline margins can overcome some of the problems associated with strip harvesting and result in more control over eyebrow softness aesthetics. In the current study, finer single hair follicles located close to the hairline margins of the peri-auricular area by the FUE method were used to restore eyebrows and good results were achieved.

Biography:

Shahid Javaid Akhtar is a talented, skilled and renowned Doctor with more than 20 years of experience in Dermatology. He is a Professor of Dermatology at Punjab Medical College, Pakistan.

Abstract:

Fractional photothermolysis has changed the whole scenario of skin resurfacing and fractional CO₂ laser are now extensively used in racially pigmented skin. We tried novel concept of using high intensity fractional CO₂ laser ablation specifically targeted to the individual acne scars in Pakistani patients. 13 patients with mixed types of acne scars underwent three fractional CO₂ phothermolysis with Fraxis Laser after 6-8 weeks. After topical anesthesia, high intensity fractional CO₂ laser therapy (125-175 mJ/cm², 20-30% coverage, 3-5 passes) was precisely targeted to the individual acne scars to get clinical end point of about 90% scar effacement. Objective mean improvement of 65% (range 40 to 80%) was seen in 9 patients who were available for final evaluation 6 months after the last session. Serosanguineous exudation, crusting and erythema followed by transient pigmentation were the most common but predictable side effects noted. It was concluded that high energy fractional CO₂ laser ablation of individual acne scars leads to significant improvement even in ice pick and box scars but at the cost of transient dyschromia.

Biography:

Roshidah Baba was Head of Department of Dermatology, Malacca Hospital for 28 years and had served as National Head of Dermatology Service, Ministry of Health & Chief Coordinator of Advanced Master of Dermatology, National University of Malaysia. She was involved in the development and implementation of Malaysian guidelines on Aesthetic Medical Practice for medical practitioners in her capacity as chairman of the Credentialing & Privileging committee and head of examination board for Certification of Aesthetic Practice by Medical Practitioners. A member of the Skin Experts Network of Southeast Asia, SEA acne alliance, regional psoriasis working group, past president of Malaysian Dermatology Society, past honorary editor of the Malaysian Journal of Dermatology, reviewer for International Journal of Dermatology & Malaysian Medical  Journal. Received several awards from His Majesty the King of Malaysia,His Excellency the Governor of Malacca and Malaysian Ministry of Health for her excellent service.
 

Abstract:

Malaysia, like the rest of the world, recognizes an increasing interest and demand for aesthetic medical practice (AMP). To ensure public safety and to uphold professional standards, a set of guidelines on AMP was successfully developed in 2014. This was an initiative by the Malaysian Ministry of Health, with the involvement of the Malaysian Medical Council. The process was arduous and it took almost five years of extensive deliberation by experts of various stake holders in the Ministry of Health, universities, professional bodies and private practitioners. The guidelines define:

• Classification of aesthetic medical procedures
• Classification of chapters of medical practitioners

Non-specialists (Chapter 1), medical specialists (Chapter 2) and surgical specialists (Chapter 3)

• Scope of AMP for respective chapters
• Process of registering of medical practitioners leading to issuance of Letter of Credentialing and Privileging (LCP)
• National Registry of Registered Medical Practitioners with LCP
• Appeal mechanism
• Application process for foreign medical practitioners

Despite some challenges encountered, its implementation has brought some positive impact on the delivery of aesthetic medical practice thus far.

• There is control on sale of class IV medical lasers to registered medical practitioners with LCP only
• Self-regulation on scope of practice has minimise complications
• There is an established channel for public complaints on unethical practice
• Availability of national registry of medical practitioners with LCP on Ministry of Health website for public reference
• Availability of well-structured training courses by qualified local trainers for interested medical practitioners
• There is a clear understanding that non-medical practitioners (beauticians) cannot perform procedures identified for medical practitioners

It is hoped that this set of guidelines will meet its objectives in ensuring public safety and upholding professional standard in the delivery of aesthetic medical practice in Malaysia.

Biography:

Dr Ghannam graduated 1983 from Alexandria University Egypt, a Master Degree of Dermatology, Venereology & Andrology in 1986. A PhD in 1994 with a thesis on Chronological Aging, Photo aging and Ionizing Radiation effects on the skin, in 1995 a board examination was passed to successfully achieve Doctorate Degree of Dermatology Venereology & Andrology. During that time she upscaled in the University positions from a teacher assistant until Associate Professor in Alexandria University. Since that time, she has been interested in aging and antiaging procedures. She do almost all Aesthetic procedures ,including injectables and Energy based devices ,but a great part of her practice is still for general dermatology. She is a world expert on chemical peels especially in our mediterranean skin type. She is a board member of the International Society of Dermatologic surgery ISDS, and the executive director of the International Peeling Society IPS.She is an active member in many International societies as AAD since 1987, EADV, ISD, ASDS ISDS, ESLD, DASIL, IACD, skin of color Society and honorary member of the Romanian Society of Cosmetic Dermatology and the Argentinan Society of Dermatologic Surgery. She is an organizing Committee member of Sharm derm meeting, on the International advisory board of the 5CC meeting and Moderator of Middle Eastern Master Class IMCAS.She is the co- author of the Chemical Peel chapter in the 3rd edition of [Surgery of the skin] published by Elsevier. Published over 20 scientific papers.She is the editorial advisory board of the Indian Journal of Dermatology and the Journal of Clinical and Aesthetic Dermatology.

Abstract:

The field of facial aesthetic surgery is experiencing explosive growth in non invasive and minimally invasive procedures. Biosynthetic fillers such as Ca hydroxy apatite, Polycaprolactone and poly L Lactic acid are biodegradable fillers,and considered to be long lasting fillers. Poly L lactic acid , was the first one to be used in aesthetic surgery ,it is a polymer that provides soft tissues augmentation through stimulation of an inflammatory tissue response with subsequent collagen deposition. Ca hydroxy apatite and Polycaprolactone each consists of a gel carrier and The Ca hydroxy apatite spheres and Polycaprolactone spheres respectively that once injected in the subcutaneous space, the gel is slowly absorbed, what remains is a matrix of material which will take the characteristics of the cell that repopulate. When injected into the tissues space, fibroblast produces collagen.The author clinical experience with these three long lasting fillers will be presented.

Biography:

Amir Feily is a Dermatologist and Researcher in Skin and Stem Cell Research Center of Tehran University of Medical Sciences and Department of Dermatology of Jahrom University of Medical Sciences, Iran. He is the Member of International Society of Dematology , European Academy of Dermatology, Editorial Board of Journal Dermatology Report, Journal of Pigmentary Disorder, Aperito Journal of Dermatology, Journal of Drug Metabolism and Toxicology, International Journal of Dermatology Research and Therapy and Associated Editor of Asian Journal of Dermatology. He is also a Reviewer of many dermatologic journals such as British Journal of Dermatology (BJD), International Journal of Dermatology (IJD), Clinical Experimental Dermatology (CED), Journal of European Academy of Dermatology (JEADV) and etc. He has more than 74 high quality papers in dermatology and pharmacology. His recent two awards were 2013 Global Education Award, granted by International Society of Dermatology (IJD) and Imrich Sarkani Non-European Memorial Award granted by European Academy of Dermatology at 23^rd EADV Congress Amsterdam, the Netherland 2014.

Abstract:

Hair restoration is a safe procedure and most of its associated complications are preventable by the surgeon and/or the patient. Recipient area necrosis is rare but arises when an increased number of recipient grafts are utilized and de-vascularization of the scalp occurs. The aim of this study was to investigate and compare all cases and pictures reported in main search engines and Iranian centers of hair transplant to find the dangerous zone of necrosis and to provide a new method for prevention of necrosis. Pictorial analysis of this study revealed that the majority of necrosis (14 of 18) occurs in central region of the scalp and is inclined, particularly, to the right parietal aspect of the scalp. Accord­ingly, a case series was done and a new method for prevention of scalp necrosis even in dense packing transplantation was discussed.

Biography:

Shahid Javaid Akhtar is a talented, skilled and renowned Doctor with more than 20 years of experience in Dermatology. He is a Professor of Dermatology at Punjab Medical College, Pakistan.

Abstract:

Introduction: Pemphigus vulgaris is a potentially fatal disease which has high death rate of up to 100% before the advent of systemic corticosteroids. But now the major cause of mortality is the side effects of these and steroid-sparing agents. Dr. J S Pasricha used Dexamethasone Cyclophosphamide Pulse therapy in 1989 for the first time to overcome this issue. But it has got its own technical flaws. We made some logical modifications in this regime to minimize the side effects and maximum the efficacy of pulse therapy.

Objective: To see the efficacy of cyclophosphamide pulse therapy in pemphigus vulgaris.

Patients & Methods: 20 new patients of pemphigus vulgaris attending the OPDs of hospitals (Allied and DHQ) attached with Punjab Medical College, Faisalabad were enrolled. After getting baseline investigations, IV cyclophosphamide (0.75-1 g/m²) was given after every 3-4 weeks. Oral Ondansetron hydrochloride 8 mg on day 1-5 and 8 mg of IV Dexamethasone on day 1-3 to prevent chemotherapy induced nausea and vomiting was also administered. Patients were advised to drink plenty of water and micturate frequently on day one to safeguard against potential cystitis. Oral prednisolone was also given in the standard dosage of 1 mg/kg, however, it was tapered earlier but gradually first to single morning dose and then to alternate day therapy once the clinical remission was achieved. These were ultimately completely withdrawn but cyclophosphamide pulses were continued 6-12 months after complete clearance of skin lesions.

Results: 15 patients completed the therapeutic trial according to the original protocol; 8 of these are now off all therapy and are in clinical remission for more than two years. Three patients are only receiving their monthly cyclophosphamide pulses and are also symptom free; rest of the enrolled (n=4) are taking 15 mg of prednisolone in addition of cyclophosphamide pulses but are free of skin lesions. Apart from transient nausea and body aches, none of the patient experienced any major side effect.

Conclusion: Cyclophosphamide pulse therapy for pemphigus vulgaris seems to be efficacious and may provide cure in this potentially fatal autoimmune disease though a large number of patients and longer follow up is required before making a final conclusion.

Biography:

Dr.S.Anandan completed his MBBS, M.D and D.D.from JIPMER, Puducherry. Worked as Registrar for 2 years till 1986. Joined Sri Ramachandra Medical College in 1986 as Assistant Professor and at present, Dean and Professor of Dermatology, SRMC & RI.  He is the Fellow of AAD, Life Member of IADVL, Member of EADV and International Society of Dermatology.  He is a Examiner in MD and DNB Dermatology for various Universities in India.  Has got 9 International and 33 National Publications.  Contributed Chapters in Text Books of Dermatology.

Abstract:

Oral lichen planus is a chronic inflammatory condition that affects the oral mucous membranes with a female predominance and peak presentation during fourth decade.  Multidisciplinary approach is required for successful management of oral LP.   T cell mediated auto immune process in which autocytotoxic CD8+ T cells trigger apoptosis of oral epithelial cells.  Systemic drugs, contact allergens in dental materials, trauma, bacterial or viral infections may unmask the antigen.  Upregulation of heat shock protein (HSP) has been demonstrated.   Increased secretion of Th 1 type cytokines such as IL-2, IFN gamma and IL-12 leads to basal cell lysis. The causative factors are drugs, contact allergens, infections, stress and genetics.    Oral lesions present as whitish lace like network, buccal mucosa is most frequently affected. The types of LP are: Reticular, papular, plaque, erosive and atrophic.  The oral LP presents with pain and burning sensation.   Diagnosis of oral LP includes clinical and histopathological criteria.  Examination of skin, hair and nails is essential.  Work up includes CBC, sugars, lipid profile, LFT,  HCV screening, buccal smear for candida, mucosal biopsy and direct immunofluorescence if necessary. Multidisciplinary approach involving dermatolgists, dentists, psychologists helps attain holistic management. Treatment of OLP includes topical steriods,  cyclosporine, calcineurin inhibitors, retinoids in ora base & in difficult cases, systemic drugs like steroids, immunosuppressive agents, dapsone , targeted phototherapy.  Excision of resistant plaques and lesion showing atypia may be undertaken.  Treatment of oral LP aims at resolution of symptoms, lesions, reducing the risk of cancer, prolonging symptom free intervals to improve the QOL.

Biography:

Zhi-qi Hu has completed his PhD from Sun Yat-sen Medical University. He is the Director of Plastic and Aesthetic Surgery Department of Nan Fang Hospital, an affiliated hospital of Southern Medical University. He has published more than 15 papers on hair medication in reputed journals.

Abstract:

To date, hair transplantation (HTS) has a history of nearly 210 years, which involves the transplantation of hair, beard, eyebrows, eyelashes and pubic hair; however, HTS is also a relatively tedious surgical procedure, involving the evaluation and design of the recipient site, selection of the donor area, the calculation of hair follicle (HF) number, separation and preservation of HFs and the process of HF implantation. Each of these steps is closely related to the visual post-operative effects. Based on our experience, the aesthetic result of HTS mainly relies on some indicators, including selection of the donor site, direction and angle of grafted hairs, density and survival rate of implanted HFs. We believe that good results can be achieved as long as attention is paid to the above four points.

Biography:

Dr. Mohammad Rafiqul Mowla has completed MBBS and MD (Dermatology) from Chittagong Medical College affiliated with the University of Chittagong. He is the Assistant Professor in the department of dermatology and venereology at Chittagong Medical College, Bangladesh. He has published more than 10 papers in reputed journals and has been serving as an editorial board member in two journals. He has been honored with ‘Global Education Award’ by International Society of Dermatology. He has presented more than 10 research papers at many international events like WCD, ICD, EADV congress.

Abstract:

Leprosy is a chronic disease caused by Mycobacterium leprae, affecting the skin, peripheral nerves, mucosa of the upper respiratory tract and eyes mimicking many dermatological and neurological entities and sometimes leading to a delay in diagnosis. The complications of leprosy are due to nerve damage, immunological reactions and bacillary infiltration. Untreated, leprosy can cause progressive and permanent damage to the skin, nerves, limbs and eyes. The disease is classified as paucibacillary (PB) or multibacillary (MB), depending on the bacillary load. PB leprosy is a milder disease characterized by few (up to five) skin lesions (pale or reddish), whereas MB is associated with multiple (more than five) skin lesions, nodules, plaques, thickened dermis or skin infiltration. Early diagnosis and treatment with multidrug therapy (MDT) remain the key elements in eliminating the disease as a public health concern. MDT comprises of three drugs, dapsone, rifampicin and clofazimine. PB and MB patients treated with MDT are cured within six months and 12 months respectively. The emergence of drug resistance to rifampicin is a big concern at this crucial time in the elimination of leprosy. If this is not taken care of immediately then the possible emergence of primary resistance to rifampicin, dapsone and ofloxacin will be on the horizon. Developing reinforced new therapies to curb reactions and deformities are important, and contact tracing, particularly of children, is essential. Domiciliary treatment needs to be made available to ensure early diagnosis. Elimination of leprosy globally was achieved in the year 2000. Pockets of high endemicity still remain in some areas of many countries. In order to reach all patients; leprosy treatment needs to be fully integrated into general health services. Moreover, political commitment needs to be sustained in countries where leprosy remains a public health problem. A global effort to address the challenges to reduce the disease burden due to leprosy and mitigate its harmful impact on persons affected by leprosy and their families is urgent.

Biography:

Maryham S Ibrahim has completed her Master’s degree in Dermatology. She is a Dermatologist in Dermatology Department, Faculty of Medicine, Minia University, Egypt.

Abstract:

Vitiligo is a multifactorial polygenic disorder with a complex pathogenesis. The precise cause behind melanocyte destruction remains unknown. The epidermal melanocytes form a functional and structural unit with neighboring keratinocytes. The keratinocytes produce certain growth factors required for melanocyte growth and damage to keratinocytes may result in passive melanocyte death with the development of vitiligo. We performed this study to confirm the role of apoptosis in the pathogenesis of vitiligo through studying the expression of caspases-8, 9 & 3 and to determine the relation between the disease activity and the expression of these apoptotic markers. 20 skin biopsies were obtained from the edge of vitiligo lesion. Immunohistochemical staining for caspases-8, 9 & 3 was carried out. We demonstrated the expression of these apoptotic markers within both the epidermis and the dermal lymphocytes. We found that the expression of caspases-8, 9 & 3 was higher in depigmented epidermis when compared to normally pigmented epidermis either from vitiligo patients or from the normal control. The majority of apoptotic keratinocytes was found in the basal and suprabasal layers of epidermis. Regarding disease activity, the expression of these apoptotic markers was significantly higher in cases with active disease when compared to those with stable disease. Also, these apoptotic markers were expressed in the dermal lymphocytes. In conclusion vitiligo is not a disease limited to melanocyte death. Apoptosis of keratinocytes also clearly occurs and may play an important role in the development of the disease.

Biography:

Abstract:

Background: Onychomycosis is defined as the fungal infection of nails caused by dermatophytes, yeasts and nondermatophyte moulds. It is one of the commonest nail disorders and accounts for upto 30% of all superficial fungal infections. Aims and Objectives: 1.To study the clinical profile of onychomycosis. 2 To study the various causative organisms of onychomycosis. 3.To study the prevalence of Diabetes Mellitus in patients of onychomycosis Setting: Outpatient department of Dermatology, Venerology Leprology of a tertiary health care centre with an attached medical college. Material and methods A total of 70 patients of with clinically suspected onychomycosis, were included in the study. Nail specimens were subjected to direct microscopy in 20% KOH to determine the presence of fungal elements. The specimens were cultured in Sabouraud’s dextrose agar. Statistical analysis used: Microsoft Excel 2010. Results: There were 34 cases (48.57%) cases in age group of 39-58 years, which formed majority of the patients. Mean age group affected was (51.01 ± 30.40 years). Nail discoloration was seen in 67 (95.71%) patients. Non – Dermatophytes molds (NDM) were involved in 18 (56.25%) cases. A. niger was causative species in 12 cases (37.5%) and A. flavus was responsible for 03 cases (9.37%) and A. fumigatus for 3 cases (9.37%). In our study, prevalence of diabetics among onychomycosis was seen in 10 out of 90 cases (10%) and nondiabetics having onychomycosis was seen in 63 cases (90%).

Conclusions: Onychomycosis in the age group of 39-58 years and also there is a male preponderance. We also conclude that direct microscopy is a more sensitive test in detecting the presence or absence of fungus than culture. We also conclude that Non –dermatophyte molds are the most common organisms involved in causing onychomycosis. And amongst Non dermatophytes, A. niger is the most common species involved.

Biography:

Anup Kumar Tiwary has completed his MBBS and MD from Ranchi University, India. He has published around 15 papers in reputed journals and given many national and international orations. He has been serving as a Dermatology Resident in the Department of Dermatology, Venereology and Leprosy in Rajendra Institute of Medical Sciences, Ranchi, India.

Abstract:

Aim: To compare the efficacy of oral and intradermal injection of tranexamic acid in the treatment of melasma.

Materials & Methods: After obtaining written informed consent, 40 females with bilateral melasma of age group 20-50 years fulfilling the inclusion criteria, were included from our out-patient department of our institution in this prospective, single-blinded trial lasting 12 weeks. Inclusion criteria: Female patients of age group 20-50 years with bilateral melasma, Fitzpatrick skin type 3, 4 and 5, patients with normal medical history and physical examination and patients giving the consent for the trial. Exclusion criteria: Pregnant women and nursing mothers, patients with known bleeding diatheses or taking anticoagulants, patients taking OCP during the study or in past 12 months, patients with known history of allergy to the drug and patients having used any depigmenting agent in the past 3 months. Group A of 20 patients were treated with oral tranexamic acid 250 mg twice daily and in group B of other 20 patients, 0.05 ml of tranexamic acid at the concentration of 4 mg/ml (diluted and prepared in normal saline) were given intradermally in the lesions at 1 cm distance weekly. At 4 weeks, 8 weeks and 12 weeks MASI was calculated. Statistical analysis was done using Wilcoxon Signed-rank test and ‘p’ value was kept <0.05 to be considered as significant.

Results: There was significant statistical difference in both the groups and group B (treated with intradermal injections) showed better response than group A (treated with oral tranexamic acid).

Biography:

Bhargavi B Kola, MD, MPA is an Assistant Professor and Vice-Chairman for the department of Pediatrics at Texas Tech University Health Sciences Center. She completed her medical school training from Gandhi Medical College, India and her MD training from New York, USA. Dr.Kola has published up to 12 articles in peer-reviewed journals and has had posters presented at national and international level. She has been a peer reviewer and acted a judge for regional research competitions at University and State level.

Abstract:

2 month old female newborn was seen in her pediatric office for her well visit and vaccines. Was formula fed and was thriving well. Mother did have concerns about her red rash that she developed at birth (tiny swelling) which seemed to grow not just on the outside but also inside and wanted her to be evaluated. On exam she was a happy active baby with clear lungs and normal heart, all peripheral pulses felt and strong, abdomen –soft, non-tender with mass palpated within the left upper quadrant with an overlying erythematous soft swelling measuring about 3.75*2.8 cm in size consistent with hemangioma. It was vascular, non-tender, soft in consistency, mass below the swelling was freely mobile and with clear margins. Interestingly the temperature on the swelling was at least 1 degree Fahrenheit higher than the surrounding skin.

Past medical history: she is a product of normal vaginal delivery and no perinatal issues.

Ultrasound was then ordered due to rapid increase in size and the intra-abdominal swelling was noted to hyperechoic areas and heterogenicity and concerns of malignant lesions were raised and patient was promptly referred to pediatric hemato-oncologist who reviewed the ultrasound, examined the patient and concluded that the intra-abdominal mass is also a hemangioma and started the patient on a beta blocker (propranolol 2.3mg twice daily). Follow up exam shows that the swelling is now stabilized and patient had no side effects. She was hemodynamically stable.

Discussion: Hemangiomas are most common vascular tumors in infancy¹ with increased occurance in female infants. Hemangiomas are clinically diagnosed and usually have a benign course and need no management as they regress with age. Visceral hemangiomas can be life threatening and may need imaging and liver being the common organ affected ¹. Treatment is based on the nature, location, complications and rapidity of the growth interfering in normal functioning. Non-selective beta blocker(namely propranolol) has been used more commnly in the recent years and has had promising results². Other treatment options are steroids, low-dose cyclophosphamide, interferon alpha, laser therapy and surgery in rare cases². Our case stands out that despite it was a visceral hemangioma and the radiological findings of possible malignant changes, our patient responded well to treatment and had no associated complications. Rapidly enlarging hemangiomas can be concerning to parents and with further referrals and investigations could be challenging in infants.