Day 2 :
Keynote Forum
Adolfo Napolez
Southern Illinois University School of Medicine, USA
Keynote: Complications, Unfavorable Results and Critical Analysis of the Double Eyelid Procedure
Time : 10:00-10:40
Biography:
Adolfo Napolez M.D. graduated from Southern Illinois University School of Medicine followed by a General Surgery Residency at West Penn Hospital in Pittsburgh, Pennsylvania, and followed that up with a Burn Surgery Chief Residency at Cook County Hospital in Chicago, Illinois and finally a two year Fellowship in General Cosmetic Surgery, highlighting Asian Cosmetic Surgery. He is a member of the American Academy of Cosmetic Surgery, American Society of Cosmetic Breast Surgery, as well as a member of the California Academy of Cosmetic Surgery. Dr. Napolez has published articles in 5 different Medical Journals, as well as a chapter Author in a textbook on Asian Facial Cosmetic Surgery. He has twice been selected as one of America’s Top Surgeons in Cosmetic Surgery, as well as a Top Doctor in Plastic Surgery Practice Magazine.
Abstract:
The double eyelid procedure is one that is potentially fraught with unfavorable results as well as numerous complications due to the fact it is a procedure based predominantly on symmetry, precision and tissue characteristics with errors measured in millimeters. Coupled with significant expectations often times unrealistic from the patient’s perspective. Who may routinely view a normal, expected outcome as an unfavorable result. Potentially unfavorable results can range from crease size dissatisfaction, relapse to a single eyelid, asymmetry, multiple creases as well as high or thick fold. Whereas, possible complications can range from ectropion, ptosis, ocular injury, hypertrophic scarring, milia as well as suture granuloma. There is probably no other facial cosmetic surgical procedure that is more dependent on exactness and precision, coupled with patient expectations and visibility then the double eyelid operation.
Keynote Forum
Bettina Rümmelein
Dr. Ruemmelein AG - House Of Skin & Laser Medicine, Switzerland
Keynote: Improving the final results of tattoo removal
Biography:
After completing my 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, I worked two years in a large group practice in Frankfurt. From 1998 to 2008 I run my own private practice near Frankfurt. After moving to Switzerland, I worked at the University Hospital Zurich for 8 years, where I directed the clinic for Aesthetic Dermatology and Laser Medicine for 3 years. Since April 2014, I dedicated myself exclusively to the work in my own clinic. I am licensed for laser treatments and accredited by the Laser Commission as a training center. Aesthetic and laser medicine have become my main topics in recent years. My 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) I take responsibility for the Swiss Laser Congress.
Abstract:
Improving the final results of tattoo removalIntroduction: Tattoo removal with q-switched laser systems, recently with picosecond lasers, has become daily business in laser clinics. The more we do the more we become aware of problems. The mayor problem is to achieve the complete removal with no residual scarring. While patients five years ago asked for the number of sessions needed, now they ask for the risk of scarring and incomplete removal. The aim of this case study is to evaluate a new standard procedure for tattoo removal treatment.
Material and Methods: We treated 20 patients between 10/2013 and 10/2015 with mono coloured black tattoos of different size. The treatment was always performed in the same way:
1. After application of an anaesthetic ointment the tattoo is treated with a q-switched NeoDym YAG laser biggest possible spot and lowest energy that leads to whitening of the colour. In our system this is mainly 8mm spot, 1.6 J initially. The dosage is adjusted each session up to the reaction of the colour.
2. During the treatment and after the treatment the tattoo area is cooled with air cooling.
3. 15-20min after the first treatment a second treatment is performed with slightly higher energy.
4. Directly afterwards the whole tattoo field is treated with an ablative CO2 fractionated laser 120 micrometre spots, 30watts,
40mJ, medium density.
5. After the treatment we apply a bandage with hyaluronic acid ointment what is continued by the patient for one week.
6. Week 2-8 the patient applies a scar ointment.
7. The next treatment is performed after 8 weeks.
Results: During this period, we finished up 18 out of 20 patients. The treatments were tolerated very well. There were no cases of infection, blistering or prolonged healing period. The results were excellent: 16 patients had total clearance of the tattoo without
scarring, 2 patients had less than 10% residual colour.
- Aesthetic and Cosmetic Dermatology | Melanoma | Dermatological Diseases |Dermatology: Therapies and Advances| Alternative Medicine Solutions | Dermatopathology
Location: Dubai
Chair
Bettina Rümmelein
Dr. Ruemmelein AG - House Of Skin & Laser Medicine, Switzerland
Session Introduction
Iqbal Bukhari
Imam Abdulrahman Bin Faisal University (IAU), Saudi Arabia
Title: Spontaneous resolution of lipedematous scalp after 13 years
Biography:
Iqbal Bukhari is a Professor and Consultant Dermatologist with more than 29 years of experience in many dermatological diseases and their management. His special interests are in laser therapy, phototherapy, dematopathology, cosmetic dermatology and study of genetic diseases. Has many publications in various international medical journals. He has a certification of added qualification in Cosmetic and Laser Procedures, 2013; King Faisal Fellowship in Dermatological Diseases, College of Medicine, King Faisal University, Dammam, Saudi Arabia, 1994; MBBS, King Faisal University, Dammam, Saudi Arabia, 1989; certificate in Alternative Medicine Therapy from Wagner College in USA, 2004 and certificate in Acupuncture Therapy from Flamel College in USA, 2004.
Abstract:
A 69-year-old southern Arabic female presented to our dermatology clinic at King Fahd Hospital of the University as a follow-up case of lipedematous scalp diagnosed in our clinic in 2003. She is a known case of supraventricular tachycardia and hypercholestermia well controlled with medication. Besides, the patient’ scalp condition was last evaluated four years prior to her current visit in our clinic with no significant change. Interestingly, on examination of the scalp, there was absence of the spongy feeling on palpation and there was no loss of hair. Routine blood tests were normal. Axial computed tomography of the skull showed scalp thickness in the high occipitoparietal region of 8 mm as compared to 21.1 mm in 2003, while mid sagittal reconstructed computed tomography showed a scalp thickness at the high occipitoparietal region of 9 mm as compared to 16.9 mm in 2003. Subcutaneous fat thickness was almost 6 mm at the occipitoparietal region which is normal compared to 19.2 mm reported in 2003 in the same region. Hence, we confirmed our impression of spontaneous complete resolution of lipedematous scalp after 13 years duration.
Jianyun Lu
Central South University, China
Title: Topical ozone therapies improve atopic dermatitis via rapidly reducing S. aureus colonization and immunoregulation
Biography:
Jianyun Lu is the Professor and Chair of the Department of Dermatology, The Third Xiangya Hospital of Central South University, and Visiting Scholar of Dermatology of Northwestern University. She is also the Standing Committee Member of the Branch of Dermatology and Immunology of China Association of Chinese Medicine. Her main research interests include the pathogenesis of atopic dermatitis and its intervention; study on clinical application and mechanism of medical ozone and Cosmetic Dermatology.
Abstract:
Background: Atopic dermatitis (AD) is an inflammatory skin disease characterized as Staphylococcus aureus (S. aureus) colonization as well as an imbalanced immune response. Current research shows that topical ozone therapy is an effective and alternative treatment in the management of multiple skin diseases, including AD. However, the mechanism for the ozone is
not clearly understood.
Methods: Patients between 6–65 years old diagnosed with moderate or severe AD were treated topically with ozone. The treatment scheme is topical application of ozonated water followed by ozonated oil, twice daily, for two weeks. The Severity Scoring for AD (SCORAD) index, Visual Analog Scale (VAS) pruritus and sleep scores were evaluated. The thickness of epidermal layer was detected by Reflectance Confocal Microscopy (RCM) and the expression of Th1, Th2, Th17 and Treg type cytokines in peripheral blood was tested by ELISA. Plate cultivation was used to quantitatively detect numbers of S. aureus colonizations in skin lesions.
Results: Twelve patients in the present study showed significant improvement in the eczematous skin lesions, with better keratinization of the stratum corneum, clearer basal layer structure and reduced infiltration. of inflammatory cells SCORAD, VAS pruritus and sleep scores were all significantly decreased (p<0.01). The ozone decreased the numbers of S. aureus colonization in skin lesions after treatment (90.74±0.14) % (P< 0.01). By using ELISA, we detected several cytokines concentrations in the serum in the patients. It was found that IL-17A expression was significantly decreased after treatment with ozone (p<0.01). On the other hand, although ozone increased the level of suppressive cytokine, IL-10, and decreased the level of pruritus related cytokine, IL-31, no significances were found (p>0.05).
Conclusion: The treatment by using topical ozone alone significantly improves eczematous lesions in patients with AD. The mechanisms involved might be related to rapid reduction of S. aureus colonization and decreasing IL-17A expression. Our findings suggest that topical ozone therapy may be a potential remedy for AD.
Iqbal Bukhari
Imam Abdulrahman Bin Faisal University (IAU), Saudi Arabia
Title: ALIGN–a multi-country, cross-sectional study to determine patient specific and general beliefs towards medication and their treatment adherence to selected systemic therapies in chronic inflammatory diseases (IMID)—results of the Lebanese and Saudi Arabian subgroup
Biography:
Iqbal Bukhari is a Professor and Consultant Dermatologist with more than 29 years of experience in many dermatological diseases and their management. His special
interests are in laser therapy, phototherapy, dematopathology, cosmetic dermatology and study of genetic diseases. Has many publications in various international medical journals. He has a certification of added qualification in Cosmetic and Laser Procedures, 2013; King Faisal Fellowship in Dermatological Diseases, College of Medicine, King Faisal University, Dammam, Saudi Arabia, 1994; MBBS, King Faisal University, Dammam, Saudi Arabia, 1989; certificate in Alternative Medicine Therapy from Wagner College in USA, 2004 and certificate in Acupuncture Therapy from Flamel College in USA, 2004
Abstract:
Background: Knowledge on the association between patient beliefs and their concerns towards systemic medication and treatment adherence in patients with chronic inflammatory diseases (IMID) is limited. Therefore, ALIGN (3D-digital scannining technique) was conducted to provide real-world data in either of the analyzed conditions.
Methods: ALIGN was a cross-sectional, multi-country epidemiological study conducted in over 7,300 patients to describe patient’s beliefs with various IMID towards systemic medication and correlate patient’s beliefs with disease characteristics, adherence levels, or patient perception parameters. Tools used included, the Beliefs about Medicines Questionnaire (BMQ), and the 4-item Morisky Medication Adherence Scale (MMAS-4). This poster displays data on the subgroup of patients documented in Lebanon and Saudi Arabia.
Results: 263 patients were analyzed in this country-specific subgroup. Therapy with TNFi (as mono or combination therapy) appeared more effective than conventional therapy, leading to complete response in more than 61% (vs. 30.3%). BMQ concern perception increased with perceived harm of medications, expected illness duration, perceived emotional involvement and risk of depression. BMQ necessity perception increased with age, expected illness duration, perceived treatment control and risk of depression. Necessity was higher in patients taking TNFi compared to those treated with conventional medications alone. In addition, the chance of being highly adherent was positively correlated with the necessity score.
Conclusions: Main results of this subgroup of Lebanese and Saudi Arabian patients are largely in concordance with the results of the overall population. Necessity beliefs were highest in patients treated with TNFi and positively correlated with high adherence.