Madridge Journal of Dermatology & Research

ISSN: 2639-0353

European Dermatology Conference

March 20-21, 2019, Frankfurt, Germany
Scientific Session Abstracts
DOI: 10.18689/2639-0353.a1.002

Treatment with Ultra Diluted Leaf Extract of Solanum Dulcamara Cures Verruca Vulgaris

Swami Shraddhamayananda

Ramakrishna Mission Charitable Dispensary, India

From Greek and Roman times both patients and clinicians are very much worried about common warts or Verruca Vulgaris. Common warts directly affect quality of life of the patients causing embarrassment, psychological trauma due to frustration of persistence and recurrence even after long continued treatment. There are many modes of treatment – surgical curettage, cautery, caustic ablation, cryotherapy, hot water treatment, ultrasound hypothermia, radiofrequency ablation, microwave treatment, infrared coagulation, immunotherapy, laser, virucidal, antimitotic therapy. However, all these therapy show high recurrence rates, persistence and transmission of the virus, formation of scars/Koebners. In fact, a recent updated Cochrane review concluded the treatment modes are only providing useful ideas only. Solanum Dulcamara also known as bitter sweet or climbing nightshade is a subshrub plant and contains steroid alkaloids α solamarine, β solamarine, soladulcidine, solasonine, solamargine, saponins and calystegines. All these agents are well known for their antimicrobial actions. I convinced after a pilot study that the ultra diluted extract of this plant could cure the disease as observed in a long follow up of some patients. In this main study we treated 190 patients suffering from common warts mostly in the age group between 10-40 years with this ultra diluted extract. There was cure of 78% patients as observed in a long time follow up. The satisfactory results were not obtained in palmo-planter and digital varieties and if we exclude these patients then the success rate becomes very high indicating it a promising medicine for treatment of these patients in days to come.

Biography:
Swami (Dr.) Shraddhamayananda graduated from Calcutta University and joined for Missionary work under Ramakrishna Mission. He is now a Monk of Ramakrishna order at Belur Math, West Bengal, India. He is now Incharge of a charitable Medical Unit at Belur Math. He has got more than 30 years of experience in medical profession as Skin specialist. He has published 12 papers in many reputed journals and presented many papers in national and international conferences. His main areas of research works are on Vitiligo, Acne, Warts, Post-Burn Scars, Post-Burn Hypopigmentation, Post Herpetic Neuralgia, etc. He has published one book on Vitiligo. He also attached to Vivekdisha (Expert unit ) of Ramakrishna Vivekananda University, India.

Recent Advances on Molecular Pathogenesis of Verruca Vulgaris

Satadal Das

St. Xavierʼs University, India

Verruca Vulgaris occurs due to infection caused by Human Papilloma Virus (HPV). Replication of HPV is closely associated with epithelial differentiation. More than 200 genotypes of HPV having tissue tropism are involved in development of a moderate range of benign tumors affecting the skin and they occasionally lead to the development of malignant tumors particularly Squamous Cell carcinoma. Benign Neoplasia mainly associated with HPV-2, HPV-4, and HPV-40 genotypes. Episomal viral genome ( ds DNA) enters the nuclei of multiplying basal cells and the infected progeny promote the neoplastic proliferation during keratinocyte differentiation. Integrin receptors, syndecan-1 and TRAPPIII complex are involved at the entry portal of the viruses particularly in basal cells. Later viral assembly and release mainly occurs by L1,L2,E4 gene often crosstalk with the Hippo pathway signaling molecules and EGFR with up regulation of IL6, IL8, IL10 and down regulation of IL1-β, IL18, IL2, TNF-α and γ-IFN are also found. Due to restricted growth clinically Verruca Vulgaris is characterized by hyperkeratotic, exophytic, dome shaped papules or nodules. The lesions are sessile, verrucous and with distinct borders. HPV-16 is notorious for development of skin cancers due to expression of viral oncoproteins E6 and E7 by activation of E genes and evade protective roles of oncogenes. Genital warts are mainly caused by HPV-11 and HPV-6 without any specificity of their lineages and sublineages although HPV-11 A2 variant is most frequently associated with genital warts.

Biography:
Prof. Satadal Das is a Research Scientist in St. Xavierʼs University, Kolkata and Principal Investigator, Virology Laboratory, Regional Research Institute, CCRH, Kolkata, is one of Indiaʼs renowned medical Microbiologist. He has published 104 papers in peer-reviewed journals and presented 232 papers in different conferences. He is member of 12 National and International associations. He has seven patents on microbiological products and processes and he has published one book on medical microbiology. At present seven PhD students are working under his guidance in different universities. He has delivered lectures at Royal Holloway, London University and at Rutgers University on microbiology related topics. He was president of Indian Association of Medical Microbiologists, West Bengal Chapter.

Basket-Weave Structure in the Stratum Corneum is an Important Factor for Maintaining Physiological Properties of Human Skin

Akihiro Tada* and Haruka Goto

POLA Chemical Industries Inc., Japan

Histological examination of normal human skin demonstrates that the Stratum Corneum (SC) comprises of two layers: an upper layer with a basket-weave pattern, and a lower compact layer. The basket-weave SC includes peripheral Corneo Desmosomes (CDs), an adhesion structure of the SC, resulting in expansion of the intracellular space where intercellular lipids can spread widely. In this study, the relationship between degradation of CDs, which is a necessary process for maturing basket-weave SC, and physical properties of the skin in 98 healthy Japanese female subjects was investigated. The outermost Corneocytes were obtained by tapestripping, then degradation of Desmoglein 1 (Dsg1), a major and important component of CDs, was examined using Immunofluorescence microscopy. We found a significant positive correlation between the number of Dsg1 pixels and transepidermal water loss and a significant negative correlation between the number of Dsg1 pixels and the high-frequency conductance of the skin. Subjects with higher degradation of Dsg1, which indicates basket-weave SC, tended to show a higher SC barrier function and a higher SC hydration, respectively. Furthermore, a significant positive correlation was observed between the number of Dsg1 pixels and a change in resonant frequency state as determined by measurement with a tactile sensor. That is, subjects with higher Dsg1 degradation, indicating basket-weave SC, tended to show a softer SC. We tried to improve basket-weave SC to improve the physiological properties of the skin. Prepared emulsion-A, an oil-in-water emulsion, successfully generated the basket-weave SC in reconstructed human epidermis in which degradation of CDs was promoted. The intercellular space of the basket-weave SC generated by emulsion-A was filled with multilamellar lipid sheets. These results indicate that degradation of CDs is likely to play an important role in maintaining the physiological properties of the skin in healthy subjects.

Biography:
Dr. Akihiro Tada has done his MS degree in Pharmaceutical Science from University of Shizuoka in 1993/3. He worked as a researcher in POLA Laboratories from POLA Chemical Industries in 1993/4. He also worked as a visiting fellow for Department of Dermatology in the University of Cincinnati during 1996-1997. He has done his Ph.D. degree conferred in Pharmaceutical Science from the University of Shizuoka in 1999. Since 2005, he is working as a Senior Research Scientist in POLA Chemical Industries.

Removal of Post-Acne Scars and Spots by Dermabrasion and Chemical Peelings

Nino Nishnianidze

Total Charm Clinic, Georgia

Introduction: Acne is rather common problem of fatty gland inflammation caused by the pathological process, based on numerous factors; whereby different type rash develops on the skin, such as Comedone, Papule-Pustules, Nodules-Cysts. Any type of acne can leave scars (atrophic or hypertrophic) and spots on the skin, which are not easy to remove. There are many treatment methods (ultrasonic, microwave, IPL- methods, etc.) used to solve this problem, but it is hard to reach fully clearness. We use dermabrasion and chemical peeling methods for acne spots and scars with very good result.

Goal: To study the efficacy of minimal invasive methods - Microdermabrasion and Chemical Peeling for treatment of Post Acne Scars and Spots.

Material and Methods: We studied 47 acne patients. The patients were divided into 3 groups. Group 1 included 23 patients with post-acne scars (hypotrophic form), out of which 16 female and 7 male of 24 to 36 years of age. Scars were 1-8 years old. The group 2, was composed by 17 patients (15 female and 2 male) with relatively new, 4-12 months old, post-acne spots. The group 3 consisted of patients with-acne spots and minimal hypotrophic scars. There were 7 female patients of 19 to 28 years old.

In the first Group the superficial anesthesia with the ointment by 5% Lidocaine was done, the skin was cleaned by Chlorhexidine solution and each scar was treated by microcrystalline surface mounts, with sizes ranging from 75 microns (in case of old and rough edges, if any) up to 125-150-170-microns (compared to new-soft scars). The procedure was repeated 4-6 times with 10 day intervals. The procedure may be repeated 6-12 months later. The skin exfoliation was done by the device and blood circulation was improved and tissues were enriched by oxygen, the restructuration of the damaged part was done.

In the Group 2 the skin was treated with combined chemical acids (14% salicylic acid, 15% glycolic acid, 14% lactic acid, azelaic acid 2%, 8% citric acid.) The trichloracetic acid 15-25-35 %, salicylic acid 30%, glycolic acid 50-70% may be used for evaluation of the spot condition. The procedure included 4 procedures with 12-14 day intervals. The procedure may be repeated 6-12 months later. The follow-up period included up to 3-14 months. Efficiency was based on long-term results.

In the group 3 the skin was treated by ultrasonic one procedure per week over all 8 procedures and microwave two procedures per week over all 8 procedures. After 3 months of treatment the results were insignificant.

Results: In each group skin condition changed dramatically, its structure improved, the skin color became pale pink, porosity of the skin reduced, the collagen-elastin synthesis, skin layer regeneration, restructuration occurred through improvement of blood circulation and exfoliation.

Conclusion: The obtained results showed that the procedures done by apparatus Microdermabrasion and Chemical peeling are very effective for further resolution of Post-Acne Scars and Spots.

Biography:
Dr. Nino Nishnianidze has worked as a medical faculty in Tbilisi State Medical University in Tbilisi, Georgia during 1996-2003. From 2003-2005 she done her Full internship course in Dermatology and in Cosmetology from Medical Clinic “Avitsena”. During 2006-2007, she done her Pressing medical aid service complete course from Tbilisi, Georgia. From 2007-2011, she has done her Full internship (resident) course in Dermatology from Tbilisi, Georgia. At present Dr. Nino Nishnianidze is working as a Dermatocosmetologist at Total Charm Clinic in Tbilisi, Georgia.

Targeting the Dermal Matrix for Skin Anti-Aging

Siming Chen*, Yong Zhuang, Lisa Di Natale, Anthony Gonzalez and John Lyga

Avon Products, USA

Cutaneous aging is a complex process involving a series of cellular and extracellular matrix events. The dermal matrix of the skin plays a pivotal role during this process. Studies by us and other investigators have consistently found that dermal matrix progressively degrades throughout a personʼs life. The manifestation of this progressive reduction of dermal matrix is the loss of skin elasticity, which may in turn lead to gradual appearing and/or deepening of facial lines, wrinkles and increased sagging.

It was postulated that enhancing dermal matrix protein production, assembly and stabilization can contribute to improve facial volume and firmness over time, thereby slowing down the appearance of skin aging. To investigate this possibility, a screen of synthetic substances and medicinal herbs was conducted to identify cosmetically acceptable substances that can influence the production and stabilization of dermal matrices. We identified a substance that showed strong stimulatory effect on dermal matrix components, such as Collagen and Hyaluronic acid in an in vitro model. Subsequently, a placebo controlled clinical split-facestudy, which was assessed by bio-instruments, showed that a 4-week of treatment of panelists with this substance could improve skin firmness as well as other skin conditions. Examination of skin biopsies with the treatment of this substance revealed the increased epidermal thickness in addition to dermal matrix improvement. To elucidate the mechanism of action of this substance, we conducted gene array study. In this presentation, our findings from both in vitro and in vivo studies will be shown and discussed.

Biography:
Dr. Siming Chen is a Fellow of Avon Products in Suffern, NY, where she leads R&D efforts in translating and implementing scientific discoveries, substantiating claims, and managing the cell biology laboratory. Dr. Chenʼs primary research focus is on anti-aging skin biology and pigmentation. Prior to joining Avon, Dr. Chen was a Research Associate in Weill Medical College of Cornell University, investigating molecular mechanisms of retinoid on stem cell growth and differentiation, early embryo development and cancer. Dr. Chen has numerous publications, and received multiple achievement awards, including two R&D Chairman Awards of Avon. Dr. Chen holds 10 US Patents.

Cutaneous Leishmaniasis CL in Afghanistan

Abdullah Naqibullah

Mezzo Anti-Age Clinic, Ukraine

Leishmaniasis is an endemic disease which is caused by the protozoan Leishmania, parasites which are transmitted by the bite of infected female phlebotomine sand flies that affects some of the poorest people on earth and is associated with malnutrition, population displacement, poor hygiene, a weak immune system and lack of public health services.

Leishmaniasis is divided into two groups:

1. Cutaneous Leishmaniasis CL (95%).
2. Visceral Leishmaniasis VL (5%).

It is estimated by WHO that between 600 000 to 1 million new cases of Leishmaniasis occur worldwide annually. Which is over two thirds of new CL cases occurred in 6 countries: Afghanistan, Algeria, Brazil, Colombia, Iran and Syria.

CL is the most common form of Leishmaniasis in Afghanistan, a disease with varying clinical presentation with a mild dermal condition usually self-healing, but the resulting scaring could be extremely disfiguring leading to social and psychological stigma. CL usually produces ulcers on the exposed parts of the body, such as the face, arms and legs.

Despite the great efforts by health authorities in Afghanistan CL continues to be a major public health problem in the country nevertheless, CL is not a fatal disease it can be cured only if the symptoms are treated in early stage.

Biography:
Abdullah Naqibullah is a Dermatologist and Cosmetologist from Afghanistan. He obtained his masters degree in Dermatology and Cosmetology in 2017 from Kharkiv National Medical University Ukraine. Presently he is working as a Dermatologist and Laser Specialist in Mezzo Anti-Age clinic at Kiev, Ukraine.

Precise Subcision for Cellulite and Micro Focused Ultrasound with Skin Tightening Visualization

Steffen Giesse

Estetic Lounge Ludwigshafen, Germany

1. Cellulite describes the scalp-like retraction of the skin in post-pubertal women and is often associated with a change in the subcutaneous adipose tissue at the thigh and buttocks area. Men have a significantly different, cross-linked connective tissue structure from women, which is why cellulite occurs almost exclusively in women due to the typical parallel connective tissue. In advanced age occurs in about 80-90% of women, the appearance of cellulite in different forms. The pathogenesis of cellulite is a multi factorial event in which the subcutaneous adipose tissue is permeated by altered connective tissue collagen strands. These structures can e.g. when hormone changes more or less swell, making the shape of collagen bands as “dents” visible.

In the technique of manual subcision, the reticular dermis is surgically separated from the underlying collagen septa. This technique is recommended only for Dellen Förmige recoveries, which are present in the rest position of the area. After the exact marking of the individual dents and after prior local anesthesia, the collagenous septa are severed individually by means of sharp micro annulas. With the purely manual subcision, the experience and technique of the surgeon is decisive for the success of the treatment, which is why it is only occasionally used by experienced users.

The manual subcision distinguishes the vacuum-assisted subcision, also known as Tissue Stabilized-Guided Subcision (TS-GS). The subcutaneous tissue is stabilized after previous tumescent anesthesia by means of a vacuum hand piece, while a motorassisted microblade separates the fibrous septa in this area. The precise and standardized transection of these septa can be performed in 2 depths at defined fan angles, depending on the location and extent of the dents. The relief effects on the skin show in a prospective clinical study after 3 months, significant improvements in the appearance of cellulite. In the meantime, 3-year results for this prospective clinical trial are available as part of the follow-up. Here, 93% of patients showed satisfaction after only a single treatment.

This standardized precision technology provides predictable and reliable effects and addresses the structural causes of cellulite, i. Fights cellulite where it originates.

2. Micro Focused Ultrasound with Visualization (MFU-V) for skin tightening. Micro Focused Ultrasound with Visualization (MFU-V) is an FDA approved non-invasive method for non-invasive lifting and skin tightening of the face, neck and décolleté. In numerous publications its effect could be shown with at the same time small number of unwanted side effects. The device consists of control unit, hand piece and different transducers. With each ultrasound head, the practitioner can visualize the tissue in a depth of up to 8 mm and at the same time deliver the ultrasound energy focused into the tissue.

By visualizing the tissue, sensitive structures, such as bones or larger vessels, can be detected and the unwanted injury to these structures during treatment can be avoided. Furthermore, the visualization allows the creation of an individual and tailor-made treatment plan for each patient, as it allows an analysis of the thickness of skin and tissue layers. Since the skin or tissue thickness of patients may be different not only individually, but also intra-individually (e.g., cheeks / submental / neck), and may not necessarily be different from external factors, e.g. BMI or visible and tactile degree of elastosis, can be deduced, the visualization represents the decisive advantage for the treatment.

3. Skin tightening with a diluted version of Calcium-hydroxyl apatite.

4. Skin tightening of the face and the body by a new radio frequency based device via Transdermal Microneedeling Radiofrequency

5. Combined therapies for rejuvenation of the Periorbital area.

Comparison between the Efficacy of Microneedling Combined with 5-Fluorouracil vs Microneedling with Tacrolimus in the Treatment of Vitiligo

Lamia Elgarhy

Tanta University, Egypt

Introduction: Several treatment modalities had been used for the treatment of Vitiligo but the optimal treatment has not yet been identified.

Material and Methods: 25 patients with Vitiligo were subjected to Microneedling of two patches of Vitiligo with Dermapen, then application of 5-Fluorouracil to one patch and Tacrolimus on the other patch. This procedure was repeated every 2 weeks for every patient for maximum 6 months (12 sessions). The patients were followed up for 3 months after the last session.

Results: The overall repigmentation was significantly higher in 5-Fluorouracil treated patches compared with Tacrolimus. Excellent improvement occurred in 48% of 5-Flurouracil treated patches while only in 16% of Tacrolimus treated patches. In the acral parts, 40% of the patches treated with 5-Flurouracil achieved excellent improvement (repigmentation>75%), while no patch in the acral parts achieved excellent improvement with Tacrolimus . However, there was significant difference between the two drugs, regarding inflammation, ulceration and hyperpigmentation which occurred with 5-Fluorouracil.

Discussion: Microneedling combined with 5-Flurouracil or Tacrolimus is safe and effective treatment of Vitiligo. However, 5-Fluorouracil achieved a greater percentage of repigmentation than Tacrolimus particularly in the acral part.

Primary Cutaneous Follicular Lymphoma Associated with Helicobacter pylori Infection

Adil H H Bashir1,6*, S M Yousif2, Lamyaa A M EL Hassan3, W M Elamin4, Ameera Adam5, M E Ibrahim5, K O Alfarouk5,6, A K Muddathir7 and A M EL Hassan5

1Khartoum College of Medical Science, Sudan
2Aliaa Medical Centre, Khartoum 3, Sudan
3School of Medicine, Ahfad University for Women, Um Durman, Sudan
4Faculty of Medical Laboratory Sciences, Alzaeim Alazhari University, Sudan
5Institute of Endemic Diseases, University of Khartoum, Sudan
6H. Alfarouk Cancer Center, Sudan
7Faculty of Pharmacy, University of Khartoum, Sudan

A 66 year old male with a long standing uncontrolled gastric H Pylori infection and Crohnʼs disease presented with nodular lesions in the back. These were removed surgically. Pathologically the lesion consisted of lymphocytes, giant cells with vacuolated cytoplasm and histiocytes. By Immunohistochemistry there were stem cells, B cells and CD1a Langerhans cells. The diagnosis of Langerhans Histiocytosis was made. The giant cells were positive for both CD 20 B cell marker and the macrophage marker CD 68 indicating that they were derived from B cells. They were strongly positive for H Pylori antigen. A year later the patient reported with non-itching nodular lesions in the right flank. There was no Lymphadenopathy or Splenomegaly. A biopsy of the lesion showed a follicular center B cell lymphoma. The tumor cells were positive for H Pylori antigen. He was treated for H Pylori infection. He completely recovered and was in good health a year later.

Keywords: Langerhans Histiocytosis, H. Pylori infection, Cutaneous Follicular B cell Lymphoma.

Biography:
Adil H H 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.

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