Scientific Program

Day 1

Day 2

Day 1

KEYNOTE SPEAKERS
  • Colours in skin biopsies – a clue to diagnosis

    Teaching Hospital
    Sri Lanka
    Biography

    Dr. Palitha Ratnayake is the current president of Sri Lanka College of Pathologists. Following MD in Histopathology, he has completed Advanced Course in Dermatopathology at St John Institute in St Thomas Hospital, London in 2001 and Fulbright Fellowship in Dermatopathology in University of California, USA in 2009.He has done a large number of research studies in the field of dermatopathology and given speeches at both local and international conferences and symposia. Dr. Rathnayake holds many years of experience in teaching junior dermatologists and pathologists and has been contributing as an examiner for MD Histopathology for several years. His special research interest is Mycosis Fungoides, Cutaneous Leishmaniasis and Cutaneous Infections.

    Abstract

    Substances with different colours may present in a skin biopsy sample, which provide clues for the definitive diagnosis of the underlying skin disease. On the other hand, pathologists use colored substances to highlight different material in a biopsy sample, which is not apparent on routine hematoxylin, and eosin stained skin biopsies. In this lecture different pathological entities of skin will be discussed where the presence of colored substance plays a major role in the diagnosis. Mucin in a skin biopsy will give bluish tinge to the tissue. Mucin can be highlighted by different mucin stains like alcian blue, colloidal iron and mucicarmine. When a bluish tinge is present in a biopsy sample depending on the dermal location , diagnosis can be narrowed down. In systemic lupus erythematosus and dermatomyositis mucin is present in the stroma. Follicular mucinosis is a clue to mycosis fungoides, especially folliculotrophic variant. Presence of mucin in a dermal based granuloma is a clue to diagnose granuloma annulare. Calcium is a substance which can be present in different skin lesions which appear dark blue in H and E stained skin biopsies. Calciphylaxis, calcinosis cutis and pancreatic panniculitis are some of the conditions where calcium is deposited in skin tissue. Fibrin gives ride characteristic red colour. Fibrin is deposited in different conditions of skin including vasculitis with fibrinoid necrosis, rheumatoid nodules with central necrobiotic focus containing fibrin etc. Deposition of amorphous or granular eosinophilic material appears as pink colour cutaneous deposits. In different cutaneous pathological conditions which help to narrow down the differential diagnosis. Amyloid, elastotic degeneration of skin and caseous necrosis can appear as pink material, which can be differentiated using different special stains. Special stains are also used to highlight different micro organisms in cutaneous infections. Fungi may appear purple with PAS stain and black with Grocotte stain. Giemsa stain highlights donovani bodies in cutaneous leishmaniasis in purple. Acid fast stains use to highlight mycobacterial which appear pink. It is important to pay attention to variation in colours and their patterns, which will provide valuable clues in the diagnosis of cutaneous diseases.

General Dermatology
Chair
Speaker
  • Can we treat atopic dermatitis without using corticosteroids?
    Speaker
    Huang Wei Ling
    Medical Acupuncture and Pain Management Clinic
    Brazil
    Biography

    Huang Wei Ling, born in Taiwan, raised in Brazil since the age of one, graduated in medicine in Brazil, specialist in infectious and parasitic diseases, a General Practitioner and Parenteral and Enteral Medical Nutrition Therapist. Once in charge of the Hospital Infection Control Service of the City of Franca’s General Hospital, she was responsible for the control of all prescribed antimicrobial medication, and received and award for the best paper presented at the Brazilian Hospital Infection Control Congress in 1998. Since 1997, she has been presenting her work worldwide, concerning the treatment of various diseases, using techniques based on several medical traditions around the world.

    Abstract

    Introduction: Atopic dermatitis (eczema) is a common chronic inflammatory skin disease, affecting up to 15-30% of children in industrialized countries, but can occur at any age as there is no definitive cure for this chronic disease, that also may be accompanied by asthma or hay fever. Patients often seek other complementary therapeutic options, such as Traditional Chinese Medicine (TCM). TCM comprises numerous treatment modalities for the management of atopic dermatitis that can relieve itching and prevent new outbreaks. Purpose: The purpose of this study is to demonstrate that the atopic dermatitis has a cure and can be treated without the use of any kind of corticosteroids. Methods: Over two case reports a 36-year-old woman and an 11-year-old boy with chronic red and itchy lesions throughout their entire bodies, were being treated with oral corticosteroids which showed little success and many side effects. These patients sought treatment in oriental medicine practices, as auricular acupuncture sessions, Chinese dietary recommendations, Radiesthesia and homeopathic medication. Results: Both patients were able to suspend entirely the use of corticosteroids with the treatment instituted. There was almost total regression in the skin lesions. These results were achieved because the patients were being looked at, in the physical, emotional and dietetically aspects, according to Traditional Chinese Medicine. Conclusion: We concluded in this study that we atopic dermatitis can be treated without using corticosteroid medication.

  • Alcohol-free topical liposome and liposomal gel formulations of some hormones
    Speaker
    Burhanuldeen Husam Niyazi
    Niyazi Pharma
    Iraq
    Biography

    Burhanuldeen H has completed his MSc in Cosmetology from Yeditepe University, Turkey. He is running a family pharmacy in Kirkuk, Iraq.

    Abstract

    Aim of the study: The purpose of this study was the formulation of liposomal gel formulations containing some hormones and hormone combinations and determination particle size, zeta potential, FT-IR analysis, PLM, SEM using different methods and to evaluate on studies. Herewith, we purposed to overcome of problems some of the topical preparations containing alcohol by preparing liposomal gel delivery systems. Introduction: Liposomes are microscopic vesicles composed of membrane like lipid layers surrounding aqueous compartments. The lipid layers are made up mainly of phospholipids. Phospholipids are amphiphilic; they have a hydrophilic head and a lipophilic tail. In aqueous solutions they are arranged in bilayers, which form closed vesicles like artificial cells. Liposomes are composed of small vesicles of a bilayer of phospholipids encapsulating an aqeous space ranging from about 0.03 to 10 micron diameter. Physical chemists, liposomes being well defined are one of the systems of choice to study amphiphiles. Biophysicists, liposomes serve as the best model for biological membranes. Biologists, liposomes serve as model to understand organelles and their function and mechanism of action of complex systems. Liposomes serve for medical and non-medical applications. Both are based on the above. The success of liposomes for medical application is demonstrated by 12 approved drugs including 2 vaccines. (Ambisome, Doxil, Daunoxome so on). Gels are an excellent formulations for several routes of administration. They are useful as liquid formulations in oral, topical, vaginal, and rectal administration. There are many gelling agents. Some of the common ones are Poloxamers and Carbopol derivatives . Testosterone is a steroid hormone from the androgen group and is found in mammals, reptiles, birds, and other vertebrates. In men, testosterone plays a key role in the development of male reproductive tissues such as the testis and prostate as well as promoting secondary sexual characteristics such as increased muscle and the growth of body-hair. Appropriate testosterone therapy can prevent or reduce the likelihood of osteoporosis, type 2 diabetes, cardio-vascular disease (CVD), obesity, depression and anxiety and the statistical risk of early mortality. Low testosterone also brings with it an increased risk for the development of Alzheimer’s Disease. Materials and methods: Testosteron (TT) containing 8 different liposome formulations were prepared by using thin film, sonication and reverse phase evaporation methods, respectively. Briefly, liposome was prepared by dissolving the 40 ?mol mL?1 of phospholipids in 30 mL chloroform in a round-bottom flask. The chloroform was removed using a rotary evaporator under reduced pressure to form a thin film over the wall of the flask. The dried film was then hydrated over a water bath with distilled water. Free TT was removed by centrifugation three times at 17,500 rpm for 45 min for each of them. Then liposomes were prepared by sonication process. The liposomes were characterized by mean particle size and size distribution, zeta potential. SEM and PLM technique were employed for obtaining size distribution and surface appearance and lamellarity. Results: During the study, mean particle size and zeta potential of liposomes were analysed. According to results, particle size of liposomes were found as 676 nm ± 5.73, 908 nm ± 24.40, 1146 nm ± 12.30 and 674 ± 30.48, respectively. According to SEM images, liquid state liposomes were clearly showed not intact and having gaps on the surface of bilayer structure. But, gel state liposomes were obviously observed intact in bilayer structure. Conclusion: Generally, liposomes topical drug applications are safer and less strict than the intravenous applications. Liposomes are used as a carrier for creams, gels (lipogelosome) containing various herbal complexes or essential oils, moisturizing agents, antibiotics, and complex products containing recombinant proteins for wound healing .These results obtained in this study confirm that alcohol free liposomal gel containing testosterone formulations are relatively safe than the other commercial testosterone products. Preliminary studies supported that liposome gel delivery system is suitable for topical applications.

  • A mixed model for treatment of atrophic acne scars based on blunt blade subcision
    Speaker
    Zahra Akbari
    Shahi Beheshti University of Medical Science
    Iran
    Biography

    Zahra Akbari is a board-certified dermatologist currently working as Managing Director of Research at the Laser Application in Medical Sciences Research Centre (Shahid Beheshti University of Medical Sciences, Tehran, Iran). She is graduated from the Tehran University of Medical Sciences and ranked third in Iran’s National Board of Dermatology exam. She has several years experience of working as a Clinical Dermatologist in hospitals and private professional dermatology clinics and the red crescent dermatology clinic. In her career as a dermatology researcher she has developed substantial research skills, particularly in clinical trials and has published several articles in high impact journals and has been serving as an Editorial Board Member of Journal of Laser in Medical Sciences.

    Abstract

    Atrophic acne scar is a common sequelae of acne vulgaris that can have a significant negative impact on patients. Treatment of this type of scar is based on repeated ablation of the surface skin with ablative lasers, peeling or dermabrasion. These methods are time consuming and show a 30-40% improvement at most. Since patients can present with multiple types of atrophic acne scars, no single procedure would yield significant improvement. We have developed a comprehensive treatment protocol that targets all three types of atrophic acne scars and their pathologic basis (loss of dermal collagen and anchorage of adhesive fibrous bands to deeper layers of skin). Firstly, chemical reconstruction of the skin scar is performed using high concentrations of trichloroacetic acid. This is particularly effective in treating deep-seated icepick scars which are usually unresponsive to laser or dermabrasion. Tumescent solution is then injected throughout the scar area, acting as a topical anaesthetic in preparation for later steps as well as creating fibrous hydro dissection to dissociate adhesive fibrous bands. Blunt blade subcision is then performed using BSBB cannula. Five types of BSBB cannula are available according to different lengths and widths and can shear the entirety of adhesive anchoring bands between the dermal and hypodermal layers in two planes (superficial and deep), particularly underneath the scar. Lastly, the acne scar area is treated with ablative fractional carbon dioxide laser. The subcision procedure and ablative laser have impressive effects on rolling as well as boxcar scars. The whole protocol is repeated two or three times within one month. So far, we have performed this protocol in more than 500 patients with skin phototypes II-IV and achieved at least 60% improvement in acne scars. No significant complications have been observed except self- limited long-lasting erythema. We present our comprehensive protocol as well as reviewing common surgical and laser procedures for the treatment of atrophic acne scars.

  • Resistant chromo blastomycosis: success of a triple regimen
    Speaker
    Shamma Aboobacker
    Pondicherry University
    India
    Biography

    Dr Shamma Aboobacker completed her MD from Pondicherry University in 2015 prior to which she had done Master of Science in Clinical Dermatology, Cardiff University in 2011. She has experience as Clinical Dermatologist in India, UAE and UK and is an Assistant Professor in Dermatology, Venereology and Leprology, India. She has keen interest in academic and research activities. Her areas of proficiency are pigmentary disorders, platelet rich plasma therapy and psoriasis. She has published a number of articles on Dowling Degos disease, melasma, Laugier Hunziker syndrome and perimenopausal dermatoses. She also serves as an editorial board member in British Journal of Dermatology (2017) and Journal of Surgical Dermatology (2015).

    Abstract

    Chromomycosis is a subcutaneous fungal infection caused by dematiaceous fungi that commonly presents as a chronic disorder with frequent relapses. Herewith reporting a case diagnosed as chronically resistant plaque type of chromomycosis that failed to respond to antimycotics, surgical excision, potassium iodide, and cryotherapy however responded to a triple regimen. The factors attributing to unsuccessful treatment were possibly single therapeutic agent, poor compliance due to side effects and uncontrolled diabetes. To ensure adequate care, treatment was commenced under in-patient care and following necessary investigations; the patient was started on itraconazole 200 mg twice daily, cryotherapy and local heat therapy. Antidiabetic and pain-relieving medications were given simultaneously. After a month of starting treatment, clinical remission was evident and remaining treatment was shifted to out patient basis. The lesion resolved completely leaving an atrophic scar and hyperpigmentation after six months of therapy. The patient has been reviewing till date with no recurrences.

  • Investigation of the working mechanism after transdermal administration of a TCM compound prescription XZT by a metabolomics-based systematic strategy
    Speaker
    Nianping Feng
    Shanghai University of Traditional Chinese Medicine, PR China
    China
    Biography

    Dr. Nianping Feng is currently full professor and the director of the Department of Pharmaceutical Sciences at Shanghai University of Traditional Chinese Medicine. He received his Ph. D. degree from China Pharmaceutical University in June 1997 and was an assistant research professor at the same university prior to joining the Shanghai University of Traditional Chinese Medicine in Oct. 1998. Dr. Feng worked as a senior scientist at Purdue University from Sept. 2012 to Sept. 2013. His research interests include novel drug delivery systems, pharmaceutical nanotechnologies and TCM-based new drug development. Professor Feng has published more than 100 peer-reviewed articles and book chapters and holds 11 patents.

    Abstract

    Traditional Chinese medicine (TCM) has a long history and rich experiences in treating cirrhotic ascites and nowadays is widely applied in clinical practice as a complementary and alternative approach. XZT, a traditional Chinese herbal cataplasm, has been shown to be effective in treating cirrhosis-associated ascites in clinical practice. XZT composed of Dahuang (Rheum palmatum L), Laifuzi (Raphanus sativus L), Gansui (Euphorbia kansui TN Liou ex TP Wang), Chenxiang (Aquilaria sinensis (Lour) Gilg), Dingxiang (Eugenia caryophyllata Thunb.), Bingpian (Borneolum syntheticum) and Shexiang (artificial Moschus). In trying to uncover the working mechanism of such combined system, we used a metabolomics-based systematic strategy to trace the molecular basis as well as the pharmacokinetic behavior of XZT. Our results revealed that the peak plasma concentrations and bio availabilities of the active ingredients were significantly increased in rats with cirrhotic ascites, thus proving the rationality of external XZT therapy. Metabolomics study demonstrated that XZT mediated synergistically abnormalities of amino acid metabolic pathways in cirrhotic rats. Biomarkers identified in the metabolic profiling were validated through targeted quantitative analysis and by the results from serum and urine. We found that regulation of L-arginine/nitric oxide (NO) pathway was the most important mechanism of XZT to improve the gastrointestinal motility of cirrhotic rats. This effect of XZT has been confirmed by the inhibition of inducible NO synthase and neuronal NO synthase activities in the small intestine. This work gave a valuable insight into the mechanism of XZT and provided an effective way to elucidate the mechanisms of combined therapeutic systems.

Day 2

KEYNOTE SPEAKERS
  • The treatment of chloasma in traditional Chinese medicine

    Medical Acupuncture and Pain Management Clinic
    Brazil
    Biography

    Huang Wei Ling, born in Taiwan, raised in Brazil since the age of one, graduated in medicine in Brazil, specialist in infectious and parasitic diseases, a General Practitioner and Parenteral and Enteral Medical Nutrition Therapist. Once in charge of the Hospital Infection Control Service of the City of Franca’s General Hospital, she was responsible for the control of all prescribed antimicrobial medication, and received and award for the best paper presented at the Brazilian Hospital Infection Control Congress in 1998. Since 1997, she has been presenting her work worldwide, concerning the treatment of various diseases, using techniques based on several medical traditions around the world.

    Abstract

    Introduction: Chloasma is a condition in which dark patches appear on the skin, most commonly on the cheeks, bridge of the nose, forehead, upper lip, and chin – areas of the face that receive the most sun exposure. In Traditional Chinese Medicine (TCM) the causes of the disease could be liver-Qi stagnation, spleen-deficiency, kidney-Yin-deficiency and kidney-Yang-insufficiency. Purpose: The purpose of this study is to demonstrate that to successfully treat chloasma you need to look for the roots of the problems, not only the symptom. Methods: Over two case reports, the first being a 42-year-old woman who sought Acupuncture treatment for chronic headache and had the doctor notice the skin stains disseminated on her face, especially in the cheeks area. The second case, a 48-year-old man with constant knee pain was on Acupuncture treatment, and at his physical examination, there was found several dark patches on his face. Both patients were diagnosed with energy imbalance (Yin, Yang, Qi and Blood) and were treated with Acupuncture sessions associated with Chinese dietary counseling. Results: Both patients had a significant improvement of the chloasma patches, even thought that wasn’t the main cause of complaint. This overall recovery was achieved with the treatment of the patient in a holistic aspect, because when the energy imbalance that is causing problems is cared for, all the physical and/or emotional symptoms of one or several medical specialties improve at the same time. Conclusion: The treatment of chloasma in TCM has a different point of view from Western medicine, by treating deeply the root cause of the problem in its energy level. Each patient has their own imbalance and the treatment must be individualized to have successful results.

Dermatopathology
Chair
Speaker
  • Microbial burden of diabetic foot ulcers: the calabar scenario
    Speaker
    Ogba O. M.
    Department of Medical Laboratory Science, University of Calabar, Nigeria
    Nigeria
    Biography

    Ogba Ofonime M. completed her Ph.D. at the age of 42 years from University of Calabar, Nigeria. She is a Senior Lecturer in the University of Calabar, Nigeria. She has over 35 publications that have been cited over 35 times, and her publication H-index is 3.0 and has been serving as an editorial board member of reputed Journals. She has Professional associations with over 10 professional bodie including: Association of Medical Laboratory Scientists of Nigeria (AMLSN), Medical Laboratory Science Council of Nigeria (MLSCN), American Society of Microbiology (ASM), International Society for Human and Animal Mycology (ISHAM), Organization for women in science for developing world (OWSD), Nigeria Cancer society (NCS) and African Society for Laboratory Medicine (ASLM). Her research interest is on Dermatology and skin infections and Antibiotic/Antifungal susceptibility studies.

    Abstract

    Foot ulcers in diabetes mellitus subjects are a leading cause of morbidity and mortality which culminates in non-traumatic amputations worldwide. Knowledge of the microbial burden in the ulcers may improve patients care and management. This prospective study was designed to isolate, identify, and carry out antibiotic susceptibility testing on bacterial isolates associated with diabetic foot ulcers among subjects in University of Calabar Teaching Hospital. Subjects with diabetic foot ulcer were recruited after obtaining ethical clearance from the Research Committee and informed consent from the subjects. Samples were obtained from subjects using sterile swabs and subjected to microscopy and culture. Isolates were identified using standard bacteriological techniques. Antibiotic susceptibility testing was done by Kirby-Bauer method. Out of the 50 subjects recruited for the study, 31 (62.0%) were females while 19 (38.1%) were males with a mean age of 55.4±10.1 and a minimum age of 40.0 years. All the subjects had grade four wounds. The study recorded 100% infection rates among subjects with 70.0% polymicrobial infections. A total of 97 isolates were encountered among the 50 subjects accounting for the average of 1.94 isolates per subject. The most prevalent isolate was Staphylococcus aureus 32 (32.9%), while the least prevalent pathogen was Klebsiella pneumonia 10 (20.4%). Candida isolates were associated with 15 (30.0%) of the subjects. Females harbored more isolates 61 (62.9%) than males 36 (37.1%) but there was no statistically significant effect of gender on infection rates (?2=15.0, p?0.05). Erythromycin was the most effective (65.6%) against S aureus while gram-negative bacteria were more susceptible to Augmentin (87.5%) and ciprofloxacin (75.0%). The study has shown a high index of wound contamination with bacteria and fungi. The multiple antibiotic resistance of the bacterial isolates calls for the need to monitor resistance. Antifungal agents should be administered alongside antibiotics to subjects with Candida infection.

  • Hyaluronic acid and sodium succinate in programs of hair loss correction
    Speaker
    Romashkina Anastasia
    Avromed Medical Center, Russia
    Russia
    Biography

    Romashkina Anastasia has completed her PhD from First Moscow State Medical University named after I M Sechenov Ministry of Health of the Russian Federation (Sechenov University). She is Chief Physician at Avromed Medical Center, Moscow, Russia. She has published more than 30 papers in reputed journals. She is an expert of skin disorders of Lyme disease in Moscow, Russia. She is an expert of injections in Hyalual Institute, Switzerland.

    Abstract

    After skin diseases, such as seborrheic dermatitis and alopecia, we observe changes in the microcirculatory, dehydrated skin, metabolic changes and chronic inflammatory in the skin. We use of the preparation, containg sodium succinate (16 mg/ml) and hyaluronic acid (11 mg/ml or 18 mg/ml). The drug was administered intradermally in the technique of papular injections with a 30G needle, 2.0 ml per procedure, at intervals of one every two weeks. All patients showed a positive dynamic: hair growth, hair quality improvement and skin hydration. Allergic reactions to drug administration have not been recorded. Absence of effect and negative dynamics during therapy were not revealed.

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