Conference Schedule

Day1: October 1, 2018

Keynote Forum

Biography

Palayakotai Raghavan is the CEO of Nanorx INC. He has completed his PhD in Organic Chemistry at Oregon State University in 1979 and MS in Chemistry at IIT Mumbai, India in 1972. He has worked on drug discovery for over 25 years at Columbia University, Max-Planck Institute, Germany, Ciba-Geigy (now Novartis) and Boehringer Ingelheim. He has over 25 US and international patents and other 15 pending patent applications.

 

Abstract

The skin is the largest organ of the body that fulfills multiple essential tasks. It forms the boundary between the inside and outside. It protects against mechanical and chemical threats, it provides innate and adaptive immune defenses, it enables thermoregulation and vitamin D production and it acts as the sensory organ of touch. Skin diseases are a significant cause of global disease burden, affecting millions of people worldwide. There are more than 3000 known diseases of the skin. Aging, environmental and genetic factors and trauma can result in the development of a diverse set of skin diseases. Metadichol a nano formulation of long-chain lipid alcohols derived from food it is an inverse agonist of vitamin D receptor (VDR), aryl hydrocarbon receptor (AHR), and ROR gamma (RORC) that could have beneficial effects on skin diseases. We now present case studies of patents with various skin disease shows Metadichol is an inverse agonist of these named nuclear receptors thus modulating Th1 pathway towards a TH2 and Th 17 and IL 17 and IL22 and also being a TNF alpha inhibitor can modulate IL23 thus blocking the major pathways that exacerbate many skin diseases. Metadichol is the first molecule to successfully navigate around the problems involved with promiscuous ligands and targets. It fulfills the goals of the emerging field of polypharmacology i.e., a single drug is able to bind to multiple targets beyond the one drug, one target philosophy. We show how Metadichol is an innovative treatment or treating multiple skin diseases like eczema, acne, diabetic wounds and viral and bacterial infection and also improving skin texture. Metadichol® is a safe non-toxic low cost solution and is an alternative to numerous clinical candidates in combating over 3000 skin diseases.

 

Biography

Shun Io President, Plastic & Cosmetic Surgical Society of Macau Surgical Association. Associate Doctor and Specialist in Plastic, Cosmetic Surgery from Yi Kui Hospital (Macau). Medical Consultant from Paul Niehans An­ti-Aging Center (Asia) and Specialist in Cosmetic Surgery, Taiwan. Special­ist in Aesthetic Medicine, Taiwan Specialist in Anti-Aging Medicine, Taiwan Official Trainer of Derma Veil Aesthetics Training.

 

Abstract

Background: Injecting cosmetic fillers is increasing worldwide and desiring cheap permanent filler had led to increased use of polyacrylamide gel (PAAG) as filler in cosmetic procedures. We frequently see complications including induration, immigration and infection after injection.

Objectives: This study aimed to introduce a new method of evacuating PAAG with the help of ultrasonography (USG) markings on face and evacuating with fat-transfer cannula.

We aimed to remove PAAG with a technique using fat-transfer cannula in patients with complicated or displaced injected materials. In this method, the exact site of PAAG was determined by USG and marking the sites on face before removal of materials.

Patients & Methods: We enrolled patients who were not satisfied with the results of injection or had developed complications such as induration, gel migration or infection referred to our clinic to evacuate the filler since 2013. Patients were examined by ultrasonography and reported the volume, place and depth of gel as well as fibrosis and marked them on the patients’ face or its photographs. We used Barikbin’s tumescent solution to facilitate the evacuation of concentrated gel and reduce the risk of injury to vital tissues.

We inserted an 18G-fat-transfer cannula through a hole on the regions and evacuated the gel by vacuum force with suction and milking. We also used a Manhattan forcep subcision blade to dissect fibrosis. The evacuated region was irrigated by normal saline.

Results: We treated 154 patients, including 150 females (97.4%), with the mean (SD) age of 33.79 years. According to VAS, 98.7% of patients reported complete satisfaction while 2 (1.2%) were not satisfied with the results. Patients reported no complication of therapy.

Conclusion: Our method provided good results and performing evacuation under the guide of bedside ultrasonography is recommended.

 

Biography

Chan Kam Tim Michael is a practicing private Dermatologist in Hong Kong. He received Dermatology Specialist Fellowship at Hong Kong Academy of Medicine in 1998. In the same year, he was granted a Government of Hong Kong scholarship for post graduate training in UCLA, USA. He is now the Vice President of the Association of Integrative Aesthetic Medicine in Hong Kong. He was Editor of Hong Kong Journal of Dermatology and Venereolo­gy from 2002 to 2007. He acts as Editorial Board Member of the following international journals since 2017: Research Journal of Nervous System; The Cognitive Neuroscience Journal; Medical Reports and Case Studies and; Advances in Neurology and Neuroscience. He has been working at the University of Hong Kong as Honorary Clinical Assistant Professor from 2007 to 2009. He is now a part time Lecturer at Baptist University of Hong Kong for teaching master course in Public Health.

 

Abstract

Introduction: Sensitive skin syndrome (SSS) is a common skin condition reported globally. The pathogenetic mechanism is still elusive. Advancements in non-invasive neurosensory techniques like functional magnetic resonance imaging and low frequency electrical current stimulation and biophysical techniques like confocal Raman spectroscopy triangulate with multiple epidemiological studies unveil SSS as a complicated syndrome not only affecting the skin; its constituents but the peripheral and central nervous system including the affective domains of the brain.

Methodology: A community base subjects self-reported epidemiological survey was carried out in the month of January 2018 to assess the prevalence, epidemiology and risk factors of SSS locally using a validated 10 items questionnaire. A total of 500 subjects were interviewed in five different geographical locations. The questionnaire has been tested in many countries globally and with a good correlation with DLQI. The date, location, gender, age, ethnicity, marital status, number, gender and age of children, concomitant skin diseases were documented. Interviewed subjects with a self-reported sensitivity scores from 20 to 60 (or more) under the 10 items versions questionnaire was considered having SSS. The risk factors were analysed by Chi-Square analysis on categorical variables: area, gender, occupation, age groups, social class, marital status, children number, first child gender, second child gender, skin type, skin condition and Mann-Whitney U test on number of children, first child’s second child’s age. Logistic regression model was used to find out possible significant and marginally significant risk factors.

Results: Our results showed a female prevalence of 55% and male 43% in Hong Kong. The results are comparable to data reported in literatures in other countries but much higher than reported in mainland China. Significant risk factors or predictors of SSS are gender, area, pre-existing skin diseases. Atopic Dermatitis is the most common reported skin disease in this survey (21.2%), followed by urticaria (3.2%), psoriasis (2.65) and other skin diseases (13.4%). Xerosis and acne vulgaris contributed a high proportion of other skin diseases.

Conclusion: SSS is a prevalent condition in ethnic Chinese in Hong Kong. A 10 - items self-reported questionnaire is a convenient, non-invasive, quick and acceptable tool to study the epidemiology and prevalence of SSS in a community setting. Further researches should address its sensitivity in clinic setting for diagnosing SSS. The reasons for the discrepancy between the prevalence of SSS in China and Hong Kong should also be further investigated

 

Tracks

  • Drugs and Therapies | Skin Cancer | Psoriasis and Psoriatic Arthritis
  • Cosmetology | Venereology | Trichology
Location: Odenwald
Speaker

Shun Io

Macau Yinkui Hospital, Maccau

Chair

Speaker

Kam Tim Michael Chan,

Hong Kong Academy of Medicine, Hong Kong

Co Chair

Biography

Germaine Escames is a Professor at Granada University School of Medicine from Spain and has broad experience in the studies of the antioxidative role of melatonin and the identification of the mitochondria as the main target of melatonin, and its anti-inflammatory activity against the innate immune response, among others. From several years to date, her activity has been focused on the oncostatic activity of melatonin and the adverse effects of radio and chemotherapy. In addition, she studied the effects of melatonin on the skin. She has four international patents on melatonin: one is currently under a multicentric clinical trial (in 10 hospitals of Spain) for the prevention and healing of oral mucositis induced by radio and/or chemotherapy, and other two patents consist of an endovenous melatonin formulation for the treatment of sepsis. The fourth patent consists in a regenerative and anti-aging cream of melatonin for its topic application in the skin. A clinical trial with this cream to treat position ulcers is now being carried out in collaboration with other groups.

 

Abstract

Melatonin, a hormone produced by the pineal gland, has been also detected in multiple extra pineal organs and tissues at much more higher concentrations than in the pineal gland. Melatonin synthesis has been demonstrated in skin cells, and its expression was located in the upper layers of the epidermis, dermal structures, blood vessels and mast cells by immunocytochemistry. Melatonin is a potent free radical scavenger with antioxidant properties, which increases the expression and activity of the endogenous antioxidant enzymes. During its scavenging activity, melatonin generates a series of metabolites that are also free radical scavengers. Capable of crossing cell membranes, melatonin can reach all cell compartments; it is taken up by mitochondria where it maintains mitochondrial homeostasis. Melatonin has also important anti-inflammatory effects, reducing the innate immune activation. Recently, we have developed a pharmaceutical preparation of melatonin plus CoQ10 for the treatment and prevention of skin aging. The success of this preparation depends on its composition, which facilitates its transdermal adsorption, reaching both molecules all skin´s layers. Moreover, the combination of both molecules favors their uptake by the mitochondria in all skin cells. The advantage of our product is that it not only reverses the mitochondrial damage produced during cellular aging, but also improves skin’s health in many pathologies coursing with oxidative stress, inflammation and mitochondrial impairment. Additionally, after reported a melatonin’s gel that protects normal cells from oral mucositis induced by radio or chemotherapy, we have demonstrated that high melatonin concentrations enhance the cytotoxicity of radio and chemotherapy in head and neck human cancer. Therefore, melatonin might be useful in the treatment of pigmentary diseases (e.g. vitiligo or hyperpigmentation), benign or malignant proliferative processes (melanoma, epidermal cancer or precancerous states), UVB-induced pathology, inflammatory dermatoses and other skin pathologies, besides skin aging.

 

Biography

Chan Kam Tim Michael is a practicing private Dermatologist in Hong Kong. He received Dermatology Specialist Fellowship in Hong Kong Academy of Medicine in 1998. In the same year, he was granted a Government of Hong Kong Scholarship for Post-graduate training at UCLA, USA. Currently, he is the Vice President of the Association of Integrative Aesthetic Medicine in Hong Kong. He was the Editor of the Hong Kong Journal of Dermatology and Venereology from 2002 to 2007. He is the Editorial Board Member of the following international journals since 2017: Research Journal of Nervous System; The Cognitive Neuroscience Journal, Medical Reports and Case Studies and Advances in Neurology and Neuroscience. He has been working at the University of Hong Kong as an Honorary Clinical Assistant Professor from 2007 to 2009. He is a Part-time Lecturer at the Baptist University of Hong Kong for teaching master course in Public Health.

 

 

Abstract

Scratching is a distinguishing feature of many resistant dermatosis like chronic atopic dermatitis. Recently, discovery in neuroendocrinology, immunology and MRI studies suggest itch-scratch cycle may be an addictive neuroendocrine mediated pathological movement pathway with an aberrant and imbalance of neurotransmitters in central nervous system (CNS). Mas-related G protein-coupled receptor A3 (MrgprA3) and MrgprC11 expressed afferent neurons penetrated in the epidermis together with transient receptor potential (TRP) receptors like TRPV (vanilloid) 1, TRPV 3, TRPV 4, TRPA (ankyrin) 1 together with serotonin receptors relay itch signals from the periphery synapses to the dorsal horn of spinal cord. Pruritogenic signals via the afferent neurons synapse with gastrin-releasing peptide receptors (GRPR) in the spinal cord. GRPR activation released substance P, calcitonin G releasing peptide and vasoactive intestinal peptide including pituitary adenylate cyclase activating peptides which was distributed in the CNS. Endothelin-1, tachykinin through neurogenic inflammation increased levels of Th2 cytokines and interleukin-31 also mediate itch. The central station of itch transmission in our brain is the thalamus. Hedonic scratch activated the primary somatosensory S1 areas gave the perception of comfort in the cingulate cortex decided the planned motor response of scratching. The midbrain, striatum, ventral tegmental area, caudate nucleus and ventromedial prefrontal cortex as shown by MRI studies are activated in this pleasant circuitry. If this endogenous neuroendocrine circuitry become uncontrolled; harmful cravings behaviour superseded. Insula cortex and claustrum of the brain play a prominent role in interoception including addiction. They are highly activated when itch is intensified. The adverse pruritic experience is represented in amygdala, subcallosal gray matter and nucleus accumbens. The miswiring and imbalance of 5-hydroxytryptamine and its multiple receptors are involved. Besides pharmacological intervention, cognitive behavioural therapy including education, refocusing attention strategy; virtual reality immersion; audio visual distraction techniques; habit reversal training; arousal reduction and cognitive restructuring are helpful.

 

Biography

Ipsa Pandya is an Assistant to Editor-in-Chief of Indian Journal of Sexually Transmitted Disease and AIDS. She awarded the first prize for paper presentation in mid-year scientific program of Indian Association of Dermato venereo leprologist in 2014, Gujarat. She is member of International Society of Dermatology.

 

Abstract

Introduction: Zinc and copper are important cofactors and modulators of many critical biological functions in different dermatological diseases including psoriasis as they are involved in a number of cellular metabolic activities.

Objectives: To study the levels of serum zinc, serum copper as well as copper/zinc (Cu: Zn) ratio in psoriasis and the role of Cu: Zn ratio as a marker of severity of psoriasis.

Methods: Fifty patients of the age group of 20-50 years having chronic plaque psoriasis were studied along with 50 ages and sex matched healthy controls. Patients with psoriasis area severity index (PASI) less than 10 were considered as mild psoriasis and PASI greater than 10 considered as moderate to severe psoriasis. Serum zinc and copper were studied using the colorimetric method and analyzed by a fully automated biochemistry analyzer.

Results: Patients with moderate to severe psoriasis have higher (121.29±42.75) mean serum copper levels than controls (99.9±23.1, p=0.0049) but there is no significant difference in serum copper level between mild and moderate to severe psoriasis ( P=0.2265). Patients with moderate to severe psoriasis have lower mean serum zinc (66.38±24.33) than controls (82.4±15.9, p=0.0006) but there is no significant difference in serum zinc level between mild and moderate to severe psoriasis (P=0.1607). Also, patients with moderate to severe psoriasis have higher mean serum copper/zinc ratio (2.04±1.04) than those with mild psoriasis (1.54±0.71) and controls (1.2±0.3). Serum copper/zinc ratio correlates significantly with PASI and can be used as a marker for assessing the severity of the disease.

Conclusion: This study suggests that serum copper/zinc ratio is the better marker for assessing the severity of psoriasis. Moreover, the therapeutic potential of these findings needs to be explored.

 

Biography

Liza Bornman has completed her PhD in Human Genetics at University of Pretoria and two Commonwealth Fellowships in the Wellcome Trust Centre for Human Genetics at University of Oxford. Her research interest is the field of epigenetic epidemiology, involving the integration of genetics, epigenetics and environment to influence phenotype. Her research focuses on Vitamin D signaling, a model of gene-environment interaction, which is hindered in cancer and infectious diseases. She has a Scopus h-index of 16. She is the Author and Co-author of 34 publications and elicited 770 citations.

 

Abstract

The impact of UVR on the skin, promotes vitamin D production while causing cancer, tenders for the label ‘oxymoron’. UVB sustains the primary source of vitamin D, which in complex with its receptor, mediates critical functions including innate immunity. Ultraviolet index and vitamin D status count among environmental factors shaping TLR2/1 signaling efficacy during infection. Non-melanoma skin cancer (NMSC) may serve as proxy for sufficient lifetime vitamin D. Association of NMSC, as first primary (FP) cancer, with second primary (SP) cancers may shed light on the risk-benefit of UVB exposure. Multiple primary (MP) cancers were explored in a retrospective cohort of blacks and whites, recorded from 1994 to 2005 by the South African National Cancer Registry. SP cancer risk and rate ratio were calculated if FP was basal cell carcinoma (BCC) or squamous cell carcinoma (SCC), compared to FP non-skin cancer. Blacks with FP BCC had a significantly reduced risk and incidence rate ratio (P<0.050) for SP genital cancer (female OR 0.09 95% CI 0.02-0.35; male OR 0.26 95% CI 0.11-0.62) and infection-related cancer (female OR 0.28 95% CI 0.15-0.52; male OR 0.27 95% CI 0.16-0.48), compared to FP non-skin cancer. Whites with FP BCC had a significantly increased risk (P<0.001) for SP breast (females, OR 2.38 95% CI 1.81-3.12), prostate (OR 1.35 95% CI 1.15-1.58) and melanoma (female OR 2.66 95% CI 1.82-3.88; male OR 2.96 95% CI 2.26-3.86), compared to FP non-skin cancer. The impact of NMSC as FP on SP is influenced by race and cancer type.

 

Biography

Magdalena Chrabaszcz is the Student in the First Faculty of Medicine and Public Health at the Medical University of Warsaw. She is the recipient of the Rector’s Scholarship Award for best students. She is an active member of Dermatology Research Club. She is the laureate and participant of many medical conferences; and the member of International Federation of Medical Students Associations (IFMSA) and Erasmus Student Network (ESN). She participated in scientific exchanges in many countries such as Germany, Armenia, Bosnia, Herzegovina and Latvia. She is the member of the Organizing Committee of the Warsaw International Medical Congresses. Her interests in dermatology field focus on Psoriasis, Surgical Dermatology and Melanoma.

 

Abstract

Introduction & Aim: The collection of microbes and their genes that exist within and on the human body, collectively known as the microbiome has emerged as a principal factor in variety of disease states. Humans and microbes have established a symbiotic association over time and perturbations in this association have been linked to several immune-mediated inflammatory diseases. Therefore, enteric microbiota dysbiosis with gut barrier disruption may be important factor in the development of psoriasis. The aim of the study was to analyse the intestinal barrier integrity in psoriasis.

Materials & Methods: We determined concentrations of gut barrier integrity markers: claudin-3 (tight junction protein), intestinal fatty acid binding protein (I-FABP; endogenous enterocyte protein), in the blood plasma of patients with chronique plaque psoriasis (n=30) and healthy individuals (n=30). Claudin-3 and I-FABP were measured using commercially available ELISA test kits.

Results: Claudin-3 concentration was higher in patients with psoriasis compared with healthy control (median: 54.07 ng/ ml vs. 42.36 ng/ml; p<0.001). Patients with psoriasis had also elevated concentration of plasma I-FABP (median 708.8 pg/ ml vs. 147.1 pg/ml p<0.05). Concentrations of claudin-3 and I-FABP significantly correlated with disease activity assessed by psoriasis area and severity index.

Conclusion: Our results support the hypothesis that dysfunction of intestinal barrier disturbs the homeostatic equilibrium between the microbiota and immune system that may result in chronic systemic inflammation. Many critical questions remain to be answered before we can apply new knowledge to improve therapeutic interventions in psoriasis.

 

Location: Odenwald
Speaker

Aditya Tandle

Insta Hair Transplant & International Hair Labs, India

Chair

Speaker

Reham Labib

One Clinic Laser & Skin Care, Egypt

Co Chair

Biography

Shadi Al-Khawaldeh is a Dermatologist, Skin Surgeon and Laser Specialist. He has completed his American Diploma in Aesthetic Medicine. He is currently working as an Aesthetic Procedures Specialist at Tlaa Al Ali Hospital, Jordon. He is also working as an Assistant Plastic Surgeon at Medicines Sans Frontiers, Jordan.

 

Abstract

Aim of this study is to make doctors able to differentiate between sutures and thread lifting and at this moment the author would like to invent new word which is floating threads. Floating threads are all the types of threads that are present in the market like: mono threads, cog threads, siloute threads and spring threads. He categorizes them as floating threads since they are not fixed to stable structure, they are fixing skin to skin which is a poor idea; he wants to present a new innovated idea which is suture lifting which means fixing the SMAS to the periosteum and since the SMAS is connected to the dermis of face by the reticular system we can lift the skin to stable point at the periosteum and this is author’s idea of micro–face lifting, where we have three zones of lifting upper face lifting, mid face lifting, lower face the SMAS and platysma to the periosteum. We have the full demonstration of our methodology with cases before and after, which prove the efficacy of our technique.

 

Biography

Aditya V Tandle has completed his Doctorate in Trichology. He is the second person to hold this degree worldwide and the first in India. He is the Founder and Chairman of his companies, Insta Hair and Hair Labs Pvt. Ltd and Vinci Trichology in India, which caters to both domestic and international clien­tele. He has completed his Graduation in Engineering and Law along with a dual MBA in Finance and Human Resource. His foundation in engineering helps him to understand the nuances of medical technology especially re­lated to trichology, while his grounding in finance and human resource helps him get his footing in business and networking precise. In India, his Insta Hair and Hair Labs Pvt Ltd is listed amongst the top five most successful hair transplant companies. His company is also ranked amongst the top three companies, in terms of association with the most number of expe­rienced doctors and nursing staff employed in the hair transplant industry. With a widespread reach and client base, expansion plans for the company is in the pipeline. He dreams of a flourishing trichology industry. He believes that hair transplant often acts as a vital psychological boost that restores confidence in people again.

 

Abstract

Statement of the Problem: Is trichology an emerging facet of the healthcare industry today, transforming the industry as a whole? To answer this a few analytical facts must be considered. As an industry, healthcare follows some parameters which form its core system. These parameters when scrutinized by the healthcare analytics tools help in generating accurate business and clinical insight. This is what consequently paves the way towards achieving the desired outcome, in this case, trichology as an emerging market for the industry. Currently on whether trichology makes the cut for a promising market for healthcare industry, will be answered with clarity on close analysis of three vital parameters: quality, performance and safety facets.

Methodology & Theoretical Orientation: Employing an analytics system framework, a fairly good inference may be drawn about if trichology is ready to be the next big thing in the healthcare industry. The traditional SWOT analysis will further filter the information and add to the process of evaluating if the healthcare industry can afford to let trichology become its part.

Findings: Quality analytics, data mining or accumulation and processing of the same and human resource are the essential elements that make any segment a force to reckon with. The same applies to trichology too. For quality analytics, the goals of the trichology industry along with the strategies that are engaged in to achieve the same must be measurable.

Conclusion & Significance: For trichology to become a significant business arm of the healthcare industry it must be recognized that today sustainability is the biggest challenge. To meet the expected quality, work out the finance part and comply with the regulatory requirements, both the healthcare industry and the trichology segment must work hand in hand. Data must be optimized and used effectively, analytical tools need to be adopted for effective real-time decision making and innovation and trial and error must have its own space if this evolution of trichology into an integral part healthcare industry has to happen.

 

Biography

Reham Labib has completed her Graduation at Ain Shams University, Faculty of Medicine 2001; and Master’s degree in Dermatology at Ain Shams University. She has more than 15 years of experience in Dermatology with special interest in Cosmetic and Aesthetic Medicine. In addition to her clinical practice, she is a highly skilled Physician in treating patients with all types of laser and energy based devices. She is a senior member and shareholder in the organization of one clinic specialized centers of laser and skin care clinics in East Cairo.

 

Abstract

Statement of the Problem: Acne vulgaris is a chronic inflammatory disease of the pilosebaceous follicles, characterized by comedones, papule, pustules, cysts, nodules and often scars. Depending on the severity and extent of involvement, treatment varies from the application of topical medications to systemic therapy with antibiotics or retinoids. The primary endpoint of current acne therapy is to decrease sebaceous gland activity, reverse hyper 8 keratinizations minimize P. acnes overgrowth, and correct hormonal imbalances with the goal of preventing scarring. Acne scars are divided into icepick scars, rolling scars and boxcar scars. Our interest in the treatment of acne scars is growing and many measures for treatment became popular. For the atrophic scars, there are chemical peels, skin fillers, dermabrasion, punch elevation, submission and finally lasers. Concerning focal trichloroacetic acid (TCA) peeling, the chemical reconstruction of skin scars cross method was described for the treatment of atrophic scars using a sharpened wooden applicator to deeply deliver trichloroacetic acid (TCA) in higher concentration.

Methodology: In our study, 20 patients with atrophic acne scarring were included and treated with a cross method to deeply deliver TCA in two concentrations 50% and 95%. Then biopsies were taken to compare the efficacy of both concentrations on collagen deposition. Using gloved hand the skin was carefully cleansed with 70% alcohol and acetone soaked gauze to remove the cutaneous oils. A concentration of 50% TCA on one side of the face and 95% on the other side was dropped within atrophic scars and the scar was pricked with a wooden applicator to facilitate deeper penetration. The areas showing insignificant frosting were recoated and special attention was drawn to the pain and erythema. Three sessions were done with four weeks interval between each. Immediate post peel washing to the skin with water was mandatory. A steroid-antibiotic cream twice daily was applied for the first week and a sunscreen with SPF>30 regularly. The patients were instructed to avoid sun exposure, irritating soaps, crust picking. The skin biopsies were performed before treatment and eight weeks after the treatment.

Findings: Comparing the effects of different TCA concentrations, the number of collagen fibers and collagen remodeling was markedly improved on the side of the cheek treated with TCA 95%.

Conclusion: We have found that the high TCA concentration led to much more myofibroblast proliferation that causes the active production of extracellular matrix components including collagen. However, high TCA concentration may lead to more aggressive complications as hyperpigmentation. We believe that acne scars cannot be treated by a single modality. The focal application of TCA is advantageous because they can reach deeply pitted areas and do not damage adjacent skin.

 

Biography

Frederick Venter has completed his Bachelor of science, Chemistry & Biology at Mount Royal University in Calgary Alberta. During this time, he also worked at a Brain Injury Rehabilitation Center for three years mostly taking care of patients post stroke. In January of 2015, he was 4th year Medical Student at Ross University School of Medicine, applied for residency for 2019, and he is currently a 4th year medical student. He has recently completed Bakersfield, California; Internal Medicine, Surgery, Psychiatry, Family medicine, Obstetrics & gynecology, Pediatrics, Radiology, Gastroenterology, Family outpatient Bronx, NY; Family inpatient in Miami, California and New York as well as presented ACP Nationals New Orleans; Giant Condylomata Acuminata of Buschke- Lowenstein Associated With Paraneoplastic Hypercalcemia at the ACP Nationals in New Orleans last month.

 

 

Abstract

Long standing genital warts can turn malignant due to dynamics between the HPV virus and the immunologic response of the host. Giant condylomata acuminata associated with squamous cell carcinoma are termed as Buschke Lowenstein tumors. The E7 gene of HPV impairs antigen presenting cells in the skin, enabling the virus to stay undetected. E6, E7 oncogenes combined induce telomerase resulting in cellular immortalization of infected cells, they also induce chronic oxidative stress increasing susceptibility to DNA damage, paving way for carcinogenesis. Co-infection with HIV/HSV-1 further enhances the oncogenesis of HPV. An association of carcinoma with hypercalcemia usually indicates a poor prognosis. We present a 42-year-old native American male admitted to the emergency department with nausea, vomiting and abdominal pain localized to groin with foul-smelling discharge. The genital warts diagnosed at age 17 had reached a considerable size. For the past 5 months the friable mass rapidly increased in size and was associated with occasional serous/bloody discharge. Patient had unintended weight loss of 100 Lbs. in the past year with fatigue and loss of appetite. A large irregular mass over bilateral inguinal regions involved the penis, scrotum and perineum measuring 31x17x6 cm draining foul-smelling purulent discharge. Serum blood calcium level at admission was 13.8 mg/dL with PTHrP 24.1 pmol/L, HSV-1 results were positive. HTLV and HIV sub types were negative. Biopsy H&E stain showed infiltrating hyperchromatic squamous cells, enlarged nuclei and high nuclear/cytoplasmic ratio, hyperkeratotic spears and acanthosis were also present. CT pelvis revealed marked skin thickening and irregularity in the perineal/inguinal/upper thigh regions and the right inguinal region was associated with inflammation and fistulous tracts. CT chest was negative for metastasis. The oncology team started pembrolizumab for the inoperable mass.

Biography

Abstract

The present work was focused with objective to optimize the ellagic acid loaded phytocomplex using complexation method. For optimization process, Box–Behnken design, with a 33 design and a total of 17 experimental runs, performed in combination with response surface methodology (RSM) were applied and effect of process variables on ellagic acid loaded phytocomplex were observed. Influence of three independent variables in the preparation of phytocomplex was investigated to get the best formulation. Independent variables covered concentration variable of lipid concentration, drug concentration and rotation time. Dependent variables included like percentage yield (PY%), drug release (%DR), and entrapment efficiency (%EE) of the prepared phytocomplex. Dialysis method was used to separate the drug from uncomplexation. Phytocomplex was optimized using response surface methodology. Accordingly, concentration of drug (100 mg), phospholipid (75 mg) and rotation time (40 minutes) were optimized and finalized as the best for optimized ellagic acid-loaded phytocomplex. In vitro characterization of the ellagic acid-loaded phytocomplex was done through some parameters including the PY%, DR% and EE%; the resulting values of 82.10%, 78.35%, and 78.36% were found to be standard characterized values respectively. It is concluded that ellagic acid-loaded phytocomplex play significant role to achieve sustained release of drug in wound areas.