Day 1 :
Dr. Ruemmelein AG - House Of Skin & Laser Medicine, Switzerland
Keynote: Optimizing Melasma Treatment
Time : 10:05-10:40
Bettina Rümmelein, after completing her Residency as a Dermatologist and Allergologist at the University Hospital Hamburg-Eppendorf, Germany, with internships at Stanford University, Palo Alto and the Mayo Clinic, Rochester, USA, worked for two years in a large group practice in Frankfurt. From 1998 to 2008, she ran her own private practice near Frankfurt. After moving to Switzerland, she worked at the University Hospital Zurich for eight years, where she directed the clinic for Aesthetic Dermatology and Laser Medicine for three years. Since April 2014, she dedicated herself exclusively to the work in her own clinic. She is licensed for laser treatments and accredited by the Laser Commission as a training center. Aesthetic and Laser Medicine have become her main topics of interest in recent years. Her clinic offers the full range of state-to-the-art laser devices that are used in dermatology. As President of the Swiss Society for Medical Laser Applications (SGML), she takes responsibility for the Swiss Laser Congress.
Introduction: In the author’s clinic, clientele melasma treatment is of increasing importance not only due to more cases in general, but also due to severe cases. Because of aggressive marketing of cosmetic industry, 90% of the patients have tried more than two cosmeceuticals with bleaching capacity before consulting me. Almost 50% have undergone peeling treatments either by beauticians or doctors with no or only transient success. The goal of this retrospective study was to evaluate a treatment setting with long-lasting success of at least 50% melasma reduction in 100% in the patients of all skin types.
Materials & Methods: We followed up 134 female patients who had been treated in the years 2014 and 2015 for the purpose of melasma reduction. The follow-up was performed either personally or by telephonic interview. The question was how satisfied they were with the performed treatment series. Since January 2014, the treatment protocol consisted of five or 10 weekly treatments with a q-switched Nd:YAG laser 1064 nm, 8 mm spot, 1 J applied in a whipping technique with 5–6 passage until the patient feels slight warming of the skin. In addition, the patient applies each morning a sunscreen SPF 50 and every other night a topic bleaching cream with hydrochinone and tretinoin. In 18 cases, the ointment could only be used two times per week due to skin irritations.
Results: All patients reported a treatment success of at least 50% deduction of the hyperpigmentation, 89 patients reported more than 75% improvement. To the question of recurrence, 133 patients reported none or minimal relapse, one patient had a full relapse. There were no differences observed between patients of different skin type (skin type I: 0 patients, skin type II: 28 patients, skin type III: 81 patients, skin type IV: 8 patients, skin type V: 16 patients, skin type VI: 2 patients).
Royal Dutch Navy, Netherlands
Time : 10:40-11:20
Stef Stienstra works internationally for several medical and biotech companies as scientific advisory board member and is also an active reserve-officer of the Royal Dutch Navy in his rank as Commander (OF4). For the Dutch Armed Forces he is CBRNe specialist with focus on (micro)biological and chemical threats and medicaland environmental functional specialist within the 1st CMI (Civil Military Interaction) Battalion of the Dutch Armed Forces. For Expertise France he is now managing an EU CBRN CoE public health project in West Africa. He is visiting professor for the University of Rome Tor Vergata in Italy for the CBRN Masters Course and lecturer for the NATO School in Oberammergau in Germany and the Joint NATO CBRN-Defense Center of Excellence in Vyskov in the Czech Republic. In his civilian position he is at this moment developing with MT-Derm in Berlin (Germany) a novel interdermal vaccination technology as well as a new therapy for cutaneous leishmaniasis for which he has won a Canadian ‘Grand Challenge’ grant. With Hemanua in Dublin (Ireland) he has developed an innovative blood separation unit, which is also suitable to produce convalescent plasma for Ebola Virus Disease therapy. He has finished both his studies in Medicine and in Biochemistry in The Netherlands with a doctorate and has extensive practical experience in cell biology, immuno-haematology, infectous diseaases, biodefense and transfusion medicine. His natural business acumen and negotiation competence helps to initiate new successful businesses, often generated from unexpected combinations of technologies
Background: Leishmaniasis is a vector-borne disease that is caused by obligate intra-macrophage protozoa of the Leishmania species. Leishmaniasis can cause different clinical syndromes, including cutaneous leishmaniasis (CL), in which the patient generally presents with one or several ulcer(s) or nodule(s) on the skin, resulting from the infection of phagocytic cells located in the dermis. It often results into severe scar tissue in the skin. Most of the twelve million people infected with Leishmania worldwide are CL cases,
a 1.5 million new cases occur annually.
Objective: WHO has a program to develop new treatments for cutaneous leishmaniasis. This study establishes a proof-of-concept that a tattoo device can target intra-dermal drug delivery against cutaneous leishmaniasis (CL).
Methods: The selected drug is oleylphosphocholine (OlPC) formulated as liposomes, particles known to be prone to macrophage ingestion. First is shown that treatment of cultured Leishmania-infected macrophages with OlPC-liposomes results in a direct dose-dependent killing of intracellular parasites. Based on this, in vivo efficacy is demonstrated using a 10-day tattooing-mediated treatment in mice infected with L. major and L. mexicana. In both models this regimen results in rapid clinical recovery with complete regression of skin lesions by Day 28. Parasite counts and histopathology examination confirm high treatment efficacy at the parasitic level. Low amount of drug required for tattooing combined with fast clinical recovery may have a positive impact on CL patient management.
Results: This first example of tattoo-mediated drug delivery could open to new therapeutic interventions in the treatment of skin diseases. This study demonstrates that the use of a tattoo instrument for drug delivery is possible in the treatment of cutaneous leishmaniasis, and that this method can successfully eliminate intracellular parasites at the site of infection. After showing that the selected drug oleylphosphocholine (OlPC) formulated as liposomes could efficiently reach intracellular.