Day 2 :
University Medical Center Schleswig-Holstein
Time : 09:45-10:30
Regina Folster-Holst has completed her PhD in 1984 from Christian Albrechts University, Germany. After a Medical Assistant time in a children's clinic for cystic fibrosis and allergy at Amrum, Germany in November 1985 she began her Specialist training for Dermatologists at the Department of Dermatology, Kiel, Germany. In 1992, she was recognized as a Specialist in Dermatology and Allergology. Since 1992 she works as a Senior Physician at the University Medical Center Schleswig-Holstein, Department of Dermatology in Kiel, Germany. Her clinical activity and research priority is primarily in the area of atopic dermatitis, pediatric dermatology and Parasitosis. She has published more than 160 papers in reputed journals. Since May 2016 she is the President of the European Society for Pediatric Dermatology (ESPD).
The clinical phenotype of atopic dermatitis (AD) results from complex interactions between genetic and environmental factors, which influence the epidermal structure and function as well as the immune system. In addition neurogenic disturbances and loss of the diversity of microbiome (intestinal and cutaneous) are causes of exacerbation. Epidermal barrier defects seem to be a hallmark of pathogenesis of AD. The quality of the skin barrier can be assessed by using a new semi-quantitative method to measure intercellular lipid lamellae. This procedure was used to evaluate the influence of emollients and also the topical application of drugs like corticosteroid and calcineurin inhibitors.
- Dermatological Oncology
University of Pennsylvania
Title: Special Session on Relationship between patients reported quality of life and psychosocial health: Identifying benchmarks for the skin cancer index
Time : 10:30-11:00
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).
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.
- Skin Diseases | Dermatological Oncology | Stem Cells in Dermatology
Anggana Rafika Paramitasari
Sebelas Maret University
Sebelas Maret University
Title: Application of conditioned media hair follicle stem cell as a combination therapy in acne scar revision: A case series
Time : 11:20-11:40
Anggana Rafika Paramitasari is a Dermatovenereology Resident of Sebelas Maret University, Surakarta, Indonesia.
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.
Sebelas Maret University
Title: Application of conditioned media hair follicle stem cell (HHF-SC) as a cmbination treatment in acne patients: A case series
Time : 11:40-12:00
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.
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.
Sebelas Maret University
Title: Advanced Adipose Protein Extract (AAPE): Sollube Factors in Post Excision Basal Cell Carcinoma
Time : 12:00: 12:20
Ferry Arrochman is a residen of Dermatovenereology department and faculty of Medicine Sebelas Maret University Dr.Moewardi Goverment hospital, Surakarta, Indonesia.
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.
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.
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.
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 1st degree relative and 8 (30%) cases were 2nd 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.
- Skin Infection