Madridge Journal of Dermatology & Research

ISSN: 2639-0353

European Dermatology Conference

March 20-21, 2019, Frankfurt, Germany
Poster Session Abstracts
DOI: 10.18689/2639-0353.a1.003

Pachyonychia Congenita Type 1 (PC-1), with Cutaneous Horn (Jadassohn-Lewandowsky syndrome)

Adil H H Bashir

Khartoum College of Medical Science, Sudan

Pachyonychia Congenita type 1 (PC-1, Jadassohn-Lewandowsky) is an autosomal dominant ectodermal dysplasia characterized by Nail Dystrophy (Wedged nails), Focal Non-Epidermolytic Palmoplantar Keratoderma (FNEPPK) and Oral Lesions (Leukokeratosis). A female patient, 34 years old, single, resident in Bouri, university graduate and work as Reviser General at Jabir Abu Eliz Diabetic Centre. The patient is complaining of pain on walking, fissuring and dryness with increased sweating at external aspects of hands & feet, since she was 13 months old. The condition is confirmed histopathologically as Pachyonychia Congenita.

Adil HH Bashir has his expertise as researcher mainly in Cutaneous manifestations of internal diseases specially Diabetes Mellitus and Helicobacter Pylori infection. His open and contextual results based on correlation between skin as marker to the internal diseases for improving methods of diagnosis and to make new entrance for treatment. He has built these results after years of experience in research, evaluation, teaching and administration both in hospital and education institutions.

Lactic Acid Peeling in the Treatment of Epidermal Melasma

Saadiya Siddiqui* and Tariq Rashid

Sir Ganga Ram Hospital, Pakistan

Objective: To determine the efficacy of lactic acid peeling in the treatment of Melasma.

Methods: This quasi-experimental study was carried out at department of Dermatology, Sir Ganga Ram Hospital, Lahore. A total number of 40 patients, with age ranging from 20-50 years were included in the study. All patients were female except 2. All patients underwent lactic acid peeling sessions at 3 weekly intervals for a total 6 sessions. The severity of Melasma was assessed by MASI score. Efficacy was based on mean decrease in MASI score at baseline and MASI score three weeks after the completion of treatment.

Results: Mean of MASI scores of all these subjects at baseline was 12.62 and the mean of MASI score recorded at the final followup was 6.30. Mean decrease in MASI scores was 6.32.

Conclusion: Lactic acid peeling is effective in the treatment of epidermal type of facial Melasma in Asian skin.

Keywords: Lactic Acid Peeling, Melasma, Efficacy.

Tissue Stabilized-Guided Subcision (TS-GS): A Revolutionary Mini- Invasive Treatment for Cellulite Blemishes in 80 Consecutive Patients

Roberto DellʼAvanzato

San Marino University, Italy

Introduction: Eighteen months ago, in October 2016, I started, as one of the first in Europe, my experience with Cellfina, a Tissue Stabilized-Guided Subcision® (TS-GS), a new procedure that represents the only FDA-cleared minimally invasive and clinically proven treatment to improve the cellulite blemishes for nearly four years in only one session.

Materials and Methods: We report our experience of 80 patients (78F; 2M) with cellulite treated in a single session, selected and classified with a simplified Cellulite Severity Scoring (CSS). Follow-up was scheduled after 7 days (T7) and 14 days (T14) for all the 80 patients; after 30 days (T30) for 77 patients; after 90 days (T90) for 72 patients; after 180 days (T180) for 65 patients; 50 patients (49F; 1M) had a medical check at 12 months and 15 months; 3 patients (2F; 1M) at 18 months. Outcome measures included subject photographs, Cellulite Severity Scale (CSS) and Global Aesthetic Improvement Scale (GAIS) assessment. Patientʼs satisfaction with a 5-point Likert scale and pain rating with Visual Analog Scale (VAS) were also recorded. The treatment takes 45-65 minutes. Cellulite dimples are marked and the device is applied to stretch and stabilize tissue in a vacuum chamber, while local anesthesia is delivered. Then, a precise minimally-invasive subcutaneous release of the connective bands or TS-GS is performed with a micro-blade, without cuts or incisions. We have safely treated 6 to 55 sites in one session. After treatment, a light compression is applied and patients are able to return promptly to their daily life.

Results: The procedure treated successfully the primary structural cause of cellulite blemishes in all the 80 patients with a range of 15-30 sites in 74% of cases, 6-14 sites in 15% and 31-55 in 11%. Concerning patientʼs satisfaction at T90, 64 patients (88, 89%) out of 72 were very satisfied score of (5) and satisfied (4) while 8 patients (11,11%) were neither satisfied nor dissatisfied (3); these excellent results have been confirmed at T180, 12 months and 15 months, with the first 3 patients that at 18 months were very satisfied (5) and satisfied (4). In our experience, 0% of the patients were dissatisfied (2) or very dissatisfied (1). Transient treatmentrelated adverse events were mild in severity and the most common side effects reported were soreness and bruising and no serious adverse events were reported. The GAIS showed that the mean baseline CSS score of 3.6 before the treatment, decreased to 1.2 at T90, 1.1 at T180, 12 months and 15 months and 1.0 in the first 3 patients at 18 months. The VAS was 2.2 at T7, 1.8 at T14 and 0 from T90 onwards. None of the 80 patients changed the weight by more than 10%, otherwise they would have been excluded from the present study.

Discussion: This revolutionary FDA-cleared procedure combines a proven approach with an innovative technology to treat the primary structural cause of cellulite blemishes in posterior thighs and buttocks. This study confirms safety and efficacy with vacuumassisted precise tissue release for the treatment of cellulite, which is also strengthened by patientʼs satisfaction.

Roberto DellʼAvanzato is specialist in Surgery with an University Master in Aesthetic Medicine and Surgery; Professor of Laser and Laser Assisted Liposuction, San Marino University (San Marino); University Diploma in Laparoscopic Surgery, Louis Pasteur University of Strasbourg (France); Honorary Member of the Israel Academy of Beauty; Honorary Member of the Italian Academy of Beauty; Certificate of excellence awarded from The Pakistan Medical Association, for humanitarian services rendered to the burnt and scarred victims of Pakistan; Certificate of Merit awarded from the Combined Military Hospital of Islamabad (Pakistan), for humanitarian services.

Endolift and Ultherapy for the Best Face, Neck and Body Non-Surgical Lifting

Roberto DellʼAvanzato

San Marino University, Italy

Background: We evaluate the results after 13 years of Endolift Laser technique for the “soft” rejuvenation of face, neck and body, using a very thin optical fibre connected to a 1470nm diode laser, combined in the last years with Ultherapy® which allows in a single session to lift the muscles and the skin.

Methods: We report our experience after more than 4000 areas treated with Endolift for the treatment of skin laxity of the face, neck and the body. A 200-300 microns fiber is used for the face and the neck; a 400-600 microns fiber is used for the body. The fiber is easily inserted, without incisions under the skin directly in the superficial hypo-derma. After Endolift, a Ultherapy® session is performed.

Results: The areas of skin laxity of the face, neck and body, can benefits from the possibility that the Endolift Laser has to retract the skin and remodel the derma, activate the collagen production, stimulate the neo-angiogenesis. Ultherapy® helps to obtain the maximum result possible working more deeply the middle and deep hypo-derma up to the muscular fascia, permitting to obtain an immediate and a long-term lifting.

Conclusions: Endolift Laser combined with Ultherapy® is the best non-surgical treatment for the areas of muscular and skin laxity of the face and the neck.

Roberto DellʼAvanzato is specialist in Surgery with an University Master in Aesthetic Medicine and Surgery; Professor of Laser and Laser Assisted Liposuction, San Marino University (San Marino); University Diploma in Laparoscopic Surgery, Louis Pasteur University of Strasbourg (France); Honorary Member of the Israel Academy of Beauty; Honorary Member of the Italian Academy of Beauty; Certificate of excellence awarded from The Pakistan Medical Association, for humanitarian services rendered to the burnt and scarred victims of Pakistan; Certificate of Merit awarded from the Combined Military Hospital of Islamabad (Pakistan), for humanitarian services.

Dermocosmetological Pomade against Bacterial Infections Arising in case of Tattooing and Piercing Especially in Mucosae

Lorenzo Martini1* and Franco Deraco2

1University of Siena, Italy
2Texias.rl. Turin, Italy

Body modification is to be considered an art or a subspecies of corporal adornment (heritage of Troglodytesʼ and Caverniculousʼ customs), in the same way of Graffiti writing or Murals that shows the neat or perhaps wild intention of embellish residential neighborhoods of towns or city gardens.

In this study we want to focus our attention on piercings in Oral and/or Perioral Mucosae and Genital Mucosae (vagina or clitoris in woman or glans and foreskin in man) and whichever type of tattooing on whichever part of the body and on the way to combat all the kinds of microbial or viral infections that could arise from this fashionable practice (or cult).

Risks and complications associated with oral piercings are the following:

• Airway compromise
• Allergic reaction to metal
• Bleeding and risk of hemorrhage
• Galvanism
• Gingival recession
• Hyperplasic and scar tissue formation
• Increased salivary flow
• Inhalation of the jewellery
• Interference with radiographic images
• Interference with speech, chewing and swallowing
• Localized and systemic infections
• Nerve damage and Paresthesia
• Pain swelling
• Tooth fracture or chipping.
• Male and Female genital piercing involves too often severe bacterial, viral and fungal infections but even yeast and mould assaults, very difficult to combat.

As far as ill-fated tattooing is concerned, these are the most serious complications that may occur:

• Bloodstream infections and sepsis
• Toxic shock syndrome
• Red blistering patches
• Organ failure
• Infection and swelling of the tissues that line the heart valves
• Coma
• Death
• Non -Tuberculous Mycobacteria (NTM) infections.

We have released an ointment extremely rich in antiviral, fungicide and antibacterial agents at highest percentages of employ that is completely capable to defeat all the complications arising from oral and genital piercings or ill-fated tattooings.

Results are quite amazing: only an overnighting consisting in three applications of the ointment is sufficient to the complete remission.

Lorenzo Martini was born in 1963, graduated magna cum laude in Pharmacy at the University of Siena (IT) in 1985 and post-graduated magna cum laude in Cosmetic Chemistry and Technologies at the University of Mailand, 1987. He has more than 160 scientific publications and issues, has been directing a big national cosmetic holding for decades, can show several international patents and besides, since 2000 he is lecturer at the Department of Pharmaceutical Biotechnologies, Faculty of Sciences at University of Siena.

Identification of Alopecia Areata Autoantigens in C3H/HeJ Mice using Whole-Skin Homogenates

Adriana Figueroa*, Christina I Tejeda, Eddy Hsi Chun Wang, Ashley Hyun Ah Kwon and Angela M Christiano

Columbia University Medical Center, USA

Alopecia Areata (AA) is a non-scarring cell mediated autoimmune inflammatory disease of the hair follicle (HF). In most AA patients, histopathological examination reveals Dystrophic Anagen stage hair follicles that are surrounded by a peri- and intra-follicular inflammatory cell infiltrates, consisting primarily of CD4 and CD8 T cells. We hypothesize that the hair follicle immune privilege is lost and normally sequestered antigens are exposed to CD8 T cells, which preferentially target Anagen HFs, leading to their destruction. Here, we present an unbiased screening approach to assess whether Anagen HFs are being specifically targeted, and to identify the autoantigen epitopes in C3H/HeJ mice. We isolated skin-draining lymph node cells (LNCs) and extracted protein homogenate from Anagen and Telogen skin of AA-affected and AA-unaffected C3H/HeJ mice. LNCs were cultured with protein homogenates and assessed for T cell activation via IFNg ELI spot assays. We found that Anagen skin protein homogenates induced a higher frequency of T cell activation in both AA-affected and AA-unaffected mice, showing that T cells are more activated by anagen HFs than telogen HFs, consistent with preferential expression of AA autoantigens in the Anagen phase of the hair cycle. To further narrow down candidate antigen targets, protein homogenates were separated by column chromatography into individual fractions of proteins. Using this approach, we found that one out of four Anagen fractions, which contains molecules with larger molecular weight, preferentially induced an immune response. We are currently performing a bias screening approach and testing AA associated proteins against melanogenesis related antigens and keratinocyte derived antigens. Characterizing the protein content and autoantigen epitopes will facilitate the identification of specific antigens and aid in the rational development of new therapies for AA.

Objective Remote Documentation and Digital Assessment of Dermatologic Conditions by Augmented Skin Imaging

Harald Schnidar*, M Schöllhammer, P Dupin, L Alfine, M Bauer, K Schnidar and S Schnidar

Scarletred Holding GmbH, Austria

We have developed a novel and state of the art digital skin imaging software capable of remote documentation and objective assessment of various skin conditions. Our clinically validated system Scarletred® Vision consists of a mobile app, skin patch and online platform. To standardize the process of skin imaging, first the skin patch is applied on the patientʼs skin, close to the investigation area. It serves as a novel digital gold standard enabling color and size calibration in images taken with the mobile app. It delivers normalized image data by reducing illumination influences between investigated subjects and/or treatment groups over study time. Generated data is automatically allocated to the subject by using anonymous patient codes, encrypted and uploaded to the online platform. Such data can then be objectively analyzed by usage of our clinically validated algorithms, to measure visual skin changes like erythema, pigmentation, scaling, wound size and tissue composition. The software is now already CE class I medical device certified and provided via Software as a Service (SaaS) to Biopharma and Cosmetics companies, hospitals and medical experts. The intended purpose is for documentation and analysis of skin diseases in a broad range of dermatological applications, preferentially in the course of pre-clinical and clinical drug development (safety/efficacy/biocompatibility testing) of drugs, medical devices and skin care products as wells as for state-of-the-art Tele-Dermatology services. It is easy to use and enables to deliver better skin care products and health care services faster at lower cost.

Dr. Harald Schnidar is the Founder and CEO of the award winning digital health Company Scarletred. The company is headquartered in Vienna and expanded recently to USA by incorporating a US at the reputational Cambridge Innovation Center next to MIT. Harald is the inventor of the Scarletred® Vision. The novel technology is on its way to transform global dermatology market. Before Scarletred, Harald worked in academics and clinical skin drug R&D. He holds a PhD in Genetics and an executive MBA by the University of Salzburg, Westminster, St. Gallen, Fudan and Toronto.